Mnemonics - ClinicalNote: Many of these mnemonics are decades old. I hope no one is offended by any of them.

Mnemonics

Mnemonics - Anatomy

Acute Rheumatic Fever "JENSH"

J oints (polyarthritis)E rythema marginatumN odules (subcutaneous)S ydenham's choreaH 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/drugsEndocrineInsulinOpiatesUremia

Toxins/traumaInfectionsPsych/porhyriaSAH, shock, stroke, seizure, space occupying lesion

Angina Pectoris or MI Precipitating Factors

"4 E's" E atingE motionE nvironmentE xercise

Antidysrrthmics

"LARC" L ocal anestheticsbeta 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

"3 Hypo's & 3 Hyper's" HypoxiaHypothermiaHypokalemia

HyperkalemiaHyper H+ (acidosis)Hyper Rx (drugs)

Atherosclerosis

Risk factors Constitutional

G eneticA geS ex

Major Hyper- tensionHyper- lipidemiaHyper- glycemiasmoking

Minor S edentary lifestyleO besityS tress

Complications

S tenosisT hromosisA neurysmB leeding

B Vitamins

"Train private-first class""TRN PFC"

B1 - T hiamineB2 - R iboflavinB3 - N iacin (nicotinic acid)B6 - P yridoxineB9 - F olic acidB12 - C yanocobalamin

Back Pain "DISK MASSS"

D egeneration: DJD, osteoporosis, spondylosisI nfection: UTI, PID, Pott's disease, osteomyelitis, prostatitis; Injury/fracture, compression fractureS pondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)K idney stones/infarction/infectionM ultiple Myeloma, Metastasis from breast, prostate, lung, thyroid, kidney cancersA neurysm, Abdominal pain referred to the backS lipped disk, spondylolisthesisS train, Scoliosis/lordosisS kin: herpes zoster

Bilateral Hilar Adenopathy

"Please Helen, Lick My Popsicle Stick." Primary TBHistoplasmosisLymphomaMetastasesPneumoconiosisSarcoidosis

Cancer

Cancer Warning Signs

"CHB Limbss" C ough - unexplained, persistentH oarsenessB owel or Bladder - change in habitsL umpI ndigestionM elanomaB leeding or discharge - unusualS ore - that does not healS 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 Malignancy30% at age 3040% at age 40etc.

Malignant Melanoma Warning Signs

"ABCDE" A symmetryB order irregularC olour irregularD iameter > 0.5 cmE 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"

PituitaryParathyroidPancreas

MEN IIa

"MPH" M edullary thyroid carcinomaP heochromocytomaH yperparathyroidism

MEN IIb

"MPM" M edullary thyroid carcinomaP heochromocytomaM 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 otationI nspirationP 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 rashRubella - post-auricular lympadenopathyErythema infectosum (5th disease) - "slapped cheeks" appearanceRoseola 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 decreasedGuilt/worthlessnessEnergy decreasedConcentration decreasedAppetite (increased/decreased)Psychomotor movementsSuicidal ideations

Differential Diagnosis

"VINDICATE"VascularInfectionNeoplasmDrugsInflammatory/IdiopathicCongenitalAutoimmuneTraumaEndocrine/Metabolic

Drugs that can be given via Endotracheal Tube "NAVEL"

N arcanA tropineV aliumE pinephrineL idocaine

Elbow Ossification Centers "Come Rub My Tree Of Love"

C apitellumR adial headM edial epicondyleT rochleaO lecranonL ateral epicondyle

These appear at 2, 4, 6, 8, 10, and 12 years of age, respectively, and disappear two years later.

Endocarditis

"FAM" F everA nemiaM urmur

Eosinophilia

"NAACP" N eoplasmA llergyA ddison'sC irrhosis, CVDP arasite (visceral larva migrans), Periarteritis nodosa

Erectile Dysfunction (ED)

"Very Nervous People Hesitate and Disappoint" V ascularN eurologicP sychogenicH ormonalD rugs

Gell & Goombs Classification of Hypersensitivity reactions

"ACID"Type I A naphylaxisType II C ytotoxic-mediatedType III I mmune-complexType IV D elayed hypersensitivity

Henoch-Schonlein Purpura

"JARS" J ointsA bdominal painR enalS kin

Hypercalcemia

"SHAMPOO DIRT" S arcoidosisH yperparathypoidism, HyperthyroidismA lkali-milk syndromeM etastases, MyelomaP aget diseaseO steogenesis imperfectaO steoporosis

vitamin D toxicityI mmobilityR TAT hiazides

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 inhibitorsB eta-blockersC alcium channel blockersD iuretics (thiazide)

Levels of Consciousness

"AVPU" A - AlertV - resonds to Verbal stimuliP - responds to Painful stimuliU - Unconscious

Malignant Hyperthermia treatment

"Some Hot Dude Better Give Iced Fluids Fast!"S: Stop all triggering agentsH: Hyperventilate; 100% O2D: Dantrolene 2.5mg/kgB: BicarbonateG: Glucose and insulinI: IV Fluids, cooling blanketF: Fluid output monitoring; FurosemideF: Fast heart (tachycardia) - be prepared to treat V tach.

Meckel's diverticulum

Rule of 2's: Affects 2% of population, 2 inches long, first 2 years of life, 2 feet proximal to ileocecal valve, 2 types of epithelium: gastric and pancreatic.

The most common congenital GI anomaly. Predominantly affects males.

Mediastinal Mass

Anterior

"4 T's" ThymomaTeratomaThyroid tumor/goiterTerrible lymphoma

Middle

"HABIT(5)" Hernia, hematomaAneurysmBronchogenic cyst/duplication cystInflammation (sarcoid, histo, coccidio, TB)Tumors (5): lung, lymphoma, leukemia, leiomyoma, lymph node hyperplasia

Posterior

"ANS" AneurysmNeuralSpine

Metabolic Acidosis

With Anion Gap

"MUDPILES" M ethanolU remiaD KA/AKAP araldehyde/phenforminI ron/INHL actic acidosis

E thylene glycolS alicylates

Without Anion Gap

"HARDUP" H yperalimentation/hyperventilationA cetazolamideR TAD iarrheaU reteral diversionP ancreatic fistula/parenteral saline

Microcytic Anemia

"TICS" T hallasemiaI ron deficiencyC hronic diseaseS 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, phenothiazinesO pioids, organophosphatesN itrogen dioxideS alicylates

Obstructive Sleep Apnea Screening

"SAD" S noringA pneaD aytime sleepiness

Organisms that Spread from Blood to Urine

"CASH CML"

C andidaA ureus (staph)S almonellaH istoplasma

C ytomegalovirusM ycobacteriaL eptospira

Pain

A - Associated symptomsO - OnsetP - Palliative factorsP - Provocative factorsQ - Quality of pain(burning, stabbing, aching, etc.)R - Region of body affectedR - RadiationS - 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 allstonesE thanolT raumaS teroidsM umpsA utoimmune (e.g. PAN)S corpion bitesH yperlipidemiaD 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% malignant10% bilateral10% extra-adrenal10% calcify10% familial10% 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 - atelectasisWater - urinary tract infectionWound - wound infectionsWind - pneumoniaWonder drugs - especially anesthetics

Rat Poisons

"RATS PANIC" R ed squillA rsenicalsT halliumS trychnine

P NU/Phosphorus/Zn PhosphideA lpha naphtha thiurea (ANTU)N orbormideI ndanedionesC oumadin/cholcalciferol

Small Bowel Obstruction

"SHAVIT" S tone (gallstone ileus)H erniaA dhesionsV olvulusI ntussusceptionT umor

Sports Injuries

- in particular, sprains, contusions, muscle strain, fractures."RICE"

R estI ceC ompressionE levation

Causes of ST Elevation:

"ELEVATION" E lectrolytesL BBBE arly RepolarizationV entricular hypertrophyA neurysmT 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, HypoxiaE pilepsyA nxietyD ysfunction of brain stem (e.g. brain stem TIA)

H eart attackE mbolism (pulmonary)A ortic obstruction (aortic stenosis, myxoma, IHSS)R hythm disturbanceT achycardia (esp. VT)

V asovagalE ctopic (e.g. hemorrhage - obvious or not)S ituational (micturation, defecation, etc.)S ubclavian stealL ow SVR (e.g. anaphalaxis)S ensitive carotid sinus

Systemic Lupus Erythematosis

"SOAP BRAIN" S erositis (pleuritis, pericarditis)O ral ulcersA rthritisP hotosensitivity

B lood (all are low - anemia, leukopenia, thrombocytopenia)R enal (proteinuria)A NAI 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

"Bad mafia" B - Basophilic stipplingA – Anemia, AnisocytosisD - Deferoxamine

M – MCV is lowA - HbA is decreasedF - HbF is increasedI – Ineffective erythropoiesisA – HbA2 is increased

Reprinted with permission from the author Sung Kim at MD4sure.com

Vertebral/Basilar Ischemia

"4D's" D izziness (nystagmus)D iplopia (skew deviation)D ysarthriaD ysphagia

Vomiting: Non-GI Causes

"A, B, C, D, E, F, G, H, I" A cute renal failureB rain (increased ICP)C ardiac (inferior MI)

D KAE ars (labyrinthitis)F oreign substances (Tylenol, theo, etc.)G laucomaH yperemesis gravidarumI nfections (pyelonephritis, meningitis)

WBC Count

"Nobody Likes My Educational Background"e.g. 60, 30, 6, 3, 1Neutrophils 60%Lymphocytes 30%Monocytes 6%Eosinophils 3%Basophils 1%