Medical Mnemonics for Examinations: Difference between revisions
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=='''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport== | =='''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport== | ||
''From proximal to distal:'' | ''From proximal to distal:'' | ||
'''D'''uodenum | # '''D'''uodenum | ||
'''J'''ejunum | # '''J'''ejunum | ||
'''I'''leum | # '''I'''leum | ||
'''A'''ppendix | # '''A'''ppendix | ||
'''C'''olon | # '''C'''olon | ||
'''S'''igmoid | # '''S'''igmoid | ||
'''R'''ectum | # '''R'''ectum | ||
=='''D'''ow '''J'''ones '''I'''ndustrial '''C'''limbing '''A'''verage '''C'''losing '''S'''tock '''R'''eport== | =='''D'''ow '''J'''ones '''I'''ndustrial '''C'''limbing '''A'''verage '''C'''losing '''S'''tock '''R'''eport== | ||
''From proximal to distal:'' | ''From proximal to distal:'' | ||
'''D'''uodenum | # '''D'''uodenum | ||
'''J'''ejunum | # '''J'''ejunum | ||
'''I'''leum | # '''I'''leum | ||
'''C'''ecum | # '''C'''ecum | ||
'''A'''ppendix | # '''A'''ppendix | ||
'''C'''olon | # '''C'''olon | ||
'''S'''igmoid | # '''S'''igmoid | ||
'''R'''ectum | # '''R'''ectum | ||
==Causes of Acute Pancreatitis== | ==Causes of Acute Pancreatitis== | ||
"'''GET SMASHED'''" | "'''GET SMASHED'''" | ||
'''G'''all stones | # '''G'''all stones | ||
'''E'''thanol | # '''E'''thanol | ||
'''T'''rauma | # '''T'''rauma | ||
'''S'''teroids | # '''S'''teroids | ||
'''M'''umps | # '''M'''umps | ||
'''A'''utoimmune disease | # '''A'''utoimmune disease | ||
'''S'''corpion venom | # '''S'''corpion venom | ||
'''H'''yperlipidemia | # '''H'''yperlipidemia | ||
'''E'''RCP (dye) | # '''E'''RCP (dye) | ||
'''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine) | # '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine) | ||
Alcohol and Gallstones are most common causes. | Alcohol and Gallstones are the most common causes. | ||
==A-P-G-A-R== | ==A-P-G-A-R== | ||
Score 0-2 at 1 and 5 minutes in each of 5 categories: | Score 0-2 at 1 and 5 minutes in each of 5 categories: | ||
A - Appearance (Color: blue/pale, trunk pink, all pink) | * A - Appearance (Color: blue/pale, trunk pink, all pink) | ||
P - Pulse (Heart rate: 0, <100, 100+) | * P - Pulse (Heart rate: 0, <100, 100+) | ||
G - Grimace (Reflex irritability: 0, grimace, grimace+cough) | * G - Grimace (Reflex irritability: 0, grimace, grimace+cough) | ||
A - Activity (Muscle tone: limp, some, active) | * A - Activity (Muscle tone: limp, some, active) | ||
R - Respiration (Respiratory effort: 0, irregular, regular) | * R - Respiration (Respiratory effort: 0, irregular, regular) | ||
10 is perfect score | 10 is perfect score | ||
| Line 62: | Line 61: | ||
==O-P-Q-R-S-T - eliciting and HPI and exploring symptoms== | ==O-P-Q-R-S-T - eliciting and HPI and exploring symptoms== | ||
'''O''' - '''O'''nset of pain (what was the patient doing when the pain started?) | * '''O''' - '''O'''nset of pain (what was the patient doing when the pain started?) | ||
'''P''' - '''P'''alliative or '''P'''rovocative factors for the pain | * '''P''' - '''P'''alliative or '''P'''rovocative factors for the pain | ||
'''Q''' - '''Q'''uality of pain (burning, stabbing, aching, etc.) | * '''Q''' - '''Q'''uality of pain (burning, stabbing, aching, etc.) | ||
'''R''' - '''R'''adiation (up to jaw, down left arm, etc.) | * '''R''' - '''R'''adiation (up to jaw, down left arm, etc.) | ||
'''S''' - '''S'''everity of pain (usually 1 - 10 scale) | * '''S''' - '''S'''everity of pain (usually 1 - 10 scale) | ||
'''T''' - '''T'''iming of pain (eg: after meals, in the morning, how long it lasts, etc.) | * '''T''' - '''T'''iming of pain (eg: after meals, in the morning, how long it lasts, etc.) | ||
==S-O-C-R-A-T-E-S - exploring the presenting complaint==== | ==S-O-C-R-A-T-E-S - exploring the presenting complaint==== | ||
'''S''' - '''S'''ite of pain | * '''S''' - '''S'''ite of pain | ||
'''O''' - '''O'''nset of pain | * '''O''' - '''O'''nset of pain | ||
'''C''' - '''C'''haracter of pain (dull, sharp, aching, stabbing, tearing etc.) | * '''C''' - '''C'''haracter of pain (dull, sharp, aching, stabbing, tearing etc.) | ||
'''R''' - '''R'''adiation of pain (eg. central abdominal pain radiating to Right Iliac Fossa) | * '''R''' - '''R'''adiation of pain (eg. central abdominal pain radiating to Right Iliac Fossa) | ||
'''A''' - '''A'''ssociated factors (eg. nausea/vomiting) | * '''A''' - '''A'''ssociated factors (eg. nausea/vomiting) | ||
'''T''' - '''T'''iming of pain/duration | * '''T''' - '''T'''iming of pain/duration | ||
'''E''' - '''E'''xacerbating/alleviating factors | * '''E''' - '''E'''xacerbating/alleviating factors | ||
'''S''' - '''S'''everity of pain (usually 1 - 10 scale) | * '''S''' - '''S'''everity of pain (usually 1 - 10 scale) | ||
==A-S-C-L-A-S-T - eliciting and HPI and exploring symptoms==== | ==A-S-C-L-A-S-T - eliciting and HPI and exploring symptoms==== | ||
'''A''' - '''A'''ggravatiing and '''A'''lleviating factors | * '''A''' - '''A'''ggravatiing and '''A'''lleviating factors | ||
'''S''' - '''S'''everity | * '''S''' - '''S'''everity | ||
'''C''' - '''C'''haracter, quality | * '''C''' - '''C'''haracter, quality | ||
'''L''' - '''L'''ocation | * '''L''' - '''L'''ocation | ||
'''A''' - '''A'''ssociated symptoms | * '''A''' - '''A'''ssociated symptoms | ||
'''S''' - '''S'''etting | * '''S''' - '''S'''etting | ||
'''T''' - '''T'''iming | * '''T''' - '''T'''iming | ||
NOTE: ASCLAST means let the patient talk first, then ask him/her specific questions. | NOTE: ASCLAST means let the patient talk first, then ask him/her specific questions. | ||
==The five '''W''''s--post-operative fever== | ==The five '''W''''s--post-operative fever== | ||
'''W'''ind - pneumonia, atelectasis | * '''W'''ind - pneumonia, atelectasis | ||
'''W'''ound - wound infections | * '''W'''ound - wound infections | ||
'''W'''ater - urinary tract infection | * '''W'''ater - urinary tract infection | ||
'''W'''alking - walking can help reduce deep vein thromboses and pulmonary embolus | * '''W'''alking - walking can help reduce deep vein thromboses and pulmonary embolus | ||
'''W'''onderdrugs - especially anesthesia | * '''W'''onderdrugs - especially anesthesia | ||
==Predisposing Conditions for Pulmonary Embolism: '''TOM SCH PREFER'''== | ==Predisposing Conditions for Pulmonary Embolism: '''TOM SCH PREFER'''== | ||
'''T''' - '''T'''rauma | * '''T''' - '''T'''rauma | ||
'''O''' - '''O'''besity | * '''O''' - '''O'''besity | ||
'''M''' - '''M'''alignancy | * '''M''' - '''M'''alignancy | ||
'''S''' - '''S'''urgery | * '''S''' - '''S'''urgery | ||
'''C''' - '''C'''ardiac disease | * '''C''' - '''C'''ardiac disease | ||
'''H''' - '''H'''ospitalization | * '''H''' - '''H'''ospitalization | ||
'''P''' - '''P'''ast history | * '''P''' - '''P'''ast history | ||
'''R''' - '''R'''est (bed-bound) | * '''R''' - '''R'''est (bed-bound) | ||
'''E''' - '''E'''strogen, pregnancy, post-partum | * '''E''' - '''E'''strogen, pregnancy, post-partum | ||
'''F''' - '''F'''racture | * '''F''' - '''F'''racture | ||
'''E''' - '''E'''lderly | * '''E''' - '''E'''lderly | ||
'''R''' - '''R'''oad trip | * '''R''' - '''R'''oad trip | ||
==6 '''P''' 's== | ==6 '''P''' 's== | ||
ARTERIAL OCCLUSION (Signs of Compartment Syndrome) | ARTERIAL OCCLUSION (Signs of Compartment Syndrome) | ||
* Pain | #* Pain | ||
* Paleness (Pallor) | #* Paleness (Pallor) | ||
* Perishing with Cold (Poikilothermia) | #* Perishing with Cold (Poikilothermia) | ||
* Pulselessness | #* Pulselessness | ||
* Paresthesias | #* Paresthesias | ||
* Paralysis | #* Paralysis | ||
==DAVE WILMINGTON== | ==DAVE WILMINGTON== | ||
| Line 164: | Line 163: | ||
*Congenital | *Congenital | ||
== | ==Metabolic Acidosis Causes== | ||
MUDPILES | |||
* '''M'''ethanol poisoning | * '''M'''ethanol poisoning | ||
* '''U'''remia | * '''U'''remia | ||
| Line 175: | Line 174: | ||
* '''S'''alicylate ingestion | * '''S'''alicylate ingestion | ||
== Causes | ==Hypercalcemia Causes== | ||
'''PAM SCHMIDT''' | '''PAM SCHMIDT''' | ||
'''P'''aget's Disease | * '''P'''aget's Disease | ||
'''A'''myloid | * '''A'''myloid | ||
'''M'''ultiple Myeloma | * '''M'''ultiple Myeloma | ||
'''S'''arcoid | * '''S'''arcoid | ||
'''C'''ancer | * '''C'''ancer | ||
'''H'''ormomal (para-thyroid) | * '''H'''ormomal (para-thyroid) | ||
'''M'''ilk-alkali Syndrome | * '''M'''ilk-alkali Syndrome | ||
'''I'''mmobilization | * '''I'''mmobilization | ||
'''D'''-vitamin overdose | * '''D'''-vitamin overdose | ||
'''T'''hyrotoxicosis | * '''T'''hyrotoxicosis | ||
OR | |||
* '''MISHAP''' | |||
* Malignancy | |||
* Intoxication (hypervitaminosis) | |||
* Sarcoidosis | |||
* Hyperparathyroidism | |||
* Alkali (Milk) syndrome | |||
* Paget's Disease (bone) | |||
* <font color="#000000"></font> | |||
also consider Addison's Disease, thiazide diuretics and simple lab error | also consider Addison's Disease, thiazide diuretics and simple lab error | ||
==5 SIGNS OF INFLAMMATION (as described by Celsus) | ==5 SIGNS OF INFLAMMATION (as described by Celsus)== | ||
# Redness/Erythema (Rubor) | |||
# Raised temperature (Calor) | |||
# Swelling (Tumor) | |||
# Pain (Dolor) | |||
# Loss of Function (Functio Laesa) | |||
== | ==Hypersentivity Reactions (Gell & Goombs Classification)== | ||
(Gell & Goombs | ACID OR'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill | ||
'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill | # Type I '''A'''naphylaxis | ||
Type I '''A'''naphylaxis | # Type II '''C'''ytotoxic-mediated | ||
Type II '''C'''ytotoxic-mediated | # Type III '''I'''mmune-complex | ||
Type III '''I'''mmune-complex | # Type IV '''D'''elayed hypersensitivity | ||
Type IV '''D'''elayed hypersensitivity | |||
=='''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas== | =='''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas== | ||
| Line 226: | Line 233: | ||
* '''B'''asophils '''1'''% | * '''B'''asophils '''1'''% | ||
=='''Sunday Hot Day, Better Give Iced Fluids Today!''' | ==Malignant Hyperthermia Treatment== | ||
'''Sunday Hot Day, Better Give Iced Fluids Today!''' | |||
S: Stop all triggering agents, give 100% O2 | * S: Stop all triggering agents, give 100% O2 | ||
H: Hyperventillate | * H: Hyperventillate | ||
D: Dantrolene 2.5 mg/kg | * D: Dantrolene 2.5 mg/kg | ||
B: Bicarbonate | * B: Bicarbonate | ||
G: Glucose and Insulin | * G: Glucose and Insulin | ||
I: IV Fluids, Cooling Blanket | * I: IV Fluids, Cooling Blanket | ||
F: Fluid Output; Furosemide | * F: Fluid Output; Furosemide | ||
T: Tachycardia, be prepared to treat V Tach | * T: Tachycardia, be prepared to treat V Tach | ||
'''M''' == '''M'''ultiple myeloma, '''M'''etastasis from breast, prostate, lung, thyroid, kidney CA | ==Back Pain Causes== | ||
'''A''' == '''A'''neurysm, '''A'''bdominal pain referred to the back (see acute abdominal pain) | '''DISK MASS''' | ||
'''S''' == '''S'''lipped disk, '''S'''pondylolisthesis | * '''D''' == '''D'''egeneration: DJD, Osteoporosis, spondylosis | ||
'''S''' == '''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster | * '''I''' == '''I'''nfection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture | ||
* '''S''' == '''S'''pondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE) | |||
* '''K''' == '''K'''idney stones/infarction/infection (pyelo/abscess) | |||
* '''M''' == '''M'''ultiple myeloma, '''M'''etastasis from breast, prostate, lung, thyroid, kidney CA | |||
* '''A''' == '''A'''neurysm, '''A'''bdominal pain referred to the back (see acute abdominal pain) | |||
* '''S''' == '''S'''lipped disk, '''S'''pondylolisthesis | |||
* '''S''' == '''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster | |||
== | ==Syncope Management== | ||
If the face is red, raise the head | * If the face is red, raise the head! | ||
If the face is pale, raise the tail! | * If the face is pale, raise the tail! | ||
==BRACHIAL PLEXUS== | ==BRACHIAL PLEXUS== | ||
Roots, Trunks, Divisions, Cords, Branches: | Roots, Trunks, Divisions, Cords, Branches: | ||
* Radical Teachers Drink Cold Beers | * Radical Teachers Drink Cold Beers | ||
* Randy Travis Drinks Cold Beers | * Randy Travis Drinks Cold Beers | ||
| Line 262: | Line 267: | ||
==CRANIAL NERVES== | ==CRANIAL NERVES== | ||
* On Old Olympus Towering Tops, A Finn And German Viewed Some Hops | * On Old Olympus Towering Tops, A Finn And German Viewed Some Hops | ||
* Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen | * Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen | ||
# I - olfactory | |||
# II - optic | |||
# III - oculomotor | |||
# IV - trochlear | |||
# V - trigeminal | |||
# VI - abducens | |||
# VII - facial | |||
# VIII - acoustic (vestibulocochlear) | |||
# IX - glossophrayngeal | |||
# X - vagus | |||
# XI - accessory | |||
# XII - hypoglossal | |||
==LR6 SO4 3== | ==LR6 SO4 3== | ||
| Line 291: | Line 296: | ||
* Ten Zulus Buggered My Cat | * Ten Zulus Buggered My Cat | ||
==INNERVATION | ==PENIS INNERVATION== | ||
"'''P'''oint and '''S'''hoot" | |||
* '''P'''arasympathetic causes erection | |||
* '''S'''ympathetic causes ejaculation | |||
"S2, 3, 4 keep the penis off the floor" | |||
* Innervation of the penis by branches of the pudendal nerve, derived from spinal cord levels S2-4 | * Innervation of the penis by branches of the pudendal nerve, derived from spinal cord levels S2-4 | ||
==ABC'S | ==Aorta Branches== | ||
* | '''ABC'S''' | ||
* '''A'''ortic arch gives off the | |||
* '''B'''racheiocephalic trunk | |||
* the left '''C'''ommon Carotid, and the left Subclavian artery | |||
=='''N(AVEL) | ==Femoral Triangle Structures in Order== | ||
'''N(AVEL)'' | |||
* Nerve | * Nerve | ||
* Artery | * Artery | ||
| Line 309: | Line 321: | ||
NOTE: Parenthesis includes things contained in the femoral sheath. | NOTE: Parenthesis includes things contained in the femoral sheath. | ||
==Hurler | ==Hurler Syndrome Features== | ||
'''HURLER'S''' | |||
*Heptosplenomegaly | *Heptosplenomegaly | ||
*Ugly facies | *Ugly facies | ||
| Line 320: | Line 333: | ||
=='''CHILD HAS PROBLEM!'''== | =='''CHILD HAS PROBLEM!'''== | ||
''Down syndrome features'' | ''Down syndrome features'' | ||
* | * '''C'''ongenital heart disease/ '''C'''ataracts | ||
* | * '''H'''ypotonia/ Hypothyroidism | ||
* | * '''I'''ncure 5th finger/ '''I'''ncreased gap between 1st and 2nd toe | ||
* | * '''L'''eukemia risk x2/ '''L'''ung problem | ||
* | * '''D'''uodenal atresia/ '''D'''elayed development | ||
* | * '''H'''irshsprung's disease/ '''H'''earing loss | ||
* | * '''A'''lzheimer's disease/ Alantoaxial instability | ||
* Squint/ Short neck | * Squint/ Short neck | ||
Revision as of 15:37, 31 January 2014
Dow Jones Industrial Average Closing Stock Report
From proximal to distal:
- Duodenum
- Jejunum
- Ileum
- Appendix
- Colon
- Sigmoid
- Rectum
Dow Jones Industrial Climbing Average Closing Stock Report
From proximal to distal:
- Duodenum
- Jejunum
- Ileum
- Cecum
- Appendix
- Colon
- Sigmoid
- Rectum
Causes of Acute Pancreatitis
"GET SMASHED"
- Gall stones
- Ethanol
- Trauma
- Steroids
- Mumps
- Autoimmune disease
- Scorpion venom
- Hyperlipidemia
- ERCP (dye)
- Drugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
Alcohol and Gallstones are the most common causes.
A-P-G-A-R
Score 0-2 at 1 and 5 minutes in each of 5 categories:
- A - Appearance (Color: blue/pale, trunk pink, all pink)
- P - Pulse (Heart rate: 0, <100, 100+)
- G - Grimace (Reflex irritability: 0, grimace, grimace+cough)
- A - Activity (Muscle tone: limp, some, active)
- R - Respiration (Respiratory effort: 0, irregular, regular)
10 is perfect score
Multiple Endocrine Neoplasia (MEN)
Each of the MENs is a disease of three or two letters plus a feature, and all are Autosomal Dominant inheritance.
- MEN I is a disease of 3 P's (pituitary, parathyroid, and pancreas) plus adrenal cortex
- MEN II is a disease of 2 C's(carcinoma of thyroid and catacholamines [pheochromocytoma]) plus parathyroid for MEN IIa or mucocutaneous neuromas for MEN IIB (aka MEN III)
- Acute pneumonia caused by Pyogenic bacteria--PMN infiltrate
- Acute pneumonia caused by Miscellaneous microbes--Mononuclear infiltrate
- Takayasu's disease = pulseless disease, therefore when you have Takayasu's, I can't Tak'a yu pulse.
CAGE - alcohol use screening
- Have you ever felt it necessary to CUT DOWN on your drinking?
- Have you ever been ANNOYED when people suggest you cut down on your drinking?
- Have you ever felt GUILTY about your drinking?
- Have you ever felt the need to have a drink in the morning for an EYE OPENER?
O-P-Q-R-S-T - eliciting and HPI and exploring symptoms
- O - Onset of pain (what was the patient doing when the pain started?)
- P - Palliative or Provocative factors for the pain
- Q - Quality of pain (burning, stabbing, aching, etc.)
- R - Radiation (up to jaw, down left arm, etc.)
- S - Severity of pain (usually 1 - 10 scale)
- T - Timing of pain (eg: after meals, in the morning, how long it lasts, etc.)
S-O-C-R-A-T-E-S - exploring the presenting complaint==
- S - Site of pain
- O - Onset of pain
- C - Character of pain (dull, sharp, aching, stabbing, tearing etc.)
- R - Radiation of pain (eg. central abdominal pain radiating to Right Iliac Fossa)
- A - Associated factors (eg. nausea/vomiting)
- T - Timing of pain/duration
- E - Exacerbating/alleviating factors
- S - Severity of pain (usually 1 - 10 scale)
A-S-C-L-A-S-T - eliciting and HPI and exploring symptoms==
- A - Aggravatiing and Alleviating factors
- S - Severity
- C - Character, quality
- L - Location
- A - Associated symptoms
- S - Setting
- T - Timing
NOTE: ASCLAST means let the patient talk first, then ask him/her specific questions.
The five W's--post-operative fever
- Wind - pneumonia, atelectasis
- Wound - wound infections
- Water - urinary tract infection
- Walking - walking can help reduce deep vein thromboses and pulmonary embolus
- Wonderdrugs - especially anesthesia
Predisposing Conditions for Pulmonary Embolism: TOM SCH PREFER
- T - Trauma
- O - Obesity
- M - Malignancy
- S - Surgery
- C - Cardiac disease
- H - Hospitalization
- P - Past history
- R - Rest (bed-bound)
- E - Estrogen, pregnancy, post-partum
- F - Fracture
- E - Elderly
- R - Road trip
6 P 's
ARTERIAL OCCLUSION (Signs of Compartment Syndrome)
- Pain
- Paleness (Pallor)
- Perishing with Cold (Poikilothermia)
- Pulselessness
- Paresthesias
- Paralysis
DAVE WILMINGTON
To write Admission Orders to Hospital (After noting date and time of Admission as well as Diagnosis and Condition (ADC), use the mnemonic to ensure all areas are addressed, but not all apply to every patient)
- Diet
- Activity
- Vital signs (how often)
- Excrement (test urine / stool)
- Weight (how often to monitor)
- I / O (monitor input / output)
- Labs (what, how often)
- Meds (which, route, interval)
- I V fluids (what and at what rate)
- Nursing care (e.g. position, wound care, up in chair, ostomy care etc)
- General care (e.g. Physical Therapy, Respiratory Thearpy etc)
- Tests (X-ray, EKG, EEG etc)
- Observe for reaction, seizure, neuro exams
- Notify parameters (e.g. Temp > 100 / respiration changes)
More standard is ADC VAAN DIML (pronounced ADC van dim(e)l)
Admit (23 hours, full admit, service of attending,...) Diagnosis Condition ("Stable", "Guarded", etc.) Vitals (post-op, routine, q 1 hour, etc.) Allergies Activities (Strict bed rest, fall precautions, ad lib, bathroom privileges, etc.) Nursing (Strict I&O's, Daily weights, Call P.R.N. whatever, etc.) Diet (NPO, Regular, Clears - advance diet as tolerated, 2000 cal ADA, renal, etc.) IV fluids (D5 1/2 NS c 20 KCL at 110 ml/hr, LR @ 100 ml/hr, etc.) Meds (scheduled and PRN's) Labs and x-ray (CBC in AM, PCXR in PACU, etc.)
Note that IV fluids follows Diet. If one writes NPO, then all such patients get maintenance fluids (use the 4-2-1 rule).
VITAMIN C
Causes of Diseases
- Vascular
- Infectious
- Trauma
- Auto-immune
- Metabolic
- Idiopathic/Iatrogenic
- Neoplastic
- Congenital
Metabolic Acidosis Causes
MUDPILES
- Methanol poisoning
- Uremia
- Diabetic Keto-acidosis
- Para-aldehyde ingestion
- Ischemia
- Lactic Acidosis
- Ethanol poisoning
- Salicylate ingestion
Hypercalcemia Causes
PAM SCHMIDT
- Paget's Disease
- Amyloid
- Multiple Myeloma
- Sarcoid
- Cancer
- Hormomal (para-thyroid)
- Milk-alkali Syndrome
- Immobilization
- D-vitamin overdose
- Thyrotoxicosis
OR
- MISHAP
- Malignancy
- Intoxication (hypervitaminosis)
- Sarcoidosis
- Hyperparathyroidism
- Alkali (Milk) syndrome
- Paget's Disease (bone)
also consider Addison's Disease, thiazide diuretics and simple lab error
5 SIGNS OF INFLAMMATION (as described by Celsus)
- Redness/Erythema (Rubor)
- Raised temperature (Calor)
- Swelling (Tumor)
- Pain (Dolor)
- Loss of Function (Functio Laesa)
Hypersentivity Reactions (Gell & Goombs Classification)
ACID ORAnna Cycled Immediately Downhill
- Type I Anaphylaxis
- Type II Cytotoxic-mediated
- Type III Immune-complex
- Type IV Delayed hypersensitivity
Never Let Monkeys Eat Bananas
- Neutrophils 60%
- Lymphocytes 30%
- Monocytes 6%
- Eosinophils 3%
- Basophils 1%
Never Let Mom Eat Beans" and "60, 30, 6, 3, 1
- Neutrophils 60%
- Lymphocytes 30%
- Monocytes 6%
- Eosinophils 3%
- Basophils 1%
Nice Ladies Make Easter Bread" and "60, 30, 6, 3, 1
- Neutrophils 60%
- Lymphocytes 30%
- Monocytes 6%
- Eosinophils 3%
- Basophils 1%
Malignant Hyperthermia Treatment
Sunday Hot Day, Better Give Iced Fluids Today!
- S: Stop all triggering agents, give 100% O2
- H: Hyperventillate
- D: Dantrolene 2.5 mg/kg
- B: Bicarbonate
- G: Glucose and Insulin
- I: IV Fluids, Cooling Blanket
- F: Fluid Output; Furosemide
- T: Tachycardia, be prepared to treat V Tach
Back Pain Causes
DISK MASS
- D == Degeneration: DJD, Osteoporosis, spondylosis
- I == Infection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture
- S == Spondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
- K == Kidney stones/infarction/infection (pyelo/abscess)
- M == Multiple myeloma, Metastasis from breast, prostate, lung, thyroid, kidney CA
- A == Aneurysm, Abdominal pain referred to the back (see acute abdominal pain)
- S == Slipped disk, Spondylolisthesis
- S == Strain, Scoliosis/lordosis, Skin: herpes zoster
Syncope Management
- If the face is red, raise the head!
- If the face is pale, raise the tail!
BRACHIAL PLEXUS
Roots, Trunks, Divisions, Cords, Branches:
- Radical Teachers Drink Cold Beers
- Randy Travis Drinks Cold Beers
- Robert Taylor Drinks Cold Beer
- Red Trucks Drive Cats Nuts
CRANIAL NERVES
- On Old Olympus Towering Tops, A Finn And German Viewed Some Hops
- Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen
- I - olfactory
- II - optic
- III - oculomotor
- IV - trochlear
- V - trigeminal
- VI - abducens
- VII - facial
- VIII - acoustic (vestibulocochlear)
- IX - glossophrayngeal
- X - vagus
- XI - accessory
- XII - hypoglossal
LR6 SO4 3
- LR6 - Lateral Rectus --> CN VI Abducens
- SO4 - Superior Oblique --> CN IV Trochlear
- 3 - The remaining 4 eyeball movers --> CN III Occulomotor
- or LAST: LA = Lateral Rectus - Abducens Nerve, ST = Superior Oblique - Trochlear Nerve
BRANCHES OF FACIAL NERVE
Temporal, Zygomatic, Buccal, Mandibular, Cervical
- Two Zebras Bought My Car
- Two Zebras Bit My Cookie
- To Zanzibar By Motor Car
- Ten Zulus Buggered My Cat
PENIS INNERVATION
"Point and Shoot"
- Parasympathetic causes erection
- Sympathetic causes ejaculation
"S2, 3, 4 keep the penis off the floor"
- Innervation of the penis by branches of the pudendal nerve, derived from spinal cord levels S2-4
Aorta Branches
ABC'S
- Aortic arch gives off the
- Bracheiocephalic trunk
- the left Common Carotid, and the left Subclavian artery
Femoral Triangle Structures in Order
'N(AVEL)
- Nerve
- Artery
- Vein
- Empty space
- Lymphatics
NOTE: Parenthesis includes things contained in the femoral sheath.
Hurler Syndrome Features
HURLER'S
- Heptosplenomegaly
- Ugly facies
- Recessive (AR inheritance)
- L-iduronidase deficiency (alpha)
- Eyes clouded
- Retarded Short/
- Stubby fingers
CHILD HAS PROBLEM!
Down syndrome features
- Congenital heart disease/ Cataracts
- Hypotonia/ Hypothyroidism
- Incure 5th finger/ Increased gap between 1st and 2nd toe
- Leukemia risk x2/ Lung problem
- Duodenal atresia/ Delayed development
- Hirshsprung's disease/ Hearing loss
- Alzheimer's disease/ Alantoaxial instability
- Squint/ Short neck
- Protruding tongue/ Palm crease
- Round face/ Rolling eye (nystagmus)
- Occiput flat/ Oblique eye fissure
- Brushfield spot/ Brachycephaly
- Low nasal bridge/ Language problem
- Epicanthic fold/ Ear folded
- Mental retardation/ Myoclonus
Drink at 21
Down Syndrome - Chromosome 21
Puberty at 13
Patau's Syndrome - Chromosome 13
Election voter at 18
Edward's Syndrome - Chromosome 18
Down syndrome pathology DOWN
Decreased alpha-fetoprotein and unconjugated estriol (maternal) One extra chromosome twenty-one Women of advanced age Non-disjunction during maternal meiosis
CUT the PY (cut the pie)
Pyrimidines nucleotides
- Cytosine
- Uracil
- Thiamine the
- PYrimidines
CATCH 22
DiGeorge/ Velocardiofacial syndrome
- Cardiac abnormalities
- Abnormal facies
- Thymic aplasia
- Cleft palate
- Hypocalcemia
- 22q11 deletion
MARFAN
- Mitral valve prolapse
- Aortic Aneurysm
- Retinal detachment
- Fibrillin
- Arachnodactyly
- Negative Nitroprusside test (differentiates from homocystinuria)
Go Sally Go! Make Children!
Cell cycle stages
- G1 phase (Growth phase 1)
- S phase (DNA Synthesis)
- G2 phase (Growth phase 2)
- M phase (Mitosis)
- C phase (Cytokinesis)
APKD
ADult Polycystic Kidney Disease is Autosomal Dominant Also, "Polycystic kidney" has 16 letters and is due to a defect on chromosome 16.
Essential Amino Acids
PriVaTe TIM HALL
- Phe, Val, Thr, Trp, Ile, Met, His, Arg, Leu, Lys
Urea Cycle
Ordinarily, Careless Crappers, Are Also Frivolous About Urination.
- Ornithine
- Carbamoyl
- Citrulline
- Aspartate
- Arginosuccinate
- Fumarate
- Arginine
- Urea
People Meet And Talk
Cell division
- Prophase
- Metaphase
- Anaphase
- Telophase
5P 's for acute intermittent porphyria
- Pain in abdomen
- Polyneuropathy
- Psychologial abnormalities
- Pink urine
- Precipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)
ABCD for BUN & creatinine elevation
- Azotremia (pre-renal)
- Bleeding (GI)
- Catabolic status
- Diet (high protein parenteral nutrition)
G6PD: oxidant drugs inducing hemolytic anemia AAA
Antibiotic (eg: sufamethoxazole) Antimalarial (eg: primaquine) Antipyretics (eg: acetanilid, but not aspirin or acetaminophen) Vitamin B3 (niacin, nicotinic acid) deficiency: pellagra
The 3D 's of pellagra
Pellegra: Vitamin B3 (niacin, nicotinic acid) deficiency
- Dermatitis
- Diarrhea
- Dementia
Pompe's disease: type "Police = Po + lys"
Pompe's disease is a lysosomal storage disease (alpha 1,4 glucosidase).
Metabolic acidosis (normal anion-gap) causes
- With hyperkalemia: RAISE K+:
RTA type 4 Aldosterone or mineralocorticord deficiency Iatrogenic: NH4Cl, HCl "Stenosis": obstructive uropathy Early uremia
- With hypokalemia: ReDUCE K+:
Renal TA type 1 and 2
Diarrhoea
Urine diversion into gut
Carbonate anhydrase inhibitor
Ex-hyperventilation
Galactosaemia: enzyme deficiency
GALIPUT: Galactose 1 Phosphate Uridyl Transferase. • There is an assay called the Galiput test for this.
==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
The FAT cat is in the ADEK (attic)
Vitamins: which are fat soluble Fat soluble vitamins are A,D,E,K.
Hemoglobin binding curve: causes of shift to right
"CADET, face right!"
- C = Increase in carbon dioxide
- A = Acidosis (low ph)
- D = Increase in 2,3 DPG aka 2,3 BPG
- E = Exercise
- T = increase in temperature
G proteins for respective receptors
"QISS & QIQ" (Kiss and Kick):
G-proteins and their respective receptors (alphabetical order)
Q: alpha 1 I: alpha 2 S: beta 1 S: beta 2 & Q: M1 I: M2 Q: M3
Adrenaline mechanism
"ABC of Adrenaline":
- Adrenaline--> activates
- Beta receptors--> increases
- Cyclic AMP
Carbon monoxide: electron transport chain target
"CO blocks CO" Carbon monoxide (CO) blocks Cytochrome Oxidase (CO)
Metabolism sites
"Use both arms to HUG": Heme synthesis Urea cycle Gluconeogenesis • These reactions occur in both cytoplasm and mitochondria.
AcetylCoA and acetacetylCoA
"A Lighter Lease" (A LyTr LeIs): amino acids forming them
- A=AcetylCoA or Acetoacetyl CoA
- Ly=Lysine
- Tr=Tryptophan
- Le=Leucine
- Is=Isoleucine
Fasting state: branched-chain amino acids used by skeletal muscles
"Muscles LIVe fast":
- Leucine
- Isoleucine
- Valine
Glycolysis steps
"Goodness Gracious, Father Franklin Did Go By Picking Pumpkins (to) Prepare Pies":
- Glucose
- Glucose-6-P
- Fructose-6-P
- Fructose-1,6-diP
- Dihydroxyacetone-P
- Glyceraldehyde-P
- 1,3-Biphosphoglycerate
- 3-Phosphoglycerate
- 2-Phosphoglycerate (to)
- Phosphoenolpyruvate [PEP] Pyruvate • 'Did', 'By' and 'Pies' tell you the first part of those three: di-, bi-, and py-.
• 'PrEPare' tells location of PEP in the process.
Glycolysis Enzymes
“Hungry Peter Pan And The Growling Pink Panther Eat Pies” Hexokinase Phosphohexo isomerase Phosphofructokinase-1 (6-phosphofructo-1 kinase) Aldolase, Triose phosphate isomerase Glyceraldehyde 3-phosphate dehydrogenase Phosphoglycerate kinase Phosphoglycerate mutase Enolase Pyruvate kinase
Citric acid cycle compounds
"Our City Is Kept Safe And Sound From Malice": Oxaloacetate Citrate Isocitrate alpha-Ketoglutarate Succinyl-CoA Succinate Fumarate Malate
Citric acid cycle compounds
"Can I Keep Selling Sex For Money, Officer?":
- Citrate
- Isocitrate
- alpha-Ketogluterate
- Succinyl CoA
- Succinate
- Fumerate
- Malate
- Oxaloacetate
Citric acid cycle compounds
"Oh! Can I Keep Some Succinate For Myself?":
- Oxaloacetate
- Citrate
- Isocitrate, alpha-Ketoglutarate
- Succinyl CoA
- Succinate
- Fumarate
- Malate
Citric acid cycle compounds
"Oh Citric Acid Is Of (course) A SiLly STupid Funny Molecule":
- Oxaloacetate
- Citrate
- Isocitrate, alpha-Ketoglutarate
- Succinyl CoA
- Succinate
- Fumarate
- Malate
Citrate Cycle Enzymes
"Corrupt Anti Intelligence Agent Spoke Slander For Money."
- Citrate synthatase
- aconitase
- Isocitrate dehydrogenase
- Alpha ketogluturate dehydrogenase
- Succinyl CoA synthetase
- Succinate dehydrogenase
- Fumarase
- Malate Dehydrogenase
Fabry's disease: FABRY'S
- Foam cells found in glomeruli and tubules/ Febrile episodes
- Alpha galactosidase A deficiency/ Angiokeratomas
- Burning pain in extremities/ BUN increased in serum/ Boys
- Renal failure
- YX genotype (male, X linked recessive)
- Sphingolipidoses
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: Phe Val Thr Trp Ile Met His Arg Leu Lys Pvt. is short for Private in the military. Arg and His are considered semiessential. Alternatively: "MATT VIL PHLy".
Golgi complex: functions
"Golgi Distributes A SPAM": Distributes proteins and lipids from ER Add mannose onto specific lysosome proteins Sulfation of sugars and slected tyrosine Proteoglycan assembly Add O-oligosugars to serine and threnonine Modify N-ologosugars on asparagine
Catabolism steps of branched chain amino acids
"Truck hit the Ox to Death":
- Transamination
- Oxidative decarboxylation
- Dehydrogenation
Niacin deficiency
The famous 4 D's:
- Diarrhea
- Dermatitis
- Dementia
- Death (if untreated)
Creatine phosphate: amino acid precursors
"Nice GAMs!":
- Glycine
- Arginine
- Methionine
Enzymes: classification
"Over The HILL":
- Oxidoreductases
- Transferases
- Hydrolases
- Isomerases
- Ligases
- Lyases
COLLAGEN
- C-terminal propeptide (procollagen)/ Covalent Cross links/ C vitamin/ Connective tissue/ Cartilage/ Chondroblasts/ Copper Cofactor (Covalent Cross linking)
- Outside the cell is where collagen normally functions/ Osteoblasts/ Osteogenesis imperfecta
- Lysyl hydroxylase/ Lysyl oxidase (oxidatively deaminates lysyl and hydroxylysyl residues to form collagen cross links, last
- biosynthesis step)
- Long triple helical fibers/ Ligaments
- Alpha chains/ Attached by H bonds form triple helix/ Ascorbate for hydroxylation of lysyl and prolyl residues of pro-Alpha chains
- (postranslational modification)
- Gly in every third position/ Glycosylation of hydroxyl group of hydroxylysine with Glucose and Galactose; GOlgi allows procollagen to GO outside of cell
- Extracellular matrix/ Eye (cornea, sclera)/ Ehlers-Danlos Syndrome
- N-terminal propeptide (procollagen)/ Nonhelical terminal extensions
Essential amino acids
"PVT. TIM HALL always argues, never tires":
- Phe
- Val
- Thr
- Trp
- Ile
- Met
- His
- Arg
- Lue
- Lys
Hypervitaminosis A
Increased Vitamin A makes you HARD
- Headache/ Hepatomegaly
- Anorexia/ Alopecia
- Really painful bones
- Dry skin/ Drowsiness