Many Medical Mnemonics for Memorization

This is a list of medical mnemonics. They are meant to help people study and memorize important information. Note that I did not personally create any of these. If you know of any useful ones that are not mentioned here, list them in the comments at the bottom of this page.

A

Abdominal Pain, acute, differential diagnosis: ABDOMINAL

Appendicitis

Biliary tract disease

Diverticulitis

Ovarian disease

Malignancy

Intestinal obstruction

Nephritic disorders

Acute pancreatitis

Liquor (ethanol)

ACE Inhibitor, contraindications: PARK

Pregnancy

Allergy

Renal artery stenosis

K (potassium) increase: hyperkalemia

Activities of Daily Living (abbreviated as ADL), assessment: BATTED

Bathing

Ambulation

Transfers

Toileting

Eating

Dressing

Addison’s Disease, clinical findings: FATIGuED

Fatigue

Antibodies (ie: anti-adrenal, antithyroid, antiparietal cell

Triad: hyponatremia, hypokalemia, azotemia

Increased pigmentation of skin and tongue

Gastrointestinal: weight loss, anorexia

Nausea and vomiting

Eosinophillia, neutropenia

Decreased blood pressure (ie: hypotension)

Alcoholism Screening Questions: CAGE

Have you ever tried to Cut down on your drinking?

Do people ever Anger you about your drinking?

Do you ever feel Guilty about your drinking?

Do you ever require an Eye opener (ie: drink of alcohol) to get going in the morning?

Aldosterone, regulation of secretion from adrenal cortex: RNAS

Renin-angiotensin mechanism

Na concentration in blood

ANP (atrial natriuretic peptide)

Stress

Alkalosis Vs Acidosis, directions of pH and HCO3: ROME

Respiratory=Opposite

pH is high, PCO2 is low (alkalosis)

pH is low, PCO2 is high (acidosis)

Metabolic=Equal

pH is high, HCO3 is high (alkalosis)

pH is low, HCO3 is low (acidosis)

Anal Pain, differential diagnosis: HHAAFF

Hemorrhoids

Hematoma

Abscess

Anal prolapse

Fistula

Fissure

Anemia, normocytic-normochromic, causes: CREAM PILE

Connective tissue disease

Renal disease

Endocrinopathy (ie: hypothyroidism, Addison’s disease, hypopituitarism, hypoparathyroidism)

Amyloidosis

Pregnancy

Infectious (eg: abscess, subacute bacterial endocarditis)

Liver disease

Everything else (eg: malnutrition, malignancy)

Angina Pectoris, precipitants: 4 E’s

Emotional upset

Exertion

Exposure to cold air

Eating large meal

Arthritis, classification: IMEDICS

Inflammatory vasculitides: polyarteritis nodosa, Wegener’s granulomatosis, hypersensitivity vasculitis, giant cell arteritis

Metabolic: gout, pseudogout, hemochromatosis

Endocrine: acromegaly

Degenerative: osteoarthritis

Infectious: septic joint, infectious synovitis, rheumatic fever

Connective tissue disorders (rheumatoid factor-positive): systemic lupus erythematosus, rheumatoid arthritis, progressive systemic sclerosis/scleroderma, polymyositis/dermatomyositis

Seronegative spondyloarthropathies (rheumatoid factor-negative): ankylosing spondylitis, Reiter’s syndrome, psoriatic arthritis, inflammatory bowel disease

Arthritis, seronegative spondyloarthropathies: PEAR

Psoriatic arthritis

Enteropathic arthritis

Ankylosing spondylitis

Reiter’s/Reactive

Ascites, causes: P^4

Peritonitis: peritoneal carcinomatosis, post-irradiation, peritoneal dialysis, pancreatitis, mesothelioma, bacterial, TB, fungal, parasitic

Peritoneal lymphatic obstruction: traumatic, congenital

Protein deficiency: cirrhosis, protein-losing enteropathy, nephrotic syndrome, kwashiorkor

Portal hypertension: pre-hepatic, hepatic, post-hepatic causes

Atrial Fibrillation (A fib), causes: PIRATES

Pulmonary: PE, COPD

Iatrogenic

Rheumatic heart: mitral regurgitation

Atherosclerotic: MI, CAD

Thyroid: hyperthyroid

Endocarditis

Sick sinus syndrome

B

Bacterial Overgrowth Syndrome, risk factors: PASSED GAS

Pernicious anemia

Achlorrhydria

Steroids (ie: corticosteroids)

Scleroderma

Endocrine (ie: diabetes mellitus, hypothyroidism)

Diverticula of jejunum

Gastrectomy (ie: partial gastrectomy)

Antibiotics

Strictures within the small bowel

Beck’s Triad of Acute Cardiac Tamponade: 3-D

Bloody Diarrhea, infectious causes: CESSYEC

Campylobacter jejuni

E coli (enterohemorrhagic strains)

Salmonella

Shigella

Yersinia enterocolytica

Entamoeba histolytica

Clostridium difficile (c diff)

Bone Metastases, common causes of: Mom, Buy The Kid Long Pants

Malignant melanoma

Breast

Thyroid

Kidney

Lung

Prostate

Burns, initial resuscitation: SAVE A PATIeNT

Stop the burning process

ABCs of basic life support

Visualize the patient for all injuries

Estimate burn size and begin fluid resuscitation

Airway: intubate if inhalation injury present

Penicillin: start antibiotics

Analgesic

Topical therapy: flumazanine cream

Intoxicants/Inhalants

e

Nasogastric tube

Tetanus toxoid

Burn Size Estimation by Total Body Surface Area: Rule of 9’s

Entire head: 9%

Entire trunk: 18% + 18% = 36%

Entire arm: 9% + 9% = 18%

Entire leg: 18% + 18% = 36%

Whole body: 100%

C

Carcinogens, known types: AABBCC

Arsenic (causes skin cancer)

Asbestos (causes mesothelioma, laryngeal cancer)

Benzidine dye (causes bladder cancer)

Beta-naphthylamine (causes bladder cancer)

Chromium (causes nasal cancer)

Chloride vinyl (causes liver angiosarcoma)

Carpal Tunnel Syndrome (CTS), causes: TENS

Trauma: Colles’ fracture, daily overuse at typing keyboard

Endocrinopathy: pregnancy, hypothyroidism, diabetes mellitus, acromegaly

Neurological: C5-C6 disk herniation can mimic CTS

Synovitis: rheumatoid arthritis

Carpal Tunnel Syndrome, treatment: WRIST

Wear splints at night

Rest

Inject steroid

Surgical decompression

Take diuretics

Celiac Disease, Treatment/prevention: Elimination of gluten-containing foods (BROW) from the diet

Barley

Rye

Oats

Wheat

Cerebellar damage signs, DANISH

Dysdiadochokinesis

Ataxia

Nystagmus

Intention tremor

Slurred speech

Hypotonia

Cerebellar Lesion, signs: DDDARN It

Dysarthria

Dysdiadokokinesia

Dysmetria

Ataxia

Rebound phenomenon

Nystagmus

Intention tremor

Cerebral Palsy, criteria for diagnosis: POSTER

Posturing: especially abnormal extensor thrusting

Oropharyngeal problems: tongue thrusts, grimacing, swallowing difficulties

Strabismus

Tone increased or decreased in muscles

Evolutionary responses: persistent primitive reflexes or failure to develop equilibrium and protective responses

Reflexes: deep tendon reflexes are increased and plantar reflexes are up going

Cervical Spine X-ray, interpretation: ABCS

Alignment of: soft tissue, vertebral bones anteriorally, facet joints, spinous processes

Bone fractures

Cartilage: intervertebral disc spaces should be equal

Soft tissues: prevertebral and retropharyngeal spaces are increased with bony injury, blood, or air from tracheal injury

Colles’ Fracture, casting position: PUP

Phlexion (ie: wrist flexion) +

Ulnar deviation of wrist +

Pronation of wrist

Compartment Syndrome (Ischemic Injury), signs: P^6

Passive stretching causes severe pain (moat reliable sign)

Pain

Pallor

Paresthesia

Poor capillary refill

Pulselessness (late sign)

Congestive Heart Failure (CHF), causes of exacerbation: FAILURE

Forgot medication

Arrhythmia/Anemia

Ischemia/Infarction/Infection

Lifestyle: consuming too much salt

Upregulation of cardiac output (CO): pregnancy, hyperthyroidism

Renal failure

Embolism: pulmonary

Constipation in Childhood, organic causes: HHHAND

Hirschprung’s disease

Hypothyroidism

Hypercalcemia

Anal fissure

Neurogenic bowel: spina bifida

Diabetes mellitus

Constipation, treatment: FECES

Fluid and fiber intake

Exercise

Cathartics (eg: lactulose)

Elimination of constipating medications

Stimulation of the gatrocolic reflex (ie: enema)

Cough (chronic), differential: When cough in nursery, rock the “CRADLE”

Cystic fibrosis

Rings, slings, and airway things (tracheal rings)/Respiratory infections

Aspiration: swallowing dysfunction, tracheoesophageal (TE) fistula, gastroesophageal reflux

Dyskinetic cilia

Lung, airway, and vascular malformations: tracheomalacia, vocal cord dysfunction

Edema: heart failure

Creutzfeldt-Jakob Disease, signs: B MAD

Blindness

Myoclonic movements of the limbs

Ataxia

Dementia: rapidly progressive in nature

Croup Scoring: Remain Calm Coughing Makes Stridor Appear

Retractions: none –> intercostal and nasal flaring

Color: normal –> central cyanosis

Cough: none –> paroxysmal “bark”

Mental status: alert –> restless –> delirious

Stridor: none –> stethoscope –> without stethoscope

Air entry: normal –> decreased –> delayed or minimal

Cushing’s Syndrome, Signs and symptoms: MOON FACE

Menstrual changes

Osteoporosis

Obesity

Neurosis

Facial plethora (moon face, hirsutism)

Altered muscle

Calor (heat) of skin

Elevated blood pressure

D

Delirium, signs: AIDS

Acute onset, then fluctuation over days

Inattentiveness: especially to conversation

Disorganized thinking: incoherent speech

State of consciousness either reduced or hypervigilant

Dementia: 7 A’s

Anosognosia – Ignorance of the presence of disease

Agnosia – Inability to recognize objects by using the senses

Aphasia – Loss of ability to speak or understand language

Apraxia – Inability to perform purposeful movements

Altered Perception – Misinterpretation of information from senses

Apathy – Lacks interest in activities or staying involved in a task

Amnesia – Memory loss

Dementia, Alzheimer’s, differential diagnosis: DEMENTIAS

Drugs

Encephalitis

Metabolic: electrolyte or liver abnormality, dehydration, acute intermittent porphyria

Endocrine: thyroid disease, diabetes mellitus

Normal-pressure hydrocephalus

Trauma: chronic subdural hematoma

Infection: of lung or urine, AIDS, syphilis

Affective disorder: depression manifesting as pseudodementia

Structural defect of brain: infarction, tumor, abscess

Dementia Patient, management: FICSMA

Family answering questions, referral to services and resources, treatment of behavioral disturbances, helping with placement, postmortem investigation and support

Intellectual status: observing for/treating delirium, depression, drug side effects, incontinence: initiating discussion

Clinical investigation, retraining regimens

Sleep: counselling family regarding expected disorders, ruling out environmental and physical causes, treating insomnia

Mobility/Activity: investigating causes of immobility, adjusting environment and drugs, restricting wandering

Depression, 5 drugs causing it: PROMS

Propanolol

Reserpine

Oral contraceptives

Methyldopa

Steroids

Depression: major episode characteristics: SPACE DIGS

Sleep disruption

Psychomotor retardation

Appetite change

Concentration loss

Energy loss

Depressed mood

Interest wanes

Guilt

Suicidal tendencies

Depression, signs and symptoms: ASSESS PAT

Appetite diminished, weight loss

Sleep disturbance: especially diminished number of sleep hours

Sexual libido diminished

Energy diminished

Suicidality, Self-worthlessness, and guilt

Psychomotor agitation

Anhedonia

Thought process impaired

Diabetic Ketoacidosis, Precipitants of: In^5

Insulin deficiency

Infarction (ie: myocardial infarction)

Infection (eg: viral respiratory tract infection)

Injury (ie: trauma)

Infant (ie: pregnancy)

Dialysis, indications: AEIOU

Acid-base problems: severe acidosis or alkalosis

Electrolyte problems: hyperkalemia

Intoxications

Overload: fluid

Uremic symptoms

Digital (finger) Clubbing, causes: FINGER Clubb

Fibrosis of lung

Infections: lung abscess, bronchiectasis, infective endocarditis

Neoplastic: lung adenocarcinoma

Gastrointestinal: chronic liver disease, inflammatory bowel disease, celiac disease

Endocrine: hyperthyroidism

Renal disease: chronic

Cardiac: cyanotic congenital cardiac disease

lubb

Direct Sympathomimetic Catecholamines: DINED

Dopamine

Isoproterenol

Norepinephrine

Epinephrine

Dobutamine

Disseminated Intravascular Coagulation (DIC), causes: TOM’S V

Trauma (especially brain trauma)

Obstetrical (ie: abruptio placenta, retained fetus, placenta previa, septic abortion)

Malignancy

Sepsis (eg: meningococcemia, E coli)

Venom (usually from viper snake bites)

Drug Toxicity/Overdose Blood Tests: A^6

Alcohols: ethanol, methanol, ethylene glycol

Aspirin

Acetaminophen

Anticonvulsants: phenytoin, phenobaribital

Antidepressants: tricyclics, lithium

Anxiolytics: benzodiazepines

Ducket John’s major criteria: ACNES

Arthritis

Carditis

Nodule (subcutaneous)

Erythrema marginatum

Sydenham chorea

Duodenal Ulcer, indications for surgical management: I PROB

Intractable pain

Perforation

Refractive to medical treatment

Obstruction (ie: of the gastric outlet)

Bleeding

Dyspnea of Sudden-Onset, causes: MAAP^5S

Mucous plug

Asthma

Aspiration, respiratory distress syndrome (RDS)

Pulmonary embolus

Pneumonia

Pneumothorax

Pulmonary edema

Psychogenic

Sepsis

E

Emergency Drugs to LEAN on

Lidocaine

Epinephrine

Atropine

Narcan

Endocarditis, clinical manifestations: LIME

Local (ie: valvular vegetations, and destruction)

Immune complexes (ie: retinal Roth spots, renal lesions, Janeway lesions, Osler’s nodes)

Metastatic lesions (ie: bacterial “mycotic” aneurysms)

Embolisms (ie: splenic, cerebral, renal, and adrenal infarcts)

Endometrial Carcinoma, risk factors: HONDA

Hypertension

Obesity

Nulliparity

Diabetes

Age: increased

Enlarged Kidneys, causes: SHAPE

Scleroderma

HIV nephropathy

Amyloidosis

Polycystic kidney disease

Endocrinopathy: diabetes

Epididymitis, bacterial causes: CENT

Chlamydia trachomatis

E coli

Nisseria gonorrhea

Tuberculosis bacteria

Epiglottitis, signs and symptoms: 5 D’s

Distressed

Drooling

Dysphagia

Dysphonia

Dyspnea

Epiphyseal injury, Salter-Harris classification: SALTEr

Type 1: Straight through the epiphyseal growth plate

Type 2: Above the epiphyseal growth plate: in a fragment of metaphysis attached to the epiphysis

Type 3: Lower: through and below the epiphyseal growth plate

Type 4: Through the epiphysis and metaphysis

Type 5: Emergency: crush of the epiphyseal growth plate

Exposures to Infectious Agents, diagnosis: COASTED

Contacts: family, friends, co-workers

Oral ingestion: seafood, restaurants, picnics

Animal exposure: pets, wild animals

Sexual history: sexual orientation, number of partners, use of prostitutes

Travel history

Employment exposure: animals, insects, fumes

Drug history: illicit drugs, needle sharing, over-the-counter medications

F

Failure to Thrive, causes: 7 C’s

Congenital abnormalities: ventricular septal defect

Chromosomal abnormalities: Down’s syndrome

Cystic fibrosis (CF)

Celiac disease

Cow’s milk protein intolerance: allergy

Calorie-protein malnutrition

Cruelty: parental neglect, abuse, environmental deprivation

Felty’s Syndrome Components: SANTA

Splenomegaly

Anemia

Neutropenia

Thrombocytopenia

Arthritis

Fire Extinguisher: PASS

Pull

Aim

Squeeze

Sweep

Fire Response Plan: RACE

Rescue

Alarm

Confine

Extinguish/Evacuate

G

Gallstone Disease, risk factors: CHOlesterol PIGment

Cirrhosis of liver

Hemolysis

Obesity

lesterol

Parity >2

Indian (ie: North American Indian)

Gender (ie: female, fair, fat, forty, flatulent, and fertile)

ment

Gastric Carcinoma, risk factors: A^5

Anemia (ie: pernicious anemia)

Achlorrhydria

Atrophic gastritis

Adenomas (ie: gastric adenomas)

A blood type

Generalized Anxiety Disorder, symptoms: STOMACH

Scanning and vigilance

Two or more worries

Organic causes should be ruled out

Motor tension

Anxiety unrelated

Course of mood or psychotic should be ruled out

Hyperactive autonomics

Glomerulonephritis in childhood: HIS PISH

Henoch-Schonlein purpura

IgA nephropathy (ie: Berger’s disease)

Systemic lupus erythematosus

Post-streptococcal glomerulonephritis

Immune vasculitis (eg: Wegener’s granulomatosis, polyarteritis nodosa)

Subacute bacterial endocarditis

Hemolytic-uremic syndrome

Graves’ Ophthalmopathy, Clinical characteristics: PREDNISOL

Proptosis

Retraction of eyelids (Dairymple’s sign)

Edema (periorbital)

Diplopia

Neuropathy of optic tract (leads to poor visual acuity

Inhibited upward gaze

Skin changes (eg: pretibial myxedema, peu d’orange)

Onset ages 20-40

Lid lag on downward gaze (Graefe’s sign)

H

Headache, classification: VITAMIN

Vascular: migraine, cluster, toxic vascular, hypertensive

Inflammatory and Traction: mass lesion (tumor, edema, hematoma, hemorrhage), arteritis, phlebitis, neuralgia, occlusive vascular disease, temperomandibular joint syndrome

Atypical variants

Muscle contraction headache: depressive equivalents and conversion reactions, cervical osteoarthritis, chronic myositis

Infectious: meningitis, encephalitis

Non-cranial sources: eyes, ears, nose, throat, teeth

Hematuria, causes: SITTTG

Stones: kidney stone

Infection: urinary tract infection

Tuberculosis

Trauma

Tumor: renal or bladder cancer

Glomerulonephritis

Hemochromatosis, clinical manifestations: ABCDEFG

Arthralgias

Bronzed skin color

Cardiac: enlargement, heart failure, conduction abnormalities

Diabetes

Early in life: aged mid-30’s upon presentation

Ferritin (serum) elevated

Gonadal involvement: decreased libido, infertility

Henoch-Schonlein Purpura, signs and symptoms: RASHH

Rash: purpuric rash over buttocks, estensor surfaces of legs, pre-tibial region

Arthralgia

Sore abdomen

Hematuria

Hematochezia

Hepatic Encephalopathy, signs and symptoms: SCALP

Sychosis

Confusion

Asterixis

Lethargy –> coma: late sign

Personality changes: early sign

HLA-B27 associated diseases: PAIR

Psoriasis

Ankylosing spondylitis

Inflammatory bowel disease

Reiter’s syndrome

Hodgkin’s Disease, clinical features: WAAARM LIFHS

Weight loss

Anemia

Abdominal pain

Alcohol-induced pain in lymph nodes

Regional lymphadenopathy

Mediastinal involvement (eg: compression of local structures)

Lymphadenopathy

Itchiness

Fever, night sweats, Pel-Epstein fever

Hyperuricemia (eg: manifesting as gout)

Splenomegaly

Hourly Rounding: 4 P’s

Pain – “How is your pain?”

Position – “Are you comfortable?”

Potty – “Do you need to use the bathroom?”

Possessions – “Do you need me to move the
phone, call light, trash can, water or your
bedside table within reach?”

Hydrocephalus in Infants and Children, causes: MHO

Meningitis: infectious

Hemorrhage: periventricular hemorrhage

Obstruction: aqueduct stenosis, tumor

Hypercalcemia, Causes: SHIFT

Sarcoidosis (and other granulomatous diseases)

Hyperparathyroidism, hyperthyroidism

Immobilization

Familial

Tumor, thiazides (others: lithium, vitamin D)

Hypercalcemia, Causes: SIR

Skeletal resorption enhanced: hyperparathyroidism (usually due to a single parathyroid adenoma), malignancy (eg: bronchial carcinoma), hyperthyroidism, immobilization

Intestinal absorption enhanced: granulomatous disease (eg: tuberculosis, sarcoidosis, vitamin D intoxication

Renal excretion reduced: diuretic ingestion

Hyperkalemia, Signs and symptoms: MURDER

Muscle weakness

Urine (oliguria, anuria)

Respiratory distress

Decrease cardiac contractility

ECG changes

Reflexes (hyperreflexia, areflexia)

Hypermagnesemia, Causes: RENAL

Renal failure

Exogenous loads (eg: MgSO4, magnesium-containing antacids)

Necrosis of tissue (eg: burns)

Adrenal insufficiency

Lithium intoxication

Hypertension (HTN), Effects on organs: HIgHER PEa

Heart (ie: left ventricular hypertrophy, angina, myocardial infarction)

Infarction in brain

g

Hemorrhage in brain

Encephalopathy

Renal disease (eg: glomerulosclerosis)

Peripheral vascular disease

Eyes (ie: arteriolar narrowing, retinal hemorrhages and exudates, papilledema)

a

Hypertension, Secondary causes: RENALS

Renal (eg: glomerulonephritis, renal artery stenosis)

Endocrine (eg: Cushing’s disease, Conn’s syndrome, pheochromocytoma, acromegaly, corticosteroids, oral contraceptive pill)

Neurogenic (eg: raised intracranial pressure)

Aortic coarctation

Little people (ie: pregnancy-induced hypertension)

Stress (eg: trauma, white coat hypertension)

Hypertension, Treatment: ABCDE

ACE inhibitors

Beta-blockers

Calcium-channel blockers

Diuretics

Exercise, weight loss, and dietary modifications (try first)

Hyperthyroidism, Symptoms of: SWEATING

Sweating

Weight loss

Emotional lability

Appetite is increased

Tremor/ Tachycardia due to AF

Intolerance to heat/ Irritability

Nervousness

Goiter/ GI problems (diarrhea) 

Hypocalcemia, Signs and symptoms: CATS

Convulsions

Arrhythmias

Tetany

Stridor/Spasms

Hypoglycemia, Causes: ExPLAIN

Exogenous: insulin, oral hypoglycemic agents, ethanol, and ASA excess

Pituitary insufficiency

Liver failure

Adrenal insufficiency (eg: Addison’s disease)

Immune (ie: anti-insulin antibodies)

Neoplastic (eg: insulinoma, sarcoma, mesothelioma)

Hypoglycemia, Symptoms: TIRED

Tachycardia

Irritability

Restlessness

Excessive hunger

Diaphoresis

Hypomagnesemia, Causes: 10 Ds

Diarrhea and gastrointestinal losses

Diuretics and renal losses

Diabetes mellitus and endocrine causes

Dietary insufficiency

Diverted to free fatty acids

Drugs (eg: cisplatin, amphotericin B, diuretics)

Drinking excess amounts of ethanol

Delivery with toxemia during pregnancy

Decompensated heart, lungs, or liver

Denuded skin (eg: burns)

Hypothyroidism: Symptoms of: MOM’S SO TIRED

Memory loss

Obesity

Malar flush/ Menorrhagia

Slowness

Skin and hair become dry

Onset is gradual

Tired

Intolerance to cold

Raised blood pressure

Energy levels are low

Depressed

I

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

Incontinence, causes of transient form: DIAPERS

Delirium

Infection of urinary tract

Atrophic urethritis

Pharmacologic agents

Endocrine: glycosuria

Restricted mobility: “geographic incontinence” of new setting

Stool impaction

Inflammatory Bowel Disease, extra-intestinal manifestations: STiNGSS

Sclerosing choangitis

Thromboembolic disease

i

Nephrolithiasis (ie: calcium oxalate, urate stones)

Skin (ie: aphthous ulcers, pyoderma gangrenosum, erythema nodosum)

Seronegative spondyloarthropathies

Iron Overdose, signs and symptoms: HIS HeP

Hemorrhagic gastroenteritis: 30-60 minutes post-ingestion

Improvement: appears improved 2-12 hours post-ingestion

Shock: 12-48 hours post-ingestion

Hepatic damage with possible hepatic failure: late

e

Pyloric stenosis: residual complication

J

Joint Pain, causes: SOFTER TISSUE

Sepsis

Osteoarthritis

Fractures

Tendon/muscle

Epiphyseal

Referred

Tumor

Ischemia

Seropositive arthritides

Seronegative arthritides

Urate

Extra-articular rheumatism: polymylagia

K

Kawasaki Disease Criteria: CREAM

Fever for greater than 5 days + 4 out of 5 of the following:

Conjunctivitis (non-exudative)

Rash (polymorphous non-vesicular)

Edema (or erythema of hands or feet)

Adenopathy (cervical, often unilateral)

Mucosal involvement (erythema, fissures, or crusting)

L

Laparotomy, emergency indications: PERFS

Peritonitis

Evisceration

Ruptured ectopic pregnancy

Free air in peritoneal cavity

Shock, with blood from rectum, nasogastric tube, or bladder

Lead Poisoning, Clinical manifestations: CRACK

Central nervous system (CNS): headache, memory loss, personality changes, encephalopathy

Reproductive: abortion, stillbirth

Anemia: microcytic

Colic: “lead colic” abdominal pain

Kidney: proximal tubular damage, interstitial fibrosis

Lithium, side effects: VANISH LITHHH

Vertigo

Ataxia

Nystagmus

Intention tremor

Stupor

Hyperreflexia

Leukocytosis

Insipidus: nephrogenic diabetes insipidus

T-wave inversion on the electrocardiogram (EKG)

Heaviness: weight gain

Hypothyroidism

Hyperparathyroidism

Lupus, drug-induced causes: CHIMP

Chorpromazine

Hydralazine

Isoniazid

Methyldopa

Procainamide

M

Malignant Melanoma, Diagnostic characteristics: ABCD

Asymmetry of lesion

Border irregularity

Color variegation

Diameter greater than 6 mm

Mania, symptoms: GREAT SAD

Grandiosity

Racing thoughts

Euphoria

Activities, goal-directed

Talkative

Sleep deprived

Activities, reckless

Distractibility

Megacolon, causes C^5

Congenital megacolon: Hirshprung’s disease

Colitis: Chron’s disease and ulcerative colitis

Cancer of the bowel

Chagas’ disease: Trypanosoma cruzi destroy the bowel plexus

Crazy: functional megacolon

Mental Status Examination: COMO ESTAS

Cognitive function: calculation, concentration, insight, judgment

Overview: appearance, attitude, level of consciousness (LOC), movements

Memory: recent and remote

Orientation: to person, place, and time

Emotion: affect and mood

Speech: fluency, form, and comprehension

Thought: process, content, and perceptual disturbances

Attention: abstract thinking, recall, and intelligence

Something else: that might be important to the patient

Metabolic Acidosis, causes: USED CARP

Ureteroenterostomy

Saline hydration

Endocrinopathies: hyperparathyroid, hyperthyroid, Addison’s

Diarrhea/DKA/Drugs

Carbonic anhydrase inhibitors

Ammonium chloride

Renal tubular acidosis

Parenteral nutrition/pancreatic fistula

Metabolism Enzyme Inducers: Randy’s Black Car Goes Putt Putt and Smokes

Rifampin

Barbiturates

Carbamazepine

Grisoefulvivn

Phenytoin

Phenobarb

Smoking cigarettes

Microcytic Anemia Causes: TICS

Thalassemia

Iron deficiency

Chronic disease

Sideroblastic anemia

Migraine Headache, precipitating factors: C^6

Cino: wine

Cheese

Chocolate

Citrus fruits

Coronary vasodilator: nitrates

Contraceptive pill

Migraine Headache, symptoms: PUPIL

Pulsatile quality

Unilateral location

Physical activity worsens headache

Inhibits daily activity when present

Location: temporal region of head

Multiple Myeloma, signs and symptoms: POOR FAB

Pathological bone fractures

Osteoporosis

Osteolytic bone lesions on x-ray

Renal insufficiency or failure

Fatigue

Anemia

Bone pain

Myeloproliferative Disorders, clinical and laboratory features: PEPTIC

Pruritus

Ecchymoses

Peptic ulcer disease

Thrombosis

Increased blood levels of: uric acid, LDH, B12, histamine, eosinophils, basophils

Causes: chronic myelogenous leukemia, polycythemia rubra vera, thrombocythemia, myelofibrosis

Myocardial Infarction, Complications of: DARTH VADER

Death

Arrythmia

Rupture

Tamponade

Heart failure

Valve disease

Aneurism of ventricle

Dressler’s syndrome

Embolism

Recurrence

Myocardial Infarction, Medical management: ABCDE

Aspirin

Beta-blocker

Coagulation (ie: thrombolytic; add heparin for anterior MI)

Dilator (ie: ACE inhibitor)

Elevated lipids (measure fasting lipids within 48 hours of admission, and start a statin agent if total cholesterol or LDL are elevated)

Myocardial Infarction (MI), Signs and symptoms: PULSE

Persistent chest pain

Upset stomach

Lightheadedness

Shortness of breath

Excessive sweating

Myocardial Infarction, Therapeutic treatment: O BATMAN!

Oxygen

Beta blocker

Aspirin

Thrombolytics (eg: heparin)

Morphine

ACE inhibitor PRN

Nitroglycerin

Myopia, clinical characteristics: LMMN

Long eyeball is…

Myopic, requiring…

Minus diopter lens for correction, and the patient is…

Nearsighted

N

Nephritic Syndrome with Decreased Complement Levels, causes: LESS Complement

Lupus

Endocarditis

Shunt infection-associated disease

Streptococcal glomerulonephritis

Cryoglobulinemia

Nicotine Effects: MTWTF (days of the week)

Mydriasis/Muscle cramps

Tachycardia

Weakness

Twitching

Hypertension/Hyperglycemia

Fasiculation

O

Obesity in Childhood, complications: FATSO

Furunculosis

Acanthosis nigricans

Triad (1. diabetes mellitus, 2. atherosclerosis, 3. hypertension)

Slipped femoral capital epiphysis

Obesity in adulthood

Occupational Lung Disease, Classification: ASTHMA

Asthma

Silicosis

Toxic gases

Hypersensitivity pneumonitis (ie: extrinsic allergic alveolitis)

Many others

Asbestosis

Oral Contraceptive Pill, absolute contraindications to its use: OCP H^3

Oestrogen-dependent tumors (eg: hepatocellular carcinoma and adenoma, uterine carcinoma, breast carcinoma)

Cardiovascular disorders (ie: thromboembolic, cerebrovascular and coronary artery disease, and moderate to severe hypertension)

Pregnancy

Hepatic disease

Hyperlipidemia

Hemorrhage from vagina not yet diagnosed

Osteoarthritis, radiological features: OSSSteo

Osteophytes

Subchondral sclerosis

Subchondral cysts

Space between joint diminished

teo

Osteoporosis, Causes: COLLES FRACture

Congenital (eg: osteoporosis imperfecta, Ehlers-Danlos, homocysteinuria)

Osteoporosis type 1 (post-menopausal) and type 2 (senile)

Leukemia and other malignancies (eg: multiple myeloma)

Liver disease

Endocrine disease (eg: hyperparathyroidism, hyperthyroidism, acromegaly, Cushing’s syndrome, hypogonadism, diabetes mellitus)

Steroids (ie: corticosteroids)

Familial

Renal disease

Anticonvulsants (eg: phenytoin)

Calcium deficiency (eg: malabsorption)

Osteoporosis Treatment: ABCDE

Activity and exercise

Biphosphonate drugs

Calcium supplementation (eg: 1000 mg/day)

D: vitamin D supplement

Estrogens: for post-menopausal women

Otalgia (Earache), causes of referred Pain: 10 T’s

Teeth

Temporomandibular joint syndrome

Trismus

Trachea

Tube: eustachian tube

Tic douloureux: trigeminal neuralgia

Tonsilar: tonsillitis, cancer

Tongue

Throat: laryngeal carcinoma

Thyroiditis

Ovarian Carcinoma, types: MEGS-GEMS

Metastatic tumors: Krukenberg gastrointestinal, breast, endometrial, lymphoma

Epithelial tumors: serous, mucinous, endometrioid, clear cell, undifferentiated, Brenner’s

Germ cells tumors: dysgerminoma, immature teratoma

Sex cord stromal tumors: granulosa cell, Sertoli-Leydig cell, thecoma

P

Pain History Checklist: CHLORIDE

CHaracter: stabbing, throbbing, etc

Location

Onset

Radiation

Intensity

Duration

Exacerbating and alleviating factors

Pain History Checklist: LOST WAR

Location

Onset

Severity

Time

Worsening factors

Alleviating factors

Radiation

Pancreatitis (Acute), Causes: IGETSMASHED

Idiopathic

Gallstones

Ethanol

Trauma

Steroids

Mumps

Autoimmune (PAN)

Scorpion stings

Hyperlipidemia/ Hypercalcemia

ERCP

Drugs

Papillary Necrosis Causes: SODA

Sickle cell

Obstructive pyelonephritis

Diabetes

Analgesics

Parkinsonism, drugs: SALAD

Selegiline

Anticholinergics: trihexyphenidyl, benzhexol, ophenadrine

L-Dopa and peripheral decarboxylase inhibitor: carbidopa, benserazide

Amantadine

Dopamine postsynaptic receptor antagonists: bromocriptine, lisuride, pergolide

Parkinsonism, essential features: TRAPS

Tremor: resting tremor

Rigidity

Akinesia

Postural changes: stooped

Stare: serpentine stare

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

Pelvic Mass That is Painful, differential diagnosis: CREAM PEA

Cyst (ie: ovarian cyst)

Renal colic

Ectopic pregnancy

Adhesions

Many other causes

Pelvic inflammatory disease

Endometriosis

Appendicitis/appendicial abscess

Penile Pain, differential diagnosis: P^8

Priapism

Phimosis

Paraphimosis

Peyronie’s disease

Penile tumor

Purulence: venereal disease

Prostatitis

Push: coitus-related trauma/overuse

Pepsin-producing cells: chief of Pepsi-Cola

Chief cells of stomach produce Pepsin

Peripheral Polyneuropathy, causes: MMIIDD

Metabolic: diabetes mellitus, amyloidosis, acute intermittent porphyria

Miscellaneous: Guillian-Barre (acute infective polyneuritis)

Infections

Idiopathic

Drugs and chemicals

Deficiency states

Pheochromocytoma, Clinical characteristics: P^8

Palpitations

Pallor

Perspiration

Panic

Paroxysmal attacks

Pain: headache, chest, abdominal

Paradoxical rise in blood pressure with beta-blockers

Pregnancy-associated hypertension in some cases

Pneumonia, community-acquired, non-immunocompromised, causes: C PHLEMS

Chlamydia pneumoniae

Pneumococcus

Haemophilus influenzae

Legionella sp

Everything else

Mycoplasma pneumoniae

Staphylococcus aureus

Post-menopausal Painless Vaginal Bleeding, causes: ACE

Atrophic vaginitis

Cervical carcinoma

Endometrial carcinoma

Post-Traumatic Stress Disorder, symptoms: IRAN

Insomnia and nightmares

Re-experiences of traumatic event at a later date

Arousal is increased

Numbing of general responsiveness to the real world

Potter Syndrome, features: POTTER

Pulmonary hypoplasia

Oligohydrominios

Twisted skin: wrinkly skin

Twisted face: Potter facies

Extremity defects

Renal agenesis: bilateral

Proptosis, causes: THE I

Tumour: retinoblastoma

Hemorrhage: traumatic posterior orbital hematoma

Endocrinopathy: Graves’ disease

Infection: orbital cellulitis

Pupillary Dilation (persistent), causes: 3AM

3rd nerve palsy

Anti-muscarinic eye drops: to facilitate fundoscopy

Myotonic pupil (Holmes Adie pupil): most commonly in young women, with absent/delayed reaction to light and convergence, and of no pathological significance

Q

R

Rheumatic Fever, Jones’ major diagnostic criteria: ACCES

Arthritis (ie: migratory arthritis)

Carditis

Chorea (ie: Sydenham’s chorea or St Vidas’ dance)

Erythema marginatum

Subcutaneous nodules

S

Scalp Layers: SCALP

Skin

Connective tissue

Aponeurosis of Galen

Loose connective tissue

Pericranial tissue

Scarlet Fever, signs and symptoms: SCARLET

Streptococcus pyogenes (ie: causative organism is group A beta-hemolytic streptococcus)

Circumoral pallor

Areas of desquamation of skin (late finding)

Rash (ie: sandpaper scarlatiniform rash, especially in axillae and groin)

Laryngitis/pharyngitis

Elevated temperature

Tongue (ie: initially, white strawberry tongue, then red)

Scoliosis, neuromuscular causes: M^4AC

Muscular dystrophy

Muscular atrophy: spinal muscle atrophy

Myelodysplasia

Mucocutaneous syndromes: neurofibromatosis

Arthrogryposis multiplex congenita

Cerebral palsy

Seizures in the Neonate, causes: H^5I

Hypoxia

Hypoglycemia

Hypocalcemia

Hypomagnesemia

Hemorrhage: periventricular, subarachnoid, subdural

Infection: fever, meningitis, TORCH organisms

Seriously Ill Pediatric Patient, recognition: SAVE A CHILD

Skin: mottled, cyanotic, petechiae, pallor

Activity: needs assistance, not ambulating, responsive

Ventilation: intercostal retractions, drooling, nasal flaring, respiratory rate, stridor, wheezing

Eye contact: glassy stare, fails to engage examiner

Abuse: unexplained bruising/injuries, inappropriate parent

Cry: high-pitched, cephalic, irritable

Heat: high fever > 41 C, hypothermia < 36 C

Immune system: AIDS, corticosteroids, asplenic, sickle cell

Level of consciousness: irritable, lethargic, convulsions, unresponsive

Dehydration: % of total weight lost with 1 mL = 1 g, capillary refill, fontanelle, mucous membranes, cold hands/feet, voiding, diarrhea, vomiting

SAVE: Observations made prior to touching the child

CHILD: History from caretaker and brief exam

Sexual Development in the Female, stages of: ABCDE

Accelerated growth: height

Breast development

Cunnus hair: vaginal

Distal hair growth: axillae

Endometrial sloughing: menarche

Shoulder Dislocation Posteriorally, causes: 3 E’s

Epileptic seizure

Ethanol intoxication

Electrical injury: electrocution, electroconvulsive therapy

Splenomegaly, causes: CHICAGO

Cancer

Hem, onc

Infection

Congestion (portal hypertension)

Autoimmune (RA, SLE)

Glycogen storage disorders

Other (amyloidosis)

Splenomegaly, causes: CHINA

Congestion/cellular infiltration

Hematological (eg: hemolytic anemia, sickle cell)

Infection/infarction (eg: malaria, GF, CMV)

Neoplasia (eg: CML, lymphoma, other myeloproliferative)

Autoimmune

Splenomegaly, causes: IBM PCM

Infectious (eg: viral: Epstein-Barr, herpes; parasitic: malaria, schistosomiasis, babesiosis, kala-azar = visceral Leishmanniasis; bacterial: subacute bacterial endocarditis)

Blood disease (eg: hemolytic anemia, hereditary spherocytosis, hemoglobinopathies (ie: sickle-cell disease, thalassemias)

Malignancy (eg: Hodgkin’s lymphoma, leukemias)

Portal hypertension (ie: Banti’s syndrome)

Connective tissue disease (eg: sarcoidosis, systemic lupus erythematosus, polyarteritis nodosa)

Miscellaneous (eg: Gaucher’s disease, Niemann-Pick disease)

Stroke, etiology: LLACC

Lacunar: seen in basal ganglia and brain stem

Large-artery disease: Takayasu’s arteritis, syphillis

Atherosclerotic: carotid artery-to-cerebral artery embolism

Cargiogenic: atheroma, bacterial vegetations in endocarditis

Coagulable (ie: hypercoagulable) states

Stroke, risk factors: HEADS

Hypertension/Hyperlipidemia

Elderly

Atrial fibrillation (a fib)

Diabetes mellitus/Drugs (cocaine)

Smoking/Sex (male)

Stroke, symptoms: FAST

If you act FAST, treatment is possible. Timing is key. The faster you act, the less likely disability or death will occur.

Face looks uneven: Ask them to smile. Does one side of the face droop?

Arm hanging down: Ask them to raise both arms. Does one arm drift downward?

Speech slurred: Ask them to repeat a phrase. Does the speech sound odd?

Time is vital: If any of these signs are present, call emergency services right away.

Suicide, risk factors: SAD

Schizophrenia

Alcohol abuse

Depression

Suicide, risk scale: SAD PERSONS

Sex: male

Above 40 years of age

Depression

Previous suicide attempt

Ethanol abuse

Rational thinking lost

Support systems lost

Organized suicide plan

No spouse

Sickness: physical illness

If score 0-2: send home with family or friend

If 3-4: arrange cose follow-up or consider short admission

If 5-6: strongly consider hospitalization

If 7-10: hospitalize and watch closely

Synovial Fluid Analysis, 3 necessary tests: 3 C’s

Cell count and differential

Crystal examination

Culture and gram stain

Systemic Lupus Erythematosus (SLE), 11 diagnostic criteria: PRUNE RASH

Photosensitivity

Rashes: discoid, malar

Ulcers in mouth

Neurologic: seizures, psychosis

Elevated blood tests: raised antinuclear antibody, positive SLE cells seen, positive anti-double-stranded DNA antibody, positive anti-smooth muscle antibody, false-positive VDRL test

Renal: proteinuria, hematuria, cellular casts

Arthritis: non-erosive

Serositis: pleuritis, pericarditis, peritonitis

Hematologic: hemolytic anemia, leukopenia, thrombocytopenia

Need 4 for diagnosis

T

Tachycardia, causes: MD PISH^3

Metabolic (eg: thyrotoxicosis)

Drugs (eg: sympathomimetics, anticholinergics)

Pain

Ischemia

Sepsis

Hypotension

Hypoxia

Hypercarbia

Thickened Nerves, causes: HANDS

Hansen’s: leprosy

Amyloidosis

Neurofibromatosis

Diabetes mellitus

Sarcoidosis

Thyroid Malignancies, Age-associated types: PPMMAAF

Papillary carcinoma seen in Pediatric group

Medullary (parafollicular) carcinoma seen in Middle-aged group

Anaplastic carcinoma seen in Aged group

Follicular carcinoma seen in all groups

Trauma Patient, Initial assessment and management: ABC^4

Airway

Breathing

Circulation

Cervical spine injury

Chest: tension pneumothorax, flail chest, pericardial tamponade

Consciousness: assess level according to the Glasgow Coma Scale (GCS)

Trauma Patient, Initial assessment and management: ABCDEF

Airway/breathing (C-spine stablilization is actually first)

Bleeding sites

Central nervous system

Digestive organs

Excretory organs (ie: urine color, quantity)

Fractures

Tricyclic Antidepressants, side effects: A^4

Anticholinergic: confusion, blurred vision, reduced lacrimation, reduced salivation, heart acceleration (tachycardia), urinary retention, constipation

Antihistaminic: sedation, weight gain

Anti-alpha 1 adrenergic: orthostatic hypotension

Arrhythmogenic: quinidine-like ventricular cardiac effects

Tuberculosis, antibiotics used: STRIPE

STreptomycin

Rifampicin

Isoniazid

Pyrizinamide

Ethambutol

Tuberculosis, treatment: PRIEST

Pyrazinamide

Rifampin

Isoniazid (INH)

Ethambutol

STreptomycin

Tubing and Line Connection Safety: I-TRACE

Illuminate the patient care area whenever invasive medical lines and tubes are manipulated (initiated, accessed, maintained, or discontinued).

Perform hand hygiene. Touch the line or tube and Trace it from the insertion point on the patient back to the point of origin.

Perform a cognitive Review. Think about the purpose and expected outcome of the actions you are about to perform. When line access or connection involves medication delivery, use defined BCMA processes or follow facility guidelines to ensure medication is checked against the medication administration record or prescriber order.

Act if any mismatch between the planned activity and desired outcome is discovered, either through BCMA alerts, independent double checks, or a cognitive review.

Clarify and Correct. Concerns expressed by primary caregivers, colleagues, patients, or family member are valid reasons to seek clarification before proceeding with a task involving lines and tubes. Correct any discrepancies before proceeding with the intervention.

Expect to use I-TRACE Process, each time a line or tube is accessed, manipulated, or discontinued and when care is handed-off to another clinician or care team.

Turner Syndrome, components: CLOWNS

Cardiac abnormalities: coartication

Lymphoedema

Ovaries underdeveloped: sterility, amenorrhea

Webbed neck

Nipples widely spaced

Short

U

Unconsciousness, differential: FISH SHAPED

Fainted

Illness/Infantile febrile convulsions

Shock

Head injuries

Stroke (CVA)

Heart problems

Asphyxia

Poisons

Epilepsy

Diabetes

Unconscious Patient, initial considerations of causes: DEATHH

Diabetes mellitus: causing DKA, non-ketotic hyperosmolar coma, or hypoglycemia

Epilepsy

Alcohol or drugs

Trauma

Hypertension: causing hypertensive encephalopathy or stroke

Heart disease: causing myocardial infarction (MI)

Unconscious Patient, initial treatments when cause unknown: DONT Forget

Dextrose: 50 mL of 50% dextrose IV bolus

Oxygen: 40% by mask

Naloxone (narcan): 1 mg IV initially, to maximum 10 mg

Thiamine: 100 mg IV (give before dextrose)

Flumazenil: 0.1 mg IV push

Urinary Incontinence, causes of acute and reversible: DRIP

Delirium

Restricted mobility/Retention

Inflammation/Infection/Impaction: fecal

Pharmaceuticals/Polyuria

Urinary Tract Infection (UTI), common causative organisms: PEEKS

Proteus

E coli

Enterococcus

Klebsiella

Serratia

Uterine (Endometrial) Carcinoma, risk factors: HEAD

Hypertension

Estrogen Unopposed (ie: post-menopausal estrogen administration, nulliparity, late-onset menopause, polycystic ovary disease, obesity)

Atherosclerosis

Diabetes mellitus

V

Valve Disease, Causes: DIC

Degenerative (most common in North America)

Inflammatory (eg: lupus, rheumatic fever)

Congenital (eg: bicuspid aortic valve, Marfan’s syndrome)

Venous Insufficiency, signs: STUBbED

Stasis dermatitis

Trendelenberg test positive

Ulceration of medial malleolus

Brown pigment coloration

b

Edema

Dependency pain (ie: painful when leg below body level)

Vomiting, Causes of: VOMITING

Vestibular/ Vagal reflex (pain)

Opiates

Migraine/ Metabolic e.g. DKA

Infection

Toxicity (cytotoxic, digoxin)

Increased ICP/ Ingested alcohol

Neurogenic

GI/ Gestation

Vulvar Pruritus, differential diagnosis: ILL DOC

Infection: candidiasis, oxyuris vermicularis (pinworms), trichomonas vaginalis

Lichen sclerosis et atrophicus

Lichen simplex (ie: neurodermatitis)

Diabetes mellitus

Oestrogen deficiency (ie: post-menopausal)

Contact dermatitis

W

Wernicke-Korsakoff’s Psychosis, findings: COAT RACK

Wernicke’s encephalopathy (acute phase):

Confusion

Ophthalmoplegia

Ataxia

Thiamine tx

Korsakoff’s psychosis (chronic phase):

Retrograde amnesia

Anterograde amnesia

Confabulation

Korsakoff’s psychosis

X

Y

Z

Pin this content!

Medical References for Caregivers

Reference:

http://www.stmichaelshospital.com/pdf/research/mapped-medical-mnemonics.pdf