Acute Rheumatic Fever
"JENSH"
J oints (polyarthritis)
E rythema marginatum
N odules (subcutaneous)
S ydenham's chorea
H eart (pancarditis)
Addison's Disease
President Kennedy had Addison's disease.
He always had a great tan (increased skin pigmentation due to increased levels of ACTH, MSH, etc.).
Alcohol Abuse Screening
"CAGE"
1. Have you ever felt it necessary to CUT DOWN on your
drinking?
2. Has anyone ever told you they were ANNOYED by your
drinking?
3. Have you ever felt GUILTY about your drinking?
4. Have you ever felt the need to have a drink in the
morning for an EYE OPENER?
Altered Mental Status
"AEIOU TIPS"
Alcohol/drugs
Endocrine
Insulin
Opiates
Uremia
Toxins/trauma
Infections
Psych/porhyria
SAH, shock, stroke, seizure, space occupying lesion
Angina Pectoris or MI Precipitating Factors
"4 E's"
E ating
E motion
E nvironment
E xercise
Antidysrrthmics
"LARC"
L ocal anesthetics
beta A drenergic blockers
"R efractory period prolongators"
C alcium channel blockers
Argyll-Robertson Pupil
Sign of neurosyphilis
"ARP" - Accommodation Reflex Present, but Pupillary Reflex Absent ("PRA" - "ARP" backwards).
Asystole
Atherosclerosis
Risk factors
Constitutional
Major
Hyper- tension
Hyper- lipidemia
Hyper- glycemia
smoking
Minor
S edentary lifestyle
O besity
S tress
Complications
S tenosis
T hromosis
A neurysm
B leeding
B Vitamins
"Train private-first class"
"TRN PFC"
B1 - T hiamine
B2 - R iboflavin
B3 - N iacin (nicotinic acid)
B6 - P yridoxine
B9 - F olic acid
B12 - C yanocobalamin
Back Pain
"DISK MASSS"
D egeneration: DJD, osteoporosis, spondylosis
I nfection: UTI, PID, Pott's disease, osteomyelitis, prostatitis; Injury/fracture, compression fracture
S pondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
K idney stones/infarction/infection
M ultiple Myeloma, Metastasis from breast, prostate, lung, thyroid, kidney cancers
A neurysm, Abdominal pain referred to the back
S lipped disk, spondylolisthesis
S train, Scoliosis/lordosis
S kin: herpes zoster
Bilateral Hilar Adenopathy
"Please Helen, Lick My Popsicle Stick."
Primary TB
Histoplasmosis
Lymphoma
Metastases
Pneumoconiosis
Sarcoidosis
Cancer
Cancer Warning Signs
"CHB Limbss"
C ough - unexplained, persistent
H oarseness
B owel or Bladder - change in habits
L ump
I ndigestion
M elanoma
B leeding or discharge - unusual
S ore - that does not heal
S wallowing - difficulty
Carcinomas that have a Propensity to Metastasize to Bone
"Kinds Of Tumours Leaping Promptly To Bone"
Kidney, Ovary, Testis, Lung, Prostate, Thyroid, Breast
Dermatomyositis or Polymyositis - Risk of underlying Malignancy
30% at age 30
40% at age 40
etc.
Malignant Melanoma Warning Signs
"ABCDE"
A symmetry
B order irregular
C olour irregular
D iameter > 0.5 cm
E levation
Malignant Melanoma Sites with a Poor Prognosis
"BANS"
Back of the Arm, Neck, or Scalp
Multiple Endocrine Neoplasia (MEN)
MEN I
"3 P's"
Pituitary
Parathyroid
Pancreas
MEN IIa
"MPH"
M edullary thyroid carcinoma
P heochromocytoma
H yperparathyroidism
MEN IIb
"MPM"
M edullary thyroid carcinoma
P heochromocytoma
M ucosal neuromas
Oral Cancer Risk Factors
"5 S's"
Smoking, Spirits (alcohol), Spicy food, Syphilis, Sharp teeth/dentures
Chest Radiograph
Check technical quality
"RIP"
R otation
I nspiration
P enetration
Structures to check
"LAMBS"
L ungs (e.g. interstitial disease, alveolar disease, atelectasis, nodules, hyperlucency)
A bdomen (e.g. pneumoperitoneum)
M ediastinum (e.g. masses, tracheal shift)
B ones (e.g. fractures, rib notching)
S oft tissues (e.g. subcutaneous emphysema)
CHF Symptoms
"DOPEN"
D OE
O rthopnea
P ND
E dema
N octuria
Childhood Rashes
Acute maculopapular rashes
Rubeola - Cough, Coryza, Conjunctivitis, & fever; Koplik's spots precede rash
Rubella - post-auricular lympadenopathy
Erythema infectosum (5th disease) - "slapped cheeks" appearance
Roseola infantosum - rash appears after fever defervesces
Varicella - "Dew drop on a rose petal" appearance
Cholinergic Crisis - parasympathetic overstimulation
"SLUD"
Salivation, Lacrimation, Urination, and Defecation
Coagulation tests
"PiTT" (PTT - I for Intrinsic pathway) - PiTTsburgh
"PeT" (PT - E for Extrinsic pathway)
Compartment Syndrome
"5 P’s"
Pain, Passive stretch (induces pain), Pallor, Pulselessness, and Paresthesias.
Depression
"SIGECAPS"
Sleep (increased/decreased)
Interests/hobbies decreased
Guilt/worthlessness
Energy decreased
Concentration decreased
Appetite (increased/decreased)
Psychomotor movements
Suicidal ideations
Differential Diagnosis
"VINDICATE"
Vascular
Infection
Neoplasm
Drugs
Inflammatory/Idiopathic
Congenital
Autoimmune
Trauma
Endocrine/Metabolic
Drugs that can be given via Endotracheal Tube
"NAVEL"
N arcan
A tropine
V alium
E pinephrine
L idocaine
Elbow Ossification Centers
"Come Rub My Tree Of Love"
C apitellum
R adial head
M edial epicondyle
T rochlea
O lecranon
L ateral epicondyle
These appear at 2, 4, 6, 8, 10, and 12 years of age, respectively, and disappear two years later.
Endocarditis
Eosinophilia
"NAACP"
N eoplasm
A llergy
A ddison's
C irrhosis, CVD
P arasite (visceral larva migrans), Periarteritis nodosa
Erectile Dysfunction (ED)
"Very Nervous People Hesitate and Disappoint"
V ascular
N eurologic
P sychogenic
H ormonal
D rugs
Gell & Goombs Classification of Hypersensitivity reactions
"ACID"
Type I A naphylaxis
Type II C ytotoxic-mediated
Type III I mmune-complex
Type IV D elayed hypersensitivity
Henoch-Schonlein Purpura
"JARS"
J oints
A bdominal pain
R enal
S kin
Hypercalcemia
Hypertension
| Condition |
Diastolic |
Systolic |
| Optimal BP |
<80 |
<120 |
| Normal BP |
80 - 84 |
120 - 129 |
| High normal BP |
85 - 89 |
130 - 139 |
| Stage I hypertension (mild) |
90 - 99 |
140 - 159 |
| Stage II hypertension (moderate) |
100 - 109 |
160 - 179 |
| Stage III hypertension (severe) |
110 - 119 |
180 - 209 |
| Stage IV hypertension (very severe) |
>120 |
>210 |
| Isolated systolic hypertension |
<90 |
>140 |
Hypertension - First Line Drug Therapy
"ABCD"
A CE inhibitors
B eta-blockers
C alcium channel blockers
D iuretics (thiazide)
Levels of Consciousness
"AVPU"
A - Alert
V - resonds to Verbal stimuli
P - responds to Painful stimuli
U - Unconscious
Malignant Hyperthermia treatment
"Some Hot Dude Better Give Iced Fluids Fast!"
S: Stop all triggering agents
H: Hyperventilate; 100% O2
D: Dantrolene 2.5mg/kg
B: Bicarbonate
G: Glucose and insulin
I: IV Fluids, cooling blanket
F: Fluid output monitoring; Furosemide
F: Fast heart (tachycardia) - be prepared to treat V tach.
Meckel's diverticulum
Mediastinal Mass
Anterior
"4 T's"
Thymoma
Teratoma
Thyroid tumor/goiter
Terrible lymphoma
Middle
"HABIT(5)"
Hernia, hematoma
Aneurysm
Bronchogenic cyst/duplication cyst
Inflammation (sarcoid, histo, coccidio, TB)
Tumors (5): lung, lymphoma, leukemia, leiomyoma, lymph node hyperplasia
Posterior
Metabolic Acidosis
With Anion Gap
"MUDPILES"
M ethanol
U remia
D KA/AKA
P araldehyde/phenformin
I ron/INH
L actic acidosis
E thylene glycol
S alicylates
Without Anion Gap
"HARDUP"
H yperalimentation/hyperventilation
A cetazolamide
R TA
D iarrhea
U reteral diversion
P ancreatic fistula/parenteral saline
Microcytic Anemia
"TICS"
T hallasemia
I ron deficiency
C hronic disease
S ideroblastic anemia
Mucopolysaccharidoses
Distingushing Hunter's from Hurler's: Children with Hunter's Syndrome do not have corneal clouding because you need to "see" in order to hunt. To remember that it is "X-Linked," picture a hunter with a bow and arrow. The bow and arrow cross each other forming an "X."
Non-Cardiogenic Pulmonary Edema
"PONS"
P hosgene, paraquat, phenothiazines
O pioids, organophosphates
N itrogen dioxide
S alicylates
Obstructive Sleep Apnea Screening
"SAD"
S noring
A pnea
D aytime sleepiness
Organisms that Spread from Blood to Urine
Pain
A - Associated symptoms
O - Onset
P - Palliative factors
P - Provocative factors
Q - Quality of pain(burning, stabbing, aching, etc.)
R - Region of body affected
R - Radiation
S - Severity of pain (e.g. 1-10 scale)
T - Timing of pain (e.g. after meals, in the morning, etc.)
T - Treatments tried
Causes of Acute Pancreatitis
"GET SMASH'D"
G allstones
E thanol
T rauma
S teroids
M umps
A utoimmune (e.g. PAN)
S corpion bites
H yperlipidemia
D rugs(e.g. azathioprine, diuretics)
Causes of Pericarditis
"CARDIAC RIND"
Collagen vascular disease, Aortic aneurysm,
Radiation, Drugs eg. hydralazine,
Infections, Acute renal failure, Cardiac infarction, Rheumatic fever, Injury, Neoplasms,
Dressler's syndrome.
Pheochromocytoma
Rule of 10's:
10% malignant
10% bilateral
10% extra-adrenal
10% calcify
10% familial
10% children
Comprises 0.2% of patients with hypertension and is the most common adrenal medullary tumor in adults. The Pheochromocytomas are associated with MEN IIa (Sipple's syndrome: pheochromocytoma, medullary carcinoma of the thyroid, and parathyroid adenoma) and MEN IIb syndrome (pheochromocytoma, medullary carcinoma of the thyroid, and oral and intestinal ganglioneuromatosis) as well as with von Hippel-Lindau disease and neurofibromatosis.
Post-op Fever
Wind - atelectasis
Water - urinary tract infection
Wound - wound infections
Wind - pneumonia
Wonder drugs - especially anesthetics
Rat Poisons
Small Bowel Obstruction
"SHAVIT"
S tone (gallstone ileus)
H ernia
A dhesions
V olvulus
I ntussusception
T umor
Sports Injuries
- in particular, sprains, contusions, muscle strain, fractures.
"RICE"
R est
I ce
C ompression
E levation
Causes of ST Elevation:
"ELEVATION"
E lectrolytes
L BBB
E arly Repolarization
V entricular hypertrophy
A neurysm
T reatment (e.g. pericardiocentesis)
I njury (AMI, contusion)
O sborne waves (hypothermia)
N on-occlusive vasospasm
Syncope
If the face is red, raise the head.
If the face is pale, raise the tail.
"HEAD, HEART, VESSLS"
H ypoglycemia, Hypoxia
E pilepsy
A nxiety
D ysfunction of brain stem (e.g. brain stem TIA)
H eart attack
E mbolism (pulmonary)
A ortic obstruction (aortic stenosis, myxoma, IHSS)
R hythm disturbance
T achycardia (esp. VT)
V asovagal
E ctopic (e.g. hemorrhage - obvious or not)
S ituational (micturation, defecation, etc.)
S ubclavian steal
L ow SVR (e.g. anaphalaxis)
S ensitive carotid sinus
Systemic Lupus Erythematosis
"SOAP BRAIN"
S erositis (pleuritis, pericarditis)
O ral ulcers
A rthritis
P hotosensitivity
B lood (all are low - anemia, leukopenia, thrombocytopenia)
R enal (proteinuria)
A NA
I mmunologic (dsDNA, etc.)
N eurologic (e.g. seizures)
Takayasu's Disease
Pulseless disease. Therefore, when you have Takayasu's, I can't "taka yu" pulse.
Thalassemia major
Vertebral/Basilar Ischemia
"4D's"
D izziness (nystagmus)
D iplopia (skew deviation)
D ysarthria
D ysphagia
Vomiting: Non-GI Causes
"A, B, C, D, E, F, G, H, I"
A cute renal failure
B rain (increased ICP)
C ardiac (inferior MI)
D KA
E ars (labyrinthitis)
F oreign substances (Tylenol, theo, etc.)
G laucoma
H yperemesis gravidarum
I nfections (pyelonephritis, meningitis)
WBC Count
"Nobody Likes My Educational Background"
e.g. 60, 30, 6, 3, 1
Neutrophils 60%
Lymphocytes 30%
Monocytes 6%
Eosinophils 3%
Basophils 1%
