This is a list of

mnemonic A mnemonic ( ) device, or memory device, is any learning technique that aids information retention or retrieval (remembering) in the human memory for better understanding. Mnemonics make use of elaborative encoding, retrieval cues, and imag ...

s used in

medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...

and medical science, categorized and alphabetized. A mnemonic is any technique that assists the human memory with information retention or retrieval by making abstract or impersonal information more accessible and meaningful, and therefore easier to remember; many of them are acronyms or initialisms which reduce a lengthy set of terms to a single, easy-to-remember word or phrase.

Mnemonics with wikipages

ABC ABC are the first three letters of the Latin script known as the alphabet. ABC or abc may also refer to: Arts, entertainment, and media Broadcasting * American Broadcasting Company, a commercial U.S. TV broadcaster ** Disney–ABC Television ...

— airway, breathing, and circulation # AEIOU-TIPS — causes of altered mental status #

APGAR The Apgar score is a quick way for doctors to evaluate the health of all newborns at 1 and 5 minutes after birth and in response to resuscitation. It was originally developed in 1952 by an anesthesiologist at Columbia University, Virginia Apgar, ...

— a

backronym A backronym is an acronym formed from an already existing word by expanding its letters into the words of a phrase. Backronyms may be invented with either serious or humorous intent, or they may be a type of false etymology or folk etymology. The ...

for appearance, pulse, grimace, activity, respiration (used to assess newborn babies) #

ASHICE ASHICE is one of several mnemonic acronyms used by emergency medical services in the United Kingdom and the Republic of Ireland to pass summarised advance details of a patient to the next group of persons or organisation dealing with them, otherwis ...

— age, sex, history, injuries/illness, condition, ETA/extra information # FAST — face, arms, speech, time (

stroke symptoms A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...

) # Hs and Ts — causes of

cardiac arrest Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...

# IS PATH WARM? — suicide risk factors #

OPQRST __NOTOC__OPQRST is a mnemonic initialism used by medical professionals to accurately discern reasons for a patient's symptoms and history in the event of an acute illness. It is specifically adapted to elicit symptoms of a possible heart attack. ...

— onset, provocation, quality, region, severity, time (symptom checklist often used by first responders) #

RICE Rice is the seed of the grass species ''Oryza sativa'' (Asian rice) or less commonly ''Oryza glaberrima ''Oryza glaberrima'', commonly known as African rice, is one of the two domesticated rice species. It was first domesticated and grown i ...

— rest, ice, compression, elevation (generic treatment strategy for sprains and bruises) # RNCHAMPS — types of

shock Shock may refer to: Common uses Collective noun *Shock, a historic commercial term for a group of 60, see English numerals#Special names * Stook, or shock of grain, stacked sheaves Healthcare * Shock (circulatory), circulatory medical emergen ...

RPM-30-2-Can Do RPM-30-2-Can Do is a mnemonic device for the criteria used in the START triage system, which is used to sort patients into categories at a mass casualty incident. The mnemonic is pronounced "R, P, M, thirty, two, can do." Mnemonic for adult tr ...

—

START triage Simple triage and rapid treatment (START) is a triage method used by first responders to quickly classify victims during a mass casualty incident (MCI) based on the severity of their injury. The method was developed in 1983 by the staff members o ...

criteria #

SOCRATES Socrates (; ; –399 BC) was a Greek philosopher from Athens who is credited as the founder of Western philosophy and among the first moral philosophers of the ethical tradition of thought. An enigmatic figure, Socrates authored no te ...

— used to evaluate characteristics of pain #

SOAP Soap is a salt of a fatty acid used in a variety of cleansing and lubricating products. In a domestic setting, soaps are surfactants usually used for washing, bathing, and other types of housekeeping. In industrial settings, soaps are use ...

– a technique for writing medical records #

SLUDGE Sludge is a semi-solid slurry that can be produced from a range of industrial processes, from water treatment, wastewater treatment or on-site sanitation systems. For example, it can be produced as a settled suspension obtained from conventiona ...

— salivation, lacrimation, urination, defecation, gastric upset, and emesis (effects of

nerve agent Nerve agents, sometimes also called nerve gases, are a class of organic chemicals that disrupt the mechanisms by which nerves transfer messages to organs. The disruption is caused by the blocking of acetylcholinesterase (AChE), an enzyme that ...

organophosphate In organic chemistry, organophosphates (also known as phosphate esters, or OPEs) are a class of organophosphorus compounds with the general structure , a central phosphate molecule with alkyl or aromatic substituents. They can be considered a ...

poisoning)

Anatomy

Anaesthesiology

Anaesthesia machine/room check

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

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

MALES: * Masks * Airways * Laryngoscopes * Endotracheal tubes * Suction/Stylette, bougie

Spinal anaesthesia agents

"Little Boys Prefer Toys": * Lidocaine * Bupivacaine * Procaine * Tetracaine

Xylocaine: where not to use with epinephrine

"Ears, nose, hose, fingers, and toes" *The vasoconstrictive effects of

xylocaine Lidocaine, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type. It is also used to treat ventricular tachycardia. When used for local anaesthesia or in nerve blocks, lidoca ...

with

epinephrine Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands and ...

are helpful in providing

hemostasis In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. This involves coagulation, whi ...

while suturing; however, they may also cause local ischemic necrosis in distal structures such as the digits, tip of nose, penis, ears, etc. "Digital PEN" – digits, penis, ear, nose

Behavioral science/psychology

Depression: major episode characteristics

SPACE DIGS: * Sleep disruption * Psychomotor retardation * Appetite change * Concentration loss * Energy loss * Depressed mood * Interest wanes * Guilt * Suicidal tendencies

Depression:
DSM-V The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...
criteria for
major depressive disorder Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introdu ...

"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

* Primary: patient's psyche improved * Secondary: symptom sympathy for patient * Tertiary: therapist's gain

Kubler-Ross dying process: stages

"Death always brings great acceptance": * Denial * Anger * Bargaining * Grieving * Acceptance

Middle adolescence (14–17 years): characteristics

HERO: * Heterosexual/Homosexual crushes * Education regarding short-term benefits * Risk-taking * Omnipotence

Narcolepsy: symptoms, epidemiology

CHAP: * Cataplexy * Hallucinations * Attacks of sleep * Paralysis on waking *Usual presentation is a young male, hence "chap"

Suicide: risk screening

SAD PERSONS scale The SAD PERSONS scale is an acronym utilized as a mnemonic device A mnemonic ( ) device, or memory device, is any learning technique that aids information retention or retrieval (remembering) in the human memory for better understanding. Mnem ...

: * 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

Delta waves during Deepest sleep (stages 3 and 4, slow-wave) dREaM during REM sleep

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: cannot maintain an erection

Male erectile dysfunction (MED): biological causes

MED: * Medicines (

propranolol Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class. It is used to treat high blood pressure, a number of types of irregular heart rate, thyrotoxicosis, capillary hemangiomas, performance anx ...

methyldopa Methyldopa, sold under the brand name Aldomet among others, is a medication used for high blood pressure. It is one of the preferred treatments for high blood pressure in pregnancy. For other types of high blood pressure including hypertensive e ...

SSRI Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions. SSRIs increase the extracellul ...

s, etc.) * Ethanol * Diabetes mellitus

Premature ejaculation: treatment

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

B vitamin names

"The rhythm nearly proved contagious": In increasing order: * Thiamine (vitamin B1, also spelled thiamin) * Riboflavin (vitamin B2) * Niacin (vitamin B3, also called nicotinic acid) * Pyridoxine (vitamin B6) * Cobalamin (vitamin B12)

Essential amino acids

"TIM HALL PVT. (Ltd.) always argue and never (get) tire": * Phe –

phenylalanine Phenylalanine (symbol Phe or F) is an essential α-amino acid with the formula . It can be viewed as a benzyl group substituted for the methyl group of alanine, or a phenyl group in place of a terminal hydrogen of alanine. This essential amino a ...

* Val –

valine Valine (symbol Val or V) is an α-amino acid that is used in the biosynthesis of proteins. It contains an α-amino group (which is in the protonated −NH3+ form under biological conditions), an α- carboxylic acid group (which is in the deprotonat ...

* Thr –

threonine Threonine (symbol Thr or T) is an amino acid that is used in the biosynthesis of proteins. It contains an α-amino group (which is in the protonated −NH form under biological conditions), a carboxyl group (which is in the deprotonated −COO� ...

* Trp –

tryptophan Tryptophan (symbol Trp or W) is an α-amino acid that is used in the biosynthesis of proteins. Tryptophan contains an α-amino group, an α- carboxylic acid group, and a side chain indole, making it a polar molecule with a non-polar aromatic ...

* Ile –

isoleucine Isoleucine (symbol Ile or I) is an α-amino acid that is used in the biosynthesis of proteins. It contains an α-amino group (which is in the protonated −NH form under biological conditions), an α-carboxylic acid group (which is in the deprot ...

* Met –

methionine Methionine (symbol Met or M) () is an essential amino acid in humans. As the precursor of other amino acids such as cysteine and taurine, versatile compounds such as SAM-e, and the important antioxidant glutathione, methionine plays a critical ro ...

* His –

histidine Histidine (symbol His or H) is an essential amino acid that is used in the biosynthesis of proteins. It contains an α-amino group (which is in the protonated –NH3+ form under biological conditions), a carboxylic acid group (which is in the de ...

* Arg –

arginine Arginine is the amino acid with the formula (H2N)(HN)CN(H)(CH2)3CH(NH2)CO2H. The molecule features a guanidino group appended to a standard amino acid framework. At physiological pH, the carboxylic acid is deprotonated (−CO2−) and both the am ...

* Leu –

leucine Leucine (symbol Leu or L) is an essential amino acid that is used in the biosynthesis of proteins. Leucine is an α-amino acid, meaning it contains an α-amino group (which is in the protonated −NH3+ form under biological conditions), an α- ca ...

* Lys –

lysine Lysine (symbol Lys or K) is an α-amino acid that is a precursor to many proteins. It contains an α-amino group (which is in the protonated form under biological conditions), an α-carboxylic acid group (which is in the deprotonated −C ...

*Always argue: A is for Arg (Arginine) not Asp (Aspartic acid). *'Never tire': T is not Tyr (Tyrosine), but is both Thr (Theronine) and Trp (Tryptophan). †Note that this initialism uses single letters for each amino acid that are ''not'' the same as the standard single-letter codes commonly used in molecular biology to uniquely specify each amino acid; for example, though

is represented here by the letter "P", it is formally represented by the letter "F" in most other contexts, and "P" is instead used to formally represent

proline Proline (symbol Pro or P) is an organic acid classed as a proteinogenic amino acid (used in the biosynthesis of proteins), although it does not contain the amino group but is rather a secondary amine. The secondary amine nitrogen is in the prot ...

Fasting state: branched-chain amino acids used by skeletal muscles

"Muscles LIVe fast": * Leucine * Isoleucine * Valine

Fat-soluble vitamins

"The fat (fat-soluble vitamins) cat lives in the ADEK (vitamins A, D, E, and K)."

Folate deficiency: causes

A FOLIC DROP: * Alcoholism * Folic acid antagonists * Oral contraceptives * Low dietary intake * Infection with ''

Giardia ''Giardia'' ( or ) is a genus of anaerobic flagellated protozoan parasites of the phylum Metamonada that colonise and reproduce in the small intestines of several vertebrates, causing the disease giardiasis. Their life cycle alternates between ...

'' * Celiac sprue * Dilantin * Relative folate deficiency * Old * Pregnant

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

ABCD: * Anderson's = Branching enzyme * Cori's = Debranching enzyme *Otherwise, cannot really distinguish clinically.

Glycogen storage: names of types I through VI

"Viagra pills cause a major hardon tendency": * Von Gierke's * Pompe's * Cori's * Anderson's * McArdle's * Her's * Tarui's

Enzyme classes

"On The Hill, LIL' Trans''formers": * 1 - Oxidoreductases * 2 - Transferases * 3 - Hydrolases * 4 - Lyases * 5 - Isomerases * 6 - Ligases * 7 - Translocases

Cardiology

Emergency medicine

Acute LVF management

LMNOP: * Lasix (furosemide) * Morphine (diamorphine) * Nitrates * Oxygen (sit patient up) * Pulmonary ventilation (if doing badly)

Atrial fibrillation: causes of new onset

THE ATRIAL FIBS: * 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)

Well's criteria

Secret little TIP (about) blood clots: Signs/symptoms of PE (3) PE is the most likely diagnosis (3) Tachycardia >100bpm (1.5) Imobilisation/surgery in the last 4 weeks (1.5) Previous DVT/PE Blood in sputum (haemoptysis) (1) Active cancer (1) Two tier score: PE likely > 4

Causes of life-threatening chest pain

PET-MAC * P =

Pulmonary embolism Pulmonary embolism (PE) is a blockage of an pulmonary artery, artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include dyspnea, shortness of breath, chest pain p ...

* E =

Esophageal rupture Esophageal rupture is a rupture of the esophageal wall. Iatrogenic causes account for approximately 56% of esophageal perforations, usually due to medical instrumentation such as an endoscopy or paraesophageal surgery. In contrast, the term Boerh ...

* T =

Tension pneumothorax A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve i ...

* M =

Myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...

* A =

Aortic dissection Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. In most cases, this is associated with a sudden onset of severe chest or ...

* C =

Cardiac tamponade Cardiac tamponade, also known as pericardial tamponade (), is the buildup of fluid in the pericardium (the sac around the heart), resulting in compression of the heart. Onset may be rapid or gradual. Symptoms typically include those of obstruct ...

GCS intubation

Under 8, intubate.

Ipecac: contraindications

4 C's: * Comatose * Convulsing * Corrosive * hydrocarbon

JVP: raised JVP differential

PQRST(EKG waves): * 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

DOGASH: * Diamorphine * Oxygen * GTN spray * Aspirin 300 mg * Streptokinase * Heparin

PEA/asystole (ACLS): cause

ITCHPAD Infarction Tension pneumothorax Cardiac tamponade Hypovolemia/hypothermia/hypo-,hyperkalemia/hypomagnesmia/hypoxemia Pulmonary embolism Acidosis Drug overdose

Rapid sequence intubation (RSI)

SOAP ME Suction Oxygen Airway equipment Positioning Monitoring & medications EtCO2 & other equipment Rapid sequence intubation medications (RSI) (CCRx) Very calmly engage the respiratory system Vecuronium 0.1 mg/kgDrug Information Handbook 19th edition 2010-2011 Cisatracurium 0.2 mg/kg Etomidate 0.3 mg/kg Rocuronium 0.6 mg/kg-1.2 mg/kg Succinylcholine 1 mg/kg

Shock: signs and symptoms

TV SPARC CUBE: Thirst Vomitting Sweating Pulse weak Anxious Respirations shallow/rapid Cool Cyanotic Unconscious BP low Eyes blank

Shock: types

RN CHAMPS (Alternatively: "MR. C.H. SNAP", or "NH CRAMPS"): Respiratory Neurogenic Cardiogenic Hemorrhagic Anaphylactic Metabolic Psychogenic Septic

Subarachnoid hemorrhage (SAH) causes

BATS: Berry aneurysm Arteriovenous malformation/adult polycystic kidney disease Trauma Stroke

Syncope causes, by system

HEAD HEART VESSELS: 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

P-THORAX Pleuritic pain Tracheal deviation Hyperresonance Onset sudden Reduced breath sounds (and dyspnea) Absent fremitus X-ray shows collapse

Ventricular fibrillation: treatment

Shock, shock, shock, everybody shock, little shock, big shock, momma shock, poppa shock: Shock= Defibrillate Everybody= Epinephrine Little= Lidocaine Big= Bretylium Momma= MgSO₄ Poppa= Pocainamide

Endocrine

Diabetes complications

KNIVES: Kidney – nephropathy Neuromuscular – peripheral neuropathy, mononeuritis, amyotrophy Infective – UTIs, TB Vascular – coronary/cerebrovascular/peripheral artery disease Eye – cataracts, retinopathy Skin – lipohypertrophy/lipoatrophy, necrobiosis lipoidica

Hematology/oncology

Anterior mediastinal masses

4 T's: Teratoma Thymoma Testicular-type T-cell / Hodgkin's lymphoma

Dermatomyositis or polymyositis: risk of underlying malignancy

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

Lung cancer: main sites for distant metastases

BLAB: Bone Liver Adrenals Brain

Esophageal cancer: risk factors

ABCDEF: Achalasia Barret's esophagus Corrosive esophagitis Diverticuliis Esophageal web Familial

Lung cancer: notorious consequences

SPEECH: Superior vena cava syndrome Paralysis of diaphragm (phrenic nerve) Ectopic hormones Eaton-Lambert syndrome Clubbing Horner syndrome/ hoarseness

Mole: signs of trouble

ABCDE: Asymmetry Border irregular Colour irregular Diameter usually > 0.5 cm Elevation irregular

Prognotic factors for cancer: general

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

"Go look for the adenoma please": Tropic hormones affected by growth tumor are: GnRH LSH FSH ACTH Prolactin function

Interviewing / physical exam

Abdominal assessment

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

AEIOU TIPS Alcohol Epilepsy, electrolytes, and encephalopathy Insulin Overdose, oxygen Underdose, uremia Trauma, temperature Infection Psychogenic, poisons Stroke, shock

Deep tendon reflexes (DTR's)

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

(Works well for cardiac, and respiratory patients.) Onset of the event Provocation or palliation Quality of the pain Region and radiation Severity Time

Fetal monitoring

VEAL CHOP

Neurovascular assessment

5 P's: Pain Pallor Paresthesia Pulse Paralysis

Trauma assessment

DCAP-BTLS Deformities & discolorations Contusions Abrasions & avulsion Penetrations & punctures Burns Tenderness Lacerations Swelling & symmetry

Toxicological seizures: causes

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

Vomiting: non-GIT differential

ABCDEFGHI: Acute renal failure Brain ncreased ICP Cardiac nferior MI DKA Ears abyrinthitis Foreign substances aracetamol, theo, etc. Glaucoma Hyperemesis gravidarum Infection yelonephritis, meningitis

Heart valve auscultation sites

"All patients take meds": Reading from top left: Aortic Pulmonary Tricuspid Mitral

Glasgow coma scale: components and numbers

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

"Assessed mental state to be positively clinically unremarkable": Appearance and behaviour bserve state, clothing... Mood ecent spirit Speech ate, form, content Thinking houghts, perceptions Behavioural abnormalities Perception abnormalities Cognition ime, place, age... Understanding of condition deas, expectations, concerns

History

SAMPLE history SAMPLE history is a mnemonic acronym to remember key questions for a person's medical assessment. The SAMPLE history is sometimes used in conjunction with vital signs and OPQRST. The questions are most commonly used in the field of emergency medi ...

Signs and symptoms Allergies Medications Past medical history, injuries, illnesses Last meal/intake Events leading up to the injury and/or illness OPQRST history Onset of symptoms Provocation/pallitive Quality or character of pain Region of pain or radiation Signs, symptoms and severity Time of onset, duration, intensity

Orthopaedic assessment

CLORIDE FPP Character: sharp or dull pain Location: 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.)

Pain history checklist

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

9 F's: Fat Feces Fluid Flatus Fetus Full-sized tumors Full bladder Fibroids False pregnancy

Head trauma: rapid neuro exam

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

"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

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

ABC: Appearance (SOB, pain, etc.) Behaviour Connections (drips, inhalers, etc. connected to patient)

Differential diagnosis checklist

"A VITAMIN C" Acquired Vascular Inflammatory (infectious and non-infectious) Trauma/ toxins Autoimmune Metabolic Idiopathic Neoplastic Congenital

Primitive reflexes

"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)

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

"I'm a people person" Inspection Auscultation Percussion Palpation

Medical history: disease checklist

MJ THREADS: Myocardial infarction Jaundice Tuberculosis Hypertension Rheumatic fever/ rheumatoid arthritis Epilepsy Asthma Diabetes Strokes

Past medical history (PMH)

VAMP THIS: Vices (tobacco, alcohol, other drugs, sexual risks) Allergies Medications Preexisting medical conditions Trauma History of hospitalizations Immunizations Surgeries SMASH FM: Social history Medical history Allergies Surgical history Hospitalizations Family history Medications

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

Physical exam for 'lumps and bumps'

"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

Short stature causes

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

S&S: Sign: I (the examiner) can detect attributes/reactions without patient description Symptom: patient only can sense attributes/feelings

Social history

FED TACOS: Food Exercise Drugs Tobacco Alcohol Caffeine Occupation Sexual activity

Surgical sieve for diagnostic categories

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)

PAST MIDNIGHT: Psychological Autoimmune Spontaneous/idiopathic Toxic Metabolic Inflammatory Degenerative Neoplastic Infection Genetic Hematological Traumatic VITAMIN CDEF: Vascular Infective/inflammatory Traumatic Autoimmune Metabolic Iatrogenic/idiopathic Neoplastic Congenital Degenerative/developmental Endocrine/environmental Functional

Breast history checklist

LMNOP: Lump Mammary changes Nipple changes Other symptoms Patient risk factors

Delivering bad news

SPIKES: Setting up Perception Invitation Knowledge Emotions Strategy and summary

Nephrology

Dialysis: Acute indications

AEIOU Acidosis (refractory to treatment) Electrolyte abnormalities (refractory to treatment, e.g. hyperkalemia) Ingestions (e.g. methanol, ethylene glycol, lithium, salicylates) Overload (volume overload refractory to IV diuresis) Uremia (presenting with pericarditis, bleeding, encephalopathy)

Neurology

Chorea: common causes

St. VITUS'S DANCE: 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

DREAMS: Dominantly inherited, mostly Reflexes decreased Enzymes normal Apathetic floppy baby Milestones delayed Skeletal abnormalities

Dementia: reversible dementia causes

DEMENTIA: Drugs/depression Elderly Multi-infarct/medication Environmental Nutritional Toxins Ischemia Alcohol

Friedreich ataxia trinucleotide repeat

"Ataxic GAAit" Guanine Adenine Adenine

Stroke risk factors

HEADS: Hypertension/ hyperlipidemia Elderly Atrial fib Diabetes mellitus/ drugs (cocaine) Smoking/sex (male)

Horner syndrome

Horny PAMELA: Ptosis Anhydrosis Miosis Enophthalmos Loss of ciliary-spinal reflex Anisocoria

Cerebellar signs

DANISH: *Dysdiadochokinesia / dysmetria *Ataxia *Nystagmus (horizontal) *Intention tremor *Slurred speech *Hypotonia

Causes of pinpoint pupils

Pinpoint pupils are caused by opioids and pontine pathology

Diagnostic criteria of neurofibromatosis type 1

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

Wet, wobbly, wacky: *Wet = urinary incontinence *Wobbly = ataxic gait *Wacky = dementia

Pathology

Pharmacology

Gynaecomastia causing drugs

Some drugs create awesome knockers Spironolactone Digitalis Cimetidine Alcohol Ketoconazole

Psychiatry

Conduct disorder vs. antisocial personality disorder

Conduct disorder is seen in children. Antisocial personality disorder is seen in adults.

Depression: symptoms and signs (DSM-IV criteria)

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

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

Delirium

DIMES & 3Ps: Drugs (or withdrawal) Infection (PUS = Pneumonia, UTI, Skin) Metabolic (e.g. Na, Ca, TSH) Environmental Structural Pain Pee Poo I WATCH DEATH
Infections – PUS, CNS Withdrawal – alcohol, sedatives, barbiturates Acute metabolic changes – pH, hypo/hyper Na, Ca, acute liver or renal failure Trauma – brain injury, subdural hematoma CNS – post-ictal, stroke, tumour, brain mets Hypoxia – CHF, anemia Deficiencies – thiamine, niacin, B12 (e.g. chronic G and T alcoholics) Endocrinopathies – hypo-/hyper-cortisol, hypoglycemia Acute vascular – hypertensive encephalopathy, septic hypotension Toxins and Drugs – especially anti-cholinergics, opioids, benzodiazepines Heavy metals PINCH ME Pain Infection Nutrition Constipation Hydration Medication Electrolytes

Erikson's developmental stages

"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 dentityand rolling fuses ole confusion Mr. N.T. Macy ntimacyisolated 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

ASEPTIC: Appearance Speech Emotion (objective/subjective) Perceptions Thoughts Insight Cognition

Mania: cardinal symptoms

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

Must have 3 of MANIAC: Mouth (pressure of speech)/ Moodl Activity increased Naughty (disinhibition) Insomnia Attention (distractibility) Confidence (grandiose ideas)

Parasomnias: time of onset

Sleep terrors and Sleepwalking occur during Slow-wave sleep (stages 3 & 4).Nightmare occurs during REM sleep (and is remembered).

Psychiatric review of symptoms

"Depressed patients seem anxious, so call 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

4 A's: Ambivalence Affective incongruence Associative loosening Autism

Substance dependence: features (DSM IV)

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

Chest radiograph: checklist to examine

"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

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

"If you see holes on chest X-ray, they are weird": Wegener's granulomatosis (now known as

granulomatosis with polyangiitis Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis (WG), is a rare long-term systemic disorder that involves the formation of granulomas and inflammation of blood vessels (vasculitis). It is a form of vasculitis ...

) 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

CRITOE: Capitellum Radial head Internal epicondyle Trochlea Olecranon External epicondyle

Head CT scan: evaluation checklist

"Blood can be very bad": Blood Cistern Brain Ventricles Bone

Neck sagittal x-ray: examination checklist

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

LOSS: Loss of joint space Osteopyhtes Subcondral sclerosis Subchondral cysts

T2 vs. T1 MRI scan

"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

BREASTS: Beryllium Radiation Extrinsic allergic alveolitis Ankylosing spondylitis Sarcoidosis TB Siliconiosis

Respiratory

Airway assessment

LEMON * Look * Evaluate * Mallampati * Occlusion * Neck mobility PIPPA * Position * Inspection * Palpation * Percussion * Auscultation

Asthma management

ASTHMA * Adrenergic agonists * Steroids * Theophylline * Hydration * Masked oxygen * Anticholinergics

COPD Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce mu ...
assessment test (CAT)

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

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

Causes of upper zone pulmonary fibrosis

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

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

LMNOP: Lasix Morphine Nitro Oxygen Position/positive pressure ventilation

Miscellaneous

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

SLUDGE and the Killer B's: Salivation Lacrimation Urination Diaphoresis, diarrhea Gastrointestinal cramping Emesis Bradycardia Bronchospasm Bronchorrhea also known as DUMBBELLS Diarrhea Urination Miosis Bradycardia Bronchospasm Emesis Lacrimation Loss of muscle strength Salivation/sweating

Cheyne-Stokes breathing

Cheyne-Stokes breathing sounds like "chain smokes" Drugs causing gynaecomastia: DISCO * Digitalis * Isoniazid * Spironolactone * Cimetidine / ketoconazole * Oestrogen

Drugs for bradycardia and hypotension

Isoproterenol Dopamine Epinephrine Atropine sulfate

Diaphragm innervation

C3, 4, 5 keeps the diaphragm alive

Intubation preparation

7 P's Preparation Preoxygenation Pretreatment Paralysis with induction Positioning Placement of tube Postintubation management

Pentad of TTP

FAT RN: Fever Anemia Thrombocytopenia Renal Neuro changes

Systemic lupus erythematosus: diagnostic symptoms

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.