MNEMONICS FROM PASTEST/mnemonic n. a pattern of letters or ideas which aid the memory

Mnemonics are a great tool for the medical student. They allow complex information to be condensed into a few words and essentially make your memory more efficient. There is no substitute for hard work and wider reading but this is of little use if you cannot locate your facts or you get the information muddled up. Mnemonics allow you to secure information in your head with the aid of word play or visual associations. If a good depth of knowledge is the cake then mnemonics are the icing!

The mnemonics presented here have been created or collated by recent medical students who have found them to be invaluable to their studies. They are arranged into subjects for you to navigate through the material.For more mnemonics, see our book title Mnemonics for Medical Undergraduates.

The best mnemonics are those that are most relevant and therefore it is beneficial to try and personalize them. A mnemonic should not have to try too hard or you will need a mnemonic to remember it!

As well as learning from the mnemonics presented here, it is really good revision tool for you to create your own. Share these with your peers at The Forum – and we may put them up on these pages.

View mnemonics on:CLINICAL SKILLS

CARDIOVASCULAR

CLINICAL CHEMISTRY

DERMATOLOGY

ENDOCRINOLOGY

GASTROENTEROLOGY

HAEMATOLOGY

INFECTIOUS DISEASES

NEUROLOGY

OBSTETRICS AND GYNAECOLOGY

OPHTHALMOLOGY

PAEDIATRICS

PSYCHIATRY

RENAL

RESPIRATORY

RHEUMATOLOGY

SURGERY

TRAUMA AND ORTHOPAEDICS

CLINICAL SKILLS

Full Medical History

When taking a history:Mnemonic: OPERATESO Onset of complaintP Progress of complaintE Exacerbating factorsR Relieving factorsA Associated symptomsT TimingE Episodes of being symptom-freeS R Relevant Systemic and general inquiry can be added here

Medications/allergiesMnemonic: PILLSP Pills, is the patient taking any?I Injections, eg Insulin/Inhalers (as some patients forget to mention when asked about

their medications)LL ILLicit drug useS Sensitivities to anything, ie allergies

In every history, don’t forget to ask about the ‘FAWR’ non-specific symptoms that the patient may exhibitMnemonic: FAWRF FeverA AppetiteW Weight loss (unintentional)R Reduced energy, ie fatigue/lethargy

When assessing psychological state:Mnemonic: SAD CASES Suicidal ideationsA AnxietyD Decreased mood/Delusions/Disordered thoughtC Difficulty ConcentratingA Auditory or other hallucinations?S Difficulties SleepingE Eating normally?

Information organization

When asked to discuss a particular disease, the following surgical sieve is widely regarded as the best way to proceed:Mnemonic: Dressed In a Surgeons Gown A Physician Might Make Progress

D DefinitionI IncidenceS SexG GeographyA AetiologyP PathogenesisM Macroscopic pathologyM Microscopic pathologyP Prognosis

CARDIOVASCULAR

Anatomy

To remember heart valve auscultation sitesMnemonic: All Patients Take MedicationsStarting from top left:Aortic – 2nd intercostal space, right sternal edgePulmonary – 2nd intercostal space, left sternal edgeTricuspid – 4th intercostal space, right sternal edgeMitral – 5th intercostal space, mid-clavicular line

AnginaManagement through lifestyle alterationsMnemonic: SLEWS Smoking cessationL Low-fat dietE ExerciseW Weight loss

Management of acute unstable anginaMnemonic: 2 As and BALIA Admit, bed rest, high-flow oxygenA AnalgesiaA Aspirin and clopidogrelB Beta blockersA Angiography with or without angioplasty/CABG if symptoms fail to improveL LMW heparinI Infusion of nitrates

AnginaPresentationMnemonic: SCARS Sudden central pain, ‘tearing’ in nature, may radiate to the backC Coronary artery occlusion can lead to chest pain, MI or angina pectoris/Carotid

obstruction can lead to hemiparesis, dysphasia or blackouts

A Anterior spinal artery can be affected leading to paraplegiaR Renal artery can be affected leading to anuria or renal failure

Cardiac arrestManagement, Basic Life Support (BLS)Mnemonic: ABCA Airway, clear and maintain with chin lift/jaw thrust/head tilt (if no spinal injury)B Breathing, look, listen and feel, if not breathing give two life saving breaths

immediatelyC Circulation, carotid pulse for at least 10 s, if absent give 15 chest compressions at

100/min

Continue the cycle of 2 breaths and 30 compressions and check the circulation every minute, proceed to more advanced life support when possible.

Management, Advanced Life Support (ALS)Mnemonic: CDE (with A after every step)C Cardiac monitor and defibrillator should be attached to the patientA Assess rhythm and pulseD Defibrillate x 3 if VF or pulseless VT, CPR for 1 minA Assess rhythm and pulseE EMD (no cardiac output despite ECG showing electrical activity) or asystole

warrants CPR for 3 minA Assess rhythm and pulse

HypertensionTreatmentMnemonic: ABCDA ACE inhibitors/Angiotensin-II-antagonists (sometimes Alpha agonists also)B Beta blockersC Calcium channel blockersD Diuretics (Thiazides)

CLINICAL CHEMISTRY

AspirinAspirin overdose – early symptomsMnemonic: DAFT HIDD DeafnessA Appear flushedF FeverT TinnitusH HyperventilationI Increased sweatingD Dizziness

Metabolic acidosisCausesMnemonic: UK SLAMSU UraemiaK KetoacidosisS SalicylatesL Lactic acidosisA AlcoholM MethanolS Sepsis

Paracetamol Paracetamol overdose – (the most common intentional drug overdose in the UK).Risk factorsMnemonic: COMAHC Chronic alcohol abusersO On drugs that increase cytochrome P450 activity, anti-TB drugsM Malnourished individualsA AnorexicsH HIV patients

DERMATOLOGY

SkinFunctions of the skinMnemonic: SKINS Specialised sensory innervation/Synthesise Vitamin D/

Secretes pheromones for SexK Keeps out unwanted molecules, microbes or radiation/Keeps in water, electrolytes

and solutesI Immunological function; contains antigen-presenting cellsN Normalises heat regulation

Contact dermatitisCommon allergens for allergic contact dermatitisMnemonic: CONTACTC Cutaneous type IV reactionO Ointments and cosmetics containing lanolinN NickelT Topical antibiotics can cause it, ie neomycinA Autosensitisation can occur (secondary spread elsewhere)C Chromates (cement, leather)/Colophony (plasters, glues, inks)T Topical antihistamines and topical anaesthetics (haemorrhoid creams) can cause it

InfestationsClinical presentation of impetigoMnemonic: IMPETIGO

I Infection with Staphylococcus aureus, Streptococcus pyogenes or bothM Mostly in young childrenP Particularly around nose and surrounding parts of faceE Erythematous base with honey-coloured crustsT Treat with Topical antibiotic such as fusidic acid for localized lesionsI Individuals are highly contagious from skin-to-skin contact;

Improve hygiene; do not share towelsG Gram stain and culture of swab diagnosticO Oral flucloxacillin required for widespread impetigo

Squamous cell carcinomaClinical presentationMnemonic: S, CELL, CS Sun-exposed areas are usually affected: ears, dorsum of the hands, bald scalpC Crusted, firm, irregular lesionE Excision used as treatmentL Lower lip can be affected in smokersL Less likely to metastasiseC Associated with Chronic inflammation such as venous leg ulcers

ENDOCRINOLOGY

Thyroid glandSymptoms of hypothyroidismHypothyroidism is 10 times more common in females than males and occurs mainly in middle life.Mnemonic: MOM’S SO TIREDM Memory lossO ObesityM Malar flush/MenorrhagiaS SlownessS Skin and hair become dryO Onset is gradualT TiredI Intolerance to coldR Raised blood pressureE Energy levels are lowD Depressed

Symptoms of hyperthyroidismMnemonic: SWEATINGS SweatingW Weight lossE Emotional labilityA Appetite is increasedT Tremor/Tachycardia due to AF

I Intolerance to heat/Irregular menstruation/IrritabilityN NervousnessG Goitre and Gastrointestinal problems (loose stools/diarrhoea)

Adrenal glandsCauses of Addison’s DiseaseMnemonic: ADDISONA Autoimmune (90% cases)D Degenerative (amyloid)D Drugs (ketoconazole)I Infections (TB, HIV)S Secondary (low ACTH); hypopituitarismO Others – adrenal bleedingN Neoplasia (secondary carcinoma)

PancreasComplications of diabetes mellitusMnemonic: KEVINSK Kidney; NephropathyE Eye disease; retinopathy and cataractsV Vascular; coronary artery disease, cerebrovascular disease, peripheral vascular diseaseI Infective; TB, recurrent UTIsN Neuromuscular; Peripheral neuropathyS Skin; Necrobiosis lipoidica diabeticorum, granuloma annulare, diabetic dermopathy

GASTROENTEROLOGY

Abdomen distensionCausesMnemonic: 6 F’sF FatF FetusF FlatusF FaecesF FluidF Flipping great tumour

Chronic liver diseaseSignsMnemonic: ABCDEFGHIJA Asterixis (‘liver flap’)/Ascites/Ankle oedema/Atrophy of testiclesB Bruising/BP.C Clubbing/Colour change of nails; white (leuconychia)D Dupuytren’s contractureE Erythema (palmar)/EncephalopathyF hepatic FoetorG Gynaecomastia

H Hepato splenomegalyI Increase in size of parotidsJ Jaundice

Inflammatory bowel disease (IBD)Features of ulcerative colitisMnemonic: ULCERS IN AbdomenU Ulcers (mucosal and submucosal)L Large intestine (rectum always involved. May extend proximally to involve entire

colon)C ClubbingE Extra-intestinal manifestationsR Remnants of old ulcers (pseudopolyps)S Stools bloodyI Inflamed, red, granular mucosa and sub mucosaN Neutrophil invasionA Abscesses in crypts

Complications of ulcerative colitisMnemonic: How To Perform GI ColonoscopyH HaemorrhageT Toxic megacolonP PerforationG GallstonesC Colorectal carcinoma (in those with extensive disease for > 10 years)

Morphology and symptoms of Crohn’s diseaseMnemonic: CHRIS Has Too Much Diarrhoea and Abdominal painC Cobblestone appearance of mucosaH High temperatureR Reduced lumen/Rose-thorn ulcersI Intestinal fistulae/Ileo-caecal region commonly involved (40% of cases)S Skip lesionsH Hyperplasia of mesenteric lymph nodesT Transmural inflammation (all layers, may ulcerate)M MalabsorptionD Diarrhoea (watery)A Abdominal pain

HAEMATOLOGY

Sickle cell diseaseSignsMnemonic: SICKLES Splenomegaly/SludgingI InfectionC Cholelithiasis

K Kidney – haematuriaL Liver congestion/Leg ulcersE Eye changes

LeukemiaSymptoms and singsMnemonic: SICKLEL Light skin (pallor)E Energy decreased/Enlarged spleen, liver, lymph nodesU UnderweightK Kidney failureE Excess heat (fever)M Mottled skin (haemorrhage)I InfectionsA Anaemia

ThrombocytopeniaCausesMnemonic: PLATELETSP Platelet disorders: TTP, ITP, DICL LeukaemiaA AnaemiaT TraumaE Enlarged spleenL Liver diseaseE EthanolT Toxins: benzene, heparin, aspirin, chemotherapy.S Sepsis

Immune thromobocytopenic purpura (ITP)CausesMnemonic: MAIDM MalignancyA Autoimmune diseases: SLE, thyroid disease, RAI Infections: malaria, EBV, HIV/Idiopathic (commonest cause)D Drugs, eg quinine

SymptomsMnemonic: BBCB BruisingB Bleeding: mucosal and nasalC Cycles heavy; menorrhagia

INFECTIOUS DISEASES

GastroenteritisCauses

Mnemonic: LESS GERMSL ListeriaE Escherichia coliS Staphylococcus aureusS SalmonellaG Giardia lambliaE Entamoeba histolyticaR RotavirusM MushroomsS Shigella

MalariaCommon early symptomsMnemonic: Heard A MosquitoH HeadacheA AnorexiaM Myalgia/Malaise

Common later symptomsMnemonic: Feel Rather ColdF Fever (peaks every third day, ie tertian)R RigorsC Chills

LeprosyClinical presentationMnemonic: LEProsyL Loss of sensation in affected skin/Loss of function (paralysis)E Enlargement of affected superficial nerves (tender too)P Positive identification of M. leprae under microscope

HIVGroups at high risk of developing infectionMnemonic: HIVH Homosexuals/HaemophiliacsIV IV drug abusers

NEUROLOGY

AnatomyCranial bonesMnemonic: PEST OF 6P ParietalE EthmoidalS SphenoidT TemporalO Occipital

F Frontal6 This indicates the number of bones

Branches of the facial nerveMnemonic: To Zanzibar By MotorcarT Temporal nerveZ Zygomatic nerveB Buccal nerveM Marginal mandibular nerveC Cervical nerve

Clinical conditionsStroke – investigationsMnemonic: The 4 PsP Plasma: FBC, U&E, ESR, glucose, lipidsP Pump, ie heart (ECG, echocardiogram)P Pipes: carotid Doppler ultrasoundP Picture of brain: CT/MRI; detects ischaemia or haemorrhages

Stroke – managementMnemonic: ABCDEFGHIA Advice – lifestyle changes eg stop smoking, reduce alcohol intake, lose weightB BP controlC Cholesterol controlD DM controlE Elastic stockings (prophylaxis for DVT, PE)F Fibrillation (anticoagulate, rate control and cardiovert as required)G Guardian drugs (aspirin, ACE inhibitors, etc)H Help from occupational therapy (OT), speech and language therapy (SALT) and

specialist stroke nurseI Incontinence care and limit Immobility (pressure sores and contractures may develop

otherwise)

MeningitisAetiology - BacterialMnemonic: NHSN Neisseria meningitides (children and adults; meningococcus)H Haemophilus influenzae (children)S Streptococcus pneumoniae (adults and elderly)

(Streptococcus produces the Severest meningitis) Viral

Aetiology - ViralMnemonic: V MECHV VZVM MumpsE Enterovirus/EBVC Coxsackie virus types A and BH Haemophilus influenzae/HIV/HSV

Aetiology - FungalMnemonic: 2 C’sC Cryptococcus (associated with HIV infection)C Candida

MigraineFeaturesMnemonic: EAT FUNE EpisodicA Aura – zigzag linesT Throbbing headacheF Family history/F(p)hoto-phobiaU UnilateralN Nausea and vomiting

OBSTETRICS AND GYNAECOLOGY

Clinical conditionsLabour - onsetMnemonic: Ready Mom for Some DiscomfortR Regular and painful uterine contractionsM Membranes rupturedS ‘Show’D Dilatation and effacement of cervix

Factors which determine the rate and outcome of labourMnemonic: Ready Mom for Some DiscomfortP Powers: strength of the uterine contractionsP Passages: size of the pelvic inlet and outletP Passengers: fetus – is it big or small, does it have anomalies, is it alive or dead?

Ante-partum haemorrhage (APH) causesMnemonic: APHA Abruption of placentaP Placenta praevia (or vasa praevia)H Haemorrhaging from the genitourinary tract

Post-partum haemorrhage (PPH) causesMnemonic: 4 TsT Tissue (retained placenta)T Tone (uterine atony)T Trauma (traumatic delivery, episiotomy)T Thrombin (coagulation disorders, DIC)

GynaecologyEndometriosis - symptomsMnemonic: Classic ‘quartet’ of DIPS

D Deep dyspareuniaI InfertilityP Pelvic pain (cyclical)S Secondary dysmenorrhoea

Menopause - symptomsMnemonic: FSH > 20 IU/LRemembering that this is the most accurate blood test in confirmation of the menopause!F hot Flushes/Female genitalia (vaginal) dryness and burningS Sweats at nightH HeadachesI InsomniaU Urge incontinenceL Libido decreases

Menopause – long-term effectsMnemonic: CONUC Cardiovascular disease: IHD, stroke, arterial diseaseO Osteoporosis: accelerated bone loss leading to osteoporosis and pathological fracturesN Neurological: Alzheimer’s diseaseU Urogenital atrophy: pelvic floor muscle tone

Infertility – causes and risk factorsMnemonic: INFERTILE (in females)I IdiopathicN No ovulation – PCOS, menopause, pituitary disease, thyroid disordersF Fibroids – physical hindranceE EndometriosisR Regular bleeding pattern disrupted – oligo/amenorrhoeaT Tubal disease leading to blocked/damaged ciliaI Increasing age >35 yearsL Large size – obesityE Excessive weight loss – anorexia nervosa

OPHTHALMOLOGY

Diseases and conditionsAllergic eye diseaseMnemonic: HFSH Delayed HypersensitivityF HayFever conjunctivitisS Spring catarrh

Clinical presentation of conjunctivitisMnemonic: BURNB Burning and lacrimation along with itching and possibly photophobiaU Usually bilateral, if unilateral consider another differential diagnosisR Red and inflamed conjunctiva, eyelids may be stuck together with purulent discharge

N Normally self-limiting, can be treated with antibiotics

Signs of optic neuropathyMnemonic: PLACP Pale discL Loss of visual acuity/Loss of red colour visionA Afferent pupillary defectC Central scotoma

Causes of retinal detachmentMnemonic: SITSS Secondary to some intraocular problem (melanoma)I IdiopathicT TraumaS Surgery for cataract

The 4 Fs of retinal detachmentMnemonic: 4 F’s

F Floaters (small dark spots on a bright background are generally harmless)F Flashes (migraine)F Field loss (dark cloud covers a field of vision)F Falling acuity (serious)

Causes of excess lacrimationMnemonic: FACEF Foreign body or corneal abrasionsA Acute glaucomaC ConjunctivitisE Emotion (typical man, I list this last!)

PAEDIATRICS

The new born babyResuscitation - IndicationsMnemonic: IF KEMPTI Instrumental deliveryF Fetal distressK Known congenital abnormalityE Emergency caesarean sectionM Multiple birthsP PrematurityT Thick meconium stains the liquor

Congenital abnormalitiesFeatures of Down’s SyndromeMnemonic: DOWNSD Dysplastic ears/Dysplastic pelvis (seen on X-ray)

O Occiput is flat/Overly large tongueW Widely spaced 1st and 2nd toes and a high-arched

palate/Weak/ ’floppy’ baby (hypotonia)N Neck skin abundantS Short, broad hands with single palmar crease/Slanting eyes/

Speckled iris (Brushfield’s spots)

Developmental assessmentPrimitive reflexesMnemonic: MPRAGM MoroP Placing reflexR RootingA Atonic neck reflexG Grasp reflex

Infant nutritionBreastfeeding - advantagesMnemonic: PACESP Psychological satisfactionA Anti-infective property/Atopic disorders risk .C ConvenientE Expenseless, ie freeS Stimulates growth and development

Breastfeeding - disadvantagesMnemonic: KIDSK vitamin K deficiency in breast-milkI Infection transmission risk eg HIVD Drugs excreted in milkS Stressful and tiring for mother

Acute presentations – the acutely ill childFour main nodes of presentation of serious illness in childrenMnemonic: SURES ShockU Unconscious/drowsy/fitting childR Respiratory distressE Emergencies (surgical)

Clinical presentation of brain tumoursMnemonic: BAN HENSB Blurred visionA Ataxia (clumsiness)N NystagmusH HeadacheE Endocrine dysfunctionN Nausea and vomiting

S Squint (6th nerve palsy)

Causes of respiratory failureMnemonic: PC FED BRAHMSP PneumoniaC Cystic fibrosis/CroupF Foreign bodyE EpiglottitisD Drug ingestionB BronchiolitisR Raised ICPA AsthmaH Head injuryM Meningitis/muscle weaknessS Severe cardiac failure

Chronic presentationsPresentation of asthmaMnemonic: CWSC Cough (dry/nocturnal/worse with exercise)W WheezeS Shortness of breath

Life threatening attack of asthmaMnemonic: CHESTC Cyanosis/Confusion/ComaH HypotensionE ExhaustionS Silent chestT Threatening PEFR <33% predicted in those above 5 years old

Chronic diarrhoeaMnemonic: 5CsInflammatory causes of chronic diarrhoea include:C Crohn’s diseaseC Ulcerative ColitisMalabsorptive causes of chronic diarrhoea include:C Cystic fibrosisC Coeliac diseaseC Cow’s milk intolerance

Features of Still’s diseaseMnemonic: STILLSS Spiking illness/Severe malaiseT There could be myalgia/arthralgiaI Increased size of liver/spleenL Lose weight, anaemiaL Looks like malignancyS Salmon-pink rash

PSYCHIATRY

Symptoms and signs in psychiatric disordersCauses of deliriumMnemonic: DELIRIUMD DegenerativeE Epilepsy (post-ictal states)L Liver failureI Intracranial (injury to the head, subarachnoid haemorrhage, TIA, meningitis, cerebral

abscess)R Rheumatic choreaI Infections – pneumonia, septicaemiaU UraemiaM Metabolic – electrolyte imbalance

Disorders due to psychoactive sustancesAlcoholismMnemonic: CAGE questionnaireC Have you ever felt you should Cut down on your drinking?A Have people Annoyed you by commenting on your drinking?G Have you ever felt Guilty about your drinking?E Have you ever needed a drink first thing in the morning to get rid of a hangover or for

nerves (Eye opener)?>1 ‘yes’ answer makes alcoholism likely

Schizophrenia and delusional disordersPositive symptoms (sometimes called type I schizophrenic symptoms)Mnemonic: THREADT Thinking may become disturbed, neologism usageH Hallucinations may occur, usually auditoryR Reduced contact with reality, the natural barrier between subjective and objective

deterioratesE Emotional control may be disturbed with inappropriate laughter or anger (incongruous

affect)A Arousal may lead to worsening of symptomsD Delusions may occur

Negative symptoms (sometimes called type II schizophrenic symptoms)Mnemonic: LESSL Loss of volition, underactivity and social withdrawalE Emotional flatness, lose normal modulation of moodS Speech is reduced, monosyllabic if at allS Slowness in thought and movement, psychomotor retardation may occur

Mood (affective) disordersSymptoms of depressionMnemonic: SLUMPS Suicidal ideation or plansL Lack of interest, enjoyment (anhedonia), energy, appetite or libido

U UnworthinessM Early Morning wakingP Poor concentration/Psychomotor retardation or agitation

Suicide – risk factorsMnemonic: SAD PERSONSS Sex (male)A Age (older)D DepressionP Previous attemptE Excessive alcohol or substance abuseR Rational thinking, loss ofS Sickness (chronic illness)O Organised planN No social supportsS Stated intention to self-harm

RENAL

Diseases and conditionsDetection of acute renal failure (ARF)Mnemonic: ACUteA Acute presentation over hours or daysC Creatinine risesU Urea rises (±oliguria <400 ml/24 h)

Causes acute renal failure (ARF)Mnemonic: ACUteA ATN/Acute GNC Circulatory dysfunction ie shock – hypovolaemia, sepsis, cardiogenicU Urinary outflow obstruction

Clinical presentation of chronic renal failureMnemonic: RESIN & 8 P’sR RetinopathyE Excoriations (scratch marks)S Skin is yellowI Increased blood pressureN Nails are brownP PallorP Purpura and bruisesP Pericarditis and cardiomegalyP Pleural effusionsP Pulmonary oedemaP Peripheral oedemaP Proximal myopathyP Peripheral neuropathy

Complicated urinary tract infections (UTIs)Mnemonic: MARIOM Male patientsA Abnormal renal tractR Renal function is impairedI Impaired host defencesO Organism that is virulent

Risk factors for UTIsMnemonic: UTIsU Urinary tract obstruction or malformationT The menopauseI Intercourse (sexual)/Instrumentation/ImmunosuppressionS female Sex/Stones

DialysisIndications forMnemonic: AEIOUA Acid–base problems (severe acidosis or alkalosis)E Electrolyte problems (hyperkalaemia)I IntoxicationsO Overload, fluidU Uraemic symptoms

Or

Mnemonic: SHARPES Severity of condition increasesH Hyperkalaemia persistent (K+ >7 mmol/l)A Acidosis is metabolic and worsening (pH <7.2 or base excess <–10)R Refractory pulmonary oedemaP Pericarditis (uraemic)E Encephalopathy (uraemic)

Complications of dialysisMnemonic: CHAIRC Cardiovascular diseaseH HypertensionA AnaemiaI InfectionsR Renal bone disease

Urinary tract malignanciesFeatures of renal cell carcinoma (RCC)Mnemonic: RCCR Renal tubule (proximal) epithelium is involvedC Renal Cancers are 90% RCCC Clinical features include haematuria, loin pain, abdominal mass, anorexia, malaise

and weight loss

RESPIRATORY

Diseases and conditionsDefinition of Acute Respiratory Distress Syndrome (ARDS)Mnemonic: ROARR Reduced lung complianceO Oedema, non-cardiogenic pulmonaryA Acute respiratory failureR Refractory hypoxaemia

Causes of Acute Respiratory Distress Syndrome (ARDS)Mnemonic: ARDSA Aspiration-gastric/Acute pancreatitis/Amniotic fluid embolusR Raised ICP/Respiratory tract infection – pneumoniaD DKA/DIC/DrugsS Sepsis/Shock/Smoke inhalation/Severe burns

Risk factors of asthmaMnemonic: FEAR UPF Family historyE EczemaA Acid refluxR Rhinitis (allergic)U UrticariaP Polyps (nasal)

History of asthmaMnemonic: WINDW WheezeI Interferes with schooling, exercise, sleep and workN Nocturnal cough, or early morning coughD Dyspnoea

Clinical manifestations of influenza infectionMnemonic: FLUF FeverL LethargyU Upset appetite (nausea and vomiting)

Features of Tuberculosis (TB)Mnemonic: 4 C’sC CoughC CaseationC CalcificationC Cavitation

RHEUMATOLOGY

Rheumatoid arthritis (RA)FeaturesMnemonic: RHEUMATISMR Rheumatoid factor (RF) +ve in 80%/Radial deviation of wristH HLA-DR1 and DR-4E ESR ./Extra-articular features (restrictive lung disease, subcutaneous nodules)U Ulnar deviation of fingersM Morning stiffness/MCP+PIP joint swellingA Ankylosis/Atlanto–axial joint subluxation/Autoimmune/ANA +ve in 30%T T-cells (CD4)/TNFI Inflammatory synovial tissue (pannus)/IL-1S Swan-neck deformity, Boutonniere deformity, Z-deformity of thumbM Muscle wastage of small muscles of hand

ManagementDMARDs (Disease-Modifying Anti-Rheumatic Drugs)Mnemonic: Most Sufferers Can Get Appropriate Pain ControlM MethotrexateS SulfasalazineC CiclosporinG GoldA AzathioprineP PenicillamineC HydroxyChloroquine

Joint painCausesMnemonic: ARTHRITISA Arthritis – rheumatoid or osteoarthritisR Reactive arthritidesT Tendon/muscle damageH Hyperuricaemia; goutR Referred painI AutoImmune, eg connective tissue disease – systemic sclerosis, SLET TumourI IschaemiaS Sepsis/Spondyloarthritides

ArthritisFeatures of Ankylosing spondylitisMnemonic: SPINALS Sacroiliac and low back painP Pleuritic chest painI Inherited gene marker: HLA-B27 (>90% HLA-B27 +ve, general population

frequency – 8%)N Neck hyperextension – question mark postureA Arthritic symptoms in peripheries (asymmetrical)

L Loss of spinal movement which is progressive

Compnents of CREST syndromeMnemonic: CRESTC CalcinosisR Raynaud’s phenomenonE OEsophageal dysmotilityS SclerodactylyT Telangiectasia

SURGERY

AnatomyAbdominal all musclesMnemonic: TIRET Transversus abdominisI Internal obliqueR Rectus abdominisE External oblique

Bowel componentsMnemonic: Dr Jones Investigates Carefully And Cuts RandomlyFrom proximal to distal:D DuodenumJ JejunumI IleumC CaecumA AppendixC ColonR Rectum

Clinical conditionsInitial management of all surgical emergenciesMnemonic: 4 As, 2 Cs, 2 Ns (could be remembered as a set of GCSE results!)A ABC assessmentA Analgesia, eg morphineA Anti-emeticA Aggressive fluid resuscitation – IV fluids and electrolyte replacementC Central venous pressure (CVP) line – may be neededC Catheter (urinary)N Nil by mouth (NBM)N Nasogastric (NG) tube

Post-operative complicationsGeneral immediateMnemonic: PROBSP Primary haemorrhage/PainR Reactive haemorrhage

O Oliguria – acute urinary retentionB Shock/Sepsis

General earlyMnemonic: ABCDEA Analgesia- or Anaesthetic-related nausea + vomitingB Breakdown of wound or anastomosis due to infection or haematoma – dehiscence / ↓BP – ↓ fluid input → hypovolaemia →↓BPC Confusion – acuteD DVT leading possibly to PEE Elevated temperature – pyrexia

General lateMnemonic: RIBR Recurrence of malignancyI Incisional herniaB Bowel obstruction

Lumps and bumpsExaminingMnemonic: 3 Ss, 3 Cs, 3Ts and the F’er3Ss Site, Size, Shape3Cs Colour, Consistency, Contour3Ts Tenderness, Tethering, TransilluminationF’er Fluctuance

HerniasGroin lump: differential diagnosisMnemonic: Surgeons Like To Manage Various HerniasS Spermatic cord (lipoma, hydrocoele)/Skin (sebaceous cyst)L Lymph nodesT Testicle (ectopic, undescended)M Muscle (psoas abscess)V Vascular (femoral artery aneurysm, saphena varyx)H Hernias (inguinal, femoral)

TRAUMA AND ORTHOPAEDICS

AnatomyCubital fossa contentsMnemonic: Please Remember Be Brave MedicallyFrom lateral to medial:P Posterior interosseus nerveR Radial nerveB Biceps tendonB Brachial arteryM Median nerve

Adductor muscles of thighMnemonic: Post-Graduates Love their Bachelor Of MedicineP PectineusG GracilisL Adductor LongusB Adductor BrevisO Obturator nerve innervates all these muscles expect for the pectineus (femoral nerve).

Part of the adductor magnus is supplied by the sciatic nerveM Adductor Magnus

Clinical conditionsPainful neck - differentialsMnemonic: Jock STRAPJ Jerking back of the head and neck, ie whiplashS Spondylosis/Spondylolisthesis of cervical discsT Torticollis (spasmodic/infantile)R Cervical RibA Abnormal postureP Prolapsed cervical disc

Carpel tunnel syndrome – causes and risk factorsMnemonic: CARPALC Cardiac failure/Combined OCP useA AcromegalyR Renal disorder – nephrotic syndrome/Raised glucose levels; DMP Pregnancy/Poor thyroid function; hypo-thyroidismA Arthritis of the wrist (rheumatoid, osteoarthritis)L Large size – obesity

Painful back - differentialsMnemonic: TOMS DIScmanT Tumours of spineO Osteoporosis/OsteomalaciaM MechanicalS SpondylolisthesisD Disc prolapse/lesionI InfectionS Stenosis of lumbar spine/lateral recess (due to facet joint osteoarthritis)

Differential diagnosis of a limpMnemonic: STARTSS HOTS Septic jointT TumourA Avascular necrosis (Legg–Calve–Perthe’s)R Rheumatoid arthritis/juvenile rheumatoid arthritisT TuberculosisS Sickle cell disease

S Slipped upper femoral epiphysis (SUFE)H HSPO OsteomyelitisT Trauma

TraumaSoft tissue injuries - treatmentMnemonic: RICE (protocol employed in the 1st 24 hours following the injury)R RestI IceC CompressionE Elevation