Sandbox: maria3

# Medical Mnemonics

## Cardiology

## Emergency medicine

## Interviewing / Physical exam

## Neurology

## Pathology

## Psychiatry

## Radiology / Oncology

# wikipedia
This is a list of medical mnemonics 
categorized and alphabetized.

# Mnemonics with wikipages
- ABC   Airway, Breathing and Circulation
- APGAR  a backronym for Appearance, Pulse, Grimace, Activity, Respiration (used to assess newborn babies)
- ASHICE  Age, Sex, History, Injuries/illness, Condition, ETA/extra information
- FAST  Face, Arms, Speech, Time  stroke symptoms
- Hs and Ts  causes of cardiac arrest
- Is Path Warm?  suicide risk factors
- OPQRST  Onset, Provocation, Quality, Region, Severity, Time  symptom checklist
- RICE  Rest, Ice, Compression, Elevation  for sprains and bruises
- SOCRATES, a mnemonic used to evaluate characteristics of pain
- SOAP, a technique for writing medical records
- SLUDGE

# Anatomy

## Afferent vs efferent
Afferent connection arrives and an efferent connection exits.

## Anterior leg muscles
"The Hospitals Are Not Dirty Places"
Tibialis anterior
extensor Hallucis longus
anterior tibial Artery
deep fibular Nerve
extensor Digitorum longus
Peronius tertius 

## Brachial plexus
- Posterior cord branches
STAR - subscapular (upper and lower), thoracodorsal, axillary, radial
RATS- Radial nerve, Axillary nerve, Thoracodorsal nerve, Subscapular (Upper & Lower)nerve.
ULTRA - upper subscapular, lower subscapular, thoracodorsal, radial, axillary
ULNAR- Upper subscapular nerve, Lower subscapular nerve,Nerve to latissimus dorsi, Axillary nerve, Radial nerve.
- STAR - subscapular (upper and lower), thoracodorsal, axillary, radial
- RATS- Radial nerve, Axillary nerve, Thoracodorsal nerve, Subscapular (Upper & Lower)nerve.
- ULTRA - upper subscapular, lower subscapular, thoracodorsal, radial, axillary
- ULNAR- Upper subscapular nerve, Lower subscapular nerve,Nerve to latissimus dorsi, Axillary nerve, Radial nerve.
- Lateral Cord Branches
LLM "Lucy Loves Me" - lateral pectoral, lateral root of the median nerve, musculocutaneous
Love Me Latha (LML) - Lateral pectoral nerve, Musculocutaneous nerve, Lateral root of Median Nerve.
Look My Lancer-Lateral pectoral nerve, Musculocutaneous nerve,Lateral root of Median nerve.
- LLM "Lucy Loves Me" - lateral pectoral, lateral root of the median nerve, musculocutaneous
- Love Me Latha (LML) - Lateral pectoral nerve, Musculocutaneous nerve, Lateral root of Median Nerve.
- Look My Lancer-Lateral pectoral nerve, Musculocutaneous nerve,Lateral root of Median nerve.
- Medial Cord Branches
MMMUM "Most Medical Men Use Morphine" - medial pectoral, medial cutaneous nerve of arm, medial cutaneous nerve of forearm, ulnar, medial root of the median nerve
Union of 4 Medials - Ulnar nerve, Medial cutaneous nerve of arm, Medial cutaneous nerve of forearm, Medial pectoral nerve, Medial root of Median Nerve.
- MMMUM "Most Medical Men Use Morphine" - medial pectoral, medial cutaneous nerve of arm, medial cutaneous nerve of forearm, ulnar, medial root of the median nerve
- Union of 4 Medials - Ulnar nerve, Medial cutaneous nerve of arm, Medial cutaneous nerve of forearm, Medial pectoral nerve, Medial root of Median Nerve.
- 5 main nerves of brachial plexus, in order laterally to medially
"My Aunty Recognised My Uncle" - Musculocutaneous, axillary, radial, median, ulnar.
- "My Aunty Recognised My Uncle" - Musculocutaneous, axillary, radial, median, ulnar.

## Bowel components
"Dow Jones Industrial Average Closing Stock Report"
From proximal to distal:
- Duodenum
- Jejunum
- Ileum
- Appendix
- Colon
- Sigmoid
- Rectum

## Carotid sheath contents
I See 10 CC's in the IV:
I See (I.C.) = Internal Carotid artery
10 = CN 10 (Vagus nerve)
CC = Common Carotid artery
IV = Internal Jugular Vein

## Cavernous sinus contents
O TOM CAT:
O TOM are lateral wall components, in order from superior to inferior.
CA are the components within the sinus, from medial to lateral. CA ends at the level of T from O TOM.
Occulomotor nerve (III)
Trochlear nerve (IV)
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Carotid artery
Abducent nerve (VI)
T: When written, connects to the T of OTOM

## Coeliac trunk: branches
Left Hand Side (LHS):
Left gastric artery
Hepatic artery
Splenic artery

## Chest
- "The servant attacks with saw and axe the lumbar, stack and cord." - Cervical (atlas, axis), thoracic, lumbar, sacral, caudal
- "I Like To Rise So High", for Iliac vein (common), Lumbar vein, Testicular vein, Renal vein, Suprarenal vein and Hepatic vein to represent the tributaries of the Inferior vena cava 
- Structures passing through greater sciatic foramen below piriformis (S.N.I.P. N.I.P.), sciatic nerve, nerve to obturator internus, internal pudendal vessel, pudendal nerve, nerve to quadratus femoris, inferior gluteal vessels, posterior cutaneous nerve of thigh
- Structures passing through lesser sciatic foramen: (P.I.N.T.) pudendal nerve, internal pudendal vessels, nerve to obturator internus, tendon of obturator internus
- One common mnemonic used to remember the contents of the Tarsal tunnel from anterior to posterior is "Tom, Dick and Harry". or alternatively "Tom, Dick (and very nervous) Harry" if the artery, vein, and nerve are included.
- One mnemonic for remembering the contents of the cavernous sinus is "OTOM CAT".
- The branches of the subclavian artery can be remembered using VITamin C and D.
- The contents of posterior mediastinum can be remembered using the mnemonic,  "DATES", for Descending aorta, Azygous vein and hemiazygos vein, Thoracic duct, Esophagus, Sympathetic trunk/ganglia.
- A commonly used mnemonic to remember the level of the diaphragmatic apertures is this: Aortic hiatus = 12 letters = T12. Oesophagus, Vagal trunk = 10 letters = T10. Vena cava = 8 letters = T8
- Another common mnemonic is: "I ate ten eggs at twelve" I (IVC) ate (TV8); ten (TV10) eggs (esophagus); at (aorta, azygos) twelve (TV12)
- "I Read Very Old And Torn Articles" - IVC, Right phrenic nerve, Vagus, Oesophagus, Aorta, Thoracic duct, Azygous vein.
- Standing room only can be used to remember that V1 passes through the superior orbital fissure, V2 through the foramen rotundum, and V3 through the foramen ovale.
- Contents of the foramen magnum: VAMPS-ATM (Vertebral arteries, Anterior Spinal artery, Meningeal branches of the cervical nerves, Posterior spinal arteries, Spinal part of the accessory nerve, Alar and Apical ligaments of the dense, Tectorial membrane, Medulla oblongata)Template:Cit
- Deep cerebellar nuclei and their positions relative to the midline: "Fat Guys Eat Donuts," where each letter indicates the medial to lateral location in the cerebellar white matter (nucleus fastigii, globose nucleus, nucleus emboliformis and dentate nucleus).Template:Cit
- A mnemonic to remember the muscles that contribute tendons to the pes anserinus and the innervations of these muscles is SGT FOT (sergeant FOT): S- Sartorius G- Gracilis T- semiTendinosus  (from anterior to posterior). F- femoral nerve O- obturator nerve T- tibial division of the sciatic nerve. Notice the order of the muscles (S, G, T) follows the order of the innervating nerves which correspond to those muscles (F, O, T)Template:Cit
- The femoral triangle is shaped like the sail of a sailing ship and hence its boundaries can be remembered using the mnemonic, "SAIL" for Sartorius, Adductor longus and Inguinal Ligament.
- The order of structures in the femoral triangle is important in the embalming of bodies, as the femoral artery is often exposed and used to pump embalming fluids into the body. The order of this neurovascular bundle can be remembered using the mnemonic, "NAVY" for Nerve, Artery, Vein, Y -fronts (the British term of a style of men's underwear with a "Y" shaped front that acts as a fly). The "Y" is midline (corresponding with the penis) and the mnemonic always reads from lateral to medial (in other words, the Femoral Nerve is always lateral). An alternate to this mnemonic is "NAVEL" for Nerve, Artery, Vein, Empty Space and Lymph, to include the deep inguinal lymph nodes located medial to the Femoral vein.Template:Cit

## Cranial nerves
There are many mnemonics for the names of the cranial nerves, e.g. "OOOTTAFAGVSH" is "OLd OPen OCeans TROuble TRIbesmen ABout Fish VEnom Giving VArious ACute/SPlitting Headaches" (a mnemonic that gives enough letters to distinguish between nerves that start with the same letter), or "On old Olympus's towering tops, a Finn and German viewed some hops,"
and for the initial letters "OOOTTAFVGVAH" is "Oh, oh, oh, to touch and feel veronica's gooey v*ga ... ah, heaven."  The differences between these depend on "acoustic" versus "vestibulocochlear" and "spinal-accessory" versus "accessory".
A common example mnemonic for remembering which nerves are motor (M), sensory (S), or both (B), "Some Say Marry Money But My Brother Says Big Boobs Matter More". There are a very large number of additional mnemonics.

## Diaphragm apertures: spinal levels
Aortic hiatus = 12 letters = T12
Oesophagus = 10 letters = T10
Vena cava = 8 letters = T8

## Duodenum: lengths of parts
"Counting 1 to 4 but staggered":
1st part: 2 inches
2nd part: 3 inches
3rd part: 4 inches
4th part: 1 inch

## Endocrine glands
The major glands of the endocrine system, excluding ovaries and testes.
"T.A.P." (T2, A3, P4)
Thymus
Thyroid
Anterior pituitary
Adrenal cortex
Adrenal medulla
Posterior pituitary
Parathyroid gland
Pancreas
Pineal

## Extraocular muscles
A good mnemonic to remember which muscles are innervated by what nerve is to paraphrase it as a molecular equation: LR6SO4R3.
- Lateral Rectus - Cranial Nerve VI
- Superior Oblique - Cranial Nerve IV
- the Rest of the muscles - Cranial Nerve III
Another way to remember which nerves innervate which muscles is to understand the meaning behind all the Latin words.
- The fourth cranial nerve, the trochlear, is so named because the muscle it innervates, the superior oblique, runs through a little fascial pulley that changes its direction of pull (the trochlea of superior oblique). This pulley exists in the superiomedial corner of each orbit, and "trochl-" is Latin for "pulley."
- The sixth cranial nerve, the abducens, is so named because it controls the lateral rectus, which abducts the eye (rotates it laterally) upon contraction.
- The third cranial nerve, the oculomotor, is so named because it is in charge of the movement (motor) of the eye (oculo-). It controls all the other muscles.

## G.I. tract layers (simplified)
M.S.M.S.
Mucosa
Submucosa
Muscularis propria
Serosa

## Lateral geniculate nucleus
A simple mnemonic for remembering this is "See I? I see, I see," with "see" representing the C in "contralateral," and "I" representing the I in "ipsilateral." Another is "Emily and Pete meet eye to eye" as in "M and P meet I to I," or again, Magno and Parvo meet Ipsi to Ipsi.
Another way of remembering this is 2+3=5, which is correct, so ipsilateral side, and 1+4 doesn't equal 6, so contralateral.

## Retina
A mnemonic to remember the layers of the retina:

## Sperm: path through male reproductive system
"My boyfriend's name is STEVE":
Seminiferous
Tubules
Epididymis
Vas deferens
Ejaculatory duct

## Sternal angle
A useful mnemonic for what passes through the sternal angle is "RAT PLLANT"
- Rib 2
- Aortic arch
- Tracheal bifurcation
- Pulmonary trunk
- Ligamentum arteriosum
- Left recurrent laryngeal
- Azygos Vein
- Nerves (Cardiac and Pulmonary plexuses)
- Thoracic duct
A more detailed mnemonic is "PLOT of EARTH PLLANTS"
- Phrenic and Vagus Nerve
- Lymph Nodes
- Oblique fissure of lungs (top of it)
- Thymus
- Esophagus (trending right to left)
- Aortic Arch (bottom of the arch)
- Rib 2, Manubrium-sternal angle, T4(more specifically T4-5 disc)
- Tracheal Bifurcation (Carina: Latin like keel of boat)
- Heart
- Pulmonary trunk bifurcation
- L2 : Left Recurrent Laryngeal (Looping under Aorta); Ligamentum Arteriosum:  Connects Aortic Arch to Pulmonary. Bifurcation
- Azygous vein arches over the root of the Rt. Lung and opens in SVC.
- Nerve plexi:  Cardiac and Pulmonary Plexus
- Thoracic duct (on its way to drain into the Left Subclavian)
- SVC going down

## Spine
Breakfast at 7:00--- 7 cervical vertebrae
Lunch at 12:00--- 12 thoracic vertebrae
Dinner at 5:00--- 5 lumbar vertebrae

## Hand
- Carpal bones:
Some Lovers Try Positions That They Can't Handle:
Scaphoid, Lunatum, Triquetrum, Pisiforme, Trapezium, Trapezoid, Capitate and Hamate
- Carpal Bones:
She Looks Too Pretty Try To Catch Her:
Scaphoid, Lunate, Triquetrum, Pisiforme, Trapezium, Trapezoid, Capitate and Hamate
- Carpal bones:
Scabby Lucy  Tried Pissing Hours after Copulating Two Twins:
Scaphoid, Lunate, Triquetrum, Pisiforme, Hamate, Capitate, Trapezoid, and Trapezium:
In clockwise order from Scaphoid-remember zoids do not touch each other. M. Hall

## Neuroscience
Coronal section of brain: structures
"In Extremis, Cannibals Eat People's Globus Pallidi Instead of Their Hearts":
 From insula to midline:
- Insula
- Extreme capsule
- Claustrum
- External capsule
- Putamen
- Globus pallidus
- Internal capsule
- Thalamus
- Hypothalamus
Anterior Pituitary Hormones
"FLAG TOP ":
FSH
LH
ACTH
GH
TSH
MelanOcyte Stimulating Hormone
Prolactin

# Anaesthesiology

## Anesthesia machine/room check
MS MAID:
Monitors (EKG, SpO2, EtCO2, etc.)
Suction
Machine check (according to ASA guidelines)
Airway equipment (ETT, laryngoscope, oral/nasal airway)
IV equipment
Drugs (emergency, inductions, NMBs, etc.)

## Endotracheal intubation: diagnosis of poor bilateral breath sounds after intubation
DOPE:
Displaced (usually right mainstem, pyreform fossa, etc.)
Obstruction (kinked or bitten tube, mucous plug, etc.)
Pneumothorax (collapsed lung)
Esophagus

## General anaesthesia: equipment check prior to inducing
MALES:
Masks
Airways
Laryngoscopes
Endotracheal tubes
Suction/ Stylette, bougie

## Spinal anesthesia agents
"Little Boys Prefer Toys":
Lidocaine
Bupivicaine
Procaine
Tetracaine

## Xylocaine: where not to use with epinephrine
"Ears, Nose, Hose, Fingers and Toes"
- Vasoconstrictive effects of xylocaine with epinephrine are helpful in providing hemostasis while suturing. However, may cause local ischemic necrosis in distal structures such as the digits, tip of nose, penis, ears.
"Digital PEN" -  Digits, Penis, ear, nose.

# Behavioural science / psychology

## Depression: major episode characteristics
SPACE DIGS:
Sleep disruption
Psychomotor retardation
Appetite change
Concentration loss
Energy loss
Depressed mood
Interest wanes
Guilt
Suicidal tendencies

## Gain: primary vs. secondary vs. tertiary
Primary: Patient's Psyche improved.
Secondary: Symptom Sympathy for patient.
Tertiary: Therapist's gain

## Kubler-Ross dying process: stages
"'Death Always Brings Great Acceptance":
Denial
Anger
Bargaining
Grieving
Acceptance

## Middle adolescence (14-17 years): characteristics
HERO:
Heterosexual crushes/ Homosexual Experience
Education regarding short term benefits
Risk taking
Omnipotence

## Narcolepsy: symptoms, epidemiology
CHAP:
Cataplexy
Hallucinations
Attacks of sleep
Paralysis on waking
- Usual presentation is a young male, hence "chap"

## Sleep stages: features
DElta waves during DEepest sleep (stages 3 & 4, slow-wave).
dREaM during REM sleep.

## Impotence causes
PLANE:
Psychogenic: performance anxiety
Libido: decreased with androgen deficiency, drugs
Autonomic neuropathy: impede blood flow redirection
Nitric oxide deficiency: impaired synthesis, decreased blood pressure
Erectile reserve: can't maintain an erection

## Male erectile dysfunction (MED): biological causes
MED:
Medicines (propranalol, methyldopa, SSRI, etc.)
Ethanol
Diabetes mellitus

## Premature ejaculation: treatment
2 S's:
SSRIs
Squeezing technique 
More detail with 2 more S's:
Sensate-focus exercises 
Stop and start method 

# Biochemistry

## B vitamin names
"The Rhythm Nearly Proved Contagious":
In increasing order:
Thiamine (B1)
Riboflavin (B2)
Niacin (B3)
Pyridoxine (B6)
Cobalamin (B12)

## Essential amino acids
"PVT. TIM HALL always argues, never tires":
Phe
Val
Thr
Trp
Ile
Met
His
Arg
Lue
Lys
- Always argues: the A is for Arg, not Asp.
- 'Never tires': T is not Tyr, but is both Thr and Trp.

## Fasting state: branched-chain amino acids used by skeletal muscles
"Muscles LIVe fast":
Leucine
Isoleucine
Valine

## Folate deficiency: causes
A FOLIC DROP:
Alcoholism
Folic acid antagonists
Oral contraceptives
Low dietary intake
Infection with Giardia
Celiac sprue
Dilatin
Relative folate deficiency
Old
Pregnant

## Glycogen storage: Anderson's (IV) vs. Cori's (III) enzyme defect
ABCD:
Anderson's=Branching enzyme.
Cori's=Debranching enzyme.
- Otherwise, can't really distinguish clinically.

## Glycogen storage: names of types I through VI
"Viagra Pills Cause A Major Hardon":
Von Gierke's
Pompe's
Cori's
Anderson's
McArdle's
Her's

# Cardiology

## Aortic regurgitation: causes
CREAM:
Congenital
Rheumatic damage
Endocarditis
Aortic dissection/ Aortic root dilatation
Marfans

## Aortic stenosis characteristics
SAD:
Syncope
Angina
Dyspnoea

## Aorta vs. vena cava: right vs. left
(When looking at the patient from the anterior side.)
Aorta and right each have 5 letters, so aorta is on the right.
Vena and cava and left each have 4 letters, so vena cava is on the left

## Aortic to left Subclavian path
ABC'S
Aortic arch gives rise to:
Brachiocephalic trunk
left Common Carotid
left Subclavian

## Apex beat: abnormalities found on palpation, causes of impalpable
HILT:
Heaving
Impalpable
Laterally displaced
Thrusting/ Tapping
If it's impalpable, causes are COPD:
COPD
Obesity
Pleural, Pericardial effusion
Dextrocardia

## Atrial Fibrillation causes
Pirates:
Pulmonary: PE, COPD
Iatrogenic
Rheumatic heart: mirtral regurgitation
Atherosclerotic: MI, CAD
Thyroid: hyperthyroid
Endocarditis
Sick sinus syndrome

## Atrial fibrillation management
ABCD:
Anti-coagulate
Beta-block to control rate
Cardiovert
Digoxin

## Beck's triad (cardiac tamponade)
3 D's:
Distant heart sounds
Distended jugular veins
Decreased arterial pressure

## Betablockers: cardioselective betablockers
Betablockers Acting Exclusively At Myocardium:
Betaxolol
Acebutelol
Esmolol
Atenolol
Metoprolol

## CHF Treatment
LMNOP
Lasix
Morphine
Nitrites
Oxygen
VassoPressors

## CHF: causes of exacerbation
Failure
Forgot medication
Arrhythmia/ Anaemia
Ischemia/ Infarction/ Infection
Lifestyle: taken too much salt
Upregulation of CO: pregnancy, hyperthyroidism
Renal failure
Embolism: pulmonary

## Complications of Myocardial Infarction
Darth Vader
Death
Arrythmia
Rupture(free ventricular wall/ ventricular septum/ papillary muscles)
Tamponade
Heart failure (acute or chronic)
Valve disease
Aneurysm of Ventricles
Dressler's Syndrome
thromboEmbolism (mural thrombus)
Recurrence/ mitral Regurgitation

## Coronary artery bypass graft: indications
Dust:
Depressed ventricular function
Unstable angina
Stenosis of the left main stem
Triple vessel disease

## ECG: left vs. right bundle block
WiLLiaM MaRRoW:
W pattern in V1-V2 and M pattern in V3-V6 is Left bundle block.
M pattern in V1-V2 and W in V3-V6 is Right bundle block.

## Exercise ramp ECG: contraindications
Ramp:
Recent MI
Aortic stenosis
MI in the last 7 days
Pulmonary hypertension

## Heart valve sequence
Try Puling My Aorta:
Tricuspid
Pulmonary
Mitral (bicuspid)
Aorta

## Infarctions
IV access
Narcotic analgesics (e.g. morphine, pethidine)
Facilities for defibrillation (DF)
Aspirin/ Anticoagulant (heparin)
Rest
Converting enzyme inhibitor
Thrombolysis
IV beta blocker
Oxygen 60%
Nitrates
Stool Softeners

## JVP: wave form
ASK ME
Atrial contraction
Systole (ventricular contraction)
Klosure (closure) of tricusps, so atrial filling
Maximal atrial filling
Emptying of atrium

## MI: basic management
BOOMAR:
Bed rest
Oxygen
Opiate
Monitor
Anticoagulate
Reduce clot size

## MI: signs and symptoms
PULSE:
Persistent chest pains
Upset stomach
Lightheadedness
Shortness of breath
Excessive sweating

## MI: therapeutic treatment
O BATMAN!
Oxygen
Beta blocker
ASA
Thrombolytics (e.g. heparin)
Morphine
Ace prn
Nitroglycerin

## MI: treatment of acute MI
COAG:
Cyclomorph
Oxygen
Aspirin
Glycerol trinitrate

## Murmur attributes
"IL PQRST" (person has ill PQRST heart waves):
Intensity
Location
Pitch
Quality
Radiation
Shape
Timing

## Murmurs: innocent murmur features
8 S's:
Soft
Systolic
Short
Sounds (S1 & S2) normal
Symptomless
Special tests normal (X-ray, EKG)
Standing/ Sitting (vary with position)
Sternal depression

## Murmurs: louder with inspiration vs expiration
LEft sided murmurs louder with Expiration
RIght sided murmurs louder with Inspiration.

## Murmurs: questions to ask
SCRIPT:
Site
Character (e.g. harsh, soft, blowing)
Radiation
Intensity
Pitch
Timing

## Murmurs: systolic vs. diastolic
PASS:Pulmonic & Aortic
Stenosis=Systolic.
PAID: Pulmonic & Aortic
Insufficiency=Diastolic.

## Pericarditis: causes
CARDIAC RIND:
Collagen vascular disease
Aortic aneurysm
Radiation
Drugs (such as hydralazine)
Infections
Acute renal failure
Cardiac infarction
Rheumatic fever
Injury
Neoplasms
Dressler's syndrome

## Pericarditis: EKG
PericarditiS:
PR depression in precordial leads.
ST elevation.

## Peripheral vascular insufficiency: inspection criteria
SICVD:
Symmetry of leg musculature
Integrity of skin
Color of toenails
Varicose veins
Distribution of hair

## Pulseless electrical activity: causes
PATCH MED:
Pulmonary embolus
Acidosis
Tension pneumothorax
Cardiac tamponade
Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia
Myocardial infarction
Electrolyte derangements
Drugs

## ST elevation causes in ECG
ELEVATION:
Electrolytes
LBBB
Early repolarization
Ventricular hypertrophy
Aneurysm
Treatment (e.g. pericardiocentesis)
Injury (AMI, contusion)
Osborne waves (hypothermia)
Non-occlusive vasospasm

## Supraventricular tachycardia: treatment
ABCDE:
Adenosine
Beta-blocker
Calcium channel antagonist
Digoxin
Excitation (vagal stimulation)

## Ventricular tachycardia: treatment
LAMB:
Lidocaine
Amiodarone
Mexiltene/ Magnesium
Beta-blocker

## White Blood Cell Count
Never let monkeys eat bananas:
Neutrophils
lymphocytes
monocytes
eosinophils
basophils

# Emergency medicine

## Acute LVF management
LMNOP:
Lasix (furosemide)
Morphine (diamorphine)
Nitrates
Oxygen (sit patient up)
Pulmonary ventilation (if doing badly)

## Atrial fibrillation: causes of new onset
THE ATRIAL FIBS:
Thyroid
Hypothermia
Embolism (P.E.)
Alcohol
Trauma (cardiac contusion)
Recent surgery (post CABG)
Ischemia
Atrial enlargement
Lone or idiopathic
Fever, anemia, high-output states
Infarct
Bad valves (mitral stenosis)
Stimulants (cocaine, theo, amphet, caffeine)

## GCS Intubation
Under 8, intubate.

## Ipecac: contraindications
4 C's:
Comatose
Convulsing
Corrosive
hydroCarbon

## JVP: raised JVP differential
PQRST(EKG waves):
Pericardial effusion
Quantity of fluid raised (fluid over load)
Right heart failure
Superior vena caval obstruction
Tricuspid stenosis/Tricuspid regurgitation/Tamponade (cardiac)

## MI: immediate treatment
DOGASH:
Diamorphine
Oxygen
GTN spray
Asprin 300mg
Streptokinase
Heparin

## PEA/Asystole (ACLS): etiology
ITCHPAD
Infarction
Tension pneumothorax
Cardiac tamponade
Hypovolemia/Hypothermia/Hypo-,Hyperkalemia/Hypomagnesmia/Hypoxemia
Pulmonary embolism
Acidosis
Drug overdose

## Rapid sequence intubation (RSI)
SOAP ME
Suction
Oxygen
Airway Equipment
Positioning
Monitoring & Meds
EtCO2 & other Equipment

## Shock: signs and symptoms
TV SPARC CUBE:
Thirst
Vomiting
Sweating
Pulse weak
Anxious
Respirations shallow/rapid
Cool
Cyanotic
Unconscious
BP low
Eyes blank

## Shock: types
RN CHAMPS (Alternatively: "MR. C.H. SNAP", or "NH CRAMPS"):
Respiratory
Neurogenic
Cardiogenic
Hemorrhagic
Anaphylactic
Metabolic
Psychogenic
Septic

## Subarachnoid hemorrhage (SAH) causes
BATS:
Berry aneurysm
Arteriovenous malformation/Adult polycystic kidney disease
Trauma
Stroke

## Syncope causes, by system
HEAD HEART VESSELS:
CNS causes include HEAD:
Hypoxia/Hypoglycemia
Epilepsy
Anxiety
Dysfunctional brain stem (basivertebral TIA)
Cardiac causes are HEART:
Heart attack
Embolism (PE)
Aortic obstruction (IHSS, AS or myxoma)
Rhythm disturbance, ventricular
Tachycardia
Vascular causes are VESSELS:
Vasovagal
Ectopic (reminds one of hypovolemia)
Situational
Subclavian steal
ENT (glossopharyngeal neuralgia)
Low systemic vascular resistance (Addison's, diabetic vascular neuropathy)
Sensitive carotid sinus

## Ventricular fibrillation: treatment
Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock:
Shock= Defibrillate
Everybody= Epinephine
Little= Lidocaine
Big= Bretylium
Momma= MgSO4
Poppa= Pocainamide

# Interviewing / Physical exam

## Abdominal Assessment
To assess abdomen, palpate all 4 quadrants for DR. GERM:
Distension: liver problems, bowel obstruction
Rigidity (board like): bleeding
Guarding: muscular tension when touched
Eviseration/ Ecchymosis
Rebound tenderness: infection
Masses

## Altered Level of Consciousness: Reasons
AEIOU TIPS
Alcohol
Epilepsy,  Electrolytes, and Encephalopathy
Insulin
Overdose, Oxygen
Underdose, Uremia
Trauma, Temperature
Infection
Psychogenic, Poisons
Stroke, Shock

## Cause of symptoms
OPQRST (Works well for cardiac, and respiratory patients.)
Onset of the event
Provocation or palliation
Quality of the pain
Region and radiation
Severity
Time

## Fetal Monitoring
VEAL CHOP

## Neurovascular Assessment
5 P's:
Pain
Pallor
Paresthesia
Pulse
Paralysis

## Trauma assessment
DCAP-BTLS
Deformities & Discolorations
Contusions
Abrasions & Avulsion
Penetrations & Punctures
Burns
Tenderness
Lacerations
Swelling & Symmetry

## Toxicological seizures: Causes
OTIS CAMPBELL
Organophosphates
Tricyclic antidepressants
Isoniazid, Insulin
Sympathomimetics
Camphor, Cocaine
Amphetamines
Methylxanthines
PCP, Propoxyphene, Phenol, Propranolol
Benzodiazepine withdrawal, Botanicals
Ethanol withdrawal
Lithium, Lidocaine
Lindane, Lead

## Vomiting: non-GIT differential
ABCDEFGHI:
Acute renal failure
Brain 
Cardiac 
DKA
Ears 
Foreign substances 
Glaucoma
Hyperemesis gravidarum
Infection 

## Heart valve auscultation sites
"All Patients Take Meds":
Reading from top left:
Aortic
Pulmonary
Tricuspid
Mitral

## Glasgow coma scale: components and numbers
Scale types is 3 V's:
Visual response
Verbal response
Vibratory (motor) response Scale scores are 4,5,6:
Scale of 4: see so much more
Scale of 5: talking jive
Scale of 6: feels the pricks (if testing motor by pain withdrawal)

## Mental state examination: stages in order
"Assessed Mental State To Be Positively Clinically Unremarkable":
Appearance and behaviour 
Mood 
Speech 
Thinking 
Behavioural abnormalities
Perception abnormalities
Cognition 
Understanding of condition 

## History
SAMPLE history
Signs and Symptoms
Allergies
Medications
Past medical history, injuries, illnesses
Last meal/intake
Events leading up to the injury and/or illness

## Orthopaedic Assessment
CLORIDE FPP
Character: sharp or dull pain
Location: region (joint) of origin
Onset: sudden vs. gradual
Radiation:
Intensity: how severe (scale 1-10), impact on ADLs (activities of daily living), is it getting better, worse or staying the same?
Duration: acute vs. chronic
Events associated: falls, morning stiffness, swelling, redness, joint clicking or locking, muscle cramps, muscle wasting, movement limitation, weakness, numbness or tingling, fever, chills, trauma (mechanism of injury), occupation activities, sports, repetitive movements
Frequency: intermittent vs. constant, have you ever had this pain before?
Palliative factors: is there anything that makes it better? (rest, activity, meds, heat, cold)
Provocative factors: is there anything that makes it worse? (rest, activity, etc.)

## Pain history checklist
SOCRATES:
Site
Onset
Character
Radiation
Alleviating factors/ Associated symptoms
Timing (duration, frequency)
Exacerbating factors
Severity
Alternatively, Signs and Symptoms with the 'S'

## Abdominal swelling causes
9 F's:
Fat
Feces
Fluid
Flatus
Fetus
Full-sized tumors
Full bladder
Fibroids
False pregnancy

## Head Trauma: rapid neuro exam
12 P's
Psychological (mental) status
Pupils: size, symmetry, reaction
Paired ocular movements
Papilloedema
Pressure (BP, increased ICP)
Pulse and rate
Paralysis, Paresis
Pyramidal signs
Pin prick sensory response
Pee (incontinent)
Patellar reflex
Ptosis

## Ocular bobbing vs. dipping
"Breakfast is fast, Dinner is slow, both go down":
Bobbing is fast
Dipping is slow
In both, the initial movement is down.

## Pupillary dilation (persistent): causes
3AM:
3rd nerve palsy
Anti-muscarinic eye drops (eg to facilitate fundoscopy)
Myotonic pupil

## Clinical examination: initial Inspection of patient from end of bed
ABC:
Appearance (SOB, pain, etc.)
Behaviour
Connections (drips, inhalers, etc. connected to patient)

## Differential diagnosis checklist
"A VITAMIN C"
A and C stand for Acquired and Congenital
VITAMIN stands for:
Vascular
Inflammatory (Infectious and non-Infectious)
Trauma/ Toxins
Autoimmune
Metabolic
Idiopathic
Neoplastic
- Example usage: List causes of decreased vision: Central retinal artery occlusion, Retinitis pigmentosa, Perforation to gobe, Chronic Gentamycin use, Ruematoid arthritis, Diabetes, Idiopathic, Any eye tumor, Myopia.

## Family history (FH)
BALD CHASM:
Blood pressure (high)
Arthritis
Lung disease
Diabetes
Cancer
Heart disease
Alcoholism
Stroke
Mental health disorders (depression, etc.)

## Four point physical assessment of a disease
"I'm A People Person"
Inspection
Auscultation
Percussion
Palpation

## Medical history: disease checklist
MJ THREADS:
Myocardial infarction
Jaundice
Tuberculosis
Hypertension
Rheumatic fever/ Rheumatoid arthritis
Epilepsy
Asthma
Diabetes
Strokes

## Past medical history (PMH)
VAMP THIS:
Vices (tobacco, alcohol, other drugs, sexual risks)
Allergies
Medications
Preexisting medical conditions
Trauma
Hospitalizations
Immunizations
Surgeries

## Patient examination organization
SOAP:
Subjective: what the patient says.
Objective: what the examiner observes.
Assessment: what the examiner thinks is going on.
Plan: what they intend to do about it

## Patient profile (PP)
LADDERS:
Living situation/ Lifestyle
Anxiety
Depression
Daily activities (describe a typical day)
Environmental risks/ Exposure
Relationships
Support system/ Stress

## Physical exam for 'lumps and bumps'
"6 Students and 3 Teachers go for CAMPFIRE":
Site, Size, Shape, Surface, Skin, Scar
Tenderness, Temperature, Transillumination
Consistency
Attachment
Mobility
Pulsation
Fluctuation
Irreducibility
Regional lymph nodes
Edge

## Physical examination - correct order
"I Palpate People's Abdomens":
Inspection
Palpation
Percussion
Auscultation

## Short stature causes
RETARD HEIGHT:
Rickets
Endocrine (cretinism, hypopituitarism, Cushing's)
Turner syndrome
Achondroplasia
Respiratory(suppurative lung disease)
Down syndrome
Hereditary
Environmental (postirradiation, postinfectious)
IUGR
GI (malabsorption)
Heart (congenital heart disease)
Tilted backbone (scoliosis)

## Sign vs. symptom
sIgn: something I can detect even if patient is unconscious. sYMptom is something only hYM knows about.

## Surgical sieve for diagnostic categories
INVESTIGATIONS:
Iatrogenic
Neoplastic
Vascular
Endocrine
Structural/ Mechanical
Traumatic
Inflammatory
Genetic/ Congenital
Autoimmune
Toxic
Infective
Old age/ Degenerative
Nutritional
Spontaneous/ Idiopathic

## Breast history checklist
LMNOP:
Lump
Mammary changes
Nipple changes
Other symptoms
Patient risk factors

## Delivering Bad News
SPIKES:
Setting up
Perception
Invitation
Knowledge
Emotions
Strategy and Summary

# Neurology

## Chorea: common causes
St. VITUS'S DANCE:
Sydenhams
Vascular
Increased RBC's (polycythemia)
Toxins: CO, Mg, Hg
Uremia
SLE
Senile chorea
Drugs
APLA syndrome
Neurodegenerative conditions: HD, neuroacanthocytosis, DRPLA
Conception related: pregnancy, OCP's
Endocrine: hyperthyroidism, hypo-, hyperglycemia

## Congenital myopathy: features
DREAMS:
Dominantly inherited, mostly
Reflexes decreased
Enzymes normal
Apathetic floppy baby
Milestones delayed
Skeletal abnormalities

## Dementia: reversible dementia causes
DEMENTIA:
Drugs/Depression
Elderly
'Multi-infarct/Medication
Environmental
Nutritional
Toxins
Ischemia
Alcohol

## Stroke risk factors
HEADS:
Hypertension/ Hyperlipidemia
Elderly
Atrial fib
Diabetes mellitus/ Drugs (cocaine)
Smoking/Sex (male)

## Horner Syndrome
Horny PAMELA:
Ptosis
Anhydrosis
Miosis
Enophtalmos
Loss of ciliary-spinal reflex
Anisocoria

# Pathology

## Acute ischemia: signs 
6 P's:
Pain
Pallor
Pulselessness
Paralysis
Paraesthesia
Perishingly cold

## Anemia (normocytic): causes
ABCD:
Acute blood loss
Bone marrow failure
Chronic disease
Destruction (hemolysis)

## Anemia causes (simplified)
ANEMIA:
Anemia of chronic disease
No folate or B12
Ethanol
Marrow failure & hemaglobinopathies
Iron deficient
Acute & chronic blood loss

## Atherosclerosis risk factors
"You're a SAD BET with these risk factors":
Sex: male
Age: middle-aged, elderly
Diabetes mellitus
BP high: hypertension
Elevated cholesterol
Tobacco

## Carcinoid syndrome: components
CARCinoid:
Cutaneous flushing
Asthmatic wheezing
Right sided valvular heart lesions
Cramping and diarrhea

## Cushing syndrome
CUSHING:
Central obesity/ Cervical fat pads/ Collagen fiber weakness/ Comedones (acne)
Urinary free corisol and glucose increase
Striae/ Suppressed immunity
Hypercortisolism/ Hypertension/ Hyperglycemia/ Hirsutism
Iatrogenic (Increased administration of corticosteroids)
Noniatrogenic (Neoplasms)
Glucose intolerance/Growth retardation

## Diabetic ketoacidosis: I vs. II
ketONEbodies are seen in type ONEdiabetes.

## Gallstones: risk factors
5 F's:
Fat
Female
Fair (gallstones more common in Caucasians)
Fertile (premenopausal- increased estrogen is thought to increase cholesterol levels in bile and decrease gallbladder contractions)
Forty or above (age)

## Hepatomegaly: 3 common causes, 3 rarer causes
Common are 3 C's:
Cirrhosis
Carcinoma
Cardiac failure
Rarer are 3 C's:
Cholestasis
Cysts
Cellular infiltration

## Inflammatory Bowel Disease: which has cobblestones
Crohn's has Cobblestones on endoscopy.

## Morphine: effects
MORPHINES:
Miosis
Orthostatic hypotension
Respiratory depression
Pain supression
Histamine release/Hormonal alterations
Increased ICT
Nausea
Euphoria
Sedation

## Kwashiorkor: distinguishing from Marasmus
FLAME:
Fatty
Liver
Anemia
Malabsorption
Edema

## Pancreatitis: causes
I GET SMASHED:
Idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hhyperlipidaemia/hypercalcaemia
ERCP
Drugs

## PKU findings
PKU:
Pale hair, skin
Krazy (neurological abnormalities)
Unpleasant smell

## Pupils in overdose: morphine vs. amphetamine
"MorPHINE:Fine. AmPHETamine:Fat":
Morphine overdose: pupils constricted (fine).
Amphetamine overdose: pupils dilated (fat).

## Pericarditis findings
PERICarditis:
Pulsus paradoxus
ECG changes
Rub
Increased JVP
Chest pain 

## Gout vs. pseudogout: crystal lab findings
P
seduogout crystals are:
P
-sitive birefringent
P
-lygon shaped
Gout therefore is the negative needle shaped crystals.
Also, gout classically strikes great Toe, and its hallmark is Tophi.

## Signs of Chronic Liver Disease
abcdefghij
Asterixis, Ascites, Ankle oedema, Atrophy of testicles
Bruising
Clubbing/ Colour change of nails (leuconychia)
Dupuytrens contracture
Encephalopathy / palmar Erythema
Foetor hepaticus
Gynaecomastia
Hepatomegaly
Increase size of parotids
Jaundice

# Psychiatry

## Conduct disorder vs. Antisocial personality disorder
Conduct disorder is seen in Children. Antisocial personality disorder is seen in Adults.

## Depression: symptoms and signs (DSM-IV criteria)
AWESOME:
Affect flat
Weight change (loss or gain)
Energy, loss of
Sad feelings/ Suicide thoughts or plans or attempts/ Sexual inhibition/ Sleep change (loss or excess)/ Social withdrawal
Others (guilt, loss of pleasure, hopeless)
Memory loss
Emotional blunting

## Depression
UNHAPPINESS:
Understandable (such as bereavement, major stresses)
Neurotic (high anxiety personalities, negative parental upbringingHypochondriasis
Agitation (usually organic causes such as dementia)
Pseudodementia
Pain
Importuniing (whingeing, complaining)
Nihilistic
Endogenous
Secondary (i.e. cancer at the head of the pancreas, bronchogenic cancer)
Syndromal

## Erikson's developmental stages
"The sad tale of Erikson Motors":
- The stages in order by age group:
Mr. Trust and MsTrust had an auto they were ashamed of. She took the initiative to find the guilty party. She found the industry was inferior. They were making cars with dents  and rolling fuses . Mr. N.T. Macy  isolated the problem, General TVT absorbed the cost. In the end, they found the tires were just gritty and the should have used de- spare!

## Mania: cardinal symptoms
DIG FAST:
Distractibility
Indiscretion (DSM-IV's "excessive involvement in pleasurable activities")
Grandiosity
Flight of ideas
Activity increase
Sleep deficit (decreased need for sleep)
Talkativeness (pressured speech)

## Mania: diagnostic criteria
Must have 3 of MANIAC:
Mouth (pressure of speech)/ Moodl
Activity increased
Naughty (disinhibition)
Insomnia
Attention (distractability)
Confidence (grandiose ideas)

## Parasomnias: time of onset
SLeep terrors and SLeepwalking occur during SLow-wave sleep (stages 3 & 4).NightmaRE occurs during REM sleep (and is REMembered).

## Psychiatric review of symptoms
"Depressed Patients Seem Anxious, So Claim Psychiatrists":
Depression and other mood disorders (major depression, bipolar disorder, dysthymia)
Personality disorders (primarily borderline personality disorder)
Substance abuse disorders
Anxiety disorders (panic disorder with agoraphobia, obsessive-compulsive disorder)
Somatization disorder, eating disorders (these two disorders are combined because both involve disorders of bodily perception)
Cognitive disorders (dementia, delirium)
Psychotic disorders (schizophrenia, delusional disorder and psychosis accompanying depression, substance abuse or dementia)

## Schizophrenia: negative features
4 A's:
Ambivalence
Affective incongruence
Associative loosening
Autism

## Substance dependence: features (DSM IV)
WITHDraw IT:
- 3 of 7 within 12-month period:
Withdrawal
Interest or Important activities given up or reduced
Tolerance
Harm to physical and psychosocial known but continue to use
Desire to cut down, control
Intended time, amount exceeded
Time spent too much

# Radiology / Oncology

## Anterior mediastinal masses
4 T's:
Teratoma
Thymoma
Testicular-type
T-cell / Hodgkin's lymphoma

## Dermatomyositis or polymyositis: risk of underlying malignancy
Risk is 30% at age 30.
Risk is 40% at age 40, and so on.

## Chest radiograph: checklist to examine
"Pamela Found Our Rotation Particularly Exciting; Very Highly Commended Mainly 'Cus She Arouses":
Patient details
Film details
Objects (e.g. lines, electrodes)
Rotation
Penetration
Expansion
Vessels
Hila
Costophrenic angles
Mediastinum
Cardiothoracic Ratio
Soft tissues and bones
Air (diaphragm, pneumothorax, subcut. emphysema)

## Chest X-ray interpretation
Preliminary is ABCDEF:
AP or PA
Body position
Confirm name
Date
Exposure
Films for comparison
Analysis is ABCDEF:
Airways (hilar adenopathy or enlargement)
Breast shadows/ Bones (rib fractures, lytic bone lesions)
Cardiac silhoutte (cardiac enlargement)/ Costophrenic angles (pleural effusions)
Diaphragm (evidence of free air)/ Digestive tract
Edges (apices for fibrosis, pneumothorax, pleural thickening or plaques)/ Extrathoracic tissues
Fields (evidence of alveolar filling)/ Failure (alveolar air space disease with prominent vascularity with or without pleural effusions)

## Chest X-ray: cavitating lesions differential
"If you see HOLES on chest X-ray, they are WEIRD":
Wegener's syndrome
Embolic (pulmonary, septic)
Infection (anaerobes, pneumocystis, TB)
Rheumatoid (necrobiotic nodules)
Developmental cysts (sequestration)
Histiocytosis
Oncological
Lymphangioleiomyomatosis
Environmental, occupational
Sarcoid
Alternatively: L=Left atrial myxoma

## Lung cancer: main sites for distant metastases
BLAB:
Bone
Liver
Adrenals
Brain

## Elbow ossification centers, in sequence
CRITOE:
Capitellum
Radial head
Internal epicondyle
Trochlea
Olecranon
External epicondyle

## Esophageal cancer: risk factors
ABCDEF:
Achalasia
Barret's esophagus
Corrosive esophagitis
Diverticuliis
Esophageal web
Familial

## Head CT scan: evaluation checklist
"Blood Can Be Very Bad":
B lood
Cistern
Brain
Ventricles
Bone

## Lung cancer: notorious consequences
SPEECH:
Superior vena cava syndrome
Paralysis of diaphragm (Phrenic nerve)
Ectopic hormones
Eaton-Lambert syndrome
Clubbing
Horner syndrome/ Hoarseness

## Mole: signs of trouble
ABCDE:
Asymmetry
Border irregular
Colour irregular
Diameter usually > 0.5cm
Elevation irregular

## Neck sagittal x-ray: examination checklist
ABCD:
Anterior: look for swelling
Bones: examine each bone for fractures
Cartilage: look for slipped discs
Dark spots: ensure not abnormally big, or could mean excess blood

## Osteoarthritis: x-ray signs
LOSS:
Loss of joint space
Osteopyhtes
Subcondral sclerosis
Subchondral cysts

## Prognotic factors for cancer: general
PROGNOSIS:
Presentation (time & course)
Response to treatment
Old (bad prog.)
Good intervention (i.e. early)
Non-compliance with treatment
Order of differentiation (>1 cell type)
Stage of disease
Ill health
Spread (diffuse)

## Pituitary endocrine functions often affected by pituitary-associated tumor
"Go Look For the Adenoma Please":
Tropic hormones affected by growth tumor are:
GnRH
LSH
FSH
ACTH
Prolactin function

## T2 vs. T1 MRI scan
"WW 2" (World War II):
Water is White in a T2 scan.
Conversely, a T1 scan shows fat as being whiter.

## Upper lobe shadowing: causes
BREASTS:
Beryllium
Radiation
Extrinsic allergic alveolitis
Ankylosing spondylitis
Sarcoidosis
TB
Siliconiosis

# Miscellaneous
The following may or may not fit properly into one of the above categories. They are being stored in this section either temporarily or permanently. Categorize them if needed.

## Asthma treatment
ASTHMA
Adrenergic agonists
Steroids
Theophylline
Hydration
Masked oxygen
Anticholinergics

## Airway assessment
LEMON
Look
Evaluate
Malompathy
Occlusion
Neck mobility

## Croup: symptoms
3 S's:
Stridor
Subglottic swelling
Seal-bark cough

## Cholinergic Crisis
SLUDGE and the Killer B's:
Salivation
Lacrimation
Urination
Diaphoresis, Diarrhea
Gastrointestinal cramping
Emesis
Bradycardia
Bronchospasm
Bronchorrhea
DISCO
DIGITALIS
ISONIAZID
SPIRILACTINE
CIMETIDINE,KETOCONQZILE
OESTROGEN

## Gynaecomastia causing drugs
Some Drugs Create Awesome Knockers
Spironolactone
Digitalis
Cimetidine
Alcohol
Ketoconazole

## Diaphragm innervation
C3, 4, 5 Keeps the Diaphragm Alive

## Intubation preparation
7 P's
Preperation
Preoxygenation
Pretreatment
Paralysis with induction
Positioning
Placement of tube
Postintubation management

## Pentad of TTP
FAT RN:
Fever
Anemia
Thrombocytopenia
Renal
Neuro changes

## Pulmonary Edema: Treatment
LMNOP:
Lasix
Morphine
Nitro
Oxygen
Position/Positive pressure ventilation