Erector spinae muscles

"I Long for Spinach"


From lateral to medial, the muscles forming erector spinae are:

• Illiocostalis
• Longissimus
• Spinalis

Inguinal canal: walls

"MALT: 2M, 2A, 2L, 2T":
· Starting from superior, moving around in order to posterior:
Superior wall (roof): 2 Muscles:
· internal oblique Muscle
· transverse abdominus Muscle
Anterior wall: 2 Aponeuroses:
· Aponeurosis of external oblique
· Aponeurosis of internal oblique
Lower wall (floor): 2 Ligaments:
· inguinal Ligament
· lacunar Ligament
Posterior wall: 2Ts:
· Transversalis fascia
· conjoint Tendon

Femoral artery deep branches

"Put My Leg Down Please":
Profundus femoris (deep femoral artery)
Medial circumflex femoral artery
Lateral circumflex femoral artery
Descending genicular arteries
Perforating arteries

Elbow joint: radius vs. ulna ends

CRAzy TULips:
Capitalum = RAdius

Trochlear = ULnar

Intrinsic muscles of hand (palmar surface)

"All For One And One For All":
· Thenar:
Abductor pollicis longus

Flexor pollicis brevis
Opponens pollicis
Adductor pollicis.
· Hypothenar:
Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi

Nerve thickening

ISLAND
IDIOPATHIC HYPERTROPHIC NEUROPATHY
SARCOIDOSIS
 LEPROSY
AMYLOIDOSIS
NEUROFIBROMATOSIS
DIABETES MELLITUS

Carpal tunnel syndrome: treatment

 WRIST:
Wear splints at night
Rest
Inject steroid
Surgical decompression
Take diuretics

GEOMED

Tumours- site of origin
G-Giant cell tmr
E-Epiphysis
O-Osteosarcoma
M-Metaphysis
E-Ewings tmr
D-Diaphysis

Growing end of bones

towards the knee(distal end femur ,upper end tibia),we flee.
away from elbow(upper end humerus,distal end radius &ulna),we go.

osteoblastic bone metastasis

5 BEES LICK POLLEN
 
Brain(medulloblastoma)
Bronchus
Breast
Bowel
Bladder
Lymphoma
Prostrate

triple deformity causes

triple deformity t-trauma.tb r-RA i-iliotibial contracture p-polio l e-extravasation of blood i.e hemarthrosis

Nonunion of bones: differential

You need a SPLINT:
Soft tissue interposition
Position of reduction (too much traction, immobilization, or movement)
Location (eg. lower third of tibia slow to heal)
Infection
Nutritional (damaged vessels or diseased bone)
Tumor (pathological fracture)

Sacroiliitis: causes

 PUB CAR:
Psoriasis
Ulcerative colitis
Behcet's disease
Crohn's disease
Ankylosing spondylitis
Reiter's disease

Diaphyseal lesions

FEMALE "

• Fibrous dysplasia
• Eosinophilic granuloma
• Metastasis
• Adamantinoma
• Leukaemia, Lymphoma
• Ewing's sarcoma

Carpal tunnel syndrome: Causes

MEDIAN TRAP"

• Myxoedema
• Edema premenstrually
• Diabetes mellitus
• Idiopathic
• Acromegaly
• Neoplasm

• Trauma
• Rheumatoid arthritis
• Amyloidosis
• Pregnancy

Bryant's traction: position BrYant's traction:

Bent Y.
· Patient's body is the stem of the Y laying on the bed, and legs are the ends of the Y up in the air.

Fractures: principles of management

 FRIAR:
First aid
Reduction
Immobilisation
Active Rehabilitation

Paget's disease of bone: clinical features

"PANICS"

• Pain
• Arthralgia
• Nerve compression/Neural deafness
• Increased bone density
• Cardiac failure
• Skull/Sclerotic vertebrae

Salter Harris fracture classification

Salter Harris, modified to SALTR:
type 1: Slipped epiphysis
type 2: Above the eiphyseal plate
type 3: Lower than the eiphyseal plate
type 4: Through both above and below eiphyseal plate
type 5: Raised epiphysis, as in a compression injury
· Salter Harris classification utilises visualising long bone distal portion with diaphysis superiorly placed and epiphysis inferiorly placed.

CAVE- correction of club foot stepwise

C-cavus
A-adduction
V-varus
E-equinus

Fracture: how to describe

PLASTER OF PARIS:
Plane
Location
Articular cartilage involvement
Simple or comminuted
Type (eg Colles')
Extent
Reason
Open or closed
Foreign bodies
disPlacement
Angulation
Rotation
Impaction
Shortening

Bone Ache

Question: Do u know what happens if “Tomato Paste Mixture Is Nasty”?
Answer: Chronic bone ache…

How??

Here it is ..

Tomato …….TUMOR (mostly secondary)
Paste………..PAGET’S DISEASE
Mixture……..METABOLIC CAUSES
Is……………chronic INFECTIONS
Nasty………..osteo-NECROSIS

Fracture: describing (short version)

DOCTOR:
Displaced vs. non-displaced
Open vs. closed
Complete vs. incomplete
Transverse fracture vs. linear fracture
Open Reduction vs. closed reduction

Forearm: fractures

 "Break the forearm of the MUGR (mugger)":
Monteggia=Ulna
Galeazzi=Radius

A LEMON

BONE TUMOURS OF DIAPHYSIS A-ADMANTINOMA L-LYMPHOMA E- EWING SARCOMA M-MULTIPLE MYELOMA O-OSTEOID OSTEOMA N-NEUROBLASTOMA

Monoarthritis: causes

"GHOST"

• Gout
• Hemarthroses
• Osteoarthritis
• Sepsis
• Trauma

Osteosarcoma: risk factors

PRIMARY:
Paget's
Radiation
Infaction of bone
Male
Alcohol, poor diet, sedentary lifestyle [adults only]
Retinoblastoma, Li-Fraumeni syndrome
Young [10-20 yrs]
· Osteosarcoma is the most common primary malignant tumor of bone.

Osteomalacia: Radiological features

"Loose Penicillin Fish"

• Looser's  zone (pseudo fractures)
• Penicilling in of  vertebral bodies
• Codfish vertebrae

Ulnar nerve palsy

 "BCDEF of Music"

• Book test
• Card test
• ADductor pollicis paralysed
• Egawa test
• Fromets sign
• Musicians nerve

chronic osteomyelitis

chronic osteomyelitis is secondary to (BAG) ie B: Brodie's abscess
A: acurte osteomyelitis
G: Garre's osteomyelitis

Treatment of it includes (SAC)ie
S: seqestrectomy and saucerisation
A: agressive aproach ie excision of infected part and amputation
C: curettage and continuous suction and irrigation.

The deformities of the foot in Congenital Talipes Equino Varus(CTEV)

"InAdEquate"

• Inversion
• Adduction
• Equinus

Also think: "tAlIpEs", to remember the sequence of correction of deformities.

• Adduction
• Inversion
• Equinus

With respect to joints the deformities are, Inversion at subtalar joint, Adduction at talonavicular joint and Equinus at ankle joint.

Joints classification, by amount of allowed movement at joint

SAD:
Synarthroses
Amphiarthroses
Diarthrose

PROSTAGLANDINS confusion

A)All have "1 MISS"
means
MISoprostol is PGE1.

B)cErviprimE has 2E so
cErviprimE is PGE2.

C)DInoproSTONE
DI=2
Remember that "stonE" in both(2) kidney n "stonE" has "E".
So DINOPROSTONE is PGE2.

D)DINO mario has 2 FArari CAR.
DINO-DINOPROST
2 FArari-F2A [A for Alpha]
CAR-CARBOPROST
so
DINOPROST n CARBOPROST r PGF2alpha

Note: DINOPROSTONE is PGE2 which is remember by 2 kidney stonE bt DINOPROST is PGF2alpha.

RLQ pain: brief female differential

AEIOU:
Appendicitis/ Abscess
Ectopic pregnancy/ Endometriosis
Inflammatory disease (pelvic)/ IBD
Ovarian cyst (rupture, torsion)
Uteric colic/ Urinary stones

Dysfunctional uterine bleeding (DUB): 3 major causes

DUB:
Don't ovulate (anovulation: 90% of cases)
Unusual corpus leuteum activity (prolonged or insufficient)
Birth control pills (since increases progesterone-estrogen ratio)

postmenopausal bleeding

postmenopause
P-olyp(cervical)
O-ovarian cancer(also ca uterus ,vagina, cervix,)
S-enile vaginitis,endometritis
T-rauma
M-yoma
E- ndometrial hyperplasia
N-ot removed pessary leading 2 ulceration
O-estrogen therapy
P-yometra(intermittent)
A-fter radiation ulceration
U-rethral carbuncle
S-arcoma uterus
E-rosion in cervix

Spontaneous abortion: definition

"Spontaneous abortion" has less than 20 letters [it's exactly 19 letters].
Spontaneous abortion is defined as delivery or loss of products of conception at less than 20 weeks gestation.

pge1

USES OF PGE1- (MISOPROST) P-PATENT DUCTUS ARTERIOSIS G-GASTRIC ULCER E-EXPULSION OF FOETUS i.e. MTP 1-IMPOTENCY

"Spontaneous abortion" has less than 20 letters [it's exactly 19 letters].
Spontaneous abortion is defined as delivery or loss of products of conception at less than 20 weeks gestation.

Alpha-fetoprotein: causes for increased maternal serum AFP during pregnancy

"Increased Maternal Serum Alpha Feto Protein":

Intestinal obstruction
Multiple gestation/ Miscalculation of gestational age/ Myeloschisis
Spina bifida cystica
Anencephaly/ Abdominal wall defect
Fetal death
Placental abruption

Histology in ovarian tumors

signet ring cells-krukenberg
walthard cell rests-brenners tumor
reinkes crystals-hilus cell tumor
call-exner bodies-granulosa cell tumor
schill-duoval bodies-endodermal sinus tumors
psammoma bodies-seros epithelial tumor

Oral contraceptive complications:

 warning signs ACHES:
Abdominal pain
Chest pain
Headache (severe)
Eye (blurred vision)
Sharp leg pain

Vaginal pH

 Vagina has 4 labia and normal pH of vagina is about 4.

Left iliac fossa: Causes of pain

SUPER CLOT:

• Sigmoid diverticulitis
• Ureteric colic
• PID
• Ectopic pregnancy
• Rectus sheath haematoma
• Colorectal carcinoma
• Left sided lower lobe pneumonia
• Ovarian cyst (rupture, torture)
• Threatened abortion/ Testicular torsion

CVS and amniocentesis: when performed

 "Chorionic" has 9 letters and Chorionic villus sampling performed at 9 weeks gestation.
"AlphaFetoProtein" has 16 letters and it's measured at 16 weeks gestation.

Postpartum collapse: causes

HEPARINS:
Hemorrhage
Eclampsia
Pulmonary embolism
Amniotic fluid embolism
Regional anaethetic complications
Infarction (MI)
Neurogenic shock
Septic shock

Gestation period, oocytes, vaginal pH, menstrual cycle:

normal numbers 4 is the normal pH of the vagina.
40 weeks is the normal gestation period.
400 oocytes released between menarche and menopause.
400,000 oocytes present at puberty.
28 days in a normal menstrual cycle.
280 days (from last normal menstrual period) in a normal gestation period.

Rise in serum amylase: Causes

Serum amylase rises in Acute pancreatitis.
 Other causes are : ' SAM MUST MERRy '

• Serum Amylase
• Mesenteric infarction
• Upper gastrointestinal tract perforation
• Salivary gland inflammation
• Torsion of intra-abdominal viscus
• Macroamylasaemia
• Ectopic pregnancy
• Retroperitoneal haematoma
• Renal failure

Post-partum examination simplified checklist BUBBLES:

Breast
Uterus
Bowel
Bladder
Lochia
Episotomy
Surgical site (for Cesarean section)

Oral contraceptives: side effects CONTRACEPTIVES:

Cholestatic jaundice
Oedema (corneal)
Nasal congestion
Thyroid dysfunction
Raised BP
Acne/ Alopecia/ Anaemia
Cerebrovascular disease
Elevated blood sugar
Porphyria/ Pigmentation/ Pancreatitis
Thromboembolism
Intracranial hypertension
Vomiting (progesterone only)
Erythema nodosum/ Extrapyramidal effects
Sensitivity to light

Forceps: indications for use FORCEPS:

Fully dilated cervix
0 ["Zero"] CPD
Ruptured membranes
Cephalic or at least deliverable presentation/ Contracting uterus
Episiotomy done/ Epidural done
P!ss and S#!t (bladder and bowel empty)

Endometrial carcinoma: Risk factors

"ENDOMET"

• Elderly
• Nulliparity
• Diabetes mellitus
• Obesity
• Menstrual irregularity
• Estrogen therapy
• hyperTension

Biophysical profile: Constituents

"Monitor Foetus To Confirm Viability"

• Movement of foetal body
• Foetal respiratory movements
• Tone of the foetus
• CTG monitoring of foetal heart rate (Non-stress test)
• Volume of amniotic fluid (Amniotic fluid index)

Absolute C/I for IUCD

"PLEASE DONT EVER PUT CONTRACEPTIVES"

Please-Pregnancy(suspected/confirmed)
Dont-DUB
Ever-Ectopic
Put-PID
Contraceptive-Ca cervix

Early cord clamping: Indications

"RAPID CS"

• Rh incompatibilty
• Asphyxia
• Premature delivery
• Infections
• Diabetic mother
• CS (caesarean section)

B-agonist tocolytic (C/I or warning)

ABCDE:
Angina (Heart disease)
BP high
Chorioamnionitis
Diabetes
Excessive bleeding

Delivery: instrumental delivery prerequisites

AABBCCDDEE:
Analgesia
Antisepsis
Bowel empty
Bladder empty
Cephalic presentation
Consent
Dilated cervix
Disproportion (no CPD)
Engaged
Episiotomy

Sexual response cycle

EXPLORE:
EXcitement
PLateau
Orgasmic
REsolution

Alfa feto protein

alfafeto protein in pregnancy
down in downs-syndrome
high in 2O-- O-OPEN NEURAL TUBE DEFECT
O-OMPHALOCELE

Omental caking: Causes

"Omental CAking = Ovarian CA"

• In gynecology, omental caking almost always signifies ovarian cancer.
• Omental caking is the radiological (CT) finding indicative of thickened greater omentum. It is caused due to neoplastic infiltration of the greater omentum, most commonly  by metastatic ovarian, gastric, colonic, or pancreatic carcinoma.

IUGR: causes

 IUGR:
Inherited: chromosomal and genetic disorders
Uterus: placental insufficency
General: maternal malnutrition, smoking
Rubella and other congenital infecton

Secondary amenorrhea: causes

 SOAP:
Stress
OCP
Anorexia
Pregnancy

Prolactin and oxytocin: Functions

• PROlactin stimulates mammary glands to PROduce milk and
• Oxytocin stimulates mammary glands to OOze milk.

Labour: factors which determine rate and outcome of labour

 3 P's:
Power: stength of uterine contractions
Passage: size of the pelvic inlet and outlet
Passenger: the fetus--is it big, small, have anomalies, alive or dead

Anthropoid pelvis

      Think: "ANthrOPoid"

• Anteroposterior diameter is greater then transverse diameter, and
• OP signifies occipito posterior positions are more common with anthropoid type of pelvis.

1st stage of labour preriquisites

F- Fluids
R- Rest
A- Analgesia epidural
M- Monitoring, foetal metarnal
E- Examination, vaginal or internal
D- Doctor, neonatologist obstetritician

Pelvic Inflammatory Disease (PID): causes, effects

"PID CAN be EPIC":
· Causes:
Chlamydia trachomatis
Actinomycetes
Neisseria gonorrhoeae
· Effects:
Ectopic
Pregnancy
Infertility
Chronic pain

Multiple pregnancy: Maternal complications

APH)²

• Antepartum hemorrhage
• Anemia
• PROM (Premature Rupture of Membranes)
• Pre-eclampsia
• Hydramnios 
• Hyperemesis

zinc deficiency

HIDA
 
H-Hyperpigmentation,Hypogonadism,Hepatosplenomegaly
I-Iron deficiency anemia
D-Dwarfism,diarrhoea,dermatitis,decreased immunocompetence,delayed (poor)wound healing
A-Acro dermatitis
loss of hair and taste alteration can also occur

VIRAL LIVE VACCINES

ViralLiveVacines

MY MR VIP

M-Mumps
Y-YellowFever
M-Measles
R-Rubella
V-V aricella
I-Influenza
P-Pox

Vaccines contraindicated in HIV!

BOY

BCG,ORAL TYPHOID,YELLOW FEVER

Trinucleotide repeat disorders!

My Fragile Huntington has spino cerebellar ataxia!

M yotonic dystrophy

F ragile X syndrome

H untington disease

S pino cerebellar ataxia

DiGeorge syndrome

CATCH-22
-congenital heart disease
-Abnormal facies
-Thymic aplasia
-Cleft palate
-Hypocalcemia
-22q deletion

Neonatal Emergencies "THE MISFITS"

Given the fact that signs and symptoms are usually non specific and the presentation is usually subtle in newborns it is a wise idea to think of a mnemonic that reminds us of all the possible neonatal emergencies.

T = Trauma (Accidental and Non Accidental)
H = Heart Disease, Hypovolemia, Hypoxia
E = Endocrine (Congenital Adrenal Hyperplasia, Thyrotoxicosis)
M = Metabolic (Electrolyte Imbalance)
I = Inborn Errors of Metabolism
S = Sepsis (Meningitis, Pneumonia, UTI)
F = Formula Mishaps (Under or Over dilution)
I = Intestinal Catastrophes (Intussusception, Volvulus, Necrotizing Enterocolitis)
T = Toxins / Poisons
S = Seizures

Breast feeding: contraindicated drugs

BREAST:
Bromocriptine/ Benzodiazepines
Radioactive isotopes/ Rizatriptan
Ergotamine/ Ethosuximide
Amiodarone/ Amphetamines
Stimulant laxatives/ Sex hormones
Tetracycline/ Tretinoin

Cystic fibrosis: presenting signs CF PANCREAS:

Chronic cough and wheezing
Failure to thrive
Pancreatic insufficiency (symptoms of malabsorption like steatorrhea)
Alkalosis and hypotonic dehydration
Neonatal intestinal obstruction (meconium ileus)/ Nasal polyps
Clubbing of fingers/ Chest radiograph with characteristic changes
Rectal prolapse
Electrolyte elevation in sweat, salty skin
Absence or congenital atresia of vas deferens
Sputum with Staph or Pseudomonas (mucoid)

Rubella: congenital signs

"Rubber Ducky, I'm so blue!" (like the "Rubber Ducky" song):
Rubber: Rubella
Ducky: Patent Ductus Arteriosus, VSD and pulmonary artery stenosis.
I'm: Eyes (cataracts, retinopathy, micropthalmia, glaucoma).
Blue: "Blueberry Muffin" rash (extramedullary hematopoesis in skin +purpura)
· Also, deafness, growth retardation, and some more.

Vitamin toxicities:

 neonatal Excess vitamin A: Anomalies (teratogenic)
Excess vitamin E: Enterocolitis (necrotizing enterocolitis)
Excess vitamin K: Kernicterus (hemolysis)

Head circumference with age

· Remember 3, 9, and multiples of 5:
Newborn 35 cm
3 mos 40 cm
9 mos 45 cm
3 yrs 50 cm
9 yrs 55 cm

Perez reflex

Eliciting the PErEz reflex will make the baby PEE.

Milestones in Development

3C/ST

CIRCULAR SCRIBBLE 2YRS

CIRCLE 3YRS

CROSS 4YRS

SQUARE 41/2YRS

TRIANGLE 5YRS

Guthrie card: diseases identified with it

"Guthrie Cards Can Help Predict Bad Metabolism":
Galactosaemia
Cystic fibrosis
Congenital adrenal hyperplasia
Hypothyroidism
Phenylketonuria
Biotidinase deficiency
Maple syrup urine disease

Short stature: differential ABCDEFG:

Alone (neglected infant)
Bone dysplasias (rickets, scoliosis, mucopolysaccharidoses)
Chromosomal (Turner's, Down's)
Delayed growth
Endocrine (low growth hormone, Cushing's, hypothyroid)
Familial
GI malabsorption (celiac, Crohn's)

mental retardation cause.....mental sleep

some causes of mental retardation........



mental sleep

m...............mucoplysaccharidosis
meningitis
malformation of brain
e..............encephlitis
n..............neural tube defect
nutritional deprivation
t...............turner syndrome
torch infection
a................asphyxia
antepartum hemorrhage
l.................leucodystrophy
s................social deprivation
l...............lead poisoning
e..............endocrine eg..
hypothyroidism
hypoglycemia
e..................environmental problem
p.................prematurity
phenylketoneuria

Cyanotic heart diseases: 5 types · 5 T's:

Tetralogy of Fallot
Transposition of the great arteries
Truncus arteriosus
Tricuspid atresia, pulmonary aTresia
Total anomalous pulmonary venous drainage

Breast feeding: benefits ABCDEFGH:

· Infant:
Allergic condition reduced
Best food for infant
Close relationship with mother
Development of IQ, jaws, mouth
· Mother:
Econmical
Fitness: quick return to pre-pregnancy body shape
Guards against cancer: breast, ovary, uterus
Hemorrhage (postpartum) reduced

Septic Arthritis: most common cause

 Staphylococcus Aureus is the most common cause of
Septic Arthritis in the pediatric population.

GEL PM

Causes of Meningitis is childhood is:
GEL PM

0-2 months:
G=Group B Strep
E=E.Coli
L=Listeria

> 2 months:
P= Pneomococcus

Adolecence:
M= Meningococcus

Hemolytic Uremic Syndrome (HUS): components

Remember it as  "Decrease the RATE of IV fluids in HUS  patients":

• Renal failure
• Anemia (microangiopathic, hemolytic)
• Thrombocytopenia
• Encephalopathy (TTP)

Dentition: eruption times of permanent dentition

"Mama Is In Pain, Papa Can Make Medicine":
1st Molar: 6 years
1st Incisor: 7 years
2nd Incisor: 8 years
1st Premolar: 9 years
2nd Premolar: 10 years
Canine: 11 years
2nd Molar: 12 years
3rd Molar: 18-25 years

WAGR syndrome: components

WAGR:

• Wilm's tumor
• Aniridia
• Gential abnormalities
• Mental Retardation

Vacterl syndrome: components VACTERL:

Vertebral anomalies
Anorectal malformation
Cardiac anomaly
Tracheo-esophageal fistula
Exomphalos (aka omphalocele)
Renal anomalies
Limb anomalies

Normal weights of children with age

3 kg is the normal weight of  Newborns
2x birth weight  at 6 mos,
Add 5 kg  for every odd yr until 11 yrs
Add 10 kg thereafter

• 6 mos         - 6 kg  (2x birth wt at 3 mos)
• 1 yr              -10 kg (3x birth wt at 1 yr)
• 3 yrs            -15 kg (odd yrs, add 5 kg until 11 yrs)
• 5 yrs            -20 kg
• 7 yrs            -25 kg
• 9 yrs            -30 kg
• 11 yrs          -35 kg  (add 10 kg thereafter)
• 13 yrs          -45 kg
• 15 yrs          -55 kg
• 17 yrs          -65 kg

Pediatric milestones in development

 1 year:
-single words
2 years:
-2 word sentences
-understands 2 step commands
3 years:
-3 word combos
-repeats 3 digits
-rides tricycle
4 years:
-draws square
-counts 4 objects

Russell Silver syndrome: features ABCDEF:

Asymmetric limb (hemihypertrophy)
Bossing (frontal)
Clinodactyly/ Cafe au lait spots
Dwarf (short stature)
Excretion (GU malformation)
Face (triangular face, micrognathia)

cyanotic heart diseases

5 T's + 2 A's 
TOF,TRUNCUS ARTERIOSUS, TRANSPOSITION OF GREAT VESSELS, TRICUSPID ATRESIA, TOTAL ANAMALOUS PULMONARY VENOUS DRAINAGE + ATRESIA PULMONARY & ANAMOLY OF EBSTEIN

Pyloric stenosis (congential): presentation Pyloric stenosis is 3 P's:

Palpable mass
Paristalsis visible
Projectile vomiting (2-4 weeks after birth)

Cerebral palsy (CP): most likely cause CP:

Cerebral Palsy
Child Premature
· The premature brain is more prone to all the possible insults.

CRASH

diagnosis for Kawasaki disease:
C- Conjuntivitis
R-Rash
A- Aneurysm
S- Strawberry Tongue
H- Hand and Foot desquamation

Cyanotic heart diseases: 5 types

· Use your five fingers:
1 finger up: Truncus Arteriosus (1 vessel)
2 fingers up: Dextroposition of the Great Arteries (2 vessels transposed)
3 fingers up: Tricuspid Atresia (3=Tri)
4 fingers up: Tetralogy of Fallot (4=Tetra)
5 fingers up: Total Anomalous Pulmonary Venous Return (5=5 words)

Necrotising enterocolitis: features

HAT '

• Hyponatremia
• Acidosis
• Thrombocytopenia

Williams syndrome: features WILLIAMS:

Weight (low at birth, slow to gain)
Iris (stellate iris)
Long philtrum
Large mouth
Increased Ca++
Aortic stenosis (and other stenoses)
Mental retardation
Swelling around eyes (periorbital puffiness)

Cong.Heart Defect Due to Maternal alcohol abuse

V A T
V= VSD
A= ASD
T= TOF

Measles: complications "MEASLES COMP" (complications):

Myocarditis
Encephalitis
Appendicitis
Subacute sclerosing panencephalitis
Laryngitis
Early death
Sh!ts (diarrhoea)
Corneal ulcer
Otis media
Mesenteric lymphadenitis
Pneumonia and related (bronchiolitis-bronchitis-croup)

Drugs which can be given via an endotracheal tube

" LANES "

• Lidocaine
• Atropine
• Naloxone
• Epinephrine
• Surfactant

These medications may be injected directly into the bronchial tree through the endotracheal tube.

Beckwith-Widemann syndrome: features HOMO:

Hypoglycemia
Omphalocel
Macroglossia/ Macrosomia
Organomegaly

Galactosemia: deficient enzyme

"GALIPUT"

• Galactose 1 Phosphate Uridyl Transferase.

Neurofibromatosis type 1: features

"CAFE SPOT" :

• Café au lait spots
• Axillary freckling
• Fibromatosis
• Eye- Lisch nodules

• Skeletal bowing
• Positive family history
• Optic Tumor

Congenital myopathy: Features

DREAMS"

• Dominantly inherited
• Reflexes decreased
• Enzymes normal
• Apathetic floppy baby
• Milestones delayed
• Skeletal abnormalities present

Paediatric history taking

· Begin with standard things: patient name, presenting complaint, history of presenting complaint and past medical history.
· Then ask BIFIDA:
Birth details and problems
Immunisations
Feeding
Infection, exposure to
Development, normality of
Allergies
· End by customary review of the rest of the standard things: medications, family history and social histor

apgar score

MIRCH
muscle tone
irritability
reflex
color
heart rate

Guthrie card: diseases identified with it

GUTHRIE:
Galactosaemia
Urine [maple syrup urine disease]
THyRoid [hypothyroidism]
Inborn Errors of metabolism [eg: PKU]

Ataxia-Telangiectasia (AT): common sign

AT:
Absent
Thymus

Left Ventricular Failure

TREATMENT OF ACUTE LEFT VENTRICULAR FAILURE 


LMNOP

L- LASIX

M- MORPHINE

N- NITRATES

O- OXYGEN

P- PROOPED UP POSITION

Lawrence Moon Biedl Syndrome c/f

"OH! MRP!!"

O= obese
H= hypogonadotropic hypogonadism
MR= mental retardation
RP= retinitis pigmentosa
P= polydactyly

HSP:CLINICAL FEATURES

H:HEMATURIA;S:SKELETAL-POLYARTHRITIS;P;1:palpable purpura;2:pain abdomen

papillary necrosis

P Pyelonephritis
O Obstructive uropathy
S Sickle cell ds
T Tuberculosis
C Cirrhosis
A Analgesic nephropathy
R Renal artery thrombosis
D Diabetic nephropathy

Prader Willi Syndrome c/f

"SOM 'eats too much' Though He Has small hands, small feet & fish shaped mouth"

S= short stature
O= obese
M= mental retardation
'eats too much'= hyperphagia
T= tone decreased
HH= hypogonadotropic hypogonadism
small hands & feet
fish shaped mouth

Hazards of transfusion

FATHER MOTHER
F=Febrile reaction
A=Allergic reaction
T=Thrombophlebitis
H=Haemosiderosis
E=Embolism
R=Reactions due to stored blood

M=Massive transfusion
O=Overload (circulatory)
T=Transmit infections
H=Haemolytic transfusion reaction
E=derrange Erythropoiesis
R=Reactions due to infected blood

Hemianopia

Superior and Inferior quadrantopias
STIP= Superior, Temporal lesion
Inferior, Parietal lesion

H.pylori - drug therapy

Drugs used in the treatment of H.pylori COMBAT C - Clarithromycin O - Omeprazole M - Metronidazole B - Bismuth subsalicylate A - Amoxicillin T - Tetracycline

Pin point pupils

Pin Point Pupils are seen in 3P @organPhosphorus poisoning @Pontine haemorrhage @oPium poisoning

Glasgow coma scale

Electronic Voting Machines 456

E=EYE OPENING 4
V=VERBAL RESPONSE 5
M=MOTOR ACTIVITY 6
TOTAL 15

Reiters syndrome

REITERS SYNDROME

has following triad

NO PEE- URETHRITIS

NO SEE- ANTERIOR UVEITIS

CANNOT CLIMB TREE- ARTHRITIS

Drugs causing Acute Intermittent Porphyria

BOOST CHAP

B-Barbiturates

O-Oral hypoglycemic durgs

O-OCPS

S-Sulphonamides

T-Tetracyclines


C-Chloramphenical

H-Halothane

A-Alcohol

P-Pentozocin

Drugs not given in HOCM

D - DIURETICS,DIGOXIN
N - NITRATES
B - BETA AGONISTS

Risk factors for gastric ca

RISK FACTORS FOR GASTRIC CA:
CAMeRA JaPPaN.
C[CHRONIC ATROPHIC GASTRITIS] A[blood group A] M[male gender] R[gastric Resection] A[Adenomatous polyps more than 2 cm in stomach]

Ja[japanese] P[H.Pylori] Pa[ Pernicious anemia] N[Nitrosamines in diet]

Drugs To Avoid In Breast Feeding

BREAST FEEDING-drugs to avoid = BILE CaTHeteR

B-benzodiazepenes, bromocriptine
I-iodine
L-laxatives (stimulant)
E-ergotamine

C-chloramphenicol, carbimazole, cyotoxics
T-tetracycline
H-hormone (sex)
R-radio-isotopes

Sarcoidosis (extra- pulmonary manifestations

SARCOID
Skin manifestations: erythema nodosum, lupus pernio, subcutaenous nodules
Arrhythmias
Reticulo- endothelial enlargement
Calcium elevation and complications; Cardiomyopathy
Ophthalmic manifestations: uveitis, keratoconjunctivitis sicca, lacrimal gland enlargement
Impaired CNS: Bell's palsy, cranial nerve palsies, aseptic meningitis, space- occupying lesions, brainstem and spinal syndromes
Distal phalangeal bone cysts

fanconis anemia

F facial microcephaly A abnormal testis n kidneys N neutropenia C cafe au lait O ocular abnormality N no thumbs n radius I increased risk of AML S skin abnormality

SLE Criteria

SOAP BRAIN MD; 4 or more of the 11 required for diagnosis

Serositis
Oral ulcers
Arthritis: non- erosive, peripheral polyarthritis
Photophobia

Blood dyscrasias: haemolytic anaemia, picture of bone marrow suppression
Renal involvement: proteinuria, red cell casts
ANA positive
Immunological abnormalities: anti- DNA,anti-Sm, Anti- phopholipid ab
Neurological involvement

Malar rash
Discoid rash

DOPAMINE AGONISTS

B-BROMOCRIPTINE
A-(CENTRAL)ANTICHOLINERGICS
L-LEVODOPA

DIC- Most common Acute causes

S3-BP-H2O

Sepsis
Shock
Snake bite

Burns
Promyelocytic leukemia

Heat stroke
Hemolytic transfusion reaction
Obstetric emergencies- Abruptio placentae, amniotic fluid embolism

Symptoms of alcoholic cirrhosis

A-astrexis,ascitis
B-bruit,easy brusing
C-cachexia or weight loss and muscle wasting,caput medosa
D-dermatogenic symptoms
E-edema,hepatic encephalopathy
F-fetor hepaticus
G-gynecomastia'testicular atrophy
H-hepato renal syndrome and hepato pulmonary syndrome hepato megaly
I-icterus
P-palmar erythmema
I-icterus
S,A-spider angioma
its ABCDEFGHI PISA

D/D OF HYPOGLYCAEMIA

.
HIPOGLICEMIA.
H-Headtrauma/Hepatic failure (Fulminant)
I-Insulinomas
P-Physhosis
O-Overdose of insulin
G-Glycogen storage Disease/glucogan Deficiency
L-Lymphomas
I-Isolated ACTH deficiency
C-Carcinomas
E-Excess Exercise/Eating problem(starvation)
M-Medications (drugs)
I-Intoxication Of alcohol
A-Addision disease.

SOCRATES

any type of pain
S-site
O-onset.acute?insidious?
C-character-sharp?pricky?
R-ratiation?
A-associated relieving factors
T-timing of the pain
E-exacerbating factors
S-severity

Sleep cycle stages with types of waves

(at night)BATS Drink Blood.

Awake(eye open) - Beta (B)
Awake(eye closed) -Alpha (A)
Light sleep -Theta (T)
Deeper sleep -Slppe spindles (S)
Deepest sleep(nREM) -Delta (D)
Dreaming,Loss of motor tone,erection -Beta (B)

CONGENITAL MALFORMATIONS IN TURNER'S SYNDROME

A:AORTIC STENOSIS B:BICUSPID AORTIC VALVE C:COARCTATION OF AORTA(MC)

Important t-cell neoplasms

remember as SNEHA
1-sezary syndrome
2-natural killer type
3-enteropathy type
4-hepatosplenic type
5-anaplastic and angioimmunoblastic type

Chronic Gastritis

Type A - 4A:Autoimmune
Autoantibodies
Anaemia
Achlorhydria

Type B - :H.pylori

TB- Conditions favoring reactivation

TB- Conditions favoring Reactivation
"CM Hates HIS MD"
Chronic renal failure
Malnutrition
HIV infection
Hemophilia
Immunosuppression
Silicosis
Malignancies
Diabetes

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

Treatment of acute pulmonary edema

As Easy as 'LMNOP'

Remember the mnemonic LMNOP when treating a patient with acute pulmonary edema:

Lasix® (furosemide) intravenous (IV), one to two times the patient's usual dose, or 40 mg if the patient does not usually take the drug.

Morphine sulfate. Initial dose, 4 to 8 mg IV (subcutaneous administration is effective in milder cases); may repeat in 2 to 4 hours. Avoid respiratory depression. Morphine increases venous capacity, lowering left atrial pressure, and relieves anxiety, which reduces the efficiency of ventilation.

Nitroglycerin IV, 5 to 10 ug/min. Increase by 5 ug/min q 3 to 5 minutes. Reduces left ventricular preload. Caution: may cause hypotension.

Oxygen, 100% given to obtain an arterial PO2>60 mm Hg.

Position patient sitting up with legs dangling over the side of the bed. This facilitates respiration and reduces venous return.

Causes of Spider Nevi

"(Pregnant woman wants CAR, TV, Children)"
Pregnancy
Cirrhosis
Alcoholics
Rheumatoid arthritis
Thyrotoxicosis
Viral hepatitis
Children- may occur normally sometimes

Causes of Refractory Ascites

"NoT ReSPoNdInG"

No: non compliance to treatment
T : tumor (hepatoma)
Re : renal failure
S: Spontaneous bacterial peritonitis
Po: portal vein thrombosis
N: NSAIDs
In: infection
G : Gastrointestinal bleeding

Causes of Pseudotumor cerebrii

WASH A Outdated Quilt...
Withdrawal of steroid
Addison's ds
SLE
Hypoparathyroidism

A-vit A overdose
Outdated-Outdated tetracyclines
Quilt-quinolones.

Adrenal: C 21 Hydroxylase Deficiency

INK For Pen of Dean
INK INcresae in K
For Pen Female Pseudohermaphrodite
Dean DEcrease in Na hence fall in Blood Pressure

and 17 hydroxylase is exactly opposite

Decrease in K
Male pseudohermaphrodite
Increase in Na (Hence decrease in Blood pressure too).

wernickes disease

classical triad of wernickes disease
GOA-
G- global confusion
O- ophthalmoplegia
A- ataxia
when u go to goa u bypass Bombay so vitamin b1 deficiency and in Goa every body have alcohol(chronic alcoholism)..so avoid Goa(do not infuse GLUCOSE , it can precipitate deficiency)

wheeze n stridor

whEEze has E, so Expiratory noise Stridor has S, so inSpiratory noise

CAUSES OF CLUBBING

ALWAYS REMEBER THE WORD: CLUBBING"

Cyanotic heart diseases and cystic fibrosis;
Lung cancer and lung abscess;
Ulcerative colitis;
Bronchiectasis;
Benign mesothelioma;
Infective endocarditis, idiopathic pulmonary
fibrosis, idiopathic, and inherited;
Neurogenic tumors; and
Gastrointestinal diseases (e.g., cirrhosis and regional enteritis)

WILLIAMS SYNDROME

"SHAME"
S-SUPRAVALVULAR AORTIC STENOSIS
H-HYPERCALCEMIA
A-AUTOSOMAL DOMINANT
M-MENTAL RETARDATION
E-ELFIN FACIES

causes of transudative plural fluid

Super Nova is Pulling My congested Cirrhotic Liver


Superier vana caval syndrome
Nephrotic syndrome
Pulmonary. emboli
Myxoedema
CCF(MC)
Cirrhosis

BEHCETS SYNDROME

remember that those with Behcets syndrome HAVE A SUPERB GAIT
H-HLA B5
A-Arthritis
V-Venous thromboembolism
E-Elevated ESR
A-Autoantibodies
S-Skin lesions
U-Ulcers that recur in oral cavity
P-Pathergy test
E-Eye lesions
R-Recurrent genital ulcers
B-Bain stem involvement(CNS-Behcets syndrome)
G-Glucocorticoids
A-Azathioprine
I-Interferon
T-Thalidomide

Wiskott-Aldrich syndrome

MR TEXT

M- decreased IgM
R- Recurrent infection
T- T & B cell
E- Eczema
X- X-linked
T- thrombocytopenia

side effects of amiodarone .....S-L-E-P-T

S- skin pigmentation

L- liver dysfunction

E- eye changes

P- pulmonary fibrosis

T- thyroid dysfunction

AUTOSOMAL RECESSIVE DISORDERS

WRAP H2A

W- WILSONS DS.
RA- RECESSIVE AUTOSOMAL
P- PHENYLKETONURIA

H-HOMOCYSTINURIA
H- HEMACHROMATOSIS
G- GAUCHER'S DS.
F- FANCONI'S SYND.
E-EMPHYSEMA d/t alpha 1- AT DEF.
D- DEAFNESS d/t PENDRED SYND.
C- CYSTIC FIBROSIS
B- BLOOD DISORDERS - SICKLE CELL DS., BETA-THALLASSEMIA
A- ALBINISM

Loss of consciousness

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

Mneumonic for Heerfordt Syndrome- PUFF

P - Parotitis
U - uveitis
F - Fever
F - Facial palsy

The 4 T's of Anterior Mediastinal Mass:

Thyroid tumor,Thymoma,Teratoma, Terrible Lymphoma

The 4 P's of arterial Occlusion

pain pallor pulselessness paresthesias

AUTOSOMAL "d o m i n a n t" conditions

D dystrophy[muscular]
O osteogenesis imperfecta & otospongiosis
M marfans syndrome
I intermittent porphyria
N neurofibroma
A adult poly cystic kidney disease& achondroplasia
N noonans syndrome
T tuberous sclerosis
(+) 3 Hs --hypercholestrolemia(familial)
--Huntingtons chorea
--heriditory spherocytosis
(+) 3 "cancers"--heriditory NON polyposis colon CA
--heriditory polyposis of colon(CA?)
--BRCA 1& brca2 BREAST CA

Takayasu's diz = pulseless diz

Therefore when you have Takayasu's, I can't Tak'a yu pulse.

classification of hypersensitivity reactions

ACID


Type I - Anaphylaxis

Type II - Cytotoxic-mediated

Type III - Immune-complex

Type IV - Delayed hypersensitivity

WBC Count:

"Never Let Monkeys Eat Banana (60, 30, 6, 3, 1)

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

ATN

IN MAINTENANCE PHASE OF ATN ALL ARE HYPER EXCEPT CORN:

C-HYPOCALCEMIA O-HYPOOSMOLARITY R-HYPORBC(ANAEMIA) N-HYPONATREMIA IN RECOVERY PHASE AL ABNORMALITIES REVERSED EXCEPT C; HYPOCALCEMIA..........IN RECOVERY C' IS THERE SO EASY TO REMEMBER !!

A-P-G-A-R:

A - appearance (color)

P - pulse (heart rate)

G - grimmace (reflex, irritability)

A - activity (muscle tone)

R - respiratory effort

Asthma pharmacological Agent

Asthma treatment Classes:
PALMS-B
P-Phosphodiesterase Inhibitor
A-Anticholinergic
L-leukoterine antagonist
M-Mediator inhibitor
S-Steroids
B-bronchodilators

Anion gap metabolic acidosis: causes

A MUDPILE CAT:
Alcohol
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Iron/ Isoniazid
Lactic acidosis
Ethylene glycol
Carbamazepine
Aspirin
Toluene

Causes of pulmonary arterial hypertension:

VICES

Vasculitis; Idiopathic primary pulmonary hypertension; COPD; Emboli; Shunt Eisemenger’s syndrome

Days of appearance of rashes

Very Sick Patients Must Take Double Exercise

Varicella (chickenpox)- 1st day
Scarlet fever – 2nd day
Pox (smallpox) – 3rd day
Mumps – 4th day
Typhus – 5th day
Dengue – 6th day
Enteric fever (typhoid) – 7th day

Causes of persistent fistula or sinus:

TWO MAFIA

Tuberculosis, Worm (rare but occurs), Obstruction, Malignancy, Absence of rest, Foreign body, Inadequate drainage, Actinomycosis

Cardinal Symptoms of Parkinson’s Disease:

TRAP

Tremor, Rigidity Akinesia and bradykinesia, Postural Instability

Causes of huge spleen are:

The three big “M”s

Myelofibrosis, Malaria, Myelogenous leukemia

ACH{ACETYLCHONE}

A........................ADRENALINE[O.5MG IM]
C........................CHLORPHENAMINE[0.5 times20=10mg iv]
H........................HYDROCORTISONE[10times20=200mg iv]

Signs of TTP

FAT RN
F – Fever; A – Anemia Hemolytic; T – Thrombocytopenia; R – Renal abnormalities N – Neurolgical abnormalities

Signs of HUS

RAT
R – Renal abnormalities; A – Anemia Hemolytic; T – Thrombocytopenia

The principles of treatment in soft-tissue injuries, especially muscular injuries

RICE
: Rest, Ice, Compression, Elevation

Indications for nasogastric tube feeding:

PLANS

Perioperative, Lavage, Aspiration, Nutrition, Swallowing problems

Differential Diagnosis checklist:

PAINED VICTIMS

Psychiatric, Autoimmune, Infectious, Neoplastic, Endocrine, Drugs,
Vascular, Inflammatory, Congenital, Traumatic, Iatrogenic, Metabolic, Social

Part of the patient assessment of a symptom (e.g. chest pain or abdominal pain):

OPQRST

Onset of event, Provocation (or palliation), Quality of pain, Radiation (and region), Severity, Time (history)

ABC of peripheral neuropathy

Proximal pn- Acute intermitent porhyria B-gullian Barre syndrome C-CIDP Diptheria Endocrinal-hypothyroidism Distal pn- A Alcoholism,AIDS B12 Deficiency Conective tissue disorder(PAN,RA,SLE) DM,Drugs(vincristin,inh,dapson etc.) Enviromental toxin-cs2,organophosphorus,as n hg cmpounds)

Walls of the inguinal canal:

MALT

Muscles (external oblique, internal oblique, transversus abdominis)
Aponeuroses (external oblique, internal oblique)
Ligaments (inguinal, lacunar)
Transversalis fascia

LOSE : ICD-10 criteria for anorexia:

Low body weight BMI 17.5, Overvalued idea – dread of fatness, Self-induced weight loss, Endocrine disturbance.

LMNOP Treatment of Pulmonary Edema:

Lasix, Morphine, Nitroglycerin, Oxygen, Prop up the patient

3U FOR BEHCET SYNDROME

uveitis ulcer oral( aphthous) ulcer genital

FAINT DAMN Local causes of epistaxis:

Foreign body, Atmospheric changes, Infection, Neoplasm of nose and paranasal sinuses, Trauma, Deviated nasal septum, Adenoiditis, Malignant tumors, Nasopharyngeal angiofibroma

DDDD – Signs of niacin B3 deficiency Pellegra

Dermatitis, Dementia, Diarrhea, Death

1ST line ATT

RIPE
R-Rifampicin
I-Isoniazid
P-Pyrazinamide
E-Ethambutol

DANISH Cerebellar signs:

Dysdiachokinesis, Ataxia, Nystagmus, Intension tremor, Slurred speech and Hypotonia

Babies Hate Pediatricians Because Pain is Inevitable

Causes of neonatal jaundice between 24 hours to 2 weeks:
Breast milk jaundice, Haemolysis, Physiological, Bruising, Polycythemia, Infection (e.g. UTI)

ABCDE Portal hypertension features:

Ascites, Bleeding (hematemesis, piles), Caput medusae, Diminished liver, Enlarged spleen

" ALMOST ALL CAUSES OF COMA "

SaDAM RENTs HIV S: Systemic Infections e.g. Pneumonia, UTI, Wound Infections D: Drugs e.g. sedatives, antipsychotics. A: Alcoholic withdrawal i.e. Delirrium tremens M: Metabolic e.g Hypoglycemia, HONC, DKA, Hypokalemia, renal failure R: Raised ICP e.g Tumor, T.B E: Epilepsy e.g Post iceric phase N: Nutritional e.g Thiamine (Wernicke's korasakoff's encephalopathy? T: Trauma e.g head injury H: Hypoxia e.g respiratory failure I: Intracranial Infections e.g. meningitis, encepalitis, HSV encephalitis V: Vascular e.g Stroke, Myocardial Infarction

Monoarthritis: causes

"GHOST"

• Gout
• Hemarthroses
• Osteoarthritis
• Sepsis
• Trauma

Arthritis: Causes

 "HINTS"

• Hemorrhage (due to trauma/hemophilia)
• Inflammatory (rhematoid arthritis, crystals due to gout, psoriasis)
• Noninflammatory (osteoarthritis)
• Trauma/Tumour
• Septic arthritis

Bronchiectasis: Causes

A SICK AIRWAY:

• Airway lesion (chronic obstruction)
• Sequestration
• Infection, Inflammation
• Cystic fibrosis
• Kartagner's syndrome
• Allergic brochopulmonary aspergilliosis
• Immunodeficiencies (hypogammaglobinaemia, myeloma, lymphoma)
• Reflux inhalation injury
• William Campbell syndrome (and other congenital ones)
• Aspiration
• Yellow nail syndrome/ Young's syndrome

Lymphoma: staging of B-cell CLL (RAI)

LOATh
I: Lymphadenopathy
II: Organomegaly (splenomegaly)
III: Anemia
IV: Thrombocytopenia

Immunoglobulins -Order of appearance

ImmunoGlobulin'
IgM appears first in response to antigens followed by IgG.

IgM antibodies appear early in the course of an infection and usually reappear, to a less extent, after further exposure. IgM antibodies do not pass across the human placenta. These two biological properties of IgM make it useful in the diagnosis of infectious diseases. Demonstrating IgM antibodies in a patient's serum indicates recent infection, or in a neonate's serum indicates intrauterine infection (e.g. congenital rubella).

SLE: factors that make SLE active

UV PRISM:
UV (sunshine)
Pregnancy
Reduced drug (eg steroid)
Infection
Stress
More drug

Renal failure (acute): management

Manage AEIOU:
Anemia/ Acidosis
Electrolyte and fluids
Infections
Other measures (eg nutrition, nausea, vomiting
Uremia

Pulmonary fibrosis: causes

SCAR:
· Upper lobe:
Silicosis/ Sarcoidosis
Coal worker pneumonconiosis
Ankylosing spondylitis
Radiation
· Lower lobe:
Systemic sclerosis
Cyptogenic fibrosing alveolitis
Asbetosis
Rheumatoid arthritis

Abdominal pain: medical causes

"ABDOMENAL PANE" [abdominal pain]:
Acute rheumatic fever
Blood [purpura, a/c hemolytic crisis]
DKA
cOllagen vascular disease
Migraine [abdominal migraine]
Epilepsy [abdominal epilepsy]
Nephron [uremia]
Abdominal angina
Lead
Porphyria
Arsenic
NSAID's
Enteric fever

Splenomegaly: causes

CHICAGO:
Cancer
Hem, onc
Infection
Congestion (portal hypertension)
Autoimmune (RA, SLE)
Glycogen storage disorders
Other (amyloidosis)

Leprosy (Hansen's disease): diagnostic criteria

 ' SAP '

• Skin lesions: hypopigmented/ erythematous, anaesthetic/ hypoesthetic lesions with epidermal atrophy
• Acid fast bacilli, AFB: can be demonstrated in skin smear or biopsy
• Peripheral nerve involvement: thickening, sensory impairment and motor weakness

Very often, small lesions of leprosy on face do not show sensory deficit due to rich innervation and overlap of sensory supply.

Motor deficits commonly in the form of claw hand (ulnar and median nerve), claw foot (posteror tibial nerve) and foot drop (deep peroneal nerve) are more pronounced in the tuberculoid form of leprosy.

Toxoplasmosis: clinical features

My Cats Eat Mice '

• Mononucleosis like illness
• Chorioretinitis
• Encephalitis
• Myocarditis

Pulmonary edema: treatments

MAD DOG:
Morphine
Aminophylline
Digitalis
Diuretics
Oxygen
GGases in blood (ABG's)

Aortic root dilatation: causes

ADAMS"

• Aneurysm
• Dissection
• Ankylosing spondylitis
• Marfan's syndrome
• Syphilis

Aortic root dilatation can produce various degrees of aortic regurgitation.

Respiratory disease: hand signs

CASH:
Clubbing
Asterixis
Small muscle wasting
HPOA

Drugs which can be given via an endotracheal tube

" LANES "

• Lidocaine
• Atropine
• Naloxone
• Epinephrine
• Surfactant

These medications may be injected directly into the bronchial tree through the endotracheal tube

Haematology: key numbers

3 and 4 are key in in haematology:
1.34 cm3 of oxygen is carried by a gram of hemoglobin.
There's 3.4mg of iron in each gram of hemoglobin.
There's an average of 3.4 lobes per neutrophil.
There's 34mg bilirubin from each gram of hemoglobin.

Chronic cough: full differential

GASPS AND COUGH:
GORD
Asthma
Smoking, chronic bronchitis
Post-infection
Sinusitis, post-nasal drip
ACE inhibitor
Neoplasm
Diverticulum
Congestive heart failure
Outer ear
Upper airway obstruction
GI-airway fistula
Hypersensitivity

Deep tendon reflexes: root values

•     S1-2: ankle jerk
•     L3-4: knee jerk
•     C5-6: biceps & supinator jerks
•     C 7: triceps jerk
•     C 8:  finger jerk

Sickle cell disease complications

SICKLE:
Strokes/ Swelling of hands and feet/ Spleen problems
Infections/ Infarctions
Crises (painful, sequestration, aplastic)/ Cholelithiasis/ Chest syndrome/ Chronic hemolysis/ Cardiac problems
Kidney disease
Liver disease/ Lung problems
Erection (priapism)/ Eye problems (retinopathy)

Clinical features of Heart failure

 A . . . . K "

• Acute pulmonary edema, Ascites
• Blood pressure fall (hypotension)
• Cyanosis, Cardiac asthma, Cheyne-Stokes respiration, Cachexia, Cerebral symptoms
• Dyspnoea
• Edema, Effusion (pleural and pericardial)
• Frequent urination at night
• Gallop rhythm
• Hepatomegaly
• Inspiratory crepts
• Jaundice, JVP increased and
• Kidney related symptoms (low urinary sodium, protienuria, oliguria etc.)

Ducket John's: major criteria

ACNES:
Arthritis
Carditis
Nodule (subcutaneous)
Erythrema marginatum
Sydenham chorea

Drugs causing pancreatitis

 ' 12345'

• 1 -ACE inhibitors
• 2 -Didanosine
• 3 -Trimethoprim
• 4 -Tetracycline
• 5 -Pentamidine

Bartter syndrome: inheritance

b AR tter'
Bartter syndrome, inheritance is autosomal recessive (AR).

Bartter syndrome is a rare inherited renal tubular disorder with defect in the thick ascending limb of the loop of Henle.Bartter syndrome is characterized by hypokalemia, hypochloremia, metabolic alkalosis, and hyperreninemia with normal blood pressure.

Alkalosis: metabolic changes in alkalosis

"Al-K-loss, Al-Ca-loss":
There is loss of K+ (hypokalemia) and Ca++ (hypocalcemia) in state of alkalosis.

Haemoptysis: causes

CAVITATES:
CHF
Airway disease, bronchiectasis
Vasculitis/ Vascular malformations
Infection (eg TB)
Trauma
Anticoagulation
Tumour
Embolism
Stomach

Felty's syndrome

' Felty's syndrome is the arthritis in which the spleen can be felty! '

Felty's syndrome is a disorder characterized by rheumatoid arthritis, splenomegaly and neutropenia.

Lead poisoning: Signs & symptoms

" AB CD EF "

• A- anemia
• B- basophilic stippling, burtonian line (on gums)
• C- colic & constipation (most common feature- occurs in 85% of cases)
• D- dry belly ache (ie., diarrhoea is rare), drops (foot drop & wrist drop), dyspepsia
• E- encephalopathy (more common in children)
• F- facial pallor (earliest sign)

Heart murmur: Characteristics

SCRIPT "

•  Site
•  Character
•  Radiation, Respiratory variation
•  Intensity (grade)
•  Pitch, Positional variation
•  Timing

Aortic regurgitation: causes

" CREAM "

•  Congenital
•  Rheumatic damage
•  Endocarditis
•  Aortic dissection, Aortic root dilatation
•  Marfan's syndrome

Hypercalcemia: differential

VITAMIN TRAPS:
Vitamin A and D intoxication
Immobilization
Thyrotoxicosis
Addison's disease/ Acidosis
Milk-alkali syndrome
Inflammatory disorders
Neoplastic disease
Thiazides, other drugs
Rhabdomyolysis
AIDS
Paget's disease/ Parenteral nutrition/ Parathyroid disease
Sarcoidosis

Cardiac tamponade: Beck's triad

3 D's "

• Distant heart sounds
• Distended jugular veins
• Decreased arterial pressure

ICU management: A to Z

A: Asepsis/ Airway
B: Bed sore/ encourage Breathing/ Blood pressure
C: Circulation/ encourage Coughing/ Consciousness
D: Drains
E: ECG
F: Fluid status
G: GI losses/ Gag reflex
H: Head positioning/ Height
I: Insensible losses
J: Jugular venous pulse
K: Kindness
L: Limb care/ Label
M: Mouth care
N: Nociception/ Nutrition
O: Oxygenation/ Orient the patient
P: Pulse/ Peristalsis/ Physiotherapy
Q: Quiet surroundings
R: Respiratory rate/ Restraint
S: Stress ulcer/ Suctioning
T: Temperature
U: Urine
V: Ventilator
W: Wounds/ Weight
X: Xerosis
Y: whY
Z: Zestful care of the patient

Macrocytic anemia: causes

ABCDEF:
Alcohol + liver disease
B12 deficiency
Compensatory reticulocytosis (blood loss and hemolysis)
Drug (cytotoxic and AZT)/ Dysplasia (marrow problems)
Endocrine (hypothyroidism)
Folate deficieny/ Fetus (pregnancy)

Toxicity/ sepsis: signs

6 T's:
Tachycardia
Tachypnea
Tremors
Toxic look
Tiredness
Temperature (fever)

Raised JVP: causes

"PQRST"

• Pericardial effusion, Pulmonary embolism, Pulmonary hypertension (chronic)
• Quantity of fluid is more (fluid overload)
• Right heart failure
• Superior venacaval obstruction (distended veins without pulsation)
• Tricuspid regurgitation, Tricuspid stenosis, Tamponade (cardiac)

Atrial contraction against a closed tricuspid valve results in a large venous pulsation, called a 'Cannon wave'. It can occur in instances of atrioventicular dissociation, for example, complete heart block.

Dry mouth: causes

"DRI"

There are two causes for each alphabet

• Drugs, Dehydration
• Renal failure, Radiotherapy
• Immunological (Sjogren's syndrome), Intense emotions

Cyanosis: DDx

COLD PALMS:
· Peripheral cyanosis:
Cold
Obstruction
LVF and shock
Decreased cardiac output
· Central cyanosis:
Polycythemia
Altitude
Lung dz
Met-, sulphaemoglobinaemia
Shun

Pancytopaenia differential

"All Of My Blood Has Taken Some Poison":
Aplastic anaemias
Overwhelming sepsis
Megaloblastic anaemias
Bone marrow infiltration
Hypersplenism
TB
SLE
Paroxysmal nocturnal haemoglobinuria

Pick's disease: features

"PICK"

• Progressive degeneration of neurons
• Intracytoplasmic pick bodies
• Cortical atrophy
• Knife edge gyri

Mass in anterior mediastinum: Causes

4 T's"

• Thyroid enlargement (Retrosternal extension)
• Thymoma
• Teratoma
• "Terrible" Lymphoma

Thrombocytosis: Causes

"MAKE MAPS"

• Myeloproliferatuve disorders (CML or PRV)
• Acute hemorrhage
• Kawasaki syndrome
• Essential thrombocytosis

• Malignancy
• Acute/chronic inflammation
• Post-operative
• Splenectomy

Raynaud's disease: causes

BAD CT:
Blood disorders (eg polycythaemia)
Arterial (eg atherosclerosis, Buerger's)
Drugs (eg beta-blockers)
Connective tissue disorders (rheumatoid arthritis, SLE)
Traumatic (eg vibration injury)

Splenomegaly: causes

HICCUPS:
Haematological
Infective : Kala azar, malaria, enteric fever
Congestive: CCF, constrictive pericarditis, IVC thrombosis, Hepatic vein thrombosis, portal vein thrombosis and splenic vein thrombosis
Collagen diseases: SLE, Felty's syndrome
Unknown etiology: tropical splenomegaly
Primary malignacies (secondaries are rare)
Storage diseases: Gaucher's disease, Niemman Pick

Lethargy, malaise causes

FATIGUED:
Fat/ Food (poor diet)
Anemia
Tumor
Infection (HIV, endocarditis)
General joint or liver disease
Uremia
Endocrine (Addison's, myxedema)
Diabetes/ Depression/ Drugs

Hyperthyroidism: clinical features

"STING"

• Sweating
• Tremor/Tachycardia
• Intolerance to heat/Irritability/Irregular menstruation
• Nervousness
• Goitre/Gastrointestinal disturbances(diarrhoea)

Hypoglycaemia: causes

"How to EXPLAIN hypoglycemia":
EXogenous drugs (insulin, oral hypoglycemics, alcohol, pentamidine, quinine, quinolones)
Pituitary insufficency (no GH or cortisol)
Liver failure (no glycogen stores)
Adrenal failure (no cortisol)
Insulinomas/ Immune hypoglycemia
Non-pancreatic neoplasms (retroperitoneal sarcoma)

Bronchiectasis: differential

BRONCHIECTASIS:
Bronchial cyst
Repeated gastric acid aspiration
Or due to foreign bodies
Necrotizing pneumonia
Chemical corrosive substances
Hypogammaglobulinemia
Immotile cilia syndrome
Eosinophilia (pulmonary)
Cystic fibrosis
Tuberculosis (primary)
Atopic bronchial asthma
Streptococcal pneumonia
In Young's syndrome
Staphylococcal pneumonia

Bowel obstruction: symptoms

"AVOID"

• Abdominal pain
• Vomiting
• Obstipation (severe constipation, not passing gas)
• Increased bowel sounds
• Distension of the abdomen

Back trouble causes

O, VERSALIUS (Versalius was the name of a famous physician):
Osteomyelitis
Vertebral fracture
Extraspinal tumour
Spondylolisthesis
Ankylosing spondylitis
Lumbar disk increase
Intraspinal tumor
Unhappiness
Stress

Bowel obstruction: causes

"HANG IV"

• Hernia
• Adhesions
• Neoplasm
• Gallstone ileus

• Intussusception
• Volvulus

Hypertension: Management

 "ABCD"

• ACE inhibitors/Angiotensin receptor blockers
• Beta blockers
• Calcium channel blockers
• Diuretics

Horner's syndrome: components

SAMPLE:
Sympathetic chain injury
Anhidrosis
Miosis
Ptosis
Loss of ciliospinal reflex
Enophthalmos

NSAIDs: contraindications

NSAID:
Nursing and pregnancy
Serious bleeding
Allergy/ Asthma/ Angioedema
Impaired renal function
Drug (anticoagulant)

Metabolic acidosis: causes

KUSSMAL:
Ketoacidosis
Uraemia
Sepsis
Salicylates
Methanol
Alcohol
Lactic acidosis

Migraine: Features

EAT FUN"

• Episodic
• Aura-zig zag lines
• Throbbing headache
• Family history/ Fotophobia (photophobia)
• Unilateral
• Nausea and vomiting

Delirium: Causes

"DELIRIUM"

• Degenerative
• Epilepsy (post ictal states)
• Liver failure
• Intracranial injury
• Rheumatic chorea
• Infections- Pneumonia, Septicemia
• Uremia
• Metabolic- Electrolyte imbalance

Anemia: non-megaloblastic causes of macrocytic anemia

HAND LAMP:
Hypothyroidism
Aplastic anaemia
Neonates
Drugs
Liver disease
Alcohol
Myelodyplasia
Pregnancy

Rashes: time of appearance after fever onset

"Really Sick Children Must Take No Exercise":
· Number of days after fever onset that a rash will appear:
1 Day: Rubella
2 Days: Scarlet fever/ Smallpox
3 Days: Chickenpox
4 Days: Measles (and see the Koplik spots one day prior to rash)
5 Days: Typhus & rickettsia (this is variable)
6 Days: Nothing
7 Days: Enteric fever (salmonella)

Acromegaly symptoms

ABCDEF:
Arthralgia/ Arthritis
Blood pressure raised
Carpal tunnel syndrome
Diabetes
Enlargemed organs
Field defect

Guillain–Barré syndrome: Features

"4 A's"

• Acute inflammatory demyelinating polyneuropathy
• Ascending paralysis
• Autonomic neuropathy
• Arrythmias

Asthma: precipitating factors for acute attack

DIPLOMAT:
Drugs (aspirin, NSAIDs, beta blockers, etc)
Infections (URTI/LRTI)
Pollutants (at home, at work)
Laughter(emotion)
Oesophageal reflux (nocturnal asthma)
Mites
Activity and exercise
Temperature (cold)

Multiple sclerosis: Features

DEMYELINATION"

• Diplopia / Dysmetria / Dysdiadochokinesis / Depression
• Eye movement painful (Optic neuritis)
• Motor: Weakness; spasticity
• nYstagmus
• Elevation in temperature (Uhthoff's phenomenon)
• Lhermitte's sign
• Intention tremor
• Neuropathic pain
• Ataxia
• Talking is slurred; dysarthria
• Impotence
• Overactive bladder (urinary urgency)
• Numbness (sensory defect)

Back pain causes

DISK MASS (since near vertebral disc):
Degeneration (DJD, osteoporosis, spondylosis)
Infection (UTI, PID, Pott's disease, osteomyelitis, prostatitis)/ Injury, fracture or compression fracture
Spondylitis (ankylosing spondyloarthropathies such as rheumatoid arthritis, Reiters, SLE)
Kidney (stones, infarction, infection)
Multiple myeloma/ Metastasis (from cancers of breast, kidney, lung, prostate, thyroid)
Abdominal pain (referred to the back)/ Aneurysm
Skin (herpes zoster)/ Strain/ Scoliosis and lordosis
Slipped disk/ Spondylolisthesis

Pneumonia: risk factors

INSPIRATION:
Immunosuppression
Neoplasia
Secretion retention
Pulmonary oedema
Impaired alveolar macrophages
RTI (prior)
Antibiotics and cytotoxics
Tracheal instrumentation
IV dug abuse
Other (general debility, immobility)
Neurologic impairment of cough reflex, (eg NMJ disorders

Sports injuries: course of action

RICE:
Rest
Ice
Compression
Elevation
· RICE especially for fractures, sprains, muscle strains, contusions
· Alternatively: I=Immobilization, C=Cold compresses.

Balint's syndrome: Features

SOOT"

• Simultagnosia
• Optic ataxia
• Ocular apraxia
• Tunnel vision

Behcet's syndrome: diagnostic criteria

PROSE:
Pathergy test (i/d saline injection)
Recurrent genital ulceration
Oral ulceration (recurrent)
Skin lesions
Eye lesions
· Oral ulceration is central criteria, plus any 2 others.

Bronchiectasis: causes

A SICK AIRWAY:
Airway lesion, chronic obstruction
Sequestration
Infection, inflamation
Cystic fibrosis
Kartagners syndrome
Allergic brochopulmonary aspergilliosis
Immunodeficiencies (hypogammaglobinaemia, myeloma, lymphoma)
Reflux, inhalation injury
William Campbell syndrome (and other congenitals)
Aspiration
Yellow nail syndrome/ Young syndrome

Thickened nerves: causes

HANDS:
Hansen's (leprosy)
Amyloidosis
Neurofibromatosis
Diabetes mellitus
Sarcoidosis

Ranson's criteria

  "LEGAL"

• Leucocytes >16000
• Enzyme AST >250
• Glucose >200
• Age >55
• LDH >350

 Ranson's criteria is used to predict the severity of acute pancreatitis.

ACEI: contraindictions

PARK:
Pregnancy
Allergy
Renal artery stenosis
K increase (hyperkalemia)

Acute stridor: differential

ABCDEFGH:
· With fever:
Abscess
Bacterial tracheitis
Croup
Diphtheria
Epiglottitis
· Without fever:
Foreign body
Gas (Toxic Gas)
Hypersensitivity

Henoch-Schönlein purpura: Features

 "PAAN"

• Purpura
• Abdominal pain
• Arthritis
• Nephritis

Henoch-Schönlein purpura is a small vessel vasculitis, usually affecting children and young adults.

Saint's triad

In a written way when a saint says to a girl that hi divine gal then u look like this in a written style:-
Saint: "Hi Divine Gal."

Saint-Saint's triad
Hi-Hiatus hernia
Divine-diverticulosis
Gal-Gall stone

SARCOMAS

SARCOMAS THAT SPREAD VIA LYMPHNODES
 
"SCARE Me"
 
SYNOVIAL CELL SARCOMA
CLEAR CELL SARCOMA
ANGIOSARCOMA
RHABDOMYO SARCOMA
EPITHELIAL SARCOMA

MALIGNANT FIBROUS HISTIOCYTOMA

Thrombophlebitis

ThromBOPHLebitis

Breast ca
Ovarian ca
Prostate ca
H Lymphoma

Trousseu's syndrome

"GOPAL"
 
GI cancer
Ovarian ca
PAncreatc ca
Lung ca
Lymphoma