Mnemonics For Medicine

Aortic stenosis characteristics SAD:
Syncope
Angina
Dyspnoea

ECG: left vs. right bundle block "WiLLiaM MaRRoW":
W pattern in V1-V2 and M pattern in V3-V6 is Left bundle block.
M pattern in V1-V2 and W in V3-V6 is Right bundle block.
· Note: consider bundle branch blocks when QRS complex is wide.

MI: signs and symptoms PULSE:
Persistent chest pains
Upset stomach
Lightheadedness
Shortness of breath
Excessive sweating

Heart compensatory mechanisms that 'save' organ blood flow during shock "Heart SAVER":
Symphatoadrenal system
Atrial natriuretic factor
Vasopressin
Endogenous digitalis-like factor
Renin-angiotensin-aldosterone system
· In all 5, system is activated/factor is released

Murmurs: right vs. left loudness "RILE":
Right sided heart murmurs are louder on Inspiration.
Left sided heart murmurs are loudest on Expiration.

ST elevation causes in ECG ELEVATION:
Electrolytes
LBBB
Early repolarization
Ventricular hypertrophy
Aneurysm
Treatment (eg pericardiocentesis)
Injury (AMI, contusion)
Osborne waves (hypothermia)
Non-occlusive vasospasm

Beck's triad (cardiac tamponade) 3 D's:
Distant heart sounds
Distended jugular veins
Decreased arterial pressure

MI: therapeutic treatment ROAMBAL:
Reassure
Oxygen
Aspirin
Morphine (diamorphine)
Beta blocker
Arthroplasty
Lignocaine

CHF: causes of exacerbation FAILURE:
Forgot medication
Arrhythmia/ Anaemia
Ischemia/ Infarction/ Infection
Lifestyle: taken too much salt
Upregulation of CO: pregnancy, hyperthyroidism
Renal failure
Embolism: pulmonary

Murmurs: systolic vs. diastolic PASS: Pulmonic & AorticStenosis=Systolic.
PAID: Pulmonic & Aortic Insufficiency=Diastolic.

Murmurs: systolic vs. diastolic Systolic murmurs: MR AS: "MR. ASner".
Diastolic murmurs: MS AR: "MS. ARden".
· The famous people with those surnames are Mr. Ed Asner and Ms. Jane Arden.

Mitral stenosis (MS) vs. regurgitation (MR): epidemiology MS is a female title (Ms.) and it is female predominant.
MR is a male title (Mr.) and it is male predominant.

Pericarditis: EKG "PericarditiS":
PR depression in precordial leads.
ST elevation.

Jugular venous pressure (JVP) elevation: causes HOLT: Grab Harold Holt around the neck and throw him in the ocean:
Heart failure
Obstruction of venea cava
Lymphatic enlargement - supraclavicular
Intra-Thoracic pressure increase

MI: therapeutic treatment MONAH:
Morphine
Oxygen
Nitrogen
Aspirin
Heparin

Depressed ST-segment: causes DEPRESSED ST:
Drooping valve (MVP)
Enlargement of LV with strain
Potassium loss (hypokalemia)
Reciprocal ST- depression (in I/W AMI)
Embolism in lungs (pulmonary embolism)
Subendocardial ischemia
Subendocardial infarct
Encephalon haemorrhage (intracranial haemorrhage)
Dilated cardiomyopathy
Shock
Toxicity of digitalis, quinidine

Murmurs: innocent murmur features 8 S's:
Soft
Systolic
Short
Sounds (S1 & S2) normal
Symptomless
Special tests normal (X-ray, EKG)
Standing/ Sitting (vary with position)
Sternal depression

Murmur attributes "IL PQRST" (person has ill PQRST heart waves):
Intensity
Location
Pitch
Quality
Radiation
Shape
Timing

Murmurs: locations and descriptions "MRS A$$":
MRS: Mitral Regurgitation--Systolic
A$$: Aortic Stenosis--Systolic
· The other two murmurs, Mitral stenosis and Aortic regurgitation, are obviously diastolic.

Betablockers: cardioselective betablockers "Betablockers ActingExclusively At Myocardium"
· Cardioselective betablockers are:
Betaxolol
Acebutelol
Esmolol
Atenolol
Metoprolol

Apex beat: abnormalities found on palpation, causes of palpable apex beat

HILT:
Heaving
Impalpable
Laterally displaced
Thrusting/ Tapping
· If it is impalpable, causes are COPD:
COPD
Obesity
Pleural, Pericardial effusion
Dextrocardia

MI: treatment of acute MI COAG:
Cyclomorph
Oxygen
Aspirin
Glycerol trinitrate

Coronary artery bypass graft: indications DUST:
Depressed ventricular function
Unstable angina
Stenosis of the left main stem
Triple vessel disease

Peripheral vascular insufficiency: inspection criteria SICVD:
Symmetry of leg musculature
Integrity of skin
Color of toenails
Varicose veins
Distribution of hair

Rheumatic fever: Revised Jones' criteria JONES crITERIA:
· Major criteria:
Joint (arthritis)
Obvious (Cardiac)
Nodule (Rheumatic)
Erythema marginatum
Sydenham chorea
· Minor criteria:
Inflammatory cells (leukocytosis)
Temperature (fever)
ESR/CRP elevated
Raised PR interval
Itself (previous Hx of Rheumatic fever)
Arthralgia

Heart murmurs "hARD ASS MRS. MSD":
hARD: Aortic Regurg = Diastolic
ASS: Aortic Stenosis = Systolic
MRS: Mitral Regurg = Systolic
MSD: Mitral Stenosis = Diastolic

Pulseless electrical activity: causes PATCH MED:
Pulmonary embolus
Acidosis
Tension pneumothorax
Cardiac tamponade
Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia
Myocardial infarction
Electrolyte derangements
Drugs

Exercise ramp ECG: contraindications RAMP:
Recent MI
Aortic stenosis
MI in the last 7 days
Pulmonary hypertension

ECG: T wave inversion causes INVERT:
Ischemia
Normality [esp. young, black]
Ventricular hypertrophy
Ectopic foci [eg calcified plaques]
RBBB, LBBB
Treatments [digoxin]

Myocardial infarctions: treatment INFARCTIONS:
IV access
Narcotic analgesics (eg morphine, pethidine)
Facilities for defibrillation (DF)
Aspirin/ Anticoagulant (heparin)
Rest
Converting enzyme inhibitor
Thrombolysis
IV beta blocker
Oxygen 60%
Nitrates
Stool Softeners

Atrial fibrillation: causes PIRATES:
Pulmonary: PE, COPD
Iatrogenic
Rheumatic heart: mirtral regurgitation
Atherosclerotic: MI, CAD
Thyroid: hyperthyroid
Endocarditis
Sick sinus syndrome

Atrial fibrillation: management ABCD:
Anti-coagulate
Beta-block to control rate
Cardiovert
Digoxin

Murmurs: questions to ask SCRIPT:
Site
Character (eg harsh, soft, blowing)
Radiation
Intensity
Pitch
Timing

Pericarditis: causes PR DIP, ST UP:
Post-pericardiectomy
Rheumatic fever
Drugs (eg isoniazid, hydralazine, procainalmide)
Infection (eg TB, coxsackie, strep)
PE
SLE/Scleroderma
Tumours/ Thyroid disease
Uraemia
Post MI (includes Dressler's)

Aortic dissection: risk factors ABC:
Atherosclerosis/ Ageing/ Aortic aneurysm
Blood pressure high/ Baby (pregnancy)
Connective tissue disorders (eg Marfan's, Ehlers-Danlos)/ Cystic medial necrosis

Heart failure: causes HEART FAILED:
Hypertension
Endocrine
Anemia
Rheumatic heart disease
Toxins
Failure to take meds
Arrythmia
Infection
Lung (PE, pneumonia)
Electrolytes
Diet

(CHARGE syndrome =
Coloboma,
Heart disease,
Atresia choanae,
Retarded growth,
hypoGonadism, and
Ear abnormalities).

The combination of diabetes mellitus, hypertension, obesity, insulin resistance, and dyslipidemia (increased VLDL, increased triglyceride, and decreased HDL) is called syndrome X 

Coronary artery disease,
Hypertension, 
Atherosclerosis, 
Obesity, and
Stroke (CHAOS).

Risk factors for delirium include:
Hypoxemia,
Infection, 
Drugs, and 
Electrolyte abnormalities (HIDE)

1.Gout=NeGoutively(negatively)birefringence

Needle-shaped

2.Pseudogout=Positive birefringence

Pheochromocytoma-rule of 10s: 

10% malignant 10% Bilateral 10% extraadrenal 10% calcified 10% children10% familial * discussed 10 times more often than actually seen 

Aphasia "BROKen aphasia" (Broca's aphasia-broken speech) "Wordys aphasia" (Wernicke's aphasia- wordy, but making no sense) 

GET SMASH'D--Causes of Acute pancreatitis 

Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune(PAN), Scorpion bites, Hyperlipidemia, Drugs(azathioprine, diuretics) 

(Multiple endocrine neoplasia) Each of the MENs is a 

disease of three or two letters plus a feature. "MEN I" is a disease of the 3 Ps (pituitary, parathyroid and pancreas) plus adrenal cortex. 

"MEN II " is a disease of the two Cs (carcinoma of the thyroid and catacholamines [pheochromocytoma]) plus parathyroid for MEN IIa or mucocutaneous neuromas for MEN IIb (aka MEN III). 

Acute pneumonia caused by Pyogenic bacteria--PMN infiltrate 

Acute pneumonia caused by Miscellaneous microbes --Mononuclear infiltrate 

Takayasu's diz = pulseless diz, therefore when you have 

Takayasu's, I can't Tak'a yu pulse. 

Argyll-Robertson Pupil--syphilitic pupil (AKA "Prostitute's pupil" - Accommodates, but doesn't react ) 

Accommodation reflex present, Pupillary reflex absent 

CAGE--alcohol use screening 
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? 

P-Q-R-S-T--eliciting and HPI and exploring symptoms 

P--palliative or provocative factors for the pain 

Q--quality of pain(burning, stabbing, aching, etc.) 

R--region of body affected 

S--severity of pain(usually 1-10 scale) 

T--timing of pain(eg.-after meals, in the morning, etc.) 

ACID or "Anna Cycled Immediately Downhill" 

classification of hypersensitivity reactions 

Type I - Anaphylaxis 

Type II - Cytotoxic-mediated 

Type III - Immune-complex 

Type IV - Delayed hypersensitivity 

WBC Count: 

"Never Let Momma Eat Beans(60, 30, 6, 3, 1) 

Neutrophils 60% 
Lymphocytes 30% 
Monocytes 6% 
Eosinophils 3% 
Basophils 1% 

A-P-G-A-R: 

A - appearance (color) 

P - pulse (heart rate) 

G - grimmace (reflex, irritability) 

A - activity (muscle tone) 

R - respiratory effort 

Predisposing Conditions for Pulmonary Embolism: TOM SCHREPFER 

T--trauma 

O--obesity 

M--malignancy 

S--surgery 

C--cardiac disease 

H--hospitalization 

R--rest (bed-bound) 

E--estrogen, pregnancy, post-partum 

P--past hx 

F--fracture 

E--elderly 

R--road trip 

The 4 P's of arterial Occlusion: pain pallor pulselessness paresthesias 

The 4 T's of Anterior Mediastinal Mass:Thyroid tumor,Thymoma,Teratoma, Terrible Lymphoma 

Mneumonic for indications of Dialysis: AEIOU
1. Acidosis
2. Electrolyte abnormalities-hyperkalemia
3. Ingestion of substances like barbiturates, salicylates, lithium, methanlo, etc
4. Overload fluid (unresponsive to diuretics)
5. Uremia symptoms (pericarditis, encephalopathy) 


Mneumonic for Heerfordt Syndrome- PUFF
P - Parotitis
U - uveitis
F - Fever
F - Facial palsy

Wallenberg syndrome..

Prostitute Wallenberg`s Horny ADVICe 

Post inferior cerebellar a occlusion
Wallwnberg syndrome
Horner`s synd
Ataxia
Dyarthria,Dysphagia
Vertigo
Contralateral body sensory loss

Isnt blurred vision assoc. with this due to "sludging of IgM?

Loss of consciousness - 
DDx : AEIOU TIPS
alcohol, epilepsy,insulin, overdose,uremia , trauma, infection,psychogenic , stroke
Tx: coma cocktail = dextrose,thiamine,naloxone and O2

ACROMegaly 

mostly due to MACROadenoma

BUPRIOPION or BUSPIRONE...??

antianXiety=buXpirone 

BuPROPERion = PROPER habits ( no smoking ) 

CAUSES OF PROLONGED QT . FORGOT AFEW ,WILL FILL IT LATER
A AMIODARONE
B BRETYLIUM
C CISAPRIDE
D DIISOPYRAMIDE
E ERYTHOMYCIN
F
G
H HYPOKALAEMIA


P PROCAINAMIDE
Q QUINIDINE
S
T THIORADAZINE

4 [C]'s:

[C]omatose

[C]onvulsing

[C]orrosive

hydro[C]arbon

a..adenosine
b...b.blocker
c...ca channel blocker
d...digoxin
e...emiodarone
treatmnt for SVT

L...lymph node
O...orifices
R...rectum
for abd examination

S...svt
H...hypoxia
E...electrolyte
D....drugs

A...ADRENALINE/ATROPINE
B....BRONCHODILATOR LIKE SALBUTAMOL/ANTI HISTAMINE
C....CORTICOSTEROIDS

acute management of cardiovascular collapse

sudden unconsciousness.,look for
C...cns exam/gcs scoring
A...acidosis...do abg,s
T..trauma

I....infection

D...drugs
E..endocrine like adrenal/hypothyroid/pancreatic/pituitary insufficiency
E...electrolyte..look for skin dryness(Na)/ecg(K)
M...metabolic like hypertensive/hepatic/renal encephalopathy

thus in emergency.,we have to look for unconsious patient as 
CAT I DEEM

Evidence of myocardial necrosis with any 1 of the following:
Cardiac biomarkers (pref. Troponins) showing sudden rise or fall
Sudden unexpected cardiac death involving cardiac Arrest
Pathological findings of acute MI



Signs of MI (windows VISTA)
Vagal activation (vomiting, bradycardia)
Impaired myocard. Func. (s1,s2 soft; hypotension; inc. JVP; Oliguria; Cold, clammy skin)
Sympathetic activation (Pallor, sweating, tachycardia)
Tissue damage (Low grade fever)
A complication (MR / VSD producing pansystolic murmur

Enzymes elevated in MI (TALC - talcum powder) 
Troponin T/I
AST
LDH
CK-MB 

Complications of MI
Immediate (RAILgaadi)
a) RV infarction
b) Arrythmias (VT, AF, VF) - may also be due to I.v. Xylocaine overdose
c) LHF 
Early (PSVT ka MELA laga hua hai !!)
a) Pericarditis 
b) Sudden death
c) VSD
d) Thromboembolic complications (Pulmonary, Arterial)
e) MR (Papillary muscle dysfunction or rupture) 
f) LV free wall rupture (Pericardial tamponade)
g) Arterial compl. (same as mentioned in d) )
Late (PADS)
a) Psychological reaction (DADDA- Denial, Acceptance, Dependency, Depression, Adjustment - this is from earliest change to last)
b) Arrythmias (ventricular like VF, VT)
c) Dressler’s syndrome (Autoimmune phenomenon characterized by fever, pericarditis, pleuritis, pneumonitis)
d) Shoulder (Frozen shoulder) – Pain n stiffness of left shoulde

Guillain-Barre Syndrome....
A- Acute , Ascending
B- Bilateral
C- cyto-albumin dissociation
D- Demyelination
E- Elevated protein count , EMG for accurate test
F- Flacid paralysis
G- Guillain-Barre 
H- Hyporeflexia or absent 

GI bleeding: causes ABCDEFGHI: Angiodysplasia Bowel cancer Colitis Diverticulitis/ Duodenal ulcer Epitaxis/ Esophageal (cancer, esophagitis, varices) Fistula (anal, aortaenteric) Gastric (cancer, ulcer, gastritis) Hemorrhoids Infectious diarrhoea/ IBD/ Ischemic bowel

Children under 5 + Fever more than 5 days= suspect Kawasaki
Manifestations of Kawasaki (acute phase)= CLASH

Conjunctivitis, Carditis, CSF pleocytosis
LAP (cervical)
Aneurysm, Arthritis
Skin rash, Strawberry tongue
Hydrops (gall bladder)

Diabetic ketoacidosis (DKA) treatment
NIKAH ,
N=normal saline
I=insulin
K=potassium
A =antibiotics
H=bicarbonates

Tabes Dorsalis morphology...

DORSALIS:

D-Dorsal column degeneration
O-Orthopedic pain (Charcot joints)
R-Reflexes decreased (deep tendon)
S-Shooting pain
A-Argyll-Robertson pupils
L-Locomotor ataxia
I-Impaired proprioception
S-Syphilis

Eye changes (Grave’s Disease)

NO SPECS
0 = No signs or symptoms 
1 = Only signs (lid retraction or lag), no symptoms 
2 = Soft tissue involvement (periorbital edema) 
3 = Proptosis (>22 mm) 
4 = Extraocular muscle involvement (diplopia) 
5 = Corneal involvement 
6 = Sight loss

DDx of Bleeding Disorders
F-CAP
F ibrinolysis (e.g. DIC)
C oagulopathy (e.g. hemophilia, vWD)
A ngiopathy - vessels (e.g. Osler-Weber-Rendu)
P latelets (e.g. thrombocytopenia or thrombocytopathia)
Initial Diagnostic tests = 3Ps
P latelets
P T = INR
P TT

Triad of Wernicke's disease..
"GOA"
G= Global confusion
O= Ophtalmoplegia
A= Ataxia

Acute tubulointerstitial nephritis;
Treatment guide as well as Drugs causing the disease.
Mnemonic:
"PATIENT NEEDS STEROIDS, PREVENT ANY DRUG CAUSING REACTION"
Patient = penicillin
Needs = NSAIDs
Steroids = sulfonamides
Prevent = phenytoin
Any = allopurinol
Drug = diuretics
Causing = cimetindine, cephalosporin
Reaction = rifampicin

Mnemonic for remembering antiarrhythmics

Class Drug Mnemonic

Class IA

Procainamide   (Professor)
Quinidine (Quackers)
Disopyramide   (dissed)

Class IB

Lidocaine  (Lydia's)
Phenytoin (penny)
Mexiletine  (Mexican)
Tocainide  (Tacos)

Class IC

Flecainide   (feeling)
Propafenone  (profaned)
Class II

Propranolol   (proper)
Beta Blockers   (Bertha Butt)

Class III

Amiodarone  (amiable)
Bretylium   (British)
Solatol   (socialite)

Class IV

Verapamil  (virtually)
Diltiazem  (dismembered 'im)
Atropine



Read as:
Professor Quackers "dissed" - Lydia's penny Mexican tacos. - Feeling profaned, - proper Bertha Butt - (amiable British socialite) - virtually dismembered 'im.

or

Professor Quackers dissed Lydia's Penny Mexican Tacos. Feeling profaned, proper Bertha Butt, (amiable British socialite), virtually dismembered 'im.

*Note: "Dissed" is used here as the slang term "dis" - from dismiss. I.e., "Don't 'dis' me, man!

Inhibitors of the electron transport chain pathway.
Complex 1 inhibited bye PAR
Complex 2 by MAL 
Complex 3 by BAL
Complex 4 by HCC
SO 1,2,3,4 BY PAR MAL BAL HCC
PAR - (P)IRICIDINE
(A)MOBARBITOL (BARBITURATES)
(R)OTENONE

MAL- (MAL)ONATE

BAL- (B)RITISH (A)NTI (L)EWISITE
HCC- (H)2S , (C)O2, -(C)N and sodium azide.

For Causes of A-Fib/Flutter:
H= cHf, other cardiomyopathies
E= Enlargement of the atria
A= Alcohol binge drinking
R= Rheumatic heart disease
T= hyperThyroid

Causes of Pure motor neuropathy.."PHD is A TALL degree"
P= Poliomyelitis
H= Hereditary spinal muscular atrophy
D= Dapsone intoxication
A= Adult variant of Hexosaminidase deficiency
T= Tick bite paralysis
A= Acute intermittent porphyria
L= Lead intoxication
L= Lambert Eaton Syndrome
L= LMN form of Amyotrophic lateral sclerosis

organisms transferred through  breast milk...just remember d abbreviation of acetylcholine(ACH)
A=Aureus (staphylococcus)
C=cytomegalovirus
H=human T-cell leukemia virus

Drugs used for the treatment of Ewing sarcoma to remember the VODCA 
V-vincristine
O
D-doxorubicin
C-cyclophosphamide
A-actinomycin-D

Viruses transmitted by blood or blood transfusion:
5 Heroes likes Priyanka Chopra.
Hepatitis B virus
Hepatitis C virus
Hepatitis G virus
HIV type I
HTLV type I( human T cell lymphotropic virus)
Parvovirus B- 19
Cytomegalovirus

X-linked recessive disorders:
"GA SOLution Will (cause) [Diabetes , CHF]^2
G-G-6PD Deficiency
A-Agammaglobulinaemia
S-Sideroblastic Anaemia
O-Ocular Albinism
L-Lesch Nyhan Syndrome
Will-Wiskott Aldrich Syndrome
Diabetes-Diabetes Insipidus
Diabetes-Duchenne Becker's muscular Dystrophy
C-Colour blindness
C-Chronic granulomatous disease
H-Haemophilia A & B
H-Hunter's disease
F-Fabry's disease
F-Fragile X syndrome

Heart valvue disorders and murmurs

REMEMBER: hARD ASS MRS. MSDoctor

hARD - Aortic Regurgitation is DIASTOLIC

ASS - Aortic Stenosis is SYSTOLIC

MRS - Mitral Regurgitation is SYSTOLIC

MSD - Mitral Stenosis is DIASTOLIC

diagnosis of RA:
SMAARRRT
S=symmetrical arthritis
M=morning stiffness(>1 hr)
A=arthritis of 3 or more joint
A=arthritis of hand joint
R= rhematoid nodules
R=rhematoid factor +ve
R=radiological changes
T=time duration >6 wks

Cerebellar Signs and symptoms

Remember: 3 Deadly ANTS Playing on your cerebellum ( = DDD ANTS P , i.e 3 Ds expanded )

Dysarthria
Decreased tone
Dysdiadochokinesis
Ataxia
Nystagmus
Tremor (Intention tremors)
Slurrred speech / Scanning speech
Pendular knee jerk

Note: Please try to quote the ANTS first in the order of symptoms before 3 Ds, as they are the most important. See the picture to remember the 3 ants better :-)