Medical Mnemonics PDF

Medical Mnemonics geekymedics.com/medical-mnemonics Dr Chris Jefferies March 23, 2022 The Geeky Medics list of medical mnemonics has been curated to help you remember important medica...

Medical Mnemonics geekymedics.com/medical-mnemonics Dr Chris Jefferies March 23, 2022 The Geeky Medics list of medical mnemonics has been curated to help you remember important medical concepts and facts. Our list of medical mnemonics includes clinical skills, medicine, surgery, paediatrics and psychiatry. For basic sciences, see the Geeky Medics list of anatomy mnemonics. Want discounted access to all Geeky Medics products? Check out our bundles to save money and supercharge your learning 🔥 Clinical skills mnemonics History structure: CHAMPS Complaint (presenting) 1/11  History of presenting complaint Allergies Medications Past medical history Social history Assessment of pain: SOCRATES Site Onset Character Radiation Associated symptoms Timing Exacerbating and relieving factors Severity See our history taking guides for more details. Significant past medical history: MJ THREADS Myocardial infarction Jaundice Tuberculosis Hypertension Rheumatic fever Epilepsy Asthma Diabetes Stroke Drug history: PILLS Pills (is the patient taking any regular medications) Injections/insulin/inhalers ILLicit drug use Sensitivities (allergies) History taking in syncope: “The Five Ps” Precipitant Prodrome Position Palpitations Post-event phenomena See our syncope overview for more details Focused history in emergencies: SAMPLE Signs and symptoms Allergies Medication Past medical history Last oral intake Events leading up to the illness or injury Handover: SBAR Situation Background Assessment Recommendation See our SBAR overview for more details Trauma handover: ATMIST Age 2/11  Time Mechanism of injury Injuries sustained Symptoms and signs Treatments given See our SBARR overview for more details VITAMIN CDEF Vascular Infective Traumatic Autoimmune Metabolic Iatrogenic Neoplastic Congenital Degenerative Endocrine Functional VINDICATE Vascular Infection Neoplasm Degenerative Iatrogenic Congenital Autoimmune Trauma Endocrine/metabolic MIDNITE Metabolic Inflammation Degenerative Neoplastic Infection Trauma Environmental INVITED MD Infection Neoplasia Vascular Inflammatory/autoimmune Trauma Endocrine Degenerative Metabolic Drugs Congenital ECG lead placement: “Ride Your Green Bike” Placement of limb leads, starting clockwise from the right wrist: Red Yellow Green Blue See our guide to recording an ECG. 3/11 Starting a clinical examination: WIPE Wash your hands (and don PPE) Introduce yourself (#HelloMyNameIs) Patient’s name, date of birth and preferred name Explain and gain consent Check out our clinical examination guides. Level of consciousness: ACVPU Alert Confused Voice Pain Unresponsive See our emergency management guides for more details. General inspection from the end of the bed: ABC Appearance (colour, pain, breathlessness etc) Behaviour (calm, agitated etc) Connections (oxygen, catheters, cannulas, surgical drains etc) Neurological examination structure: “Is The Physician Really So Cool?” Inspection Tone Power Reflexes Sensation Co-ordination Tendon reflex nerve roots Count upwards from the ankles: S1 S2: ankle jerk L3 L4: knee jerk C5 C6: biceps and brachioradialis C7 C8: triceps Also, as a rhyme: “1,2 buckle my shoe 3,4 kick the door 5,6 pick up sticks 7,8 shut the gate” Cerebellar signs: DANISH Dysdiadochokinesia & Dysmetria Ataxia Nystagmus Intention tremor Slurred speech Hypotonia See our guide to cerebellar examination. Heart valve auscultation sites: “All Physicians Take Money” From right upper sternal border: Aortic Pulmonary Tricuspid Mitral Assessing a cardiac murmur: SCRIPT Site Character Radiation 4/11  Intensity Pitch and quality Timing (in the cardiac cycle, systolic or diastolic?) See our guide to cardiovascular examination. Breaking bad news: SPIKES Setting up Perception Invitation Knowledge Emotions Strategy and summary See our guide to breaking bad news. Medicine mnemonics Chest X-ray findings in heart failure: ABCDE Alveolar oedema (perihilar/bat-wing opacification) Kerley B lines (interstitial oedema) Cardiomegaly (cardiothoracic ratio >50%) – may be difficult to assess on an AP film Dilated upper lobe vessels Effusions (i.e. pleural effusions – blunted costophrenic angles with meniscus sign) See our overview of acute heart failure. Triggers of atrial fibrillation: PIRATES Pulmonary embolism Ischaemia Respiratory disease Atrial enlargement or myxoma Thyroid disease Ethanol Sepsis/sleep apnoea See our overview of atrial fibrillation. Features of aortic stenosis: SAD Syncope (exertional) Angina Dyspnoea See our aortic stenosis examination guide. Beck’s triad for cardiac tamponade: “Three Ds” Distant heart sounds Distended jugular veins Decreased arterial pressure (low BP) Features of infective endocarditis: FROM JANE Fever Roth’s spots Osler’s nodes Murmur Janeway lesions Anaemia Nail bed haemorrhage Embolism See our overview of infective endocarditis. 5/11 Management of hypertension: ABCD Angiotensin-converting enzyme inhibitors Beta-blockers (no longer first line) Calcium channel blockers Diuretics See our overview of hypertension. Features of asthma: CRAB Chronic inflammation of the airways Reversible airway obstruction Airway hyper-responsiveness Bronchial inflammation See our overview of asthma to learn more. Management of tuberculosis: RIPE Rifampicin Isoniazid (+ pyridoxine) Pyrazinamide Ethambutol See our overview of tuberculosis. Interpreting a chest X-ray: ABCDE Airway: trachea, carina, bronchi and hilar structures. Breathing: lungs and pleura. Cardiac: heart size and borders. Diaphragm: including assessment of costophrenic angles. Everything else: mediastinal contours, bones, soft tissues, tubes, valves, pacemakers and review areas. See our guide to chest x-ray interpretation. Features of thyroid eye disease: NO SPECS No signs or symptoms Only ocular irritation (dryness, gritty sensation) Soft tissue involvement (conjunctival oedema or injection) Proptosis Extraocular muscle involvement Corneal exposure and ulceration Sight loss (due to compressive optic neuropathy) See our overview of thyroid eye disease. Diabetic ketoacidosis precipitants: “The 5 Is” Infection Ischaemia Infarction Ignorance (poor diabetic control) Intoxication See our guide to the acute management of diabetic ketoacidosis. Features of hypercalcaemia: “Bones, Stones, Groans and Moans” Painful bones Renal stones Abdominal groans (pain) Psychiatric moans (depression, confusion, lethargy) Indications for renal replacement therapy: AEIOU Acidosis Electrolyte abnormalities 6/11  Ingested toxins Fluid Overload Uraemia Management of acute kidney injury: ABCDE Address drugs (nephrotoxics) Boost blood pressure Calculate fluid balance Dip urine Exclude obstruction See our overview of acute kidney injury. Functions of the kidney (and complications of CKD): A WET BED Acid-base balance: metabolic acidosis Water removal: pulmonary oedema Erythropoiesis: anaemia Toxin removal: uraemia Blood pressure control: hypertension Electrolyte balance: hyperkalaemia Vitamin D activation: bone-mineral disorder of chronic kidney disease (CKD-BMD) Causes of pancreatitis: I GET SMASHED Idiopathic Gallstones Ethanol Trauma Steroids Mumps/malignancy Autoimmune disease Scorpion sting (very rare…) Hypertriglyceridemia/hypercalcaemia ERCP (endoscopic retrograde cholangiopancreatography) Drugs: commonly azathioprine, thiazides, septrin, tetracyclines Glasgow score for pancreatitis: PANCREAS PaO2 55 Neutrophils (white cell count) > 15 Calcium < 2 mmol/L Raised urea >16 mmol/L Enzyme (LDH) >600 IU/L Albumin 10 mmol/L See our overview of acute pancreatitis. Conditions associated with coeliac disease: “I Don’t Take Apples, I Take Oranges” IgA deficiency Down’s syndrome Turner’s syndrome Autoimmune thyroid disease and autoimmune hepatitis IgA nephropathy Type 1 diabetes mellitus Other autoimmune conditions (e.g. Sjögren’s, myasthenia gravis, Addison’s disease) See our overview of coeliac disease. Features of myeloma: CRAB HyperCalcaemia Renal failure Anaemia 7/11  Bone lesions See our overview of multiple myeloma. Vitamin K-dependent clotting factors: “2 + 7 = 9, not 10” Causes of microcytic anaemia: TAILS Thalassemia Anaemia of chronic disease Iron deficiency anaemia Lead poisoning (rare) Sideroblastic anaemia (rare) See our guide to full blood count interpretation. Drugs that potentiate warfarin (increase INR): O DEVICES Cytochrome P450 inhibitors: Omeprazole Disulfiram Erythromycin Valproate Isoniazid Ciprofloxacin/Cimetidine Ethanol (acute intoxication) Sulphonamides Drugs that decrease the effectiveness of warfarin (decrease INR): PC BRAS Cytochrome P450 inducers: Phenytoin Carbamazepine Barbiturates Rifampicin Alcohol (chronically) Sulphonylureas See our guide to warfarin prescribing. Features of migraine: POUND Pulsating One to three days duration (4 – 72 hours) Unilateral Nausea and/or vomiting Disabling Features of Parkinson’s disease: SMART Shuffling gait Mask facies Akinesia Rigidity Tremor See our guide to Parkinson’s disease examination. Features of normal pressure hydrocephalus: “Wet, Wobbly and Wacky” Wet: urinary incontinence Wobbly: wide-based gait Wacky: cognitive impairment See our neurosurgery topic summaries. Features of limited cutaneous systemic sclerosis: CREST 8/11  Calcinosis: deposits of calcium in soft tissue Raynaud’s: characterised by colour change of the hands, initially white (ischaemic change), then purple (deoxygenated blood) then pink (reperfusion) (o)Esophageal dysmotility: presents as dysphagia most often but there are other oesophageal symptoms Sclerodactyly: thickening and tightness of the skin of the fingers Telangiectasia: red spots around the mouth, nose and sometimes the palms, due to dilated capillaries See our rheumatology topic summaries. Features of melanoma: ABCDE Asymmetry Border irregularity (or poorly defined) Colour (varying colours) Diameter (>6mm) Evolving (changing in size, colour or shape See our dermatology guides. Causes of delirium: PINCH ME Pain Infection Nutrition Constipation Hydration Medication Environment See our guide to delirium assessment & management, Red flags for back pain: TUNA FISH Trauma Unexplained weight loss Neurological symptoms / signs Age > 50 Fever Intravenous drug use Steroid use History of cancer See our back pain history taking guide. Reversible causes of cardiac arrest: “4Hs and 4Ts” Hypoxia Hypokalaemia/hyperkalaemia Hypothermia/hyperthermia Hypovolaemia Tension pneumothorax Tamponade Thrombosis Toxins See our emergency guides. Interpreting a CT head: “Blood Can Be Very Bad” Blood Cisterns Brain Ventricles Bone See our guide to CT head interpretation. 9/11 Surgery mnemonics Causes of abdominal distension: “The 6Fs” Fat Fluid Flatus Faeces Fetus Fatal mass (ie, malignancy) See our guide to abdominal examination. X-ray changes in osteoarthritis: LOSS Loss of joint space Osteophytes Subchondral sclerosis Subchondral cysts See our guide to osteoarthritis. Management of soft tissue injuries: RICE Rest Ice Compression Elevation Salter-Harris classification: SALTR Slipped (type I) Above the joint (type II) Lower (Type III) Through (Type IV) Ruined or rammed (Type V) See our guide to musculoskeletal x-ray interpretation. Features of acute limb ischaemia: “The Six Ps” Pain Pallor Pulselessness Perishingly cold (poikilothermia) Paraesthesia Paralysis See our guide to acute limb ischaemia Assessment of breast lump: LMNOP Lumps Mammary changes Nipple changes Other symptoms Patient risk factors (risk factors for cancer) See our guides to breast examination and breast cancer. Management of shoulder dystocia: HELPERR Help: call for help Evaluate for episiotomy Legs (McRoberts’ position) Pressure (suprapubic) Enter manoeuvres (rotational) Remove the posterior arm Roll over onto all fours 10/11 See our guide to shoulder dystocia. Features of nasopharyngeal cancer: NOSE Neck mass Obstructed nasal passage Serous otitis media externa Epistaxis and discharge See our guide to nasal examination. Paediatric mnemonics Pyloric stenosis: “Three Ps” Palpable mass Peristalsis visible Projective vomiting Features of croup: “Three Ss” Stridor Subglottic swelling Seal like cough See our guide to croup. Paediatric history: BINDS Birth Immunisations Nutrition Development Social history See our guide to paediatric history taking. Psychiatry mnemonics Risk factors for suicide: SAD PERSONS Sex (male) Age (45 years) Depression Previous attempt Excess alcohol or substance use Rational thinking loss Social support lacking Organised plan No spouse Sickness See our guide to suicide risk assessment. Features of post-traumatic stress disorder: HARD Hyperarousal: persistently heightened perception of current threat (may include enhanced startle reaction) Avoidance of situations/activities reminiscent of the events, or of thoughts/memories of the events Re-experiencing the traumatic events (vivid intrusive memories, flashbacks, or nightmares) Distress: strong/overwhelming fear and physical sensations when re-experiencing Copyright © Geeky Medics 11/11