List of medical mnemonics

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This is a list of medical mnemonics, categorized and alphabetized.

Contents

Mnemonics with wikipages[edit]

Anatomy[edit]

Anaesthesiology[edit]

Anesthesia machine/room check[edit]

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[edit]

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[edit]

MALES:

Masks

Airways

Laryngoscopes

Endotracheal tubes

Suction/ Stylette, bougie

Spinal anesthesia agents[edit]

"Little Boys Prefer Toys":

Lidocaine

Bupivicaine

Procaine

Tetracaine

Xylocaine: where not to use with epinephrine[edit]

"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[edit]

Depression: major episode characteristics[edit]

SPACE DIGS:

Sleep disruption

Psychomotor retardation

Appetite change

Concentration loss

Energy loss

Depressed mood

Interest wanes

Guilt

Suicidal tendencies

Depression: DSM-V Criteria for Major Depressive Disorder

"SIG E CAPS":

Sleep disturbances

Interest decreased (anhedonia)

Guilt and/or feelings of worthlessness

Energy decreased

Concentration problems

Appetite/weight changes

Psychomotor agitation or retardation

Suicidal ideation

Gain: primary vs. secondary vs. tertiary[edit]

Primary: Patient's Psyche improved.

Secondary: Symptom Sympathy for patient.

Tertiary: Therapist's gain

Kubler-Ross dying process: stages[edit]

"'Death Always Brings Great Acceptance":

Denial

Anger

Bargaining

Grieving

Acceptance

Middle adolescence (14-17 years): characteristics[edit]

HERO:

Heterosexual crushes/ Homosexual Experience

Education regarding short term benefits

Risk taking

Omnipotence

Narcolepsy: symptoms, epidemiology[edit]

CHAP:

Cataplexy

Hallucinations

Attacks of sleep

Paralysis on waking

  • Usual presentation is a young male, hence "chap"

Suicide: risk screening[edit]

SAD PERSONS scale:

Sex (Male - Completion, Female - Attempt)

Age (Adolescent or Elderly)

Depression

Previous attempt

Ethanol abuse

Rational thinking loss

Social support problems

Organised plan

No spouse

Sickness (chronic illness)

Sleep stages: features[edit]

DElta waves during DEepest sleep (stages 3 & 4, slow-wave).

dREaM during REM sleep.

Impotence causes[edit]

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[edit]

MED:

Medicines (propranalol, methyldopa, SSRI, etc.)

Ethanol

Diabetes mellitus

Premature ejaculation: treatment[edit]

2 S's:

SSRIs

Squeezing technique [glans pressure before climax]

More detail with 2 more S's:

Sensate-focus exercises [relieves anxiety]

Stop and start method [5-6 rehearsals of stopping stimulation before climax]

Biochemistry[edit]

B vitamin names[edit]

"The Rhythm Nearly Proved Contagious":

In increasing order:

Thiamine (B1)

Riboflavin (B2)

Niacin (B3)

Pyridoxine (B6)

Cobalamin (B12)

Essential amino acids[edit]

"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[edit]

"Muscles LIVe fast":

Leucine

Isoleucine

Valine

Folate deficiency: causes[edit]

A FOLIC DROP:

Alcoholism

Folic acid antagonists

Oral contraceptives

Low dietary intake

Infection with Giardia

Celiac sprue

Dilantin

Relative folate deficiency

Old

Pregnant

Glycogen storage: Anderson's (IV) vs. Cori's (III) enzyme defect[edit]

ABCD:

Anderson's=Branching enzyme.

Cori's=Debranching enzyme.

  • Otherwise, can't really distinguish clinically.

Glycogen storage: names of types I through VI[edit]

"Viagra Pills Cause A Major Hardon Tendency":

Von Gierke's

Pompe's

Cori's

Anderson's

McArdle's

Her's

Tarui's

Enzymes involved in Genetic Defects in Glycogen Metabolism (From 0-7, and 9)[edit]

0- Store fat, "winter is coming"→ glycogen synthase

1- Shit, now you're too fat, lets burn calories with sex... sex sounds like six so→ glucose-6-phosphatase

2- Then take some acid, because that's what you do after sex→ acid maltase

3- Now you are so freaking high you rip all the branches from the Christmas tree→ debranching enzyme

4- Then you think Holy Crap! Why did I do that, so you try to put the branches back on→ branching enzyme

5- After all of this your MUSCLES are so tired from phosphorylation→ m-glycogen phosphorylase

6- To make up for all that PHOSPHORYLATION you get drunk which ruins your liver→ L-glycogen phosphorylase

7- more Points For Killing your liver→ muscle phosphofructokinase (m-PFK1)

9- PHOK I'm a dumbass→ Phosphorylase Kinase (PHOK)

Cardiology[edit]

Emergency medicine[edit]

Acute LVF management[edit]

LMNOP:[3]

Lasix (furosemide)

Morphine (diamorphine)

Nitrates

Oxygen (sit patient up)

Pulmonary ventilation (if doing badly)

Atrial fibrillation: causes of new onset[edit]

THE ATRIAL FIBS:[3]

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)

Causes of life threatening chest pain[edit]

PET-MAC[4]

P= Pulmonary embolism

E= Esophageal rupture

T= Tension pneumothorax

M= Myocardial infarction

A= Aortic dissection

C= Cardiac tamponade

GCS Intubation[edit]

Under 8, intubate.[5]

Ipecac: contraindications[edit]

4 C's:[3]

Comatose

Convulsing

Corrosive

hydroCarbon

JVP: raised JVP differential[edit]

PQRST(EKG waves):[3]

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[edit]

DOGASH:[3]

Diamorphine

Oxygen

GTN spray

Asprin 300 mg

Streptokinase

Heparin

PEA/Asystole (ACLS): cause[edit]

ITCHPAD[3]

Infarction

Tension pneumothorax

Cardiac tamponade

Hypovolemia/Hypothermia/Hypo-,Hyperkalemia/Hypomagnesmia/Hypoxemia

Pulmonary embolism

Acidosis

Drug overdose

Rapid sequence intubation (RSI)[edit]

SOAP ME

Suction

Oxygen

Airway Equipment

Positioning

Monitoring & Meds

EtCO2 & other Equipment[6]

Rapid Sequence intubation Medications (RSI) (CCRx)

Very Calmly Engage the Respiratory System

Vecuronium 0.1 mg/kg[7]

Cisatracurium 0.2 mg/kg[7]

Etomidate 0.3 mg/kg[7]

Rocuronium 0.6 mg/kg-1.2 mg/kg[7]

Succinylcholine 1 mg/kg[7]

Shock: signs and symptoms[edit]

TV SPARC CUBE:[3]

Thirst

Vomitting

Sweating

Pulse weak

Anxious

Respirations shallow/rapid

Cool

Cyanotic

Unconscious

BP low

Eyes blank

Shock: types[edit]

RN CHAMPS (Alternatively: "MR. C.H. SNAP", or "NH CRAMPS"):

Respiratory

Neurogenic

Cardiogenic

Hemorrhagic

Anaphylactic

Metabolic

Psychogenic

Septic[8]

Subarachnoid hemorrhage (SAH) causes[edit]

BATS:[3]

Berry aneurysm

Arteriovenous malformation/Adult polycystic kidney disease

Trauma

Stroke

Syncope causes, by system[edit]

HEAD HEART VESSELS:[3]

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

Tension pneumothorax: signs and symptoms[edit]

P-THORAX[9]

Pleuritic pain

Tracheal deviation

Hyperresonance

Onset sudden

Reduced breath sounds (and dyspnea)

Absent fremitus

X-ray shows collapse

Ventricular fibrillation: treatment[edit]

Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock:[3]

Shock= Defibrillate

Everybody= Epinephrine

Little= Lidocaine

Big= Bretylium

Momma= MgSO4

Poppa= Pocainamide

Endocrine[edit]

Hematology/Oncology[edit]

Anterior mediastinal masses[edit]

4 T's:

Teratoma

Thymoma

Testicular-type

T-cell / Hodgkin's lymphoma

Dermatomyositis or polymyositis: risk of underlying malignancy[edit]

Risk is 30% at age 30. Risk is 40% at age 40, and so on.

Lung cancer: main sites for distant metastases[edit]

BLAB:

Bone

Liver

Adrenals

Brain

Esophageal cancer: risk factors[edit]

ABCDEF:

Achalasia

Barret's esophagus

Corrosive esophagitis

Diverticuliis

Esophageal web

Familial

Lung cancer: notorious consequences[edit]

SPEECH:

Superior vena cava syndrome

Paralysis of diaphragm (Phrenic nerve)

Ectopic hormones

Eaton-Lambert syndrome

Clubbing

Horner syndrome/ Hoarseness

Mole: signs of trouble[edit]

ABCDE:

Asymmetry

Border irregular

Colour irregular

Diameter usually > 0.5 cm

Elevation irregular

Prognotic factors for cancer: general[edit]

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[edit]

"Go Look For the Adenoma Please":

Tropic hormones affected by growth tumor are:

GnRH

LSH

FSH

ACTH

Prolactin function

Interviewing / Physical exam[edit]

Abdominal Assessment[edit]

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[edit]

AEIOU TIPS

Alcohol

Epilepsy, Electrolytes, and Encephalopathy

Insulin

Overdose, Oxygen

Underdose, Uremia

Trauma, Temperature

Infection

Psychogenic, Poisons

Stroke, Shock[10]

Deep Tendon Reflexes (DTR's)[edit]

One Two, put on my shoe - S1/2 roots for Achilles Reflex (foot plantarflexion)

Three Four, kick the door - L3/4 roots for Patellar Reflex (knee extension)

Five Six, pick up sticks - C5/6 roots for Brachioradialis and Biceps Brachii Reflexes (elbow flexion)

Seven Eight, shut the gate - C7/8 roots for Triceps Brachii Reflex (elbow extension)

Cause of symptoms[edit]

OPQRST (Works well for cardiac, and respiratory patients.)[11]

Onset of the event

Provocation or palliation

Quality of the pain

Region and radiation

Severity

Time

Fetal Monitoring[edit]

VEAL CHOP

FHR Pattern: Variable Early Deceleration Acceleration Late Deceleration
Meaning: Cord compression Head compression O2 Placental Insufficiency

[12]

Neurovascular Assessment[edit]

5 P's:

Pain

Pallor

Paresthesia

Pulse

Paralysis[13]

Trauma assessment[edit]

DCAP-BTLS

Deformities & Discolorations

Contusions

Abrasions & Avulsion

Penetrations & Punctures

Burns

Tenderness

Lacerations

Swelling & Symmetry

Toxicological seizures: Causes[edit]

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[14]

Vomiting: non-GIT differential[edit]

ABCDEFGHI:

Acute renal failure

Brain [increased ICP]

Cardiac [inferior MI]

DKA

Ears [labyrinthitis]

Foreign substances [paracetamol, theo, etc.]

Glaucoma

Hyperemesis gravidarum

Infection [pyelonephritis, meningitis]

Heart valve auscultation sites[edit]

"All Patients Take Meds":

Reading from top left:

Aortic

Pulmonary

Tricuspid

Mitral

Glasgow coma scale: components and numbers[edit]

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[edit]

"Assessed Mental State To Be Positively Clinically Unremarkable":

Appearance and behaviour [observe state, clothing...]

Mood [recent spirit]

Speech [rate, form, content]

Thinking [thoughts, perceptions]

Behavioural abnormalities

Perception abnormalities

Cognition [time, place, age...]

Understanding of condition [ideas, expectations, concerns]

History[edit]

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[edit]

CLORIDE FPP

Character: sharp or dull pain

Loccasion: 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.)[15]

Pain history checklist[edit]

SOCRATES:

Site

Onset

Character

Radiation

Alleviating factors/ Associated symptoms

Timing (duration, frequency)

Exacerbating factors

Severity

Alternatively, Signs and Symptoms with the 'S'

PLOTRADIO

Past history

Location

Onset/offset

Type/character (of pain)

Radiation

Aggravating/alleviating factors

Duration

Intensity

Other associated symptoms

Abdominal swelling causes[edit]

9 F's:

Fat

Feces

Fluid

Flatus

Fetus

Full-sized tumors

Full bladder

Fibroids

False pregnancy

Head Trauma: rapid neuro exam[edit]

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[edit]

"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[edit]

3AM:

3rd nerve palsy

Anti-muscarinic eye drops (e.g. to facilitate fundoscopy)

Myotonic pupil

Clinical examination: initial Inspection of patient from end of bed[edit]

ABC:

Appearance (SOB, pain, etc.)

Behaviour

Connections (drips, inhalers, etc. connected to patient)

Differential diagnosis checklist[edit]

"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.

Primitive Reflexes[edit]

"Absent Reflexes Should Get Paediatrics Professors Mad"

Absent: Asymmetrical Tonic Neck Reflex

Reflexes: Rooting Reflex

Should: Suck Reflex

Get: Grasp Reflex

Paediatrics: Placing Reflex

Professors: Parachute Reflex

Mad: Moro Reflex

Family history (FH)[edit]

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[edit]

"I'm A People Person"

Inspection

Auscultation

Percussion

Palpation

Medical history: disease checklist[edit]

MJ THREADS:

Myocardial infarction

Jaundice

Tuberculosis

Hypertension

Rheumatic fever/ Rheumatoid arthritis

Epilepsy

Asthma

Diabetes

Strokes

Past medical history (PMH)[edit]

VAMP THIS:

Vices (tobacco, alcohol, other drugs, sexual risks)

Allergies

Medications

Preexisting medical conditions

Trauma

Hospitalizations

Immunizations

Surgeries

Patient examination organization[edit]

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)[edit]

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'[edit]

"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[edit]

"I Palpate People's Abdomens":

Inspection

Palpation

Percussion

Auscultation

Short stature causes[edit]

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[edit]

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

Surgical sieve for diagnostic categories[edit]

INVESTIGATIONS:

Iatrogenic

Neoplastic

Vascular

Endocrine

Structural/ Mechanical

Traumatic

Inflammatory

Genetic/ Congenital

Autoimmune

Toxic

Infective

Old age/ Degenerative

Nutritional

Spontaneous/ Idiopathic

Surgical sieve for diagnostic categories (alternate)[edit]

PAST MIDNIGHT:

Psychological

Autoimmune

Spontaneous/idiopathic

Toxic

Metabolic

Inflammatory

Degenerative

Neoplastic

Inflammatory

Genetic

Hematological

Traumatic

VITAMIN CDEF:

Vascular

Infective/inflammatory

Traumatic

Autoimmune

Metabolic

Iatrogenic/idiopathic

Neoplastic

Congenital

Degenerative/developmental

Endocrine/environmental

Functional

Breast history checklist[edit]

LMNOP:

Lump

Mammary changes

Nipple changes

Other symptoms

Patient risk factors

Delivering Bad News[edit]

SPIKES:

Setting up

Perception

Invitation

Knowledge

Emotions

Strategy and Summary

Neurology[edit]

Chorea: common causes[edit]

St. VITUS'S DANCE:[3]

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[edit]

DREAMS:[3]

Dominantly inherited, mostly

Reflexes decreased

Enzymes normal

Apathetic floppy baby

Milestones delayed

Skeletal abnormalities

Dementia: reversible dementia causes[edit]

DEMENTIA:[3]

Drugs/Depression

Elderly

Multi-infarct/Medication

Environmental

Nutritional

Toxins

Ischemia

Alcohol

Stroke risk factors[edit]

HEADS:[3]

Hypertension/ Hyperlipidemia

Elderly

Atrial fib

Diabetes mellitus/ Drugs (cocaine)

Smoking/Sex (male)

Horner Syndrome[edit]

Horny PAMELA:

Ptosis

Anhydrosis

Miosis

Enophthalmos

Loss of ciliary-spinal reflex

Anisocoria

Cerebellar signs[edit]

DANISH:

  • Dysdiadochokinesia/ Dysmetria
  • Ataxia
  • Nystagmus (horizontal)
  • Intention tremor
  • Slurred speech
  • Hypotonia

Causes of Pinpoint pupils[edit]

Pinpoint Pupils are caused by oPioids and Pontine Pathology

Diagnostic criteria of Neurofibromatosis Type 1[edit]

CAFÉ SPOT:

  • Café au lait spots
  • Axillary + inguinal freckling
  • Fibromas
  • Eye: Lisch nodules
  • Sphenoid dysplasia
  • Positive family history
  • Optic Tumour (glioma)

Features of normal pressure hydrocephalus[edit]

Wet, Wobbly, Wacky:

  • Wet = urinary incontinence
  • Wobbly = ataxic gait
  • Wacky = dementia

Pathology[edit]

Pharmacology[edit]

Gynaecomastia causing drugs[edit]

Some Drugs Create Awesome Knockers

Spironolactone

Digitalis

Cimetidine

Alcohol

Ketoconazole[16]

Psychiatry[edit]

Conduct disorder vs. Antisocial personality disorder[edit]

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

Depression: symptoms and signs (DSM-IV criteria)[edit]

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[edit]

UNHAPPINESS:

Understandable (such as bereavement, major stresses)

Neurotic (high anxiety personalities, negative parental upbringing Hypochondriasis)

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[edit]

"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 [identity] and rolling fuses [role confusion]. Mr. N.T. Macy [intimacy] 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!

Mental state examination[edit]

ASEPTIC:

Appearance

Speech

Emotion (Objective/Subjective)

Perceptions

Thoughts

Insight

Cognition

Mania: cardinal symptoms[edit]

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[edit]

Must have 3 of MANIAC:

Mouth (pressure of speech)/ Moodl

Activity increased

Naughty (disinhibition)

Insomnia

Attention (distractability)

Confidence (grandiose ideas)

Parasomnias: time of onset[edit]

SLeep terrors and SLeepwalking occur during SLow-wave sleep (stages 3 & 4).NightmaRE occurs during REM sleep (and is REMembered).

Psychiatric review of symptoms[edit]

"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[edit]

4 A's:

Ambivalence

Affective incongruence

Associative loosening

Autism

Substance dependence: features (DSM IV)[edit]

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[edit]

Chest radiograph: checklist to examine[edit]

"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[edit]

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[edit]

"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

Elbow ossification centers, in sequence[edit]

CRITOE:

Capitellum

Radial head

Internal epicondyle

Trochlea

Olecranon

External epicondyle

Head CT scan: evaluation checklist[edit]

"Blood Can Be Very Bad":

B lood

Cistern

Brain

Ventricles

Bone

Neck sagittal x-ray: examination checklist[edit]

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[edit]

LOSS:

Loss of joint space

Osteopyhtes

Subcondral sclerosis

Subchondral cysts

T2 vs. T1 MRI scan[edit]

"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[edit]

BREASTS:

Beryllium

Radiation

Extrinsic allergic alveolitis

Ankylosing spondylitis

Sarcoidosis

TB

Siliconiosis

Respiratory[edit]

Airway assessment[edit]

LEMON

Asthma management[edit]

ASTHMA

  • Adrenergic agonists
  • Steroids
  • Theophylline
  • Hydration
  • Masked oxygen
  • Anticholinergics[17]

COPD Assessment Test (CAT)[18][edit]

CAT items: CHEST SEA

To aid memory, think of the chest (or lungs) floating in a sea of yellow sputum, which is commonly seen in COPD.

  • Cough
  • Home-leaving confidence
  • Exercise tolerance (uphill/ 1 flight of stairs)
  • Sputum (phlegm/ mucus)
  • Tightness of chest
  • Sleep
  • Energy level
  • ADL at home

Croup symptoms[edit]

  • 3 S's:
    • Stridor
    • Subglottic swelling
    • Seal-bark cough

Causes of upper zone pulmonary fibrosis[edit]

A TEA SHOP

  • ABPA
  • TB
  • Extrinsic allergic alveolitis
  • Ankylosing Spondylitis
  • Sarcoidosis
  • Histiocytosis
  • Occupational (silicosis, berylliosis)
  • Pneumoconiosis (coal-worker’s)

Features of a life-threatening asthma attack[edit]

A CHEST

  • Arrhythmia/Altered conscious level
  • Cyanosis, PaCO2 normal
  • Hypotension, Hypoxia (PaO2<8kPa, SpO2 <92%)
  • Exhaustion
  • Silent chest
  • Threatening PEF < 33% best or predicted (in those >5yrs old)

Pulmonary Edema: Treatment[edit]

LMNOP:

Lasix

Morphine

Nitro

Oxygen

Position/Positive pressure ventilation[19]

Miscellaneous[edit]

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.

Cholinergic Crisis[edit]

SLUDGE and the Killer B's:

Salivation

Lacrimation

Urination

Diaphoresis, Diarrhea

Gastrointestinal cramping

Emesis

Bradycardia

Bronchospasm

Bronchorrhea[20]

also known as DUMBBELLS

Diarrhea

Urination

Miosis

Bradycardia

Bronchospasm

Emesis

Lacrimation

Loss of muscle strength

Salivation/Sweating

DISCO

DIGITALIS ISONIAZID SPIRILACTINE CIMETIDINE, KETOCONQZILE OESTROGEN

Drugs for Bradycardia and Hypotension[edit]

Isoproterenol

Dopamine

Epinephrine

Atropine Sulfate[citation needed]

Diaphragm innervation[edit]

C3, 4, 5 Keeps the Diaphragm Alive[21]

Intubation preparation[edit]

7 P's

Preparation

Preoxygenation

Pretreatment

Paralysis with induction

Positioning

Placement of tube

Postintubation management[22]

Pentad of TTP[edit]

FAT RN:

Fever

Anemia

Thrombocytopenia

Renal

Neuro changes[23]

Systemic lupus erythematosus: Diagnostic symptoms[edit]

SOAP BRAIN MD

Serositis

Oral ulcers

Arthritis

Photosensitivity, pulmonary fibrosis

Blood cells

Renal, Raynaud's

ANA

Immunologic (anti-Sm, anti-dsDNA)

Neuropsych

Malar rash

Discoid rash however, not in order of diagnostic importance.

References[edit]

  1. ^ Mahadevan; Garmel (2012), An Introduction to Clinical Emergency Medicine, p. 831, ISBN 0521747767
  2. ^ APGAR, V (1953). "A proposal for a new method of evaluation of the newborn infant". Current Researches in Anesthesia & Analgesia. 32 (4): 260–7. doi:10.1213/00000539-195301000-00041. PMID 13083014.
  3. ^ a b c d e f g h i j k l m n "Anatomy" (PDF). medicalmnemonics.com. Retrieved 14 February 2015.
  4. ^ http://embasic.org/wp-content/uploads/2011/10/em-basic-chest-pain-show-notes4.pdf
  5. ^ "Pediatric Brain Care" (PDF). Oregon Health and Science University. December 8, 2009. Retrieved February 22, 2016.
  6. ^ "UMEM Educational Pearls". University of Maryland School of Medicine. Retrieved 13 May 2015.
  7. ^ a b c d e Drug Information Handbook 19th edition 2010-2011
  8. ^ "Emergency Medicine Mnemonics". DoctorsHangout.com. Retrieved 13 May 2015.
  9. ^ Mega List of Mnemonics for Nurses & Nursing Students. Examville Study Guides. 2010.
  10. ^ "The Approach To Altered Mental Status". Retrieved 12 May 2015.
  11. ^ Coughlin, Christopher. EMT Emergency Medical Technician Crash Course. Research and Education Association. p. 114. ISBN 978-0-7386-1006-1.
  12. ^ NCLEX-RN EXCEL: Test Success through Unfolding Case Study Review.
  13. ^ Andrews LW. "Neurovascular assessment". Adv Clin Care. 5: 5–7. PMID 2222741.
  14. ^ The Pediatric Emergency Medicine Resource. American College of Emergency Physicians.
  15. ^ Williams, Benjamin R. (5 January 2011). "Orthopaedic Assessment". OrthopaedicsOne. Retrieved 12 May 2015.
  16. ^ "Pharmacology Recall". Retrieved 13 May 2015.
  17. ^ ASTHMA
  18. ^ "COPD Assessment Test" (PDF).
  19. ^ "PULMONARY EDEMA" (PDF). Retrieved 19 May 2015.
  20. ^ Burchum, Jacqueline. Lehne's Pharmacology for Nursing Car.
  21. ^ Davies SJ. ""C3, 4, 5 Keeps the Diaphragm Alive." Is phrenic nerve palsy part of the pathophysiological mechanism in strangulation and hanging?". Am J Forensic Med Pathol. 31: 100–2. doi:10.1097/PAF.0b013e3181c297e1. PMID 19935388.
  22. ^ Cooper, Angus. "Rapid Sequence Intubation - A guide for assistants" (PDF). Scottish Intensive Care Society Education. NHS - Education for Scotland. Retrieved 31 March 2013.
  23. ^ Samir Mehta (1 October 2009). Step-Up to USMLE Step 1: A High-Yield, Systems-Based Review for the USMLE Step 1. Lippincott Williams & Wilkins. pp. 293–. ISBN 978-1-60547-470-0.

Further reading[edit]