MNEMONICS

1)CLINICAL SKILLS

Full Medical History
When taking a history:
Mnemonic: OPERATES
O Onset of complaint
P Progress of complaint
E Exacerbating factors
R Relieving factors
A Associated symptoms
T Timing
E Episodes of being symptom-free
S Relevant Systemic and general inquiry can be added here

Medications/allergies
Mnemonic: PILLS
P Pills, is the patient taking any?
I Injections/Insulin/Inhalers (as some patients forget to mention when asked
about their medications)
LL ILLicit drug use
S Sensitivities to anything, ie allergies
In every history, donʼt forget to ask about the ʻFAWRʼ non-specific symptoms that the
patient may exhibit
Mnemonic: FAWR
F Fever
A Appetite
W Weight loss (unintentional)
R Reduced energy (i.e. fatigue/lethargy)
When assessing psychological state:
Mnemonic: SAD CASE
S Suicidal ideations
A Anxiety
D Decreased mood/Delusions/Disordered thought
C Difficulty Concentrating
A Auditory or other hallucinations?
S Difficulties Sleeping
E 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 Definition
I Incidence
S Sex
G Geography
A Aetiology
P Pathogenesis
M Macroscopic pathology

P Prognosis

2)CARDIOVASCULAR

To remember heart valve auscultation sites:

Mnemonic: All Patients Take Medications

Starting from top left:

Aortic – 2nd intercostal space, right sternal edge

Pulmonary – 2nd intercostal space, left sternal edge

Tricuspid – 4th intercostal space, right sternal edge

Mitral – 5th intercostal space, mid-clavicular line

Angina

Management through lifestyle alterations

Mnemonic: SLEW

S Smoking cessation

L Low-fat diet

E Exercise

W Weight loss

Management of acute unstable angina

Mnemonic: 2 As and BALI

A Admit, bed rest, high-flow oxygen

A Analgesia

A Aspirin and clopidogrel

B Beta blockers

A Angiography with or without angioplasty/CABG if symptoms fail to improve

L Low molecular weight heparin (LMWH)

I Infusion of nitrates

Presentation

Mnemonic: SCAR

S Sudden central pain, ʻtearingʼ in nature, may radiate to the back

C 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 paraplegia

R Renal artery can be affected leading to anuria or renal failure

Cardiac arrest

Management, Basic Life Support (BLS)

Mnemonic: ABC

A 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

immediately

C 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 patient

A Assess rhythm and pulse

D Defibrillate x 3 if VF or pulseless VT, CPR for 1 min

A Assess rhythm and pulse

E EMD (no cardiac output despite ECG showing electrical activity) or asystole

warrants CPR for 3 min

A Assess rhythm and pulse

Hypertension

Treatment

Mnemonic: ABCD

A ACE inhibitors/Angiotensin-II-antagonists (sometimes Alpha-agonists also)

B Beta blockers

C Calcium channel blockers

D Diuretics (Thiazides)

3)CLINICAL CHEMISTRY

Aspirin

Aspirin overdose – early symptoms

Mnemonic: DAFT HID

D Deafness

A Appear flushed

F Fever

T Tinnitus

H Hyperventilation

I Increased sweating

D Dizziness

Metabolic acidosis

Causes

Mnemonic: UK SLAMS

U Uraemia

K Ketoacidosis

S Salicylates

L Lactic acidosis

A Alcohol

M Methanol

S Sepsis

Paracetamol

Paracetamol overdose – (the most common intentional drug overdose in the UK).

Risk factors

Mnemonic: COMAH

C Chronic alcohol abusers

O On drugs that increase cytochrome P450 activity, anti-TB drugs

M Malnourished individuals

A Anorexic patients

H HIV patients

4)DERMATOLOGY

Skin

Functions of the skin

Mnemonic: SKIN

S Specialised sensory innervation/Synthesise Vitamin D/Secretes pheromones

for Sex

K Keeps out unwanted molecules, microbes or radiation/Keeps in water,

electrolytes and solutes

I Immunological function; contains antigen-presenting cells

N Normalises heat regulation

Common allergens for allergic contact dermatitis

Mnemonic: CONTACT

C Cutaneous type IV reaction

O Ointments and cosmetics containing lanolin

N Nickel

T Topical antibiotics can cause it (e.g. neomycin)

A 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

Infestations

Clinical presentation of impetigo

Mnemonic: IMPETIGO

I Infection with Staphylococcus aureus, Streptococcus pyogenes or both

M Mostly in young children

P Particularly around nose and surrounding parts of face

E Erythematous base with honey-coloured crusts

T Treat with Topical antibiotic such as fusidic acid for localized lesions

I Individuals are highly contagious from skin-to-skin contact; Improve hygiene;

do not share towels

G Gram stain and culture of swab diagnostic

O Oral flucloxacillin required for widespread impetigo

Squamous cell carcinoma

Clinical presentation

Mnemonic: S, CELL, C

S Sun-exposed areas are usually affected: ears, dorsum of the hands, bald

scalp

C Crusted, firm, irregular lesion

E Excision used as treatment

L Lower lip can be affected in smokers

L Less likely to metastasise

C Associated with Chronic inflammation such as venous leg ulcers.

5)ENDOCRINOLOGY

Thyroid gland

Symptoms of hypothyroidism

Hypothyroidism is 10 times more common in females & occurs mainly in middle life.

Mnemonic: MOMʼS SO TIRED

M Memory loss

O Obesity

M Malar flush/Menorrhagia

S Slowness

S Skin and hair become dry

O Onset is gradual

T Tired

I Intolerance to cold

R Raised blood pressure

E Energy levels are low

D Depressed

Symptoms of hyperthyroidism

Mnemonic: SWEATING

S Sweating

W Weight loss

E Emotional lability

A Appetite is increased

T Tremor/Tachycardia due to AF

I Intolerance to heat/Irregular menstruation/Irritability

N Nervousness

G Goitre and Gastrointestinal problems (loose stools/diarrhoea)

Adrenal glands

Causes of Addisonʼs Disease

Mnemonic: ADDISON

A Autoimmune (90% cases)

D Degenerative (amyloid)

D Drugs (ketoconazole)

I Infections (TB, HIV)

S Secondary (low ACTH); hypopituitarism

O Others – adrenal bleeding

N Neoplasia (secondary carcinoma)

Pancreas

Complications of diabetes mellitus

Mnemonic: KEVINS

K Kidney: Nephropathy

E Eye disease: retinopathy and cataracts

V Vascular: coronary artery disease, cerebrovascular disease, peripheral

vascular disease

I Infective: TB, recurrent UTIs

N Neuromuscular; Peripheral neuropathy

S Skin: Necrobiosis lipoidica diabeticorum, granuloma annulare, diabetic

dermopathy

6)GASTROENTEROLOGY

Abdomen distension

Causes

Mnemonic: 6 Fʼs

F Fat

F Fetus

F Flatus

F Faeces

F Fluid

F Flipping great tumour

Chronic liver disease

Signs

Mnemonic: ABCDEFGHIJ

A Asterixis (ʻliver flapʼ)/Ascites/Ankle oedema/Atrophy of testicles

B Bruising/BP.

C Clubbing/Colour change of nails; white (leuconychia)

D Dupuytrenʼs contracture

E Erythema (palmar)/Encephalopathy

F hepatic Foetor

G Gynaecomastia

H Hepato splenomegaly

I Increase in size of parotids

J Jaundice

Inflammatory bowel disease (IBD)

Features of ulcerative colitis

Mnemonic: ULCERS IN Abdomen

U Ulcers (mucosal and submucosal)

L Large intestine (rectum always involved. May extend proximally to involve

entire colon)

C Clubbing

E Extra-intestinal manifestations

R Remnants of old ulcers (pseudopolyps)

S Stools bloody

I Inflamed, red, granular mucosa and sub mucosa

N Neutrophil invasion

A Abscesses in crypts

Complications of ulcerative colitis

Mnemonic: How To Perform GI Colonoscopy

H Haemorrhage

T Toxic megacolon

P Perforation

G Gallstones

C Colorectal carcinoma (in those with extensive disease for > 10 years)

Morphology and symptoms of Crohnʼs disease

Mnemonic: CHRIS Has Too Much Diarrhoea and Abdominal pain

C Cobblestone appearance of mucosa

H High temperature

R Reduced lumen/Rose-thorn ulcers

I Intestinal fistulae/Ileo-caecal region commonly involved (40% of cases)

S Skip lesions

H Hyperplasia of mesenteric lymph nodes

T Transmural inflammation (all layers, may ulcerate)

M Malabsorption

D Diarrhoea (watery)

A Abdominal pain

7)HAEMATOLOGY

Sickle cell disease

Signs

Mnemonic: SICKLE

S Splenomegaly/Sludging

I Infection

C Cholelithiasis

K Kidney – haematuria

L Liver congestion/Leg ulcers

E Eye changes

Leukaemia

Symptoms and sings

Mnemonic: LEUKEMIA (the US spelling!)

L Light skin (pallor)

E Energy decreased/Enlarged spleen, liver, lymph nodes

U Underweight

K Kidney failure

E Excess heat (fever)

M Mottled skin (haemorrhage)

I Infections

A Anaemia

Thrombocytopenia

Causes

Mnemonic: PLATELETS

P Platelet disorders: TTP, ITP, DIC

L Leukaemia

A Anaemia

T Trauma

E Enlarged spleen

L Liver disease

E Ethanol

T Toxins: benzene, heparin, aspirin, chemotherapy.

S Sepsis

Immune thromobocytopenic purpura (ITP)

Causes

Mnemonic: MAID

M Malignancy

A Autoimmune diseases: SLE, thyroid disease, RA

I Infections: malaria, EBV, HIV/Idiopathic (commonest cause)

D Drugs, e.g. quinine

Symptoms

Mnemonic: BBC

B Bruising

B Bleeding: mucosal and nasal

C Cycles heavy; menorrhagia

8)INFECTIOUS DISEASES

Gastroenteritis

Causes

Mnemonic: LESS GERMS

L Listeria

E Escherichia coli

S Staphylococcus aureus

S Salmonella

G Giardia lamblia

E Entamoeba histolytica

R Rotavirus

M Mushrooms

S Shigella

Malaria

Common early symptoms

Mnemonic: Heard A Mosquito

H Headache

A Anorexia

M Myalgia/Malaise

Common later symptoms

Mnemonic: Feel Rather Cold

F Fever (peaks every third day, i.e. tertian)

R Rigors

C Chills

Leprosy

Clinical presentation

Mnemonic: LEProsy

L 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

HIV

Groups at high risk of developing infection

Mnemonic: HIV

H Homosexuals (note the rising incidence in Heterosexuals too)/Haemophiliacs

IV IV drug abusers

9)NEUROLOGY

Anatomy

Cranial bones

Mnemonic: PEST OF 6

P Parietal

E Ethmoidal

S Sphenoid

T Temporal

O Occipital

F Frontal

6 This indicates the number of bones

Branches of the facial nerve

Mnemonic: To Zanzibar By Motorcar

T Temporal nerve

Z Zygomatic nerve

B Buccal nerve

M Marginal mandibular nerve

C Cervical nerve

Clinical conditions

Stroke – investigations

Mnemonic: The 4 Ps

P Plasma: FBC, U&E, ESR, glucose, lipids

P Pump, i.e heart (ECG, echocardiogram)

P Pipes: carotid Doppler ultrasound

P Picture of brain: CT/MRI; detects ischaemia or haemorrhages

Stroke – management

Mnemonic: ABCDEFGHI

A Advice – lifestyle changes e.g. stop smoking, reduce alcohol intake, lose

weight

B BP control

C Cholesterol control

D Diabetes control

E 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 nurse

I Incontinence care and limit Immobility (pressure sores and contractures may

develop otherwise)

Meningitis

Aetiology - Bacterial

Mnemonic: NHS

N Neisseria meningitides (children and adults; meningococcus)

H Haemophilus influenzae (children)

S Streptococcus pneumoniae (adults and elderly)/(Streptococcus produces the

Severest meningitis)/Viral

Aetiology - Viral

Mnemonic: V MECH

V VZV

M Mumps

E Enterovirus/EBV

C Coxsackie virus types A and B

H Haemophilus influenzae/HIV/HSV

Aetiology - Fungal

Mnemonic: 2 Cʼs

C Cryptococcus (associated with HIV infection)

C Candida

Migraine

Features

Mnemonic: EAT FUN

E Episodic

A Aura – zigzag lines

T Throbbing headache

F Family history/F(p)hoto-phobia

U Unilateral

N Nausea and vomiting

10)OBSTETRICS AND GYNAECOLOGY

Clinical conditions

Labour - onset

Mnemonic: Ready Mom for Some Discomfort

R Regular and painful uterine contractions

M Membranes ruptured

S ʻShowʼ

D Dilatation and effacement of cervix

Factors that determine the rate and outcome of labour

Mnemonic: 3 Pʼs

P Powers: strength of the uterine contractions

P Passages: size of the pelvic inlet and outlet

P Passengers: fetus – is it big or small, does it have anomalies, is it alive or

dead?

Ante-partum haemorrhage (APH) causes

Mnemonic: APH

A Abruption of placenta

P Placenta praevia (or vasa praevia)

H Haemorrhaging from the genitourinary tract

Post-partum haemorrhage (PPH) causes

Mnemonic: 4 Tʼs

T Tissue (retained placenta)

T Tone (uterine atony)

T Trauma (traumatic delivery, episiotomy)

T Thrombin (coagulation disorders, DIC)

Gynaecology

Endometriosis - symptoms

Mnemonic: Classic ʻquartetʼ of DIPS

D Deep dyspareunia

I Infertility

P Pelvic pain (cyclical)

S Secondary dysmenorrhoea

Menopause - symptoms

Mnemonic: FSH > 20 IU/L

Remembering that this is the most accurate blood test in confirmation of the

menopause!

F hot Flushes/Female genitalia (vaginal) dryness and burning

S Sweats at night

H Headaches

I Insomnia

U Urge incontinence

L Libido decreases

Menopause – long-term effects

Mnemonic: CONU

C Cardiovascular disease: IHD, stroke, arterial disease

O Osteoporosis: accelerated bone loss leading to osteoporosis and pathological

fractures

N Neurological: Alzheimerʼs disease

U Urogenital atrophy: loss of pelvic floor muscle tone

Infertility – causes and risk factors

Mnemonic: INFERTILE (in females)

I Idiopathic

N No ovulation – PCOS, menopause, pituitary disease, thyroid disorders

F Fibroids – physical hindrance

E Endometriosis

R Regular bleeding pattern disrupted – oligo/amenorrhoea

T Tubal disease leading to blocked/damaged cilia

I Increasing age >35 years

L Large size – obesity

E Excessive weight loss – anorexia nervosa

11)OPHTHALMOLOGY

Diseases and conditions

Allergic eye disease

Mnemonic: HFS

H Delayed Hypersensitivity

F HayFever conjunctivitis

S Spring catarrh

Clinical presentation of conjunctivitis

Mnemonic: BURN

B Burning and lacrimation along with itching and possibly photophobia

U Usually bilateral, if unilateral consider another differential diagnosis

R Red and inflamed conjunctiva, eyelids may be stuck together with purulent

discharge

N Normally self-limiting, can be treated with antibiotics

Signs of optic neuropathy

Mnemonic: PLAC

P Pale disc

L Loss of visual acuity/Loss of red colour vision

A Afferent pupillary defect

C Central scotoma

Causes of retinal detachment

Mnemonic: SITS

S Secondary to some intraocular problem (melanoma)

I Idiopathic

T Trauma

S Surgery for cataract

The 4 Fs of retinal detachment

Mnemonic: 4 Fʼs

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 lacrimation

Mnemonic: FACE

F Foreign body or corneal abrasions

A Acute glaucoma

C Conjunctivitis

E Emotion (typical man, I list this last!)

12)PAEDIATRICS

The new born baby

Resuscitation - Indications

Mnemonic: IF KEMPT

I Instrumental delivery

F Fetal distress

K Known congenital abnormality

E Emergency caesarean section

M Multiple births

P Prematurity

T Thick meconium stains the liquor

Congenital abnormalities

Features of Downʼs Syndrome

Mnemonic: DOWNS

D Dysplastic ears/Dysplastic pelvis (seen on X-ray)

O Occiput is flat/Overly large tongue

W Widely spaced 1st and 2nd toes and a high-arched palate/Weak/ʼfloppyʼ baby

(hypotonia)

N Neck skin abundant

S Short, broad hands with single palmar crease/Slanting eyes/Speckled iris

(Brushfieldʼs spots)

Developmental assessment

Primitive reflexes

Mnemonic: MPRAG

M Moro

P Placing reflex

R Rooting

A Atonic neck reflex

G Grasp reflex

Infant nutrition

Breastfeeding - advantages

Mnemonic: PACES

P Psychological satisfaction

A Anti-infective property/Atopic disorders risk .

C Convenient

E Expenseless, ie free

S Stimulates growth and development

Breastfeeding - disadvantages

Mnemonic: KIDS

K vitamin K deficiency in breast-milk

I Infection transmission risk eg HIV

D Drugs excreted in milk

S Stressful and tiring for mother

Acute presentations – the acutely ill child

Four main nodes of presentation of serious illness in children

Mnemonic: SURE

S Shock

U Unconscious/drowsy/fitting child

R Respiratory distress

E Emergencies (surgical)

Clinical presentation of brain tumours

Mnemonic: BAN HENS

B Blurred vision

A Ataxia (clumsiness)

N Nystagmus

H Headache

E Endocrine dysfunction

N Nausea and vomiting

S Squint (6th nerve palsy)

Causes of respiratory failure

Mnemonic: PC FED BRAHMS

P Pneumonia

C Cystic fibrosis/Croup

F Foreign body

E Epiglottitis

D Drug ingestion

B Bronchiolitis

R Raised ICP

A Asthma

H Head injury

M Meningitis/muscle weakness

S Severe cardiac failure

Chronic presentations

Presentation of asthma

Mnemonic: CWS

C Cough (dry/nocturnal/worse with exercise)

W Wheeze

S Shortness of breath

Life threatening attack of asthma

Mnemonic: CHEST

C Cyanosis/Confusion/Coma

H Hypotension

E Exhaustion

S Silent chest

T Threatening PEFR <33% predicted in those above 5 years old

Chronic diarrhoea

Mnemonic: 5 Cʼs

Inflammatory causes of chronic diarrhoea include:

C Crohnʼs disease

C Ulcerative Colitis

Malabsorptive causes of chronic diarrhoea include:

C Cystic fibrosis

C Coeliac disease

C Cowʼs milk intolerance

Features of Stillʼs disease

Mnemonic: STILLS

S Spiking illness/Severe malaise

T There could be myalgia/arthralgia

I Increased size of liver/spleen

L Lose weight, anaemia

L Looks like malignancy

S Salmon-pink rash

13)PSYCHIATRY

Symptoms and signs in psychiatric disorders

Causes of delirium

Mnemonic: DELIRIUM

D Degenerative

E Epilepsy (post-ictal states)

L Liver failure

I Intracranial (injury to the head, subarachnoid haemorrhage, TIA, meningitis,

cerebral abscess)

R Rheumatic chorea

I Infections – pneumonia, septicaemia

U Uraemia

M Metabolic – electrolyte imbalance

Disorders due to psychoactive substances

Alcoholism

Mnemonic: CAGE questionnaire

C 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 disorders

Positive symptoms (sometimes called type I schizophrenic symptoms)

Mnemonic: THREAD

T Thinking may become disturbed, neologism usage

H Hallucinations may occur, usually auditory

R Reduced contact with reality, the natural barrier between subjective and

objective deteriorates

E Emotional control may be disturbed with inappropriate laughter or anger

(incongruous affect)

A Arousal may lead to worsening of symptoms

D Delusions may occur

Negative symptoms (sometimes called type II schizophrenic symptoms)

Mnemonic: LESS

L Loss of volition, underactivity and social withdrawal

E Emotional flatness, lose normal modulation of mood

S Speech is reduced, monosyllabic if at all

S Slowness in thought and movement, psychomotor retardation may occur

Mood (affective) disorders

Symptoms of depression

Mnemonic: SLUMP

S Suicidal ideation or plans

L Lack of: interest, enjoyment (anhedonia), energy, appetite or libido

U Unworthiness

M Early Morning waking

P Poor concentration/Psychomotor retardation or agitation

Suicide – risk factors

Mnemonic: SAD PERSONS

S Sex (male)

A Age (older)

D Depression

P Previous attempt

E Excessive alcohol or substance abuse

R Rational thinking, loss of

S Sickness (chronic illness)

O Organised plan

N No social supports

S Stated intention to self-harm

14)RENAL

Diseases and conditions

Detection of acute renal failure (ARF)

Mnemonic: ACUte

A Acute presentation over hours or days

C Creatinine rises

U Urea rises (±oliguria <400 ml/24 h)

Causes acute renal failure (ARF)

Mnemonic: ACUte

A ATN/Acute GN

C Circulatory dysfunction (i.e. shock – hypovolaemia, sepsis, cardiogenic)

U Urinary outflow obstruction

Clinical presentation of chronic renal failure

Mnemonic: RESIN & 8 Pʼs

R Retinopathy

E Excoriations (scratch marks)

S Skin is yellow

I Increased blood pressure

N Nails are brown

P Pallor

P Purpura and bruises

P Pericarditis and cardiomegaly

P Pleural effusions

P Pulmonary oedema

P Peripheral oedema

P Proximal myopathy

P Peripheral neuropathy

Complicated urinary tract infections (UTIs)

Mnemonic: MARIO

M Male patients

A Abnormal renal tract

R Renal function is impaired

I Impaired host defences

O Organism that is virulent

Risk factors for UTIs

Mnemonic: UTIs

U Urinary tract obstruction or malformation

T The menopause

I Intercourse (sexual)/Instrumentation/Immunosuppression

S female Sex/Stones

Dialysis

Indications for

Mnemonic: AEIOU

A Acid–base problems (severe acidosis or alkalosis)

E Electrolyte problems (hyperkalaemia)

I Intoxications

O Overload, fluid

U Uraemic symptoms

Or

Mnemonic: SHARPE

S Severity of condition increases

H Hyperkalaemia persistent (K+ >7 mmol/l)

A Acidosis is metabolic and worsening (pH <7.2 or base excess <–10)

R Refractory pulmonary oedema

P Pericarditis (uraemic)

E Encephalopathy (uraemic)

Complications of dialysis

Mnemonic: CHAIR

C Cardiovascular disease

H Hypertension

A Anaemia

I Infections

R Renal bone disease

Urinary tract malignancies

Features of renal cell carcinoma (RCC)

Mnemonic: RCC

R Renal tubule (proximal) epithelium is involved

C Renal Cancers are 90% RCC

C Clinical features include haematuria, loin pain, abdominal mass, anorexia,

malaise and weight loss

15)RESPIRATORY

Diseases and conditions

Definition of Acute Respiratory Distress Syndrome (ARDS)

Mnemonic: ROAR

R Reduced lung compliance

O Oedema, non-cardiogenic pulmonary

A Acute respiratory failure

R Refractory hypoxaemia

Causes of Acute Respiratory Distress Syndrome (ARDS)

Mnemonic: ARDS

A Aspiration-gastric/Acute pancreatitis/Amniotic fluid embolus

R Raised ICP/Respiratory tract infection – pneumonia

D DKA/DIC/Drugs

S Sepsis/Shock/Smoke inhalation/Severe burns

Risk factors of asthma

Mnemonic: FEAR UP

F Family history

E Eczema

A Acid reflux

R Rhinitis (allergic)

U Urticaria

P Polyps (nasal)

History of asthma

Mnemonic: WIND

W Wheeze

I Interferes with schooling, exercise, sleep and work

N Nocturnal cough, or early morning cough

D Dyspnoea

Clinical manifestations of influenza infection

Mnemonic: FLU

F Fever

L Lethargy

U Upset appetite (nausea and vomiting)

Features of Tuberculosis (TB)

Mnemonic: 4 Cʼs

C Cough

C Caseation

C Calcification

C Cavitation

16)RHEUMATOLOGY

Rheumatoid arthritis (RA)

Features

Mnemonic: RHEUMATISM

R Rheumatoid factor (RF) +ve in 80%/Radial deviation of wrist

H HLA-DR1 and DR-4

E ESR/Extra-articular features (restrictive lung disease, subcutaneous nodules)

U Ulnar deviation of fingers

M Morning stiffness/MCP+PIP joint swelling

A Ankylosis/Atlanto–axial joint subluxation/Autoimmune/ANA +ve in 30%

T T-cells (CD4)/TNF

I Inflammatory synovial tissue (pannus)/IL-1

S Swan-neck deformity, Boutonniere deformity, Z-deformity of thumb

M Muscle wastage of small muscles of hand

Management

DMARDs (Disease-Modifying Anti-Rheumatic Drugs)

Mnemonic: Most Sufferers Can Get Appropriate Pain Control

M Methotrexate

S Sulfasalazine

C Ciclosporin

G Gold

A Azathioprine

P Penicillamine

C HydroxyChloroquine

Joint pain

Causes

Mnemonic: ARTHRITIS

A Arthritis – rheumatoid or osteoarthritis

R Reactive arthritides

T Tendon/muscle damage

H Hyperuricaemia; gout

R Referred pain

I AutoImmune, eg connective tissue disease – systemic sclerosis, SLE

T Tumour

I Ischaemia

S Sepsis/Spondyloarthritides

Arthritis

Features of Ankylosing spondylitis

Mnemonic: SPINAL

S Sacroiliac and low back pain

P Pleuritic chest pain

I Inherited gene marker: HLA-B27 (>90% HLA-B27 +ve, general population

frequency – 8%)

N Neck hyperextension – question mark posture

A Arthritic symptoms in peripheries (asymmetrical)

L Loss of spinal movement which is progressive

Components of CREST syndrome

Mnemonic: CREST

C Calcinosis

R Raynaudʼs phenomenon

E OEsophageal dysmotility

S Sclerodactyly

T Telangiectasia

16)SURGERY

Anatomy

Abdominal wall muscles

Mnemonic: TIRE

T Transversus abdominis

I Internal oblique

R Rectus abdominis

E External oblique

Bowel components

Mnemonic: Dr Jones Investigates Carefully And Cuts Randomly

From proximal to distal:

D Duodenum

J Jejunum

I Ileum

C Caecum

A Appendix

C Colon

R Rectum

Clinical conditions

Initial management of all surgical emergencies

Mnemonic: 4 Aʼs, 2 Cʼs, 2 Nʼs (could be remembered as a set of GCSE results!)

A ABC assessment

A Analgesia, eg morphine

A Anti-emetic

A Aggressive fluid resuscitation – IV fluids and electrolyte replacement

C Central venous pressure (CVP) line – may be needed

C Catheter (urinary)

N Nil by mouth (NBM)

N Nasogastric (NG) tube

Post-operative complications

General immediate

Mnemonic: PROBS

P Primary haemorrhage/Pain

R Reactive haemorrhage

O Oliguria – acute urinary retention

B Shock/Sepsis

General early

Mnemonic: ABCDE

A Analgesia- or Anaesthetic-related nausea + vomiting

B Breakdown of wound or anastomosis due to infection or haematoma –

dehiscence / ↓BP – ↓fluid input → hypovolaemia →↓BP

C Confusion – acute

D DVT leading possibly to PE

E Elevated temperature – pyrexia

General late

Mnemonic: RIB

R Recurrence of malignancy

I Incisional hernia

B Bowel obstruction

Lumps and bumps

Examining

Mnemonic: 3 Sʼs, 3 Cʼs, 3 Tʼs and the Fʼer

3Ss Site, Size, Shape

3Cs Colour, Consistency, Contour

3Ts Tenderness, Tethering, Transillumination

Fʼer Fluctuance

Hernias

Groin lump: differential diagnosis

Mnemonic: Surgeons Like To Manage Various Hernias

S Spermatic cord (lipoma, hydrocoele)/Skin (sebaceous cyst)

L Lymph nodes

T Testicle (ectopic, undescended)

M Muscle (psoas abscess)

V Vascular (femoral artery aneurysm, saphena varyx)

H Hernias (inguinal, femoral)

17)TRAUMA AND ORTHOPAEDICS

Anatomy

Cubital fossa contents

Mnemonic: Please Remember Be Brave Medically

From lateral to medial:

P Posterior interosseus nerve

R Radial nerve

B Biceps tendon

B Brachial artery

M Median nerve

Adductor muscles of thigh

Mnemonic: Post-Graduates Love their Bachelor Of Medicine

P Pectineus

G Gracilis

L Adductor Longus

B Adductor Brevis

O Obturator nerve innervates all these muscles expect for the pectineus

(femoral nerve). Part of the adductor magnus is supplied by the sciatic nerve

M Adductor Magnus

Clinical conditions

Painful neck - differentials

Mnemonic: Jock STRAP

J Jerking back of the head and neck, ie whiplash

S Spondylosis/Spondylolisthesis of cervical discs

T Torticollis (spasmodic/infantile)

R Cervical Rib

A Abnormal posture

P Prolapsed cervical disc

Carpel tunnel syndrome – causes and risk factors

Mnemonic: CARPAL

C Cardiac failure/Combined OCP use

A Acromegaly

R Renal disorder – nephrotic syndrome/Raised glucose levels; DM

P Pregnancy/Poor thyroid function; hypo-thyroidism

A Arthritis of the wrist (rheumatoid, osteoarthritis)

L Large size – obesity

Painful back - differentials

Mnemonic: TOMS DIScman

T Tumours of spine

O Osteoporosis/Osteomalacia

M Mechanical

S Spondylolisthesis

D Disc prolapse/lesion

I Infection

S Stenosis of lumbar spine/lateral recess (due to facet joint osteoarthritis)

Differential diagnosis of a limp

Mnemonic: STARTSS HOT

S Septic joint

T Tumour

A Avascular necrosis (Legg–Calve–Pertheʼs)

R Rheumatoid arthritis/juvenile rheumatoid arthritis

T Tuberculosis

S Sickle cell disease

S Slipped upper femoral epiphysis (SUFE)

H HSP

O Osteomyelitis

T Trauma

Trauma

Soft tissue injuries - treatment

Mnemonic: RICE (protocol employed in the 1st 24 hours following the injury)

R Rest

I Ice

C Compression

E Elevation