Mnemonics - Clinical


Many of these mnemonics are decades old.
Mnemonics - Anatomy
Mnemonics - MCAT
Mnemonics - General

    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

      "3 Hypo's & 3 Hyper's"
        Hypoxia
        Hypothermia
        Hypokalemia

        Hyperkalemia
        Hyper H+ (acidosis)
        Hyper Rx (drugs)

    Atherosclerosis

      Risk factors
        Constitutional
          G enetic
          A ge
          S ex
        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

      "FAM"
        F ever
        A nemia
        M urmur

    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

      "SHAMPOO DIRT"
        S arcoidosis
        H yperparathypoidism, Hyperthyroidism
        A lkali-milk syndrome
        M etastases, Myeloma
        P aget disease
        O steogenesis imperfecta
        O steoporosis

        vitamin D toxicity
        I mmobility
        R TA
        T 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 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

      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"
          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

        "ANS"
          Aneurysm
          Neural
          Spine

    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

      "CASH CML"
        C andida
        A ureus (staph)
        S almonella
        H istoplasma

        C ytomegalovirus
        M ycobacteria
        L eptospira

    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

      "RATS PANIC"
        R ed squill
        A rsenicals
        T hallium
        S trychnine

        P NU/Phosphorus/Zn Phosphide
        A lpha naphtha thiurea (ANTU)
        N orbormide
        I ndanediones
        C oumadin/cholcalciferol

    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

      "Bad mafia"
        B - Basophilic stippling
        A – Anemia, Anisocytosis
        D - Deferoxamine

        M – MCV is low
        A - HbA is decreased
        F - HbF is increased
        I – Ineffective erythropoiesis
        A – 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 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%


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