BEST MEDICAL MNEMONICS

The 6 P's of acute ischemia: Pain

Pallor Paralysis

Pulse deficit Paresthesias Poikilothermia

Acute ischemia

The 4 S' s of adrenal crisis management:

• Salt: 0.9% saline • Steroids: IV hydrocortisone 100 mg

q 8 h • Support • Search for the underlying illness

AIDS pathogens The Major Pathogens

Concerning Complete T-Cell Collapse

• Toxoplasma gondii • Mycobacterium avium-intracelLular • Pneumocystis jiroveci • Candida albicans • Cryptococcus neoformans • Tuberculosis • CMV • Cryptosporidium parvum

Alcohol Abuse : CAGE

• Have you ever felt you should Cut down on your drinking?

• Have people Annoyed you by criticizing your drinking ?

• Have you ever felt bad or Guilty about your drinking?

• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover(Eye opener)?

Aortic Stenosis

• ACS-• Angina, • CHF , • Syncope.

It' s not (h)ARDS to diagnose ARDS:

• Acute onset • Ratio (Pao2/Fio2) < 200 • Diffuse infiltration • Swan-Ganz wedge pressure < 18 mm

Hg

Meds for asthma exacerbations ASTHMA

• Albuterol • Steroids • Theophylline (rare) • Humidified 02 • Magnesium (severe exacerbations) • Anticholinergics

Conditions associated with berry aneurysms that can MAKE on SAH more likely:

• Marfan's syndrome • Aortic coarctation • Kidney disease (autosomal dominant, • polycystic) • Ehlers-Danlos syndrome • Sickle cell anemia • Atherosclerosis • History (familial)

BPP

• When performing a BPP, remember

• to Test the Baby, MAN!

• Fetal Tone • Fetal Breathing • Fetal Movement • Amniotic fluid volume • Nonstress test

BPPV,

• With BPPV, it's all in the name: • Benign =otolith (not a tumor). • Paroxysmal = sudden, temporary episodes • lasting < 1 minute. • Positional =triggered by turning in bed or • reaching overhead. • Vertigo = vertigo or dizziness is the main • symptom.

DEMENTIAS

• Degenerative diseases (Parkinson's, Huntington's) • Endocrine (thyroid, parathyroid, pituitary, adrenal) • Metabolic (alcohol, electrolytes, vitamin B12 deficiency,

glucose, hepatic, renal, Wilson's disease) • Exogenous (heavy metals, carbon monoxide, drugs) • Neoplasia • Trauma (subdural hematoma) • Infection (meningitis, encephalitis, endocarditis, syphilis,

HIV , prion diseases, Lyme disease) • Affective disorders (pseudodementia) • Stroke/Structure (vascular dementia, ischemia, vasculitis,

normal pressure hydrocephalus)

Causes of Secondary hypertension

CHAPS • Cushing's syndrome • Hyperaldosteronism (Conn's

syndrome) • Aortic coarctation • Pheochromocytoma • Stenosis of renal arteries

Common UTI bugs

SEEKS PP • Serratia • Ecoli • Enterobader • Klebsiella pneumoniae • Staphylococcus saprophyticus • Pseudomonas • Proteus mirabiLIs

Congenital heart disease

5 Ts:• 1. Truncus arteriosus (1vessel)• 2. Transposition (2 switched vessels)• 3. Tricuspid atresia (3= Tri)• 4. Tetralogy of Fallot (4= Tet r a)• 5. TAPVR (5 letters in the name)

Rx for COPD

COPD

• Corticosteroids • Oxygen • Prevention (cigarette-smoking

cessation, • pneumococcal and influenza vaccines) • Dilators (B2-agonists, anticholinergics)

CREST Syndrome

• Calcinosis• Raynaud's• Esophageal Dysmotility• Sclerodactyly• Telangiectasia

I WATCH DEATH

• Infection • Withdrawal • Acute metabolic/substance Abuse • Trauma • CNS pathology • Hypoxia • Deficiencies • Endocrine • Acute vascular/MI • Toxins/drugs • Heavy metals

Indications for urgent dialysis

AEIOU

• Acidosis • Electrolyte abnormalities (hyperkalemia) • Ingestions (salicylates, theophylline, • methanol, barbiturates, lithium, • ethylene glycol) • Overload (fluid) • Uremic symptoms (pericarditis, • encephalopathy , bleeding, nausea, • pruritus, myoclonus)

DiGeorge syndrome

CATCH 22

• Cardiac abnormalities (tra nsposition) • Abnormal facies • Thymic aplasia • Cleft palate • Hypocalcemia • 22q 11 deletion

Presentation of endocarditis

JR = NO FAME

• Janeway lesions • Roth's spots • Nail-bed (splinter) hemorrhage • OsLer's nodes • Fever • Anemia • Murmur • Emboli

Extrapyramidal System

• Evolution of EPS-4 and A • 4 hours: Acute dystonia • 4 days: Akinesia • 4 weeks: Akathisia • 4 months: Tardive dyskinesia (often • permanent)

Fever and Rash

Tiny GERMS • Typhoid fever • Gonococcemia • Endocarditis • Rocky Mountain spotted fever • Meningococcemia • Sepsis (bacterial)

GBS

The 5 A' s of GBS: • Acute inflammatory demyelinating • polyradiculopathy • Ascending paralysis • Autonomic neuropathy • Arrhythmias • Albuminocytologic dissociation

HELLP syndrome

• Hemolysis • Elevated LFTs • Low Platelets

Hematuria I PEE RBCS

• Infection (UTI) • Polycystic kidney disease • Exercise • External trauma • Renal glomerular disease • Benign prostatic hyperplasia • Cancer • Stones

Howell Jolly bodies & Heinz bodies

• Howell Jolly bodies are nuclear inclusions with in RBC. Normally they are removed during circulation when they pass through spleen,

• Howell Jolly bodies are associated with Asplenia or in Splenectomy cases.

• Heinz bodies are associated with conditions where there is Oxidative damage of Hemoglobin

• Heinz Bodies are inclusions within RBC composed of denatured hemoglobin

Hypercalcemia CHIMPANZEES

• Calcium supplementation • Hyperparathyroidism/Hyperthyroidism • Iatrogenic (thiazides, parenteral nutrition)/Immobility

(especially in the ICU setting) • Milk-alkali syndrome • Paget's disease • Adrenal insufficiency/Acromegaly • Neoplasm • Zollinger-ELLison syndrome (MEN type 1) • Excess vitamin A • Excess vitamin D • Sarcoidosis and other granulomatous disease

Treatment of hyperkalemia

C BIG K

• Calcium • Bicarbonate • Insulin • Glucose • Kayexalate

Hypernatremia

causes

• The 6 D's • Diuresis • Dehydration • Diabetes insipidus • Docs (iatrogenic) • Diarrhea • Disease (kidney, sickle cell)

Infective Endocarditis

Bacteria FROM JANE :

• Fever• Roth spots• Osler nodes• Murmur• Janeway lesions• Anemia• Nail-bed hemorrhage• Emboli

Lichen planus

• Pruritic, purple, polygonal planar papules and plaques (6 P’s)

• Lichen planus is the "P" disease: Planar ,

• Purple, Pruritic, Persistent, Polygonal, • Penile, Perioral, Puzzling, and

Koebner's • Phenomenon.

Lung cancer

Lung cancer mets are often found in LABBs

• Liver • Adrenals • Brain • Bone

Lyme Disease

FAKE a Key Lyme pie: • Facial nerve palsy (typically bilateral)• Arthritis• Kardiac block• Erythema migrans

Mania

DIG FAST

• Distractibility • Insomnia (J- need for sleep) • Grandiosity (i self-esteem)/more Goal directed • Flight of ideas (or racing thoughts) • Activities/psycho-Motor Agitation • Sexual indiscretions/other pleasurable

activities • Talkativeness/pressured speech

MCA stroke

MCA stroke can cause CHANGes:

• Contralateral paresis and sensory loss in the face and arm

• Homonymous hemianopsia • Aphasia (dominant) • Neglect (nondomin ant) • Gaze preference toward the side of the

lesion

Melanoma

The ABCDEs of melanoma: • Asymmetric • Irregular Border • Irregular Color • Diameter > 6 mm • Evolution: changing or new lesions

Osteosarcoma

osteo-SarComa -->

• Sun burst• Codman triangle (periosteal

elevation)

Ectopic pregnancy

The classic triad of ectopic pregnancy PAVEs the way for diagnosis:

• Pain (abdominal) • Amenorrhea • Vaginal bleeding • Ectopic pregnancy

Differential diagnosis of pediatric limp

STARTSS HOTT

• Septic joint • Tumor • Avascular necrosis (Legg-Calve-Perthes) • Rheumatoid arthritis/JIA • Tuberculosis • Sickle cell disease • SCFE • Henoch-Schonlein purpura • Osteomyelitis • Trauma • Toxic synovitis

Acute causes of pelvic pain A ROPE • Appendicitis • Ruptured ovarian cyst • Ovarian torsion/abscess • PID • Ectopic pregnancy

Causes of pericarditis

CARDIAC RIND • Collagen vascular disease • Aortic dissection • Radiation • Drugs • Infections • Acute renal failure • Cardiac (MI) • Rheumatic fever • Injury • Neoplasms • Dressler's syndrome

Characteristics of personality disorders

MEDIC

• Maladaptive • Enduring • Deviate from cultural norms • Inflexible • Cause impairment in social or

occupational functioning

Pheochromocytoma

rule of 70' s: • 10% extra-adrenal • 10% bilateral • 10% malignant • 10% occur in children • 10% familial

Presentation of pneumothorax

P-THORAX • Pleuritic pain • Tracheal deviation • Hyperresonance • Onset sudden • Reduced breath sounds (and dyspnea) • Absent fremitus (asymmetric chest

wall) • X-ray shows collapse

Posterior circulation strokes

• The 4 "deadly D' s" of posterior circulation strokes

• Diplopia • Dizziness • Dysphagia • Dysarthria

Postoperative fever

The 6 W's of postoperative fever: • Wind: Atelectasis, pneumonia • Water: UTI • Wounds: Wound infection, abscess • Walking: DVT • Wonder drugs: Drug reaction • Womb: Endometritis

Preeclampsia

The classic triad of preeclampsia • It's not just HyPE

• Hypertension • Proteinuria • Edema

Pulmonary thromboembolism

VIRchow' s triad: • Vascular trauma • Increased coagulability • Reduced blood flow (stasis)

Pulseless Electrical Activity

The 5 H's and 5 T's

• Hypovolemia • Hypoxia • Hydrogen ion: Acidosis • Hyper/Hypo: K+, other metabolic • Hypothermia • Tablets: Drug OD, ingestion • Tamponade: Cardiac • Tension pneumothorax • Thrombosis: Coronary • Thrombosis: Pulmonary embolism

Restrictive lung disease

If the lungs AIN'T compliant:

• Alveolar (edema, hemorrhage, pus) • Interstitial lung disease (idiopathic interstitial

pneumonias), Inflammatory (sarcoid, cryptogenic organizing pneumonitis), Idiopathic

• Neuromuscular (myasthenia, phrenic nerve palsy, myopathy)

• Thoracic wall (kyphoscoliosis, obesity, ascites, pregnancy, ankylosing spondylitis)

Rheumatic fever

FEVERSS:• Fever • Erythema marginatum• Valvular damage (vegetation and

fibrosis) • ESR �• Red-hot joints (migratory polyarthritis)• Subcutaneous nodules• St. Vitus’ dance (Sydenham chorea)

Sarcoidosis

GRUELING

• Granulomas • aRthritis • Uveitis • Erythema nodosum • Lymphadenopathy • Interstitial fibrosis • Negative TB test • Gammaglobulinemia

Secondary Eosinophilia

Causes of 2° eosinophilia NAACP • Neoplasm • Allergies • Asthma • Collagen vascular disease • Parasites

SLEDOPAMINE RASH

• Discoid rash • Oral ulcers • Photosensitivity • Arthritis • Malar rash • Immunologic criteria • Neurologic symptoms (lupus cerebritis, seizures) • Elevated ESR • Renal disease • ANA (±) • Serositis (pleural or pericardia! effusion) • Hematologic abnormalities

Substance dependence

Features of substance dependence WITHDraw IT

Three or more of 7 within a 12-month period:

• Withdrawal • Interest or Important activities given up or reduced • Tolerance • Harm (physical and psychosocial) with continued

use • Desire to cut down/control • Intended time/amount exceeded • Time spent obtaining/using the substance is increase

SUICIDE

Risk factors for suicide SAD PERSONS • Sex (male) • Age (older) • Depression • Previous attempt • Ethanol/substance abuse • Rational thought • Sickness (chronic illness) • Organized plan/access to weapons • No spouse • Social support lacking

TCA toxicity

Tri-C's • Convulsions • Coma • Cardiac arrhythmias

Pheochromocytoma

The 5 P's of pheochromocytoma: • Pressure (BP) • Pain (headache) • Perspiration • Palpitations • Pallor

Thyroid neoplasms

Thyroid neoplasms The most Popular is Papillary • Papillae (branching) • Palpable lymph nodes • "Pupil" nuclei ("Orphan Annie" nuclei) • Psammoma bodies within lesion

(often) Also has a Positive Prognosis

TORCHeS

TORCHeS pathogens:

• Toxoplasmosis • Other' • Rubella • CMV • Herpes simplex virus • HIV • Syphilis

Contraindications to tPA therapy

SAMPLE STAGES

• Stroke or head trauma within the last 3 months • Anticoagulation with INR > 1.7 or prolonged PTI • MI (recent) • Prior intracranial hemorrhage • Low platelet count (< 100,000/mm') • Elevated BP: Systolic > 185 or diastolic > 110 mm Hg • Surgery in the past 14 days • TIA (mild symptoms or rapid improvement of symptoms) • Age < 18 • GI or urinary bleeding in the past 21 days • Elevated (> 400 mg/dL) or J- (< 50 mg/dL) blood glucose • Seizures present at the onset of stroke

Trauma• Primary survey of a trauma patient

• ABCDE • Airway • Breathing • Circulation • Disability • Exposure

Causes of urinary incontinence

• without specific urogenital pathology DIAPPERS

• Delirium/confusional state • Infection • Atrophic urethritis/vaginitis • Pharmaceutical • Psychiatric causes (especially depression) • Excessive urinary output (hyperglycemia,

hypercalcemia, CHF) • Restricted mobility • Stool impaction

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