Epidemiology and Biostats Mnemonics

Suicide risk factors SAD PERSONS:
Sex: male
Age: young, elderly
Depression
Previous suicide attempts
Ethanol and other drugs
Reality testing/ Rational thought (loss of)
Social support lacking
Organized suicide plan
No spouse
Sickness/ Stated future intent

Sensitivity and Specificity

seNsitivity of a test: related to the rate of false Negatives.
sPecificity of a test: related to the rate of false Positives.
· Alternatively written:
seNsitive: No Non-Negatives.
sPecific: Puny Psuedo-Positives.

Informed consent: requirements, exceptions "Sign this DOC before we can start":
Discussion
Obtain agreement
Coercion-free
· Exceptions to informed consent are WIPE:
Waiver
Incompetent
Privilege (therapeutic privilege)
Emergency

Hill criteria for causality " 'Clowns Pursuing Epidemiology' Commonly Behind The Silly Samples":
Consistency
Plausibility
Experimentation
Biological gradient
Coherence
Temporality
Strength of association
Specificity

Primary: Predisposing factors decreased.
Secondary: Severity decreased.
Tertiary: Therapy, Training.

Suicide risk factors in order of risk SOARS:
· Top 6 risk factors in order of highest to lowest risk:
Serious previous attempt
Older than 45
Alcohol
Rage history
Sex (male)

Reliability Random Error
REduces
REliability (REproducibility)

Error: type I (alpha) vs. type II (beta) Type I (Alpha) Error:
"There Is An Effect" where in reality there is none.

Cigarette smoke: major carcinogens PANT:
Polynuclear aromatic hydrocarbons
Aromatic amines
Nitrosamines
Tar
· Nicotine and Carbon monoxide are Non-Carcinogenic.

Behaviour Science and Psychiatric Mnemonics

Cluster personality disorders Cluster A Disorder = Atypical. Unusual and eccentric.
Cluster B Disorder = Beast. Uncontrolled wildness.
Cluster C Disorder = Coward [avoidant type], Compulsive [obsessive-compulsive type], or Clingy [dependent type].

Gain: primary vs. secondary vs. tertiary Primary: Patient's Psyche improved.
Secondary: Symptom Sympathy for patient.
Tertiary: Therapist's gain.

Depression: major episode characteristics SPACE DIGS:
Sleep disruption
Psychomotor retardation
Appetite change
Concentration loss
Energy loss
Depressed mood
Interest wanes
Guilt
Suicidal tendencies

Impotence causes PLANE:
Psychogenic: performance anxiety
Libido: decreased with androgen deficiency, drugs
Autonomic neuropathy: impede blood flow redirection
Nitric oxide deficiency: impaired synthesis, decreased blood pressure
Erectile reserve: can't maintain an erection

Sleep stages: features DElta waves during DEepest sleep (stages 3 & 4, slow-wave).
dREaM during REM sleep.

AIDS Dementia Complex (ADC): features AIDS:
Atrophy of cortex
Infection/ Inflammation
Demyelination
Six months death

REM:
Rapid pulse/ Respiratory rate
Erection
Mental activity increase/ Muscle paralysis

Depression: symptoms BAD CRISES:
Behavioural change (slowing down or agitation)
Appetite change (weight loss or weight gain in the young)
Depressed look (looking down)
Concentration decrease (does not do serial 7s well)
Ruminations (constant negative thoughts, hopelessness good indicator of suicidality)
Interest (reduced interest in what is normally pleasurable)
Sleep change (insomnia or hypersomnia, sleeping early, waking up at night, waking up feeling tired)
Energy change (fatigue)
Suicide

Male erectile dysfunction (MED): biological causes MED:
Medicines(propranalol, methyldopa, SSRI, etc.)
Ethanol
Diabetes mellitus

HERO:
Heterosexual crushes/ Homosexual Experience
Education regarding short term benefits
Risk taking
Omnipotence
· And there is interest in being a Hero (popular).

Autistic disorder: features AUTISTICS:
Again and again (repetitive behavior)
Unusual Abilities
Talking (language) delay
IQ subnormal
Social development poor
Three years onset
Inherited component [35% concordance]
Cognitive impairment
Self injury

Narcolepsy: symptoms, epidemiology CHAP:
Cataplexy
Hallucinations
Attacks of sleep
Paralysis on waking
· Usual presentation is a young male, hence "chap".

Surgery Mnemonics

Post-operative fever causes Six W's:
Wind: pulmonary system is primary source of fever first 48 hours, may have pneumonia
Wound: infection at surgical site
Water: check IV for phlebitis
Walk: deep venous thrombosis, due to pelvic pooling or restricted mobility related to pain and fatigue
Whiz: urinary tract infection if urinary catheterization
Wonder drugs: drug-induced fever

Scrotum: scrotum swelling differential THE THEATRES:
Torsion
Hernia
Epididymytis, orchitis
Trauma
Hydrocoele, varicocele, hematoma
Edema
Appendix testes (torsion, hemorrhage)
Tumour
Recurrent leukemia
Epididymal cyst
Syphilis, TB

Post-operative complications (immediate) "Post-op PROBS":
Pain
Primary haemorrhage
Reactionary haemorrhage
Oliguria
Basal atelectasis
Shock/ Sepsis

Fistulas: conditions preventing closure FETID:
Foreign body
Epithelialization
Tumor
Infection
Distal obstruction

Oedema causes: localised ALIVE:
Allergic (angio-oedema)
Lymphatic (elephantiasis)
Inflammatory (infection, injury)
VEnous (DVT, chronic venous insufficiency)

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

Compartment syndrome: signs and symptoms · 5 P's:
Pain
Palor
P ulseless
Paresethesia
Pressure (increased)

Swollen leg: unilateral swelling causes TV BAIL:
Trauma
Venous (varicose veins, DVT, venous insufficiency)
Baker's cyst
Allergy
Inflammation (cellulitis)
Lymphoedema

F PURE:
Flat (eg venous)
Punched-out (eg trophic, arterial)
Undetermined (eg pressure, TB)
Rolled (eg BCC)
Everted (eg SCC)

Pancreatitis: treatment MACHINES:
Monitor vital signs
Analgesia/ Antibiotics
Calcium gluconate (if deemed necessary)
H2 receptor antagonist
IV access/ IV fluids
Nil by mouth
Empty gastric contents
Surgery if required/ Senior review

Appendicitis: Alvarado's scoring system for diagnosis MANTRELS:
Migratory pain (1)
Anorexia (1)
Nausea (1)
Tenderness (2)
Rebound tenderness (1)
Elevated temperature (1)
Leucocytosis (2)
Shift to left (1)
· Score 3-4 = no appendicitis. Score 5-6 = doubtful. Score 7 or more = appendicitis is confirmed.

Post operative order list check-up FLAVOR:
Fluids
Laboratories
Activity
Vital signs
Oral allowances
Rx [medications]

Pediatric Mnemonics

Croup: symptoms 3 S's:
Stridor
Subglottic swelling
Seal-bark cough

Ataxia-Telangiectasia (AT): common sign AT:
Absent
Thymus

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

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)

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)

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

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)

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

Cyanotic congenital heart diseases 5 T's:
Truncus arteriosus
Transposition of the great arteries
Tricuspid atresia
Tetrology of Fallot
Total anomalous pulmonary venous return

Weights of children with age Newborn 3 kg
6 mos 6 kg (2x birth wt at 6 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

Hemolytic-Uremic Syndrome (HUS): components "Remember to decrease the RATE of IV fluids in these patients":
Renal failure
Anemia (microangiopathic, hemolytic)
Thrombocytopenia
Encephalopathy (TTP)

Cough (chronic): differential When cough in nursery, rock the "CRADLE":
Cystic fibrosis
Rings, slings, and airway things (tracheal rings)/ Respiratory infections
Aspiration (swallowing dysfunction, TE fistula, gastroesphageal reflux)
Dyskinetic cilia
Lung, airway, and vascular malformations (tracheomalacia, vocal cord dysfunction)
Edema (heart failure)

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)

WAGR syndrome: components WAGR:
Wilm's tumor
Aniridia
Gential abnormalities
Mental Retardation

Haematuria: differential in children ABCDEFGHIJK:
Anatomy (cysts, etc)
Bladder (cystitis)
Cancer (Wilm's tumour)
Drug related (cyclophosphamide)
Exercise induced
Factitious (Munchausen by proxy)
Glomerulonephritis
Haematology (bleeding disorder, sickle cell)
Infection (UTI)
In Jury (trauma)
Kidney stones (hypercalciuria)

Vitamin Toxicity:

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

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

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

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 history.

Neonatal resuscitation: successive steps "Do What Pediatricians Say To, Or Be Inviting Costly Malpractice":
Drying
Warming
Positioning
Suctioning
Tactile stimulation
Oxygen
Bagging
Intubate endotracheally
Chest compressions
Medications

Obstetric Mnemonic

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

Abdominal pain: causes during pregnancy LARA CROFT:
Labour
Abruption of placenta
Rupture (eg. ectopic/ uterus)
Abortion
Cholestasis
Rectus sheath haematoma
Ovarian tumour
Fibroids
Torsion of uterus

Post-partum haemorrhage (PPH): causes 4 'T's:
Tissue (retained placenta)
Tone (uterine atony)
Trauma (traumatic delivery, episiotomy)
Thrombin (coagulation disorders, DIC)

Prenatal care questions ABCDE:
Amniotic fluid leakage?
Bleeding vaginally?
Contractions?
Dysuria?
Edema?
Fetal movement?

Asherman syndrome features ASHERMAN:
Acquired Anomaly
Secondary to Surgery
Hysterosalpingography confirms diagnosis
Endometrial damage/ Eugonadotropic
Repeated uterine trauma
Missed Menses
Adhesions
Normal estrogen and progesterone

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.

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.

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

Female pelvis: shapes GAP:
· In order from most to least common:
Gynecoid
Android /Anthropoid
Platypelloid

Pelvic Inflammatory Disease (PID): complications I FACE PID:
Infertility
Fitz-Hugh-Curitis syndrome
Abscesses
Chronic pelvic pain
Ectopic pregnancy
Peritonitis
Intestinal obstruction
Disseminated: sepsis, endocarditis, arthritis, meninigitis

B-agonist tocolytic (C/I or warning) ABCDE:
Angina (Heart disease)
BP high
Chorioamnionitis
Diabetes
Excessive bleeding

Secondary amenorrhea: causes SOAP:
Stress
OCP
Anorexia
Pregnancy

Preeclampsia: classic triad PREeclampsia:
Proteinuria
Rising blood pressure
Edema

Alpha-fetoprotein: some major causes for increased maternal serum AFP during pregnancy TOLD:
Testicular tumours
Obituary (fetal death)
Liver: hepatomas
Defects (neural tube defects)

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)

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

Early cord clamping: indications RAPID CS:
Rh incompatibility
Asphyxia
Premature delivery
Infections
Diabetic mother
CS (caesarian section) previously, so the funda is RAPID CS

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 delivery FORCEPS:
Foetus alive
Os dilated
Ruptured membrane
Cervix taken up
Engagement of head
Presentation suitable
Sagittal suture in AP diameter of inlet

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

APGAR score components SHIRT:
Skin color: blue or pink
Heart rate: below 100 or over 100
Irritability (response to stimulation): none, grimace or cry
Respirations: irregular or good
Tone (muscle): some flexion or active

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

Multiple pregnancy complications HI, PAPA:
Hydramnios (Poly)
IUGR
Preterm labour
Antepartum haemorrhage
Pre-eclampsia
Abortion

IUD: side effects PAINS:
Period that is late
Abdominal cramps
Increase in body temperature
Noticeable vaginal discharge
Spotting

Labour: preterm labor causes DISEASE:
Dehydration
Infection
Sex
Exercise (strenuous)
Activities
Stress
Environmental factor (job, etc)

Miscarriage: recurrent miscarriage causes RIBCAGE:
Radiation
Immune reaction
Bugs (infection)
Cervical incompetence
Anatomical anomaly (uterine septum etc.)
Genetic (aneuploidy, balanced translocation etc.)
Endocrine

Shoulder dystocia: management HELPER:
Call for Help
Episiotomy
Legs up [McRoberts position]
Pressure subrapubically [not on fundus]
Enter vagina for shoulder rotation
Reach for posterior shoulder and deliver posterior shoulder/ Return head into vagina [Zavanelli maneuver] for C-section/ Rupture clavicle or pubic symphisis

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

Post-partum examination simplified checklist BUBBLES:
Breast
Uterus
Bowel
Bladder
Lochia
Episotomy
Surgical site (for Cesarean section)

Internal Medicine Cardiovascular Mnemonics

Aortic stenosis characteristics SAD:
Syncope
Angina
Dyspnoea

MI: basic management BOOMAR:
Bed rest
Oxygen
Opiate
Monitor
Anticoagulate
Reduce clot size

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

Pericarditis: causes CARDIAC RIND:
Collagen vascular disease
Aortic aneurysm
Radiation
Drugs (such as hydralazine)
Infections
Acute renal failure
Cardiac infarction
Rheumatic fever
Injury
Neoplasms
Dressler's syndrome

Murmurs: systolic types SAPS:
Systolic
Aortic
Pulmonic
Stenosis
· Systolic murmurs include aortic and pulmonary stenosis.
· Similarly, it's common sense that if it is aortic and pulmonary stenosis it could also be mitral and tricusp regurgitation].

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

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

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

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

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

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

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

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

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

MI: therapeutic treatment "O BATMAN!":
Oxygen
Beta blocker
ASA
Thrombolytics (eg heparin)
Morphine
Ace prn
Nitroglycerin

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

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

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

MI: therapeutic treatment MONAH:
Morphine
Oxygen
Nitrogen
Aspirin
Heparin

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

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

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

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

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

Apex beat: abnormalities found on palpation, causes of impalpable HILT:
Heaving
Impalpable
Laterally displaced
Thrusting/ Tapping
· If it is impalpable, causes are COPD:
COPD
Obesity
Pleural, Pericardial effusion
Dextrocardia

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

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

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

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

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

Rheumatic fever: Revised Jones criteria JONES PEACE:
· Major criteria:
Joints: migratory
O (heart shaped) Carditis: new onset murmur
Nodules, subcutaneous: extensor surfaces
Erythema marginatum
Sydenham's chorea
· Minor criteria:
PR interval, prolonged
ESR elevated
Arthralgias
CRP elevated
Elevated temperature (fever)
· Need 2 major or 1 major and 2 minor criteria, plus evidence of recent GAS infection (throat cx, rapid antigen test, or rising strep antibody titer).

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

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

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

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

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

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

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

Murmurs: louder with inspiration vs expiration LEft sided murmurs louder with Expiration
RIght sided murmurs louder with Inspiration.

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

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

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

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

Hi Friends I am going to post Medical Mnemonics according to subjectwise...hoping that it may help you....

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