Internal Medicine with Mnemonics: Quick Recall for Medical Professionals

A

ACEI: contraindications: PARK:

Pregnancy
Allergy
Renal artery stenosis
K increase (hyperkalemia)
- Author: Anthony Chan

Anion gap metabolic acidosis: causes: A MUDPILE CAT:

Alcohol
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Iron/ Isoniazid
Lactic acidosis
Ethylene glycol
Carbamazepine
Aspirin
Toluene
- Author: Mohamed Azim MD Pediatric Surgeon, Alexandria University, Egypt

Acromegaly symptoms: ABCDEF:

Arthralgia/ Arthritis
Blood pressure raised
Carpal tunnel syndrome
Diabetes
Enlargemed organs
Field defect
- Reference: http://medicalmnemonics.com/

Alkalosis: metabolic changes in alkalosis: “Al-K-loss, Al-Ca-loss”:

There is loss of K+ (hypokalemia) and Ca++ (hypocalcemia) in state of alkalosis.
- Author: Ibrahim Mansoor King Edward Medical College

Allopurinol: indications: STORE:

Stones (history of renal stones)
Tophaceous gout (chronic)
Over-producers of urate
Renal disease
Elderly

Bonus: Probenecid indications are basically the opposite of STORE (no renal stone history, etc.).

- Author: Hugo M. Rodriguez, MD University of Virginia Roanoke-Salem Program

Acute stridor: differential: ABCDEFGH:

With fever:

Abscess
Bacterial tracheitis
Croup
Diphtheria
Epiglottitis
Without fever:
Foreign body
Gas (Toxic Gas)Hypersensitivity
- Author: Anthony Chan Chinese University of Hong Kong

B

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
- Reference: http://medicalmnemonics.com/

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.

- Author: Harsh Sharma BJMC, Pune, India

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
- Author: LW Mason 4th Year Medical Student

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
- Author: Benson Moses Benjamin JSS Medical College Mysore India

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
- Reference: http://medicalmnemonics.com/

D

Dialysis indications: HAVE PEE:

Hyperkalemia (refractory)
Acidosis (refractory)
Volume overload
Elevated BUN (> 36 mM)
Pericarditis
Encephalopathy
Edema (pulmonary)
- Author: Tim Welke and Darren Yuen University of Toronto Medical School

E

Eosinophilia: differential: NAACP:

Neoplasm
Allergy/ Asthma
Addison’s disease
Collagen vascular diseases
Parasites
- Reference: http://medicalmnemonics.com/

G

Gynecomastia: common causes: GYNECOMASTIA:

Genetic Gender disorder (Klinefelter)
Young boy (pubertal)*
Neonate*
Estrogen
Cirrhosis/ Cimetidine/ Ca Channel blockers
Old age*
Marijuana
Alcoholism
Spironolactone
Tumors (Testicular & adrenal)
Isoniazid/ Inhibition of testosterone
Antineoplastics (Alkylating Agents)/ Antifungal(ketoconazole)

*Asterisk indicates physiologic cause.

- Author: Uberoi UNIBE

H

Haematology: key numbers

3 and 4 are key in in haematology:
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.
- Reference: http://medicalmnemonics.com/

Hypercalcemia causes: MD PIMPS ME:

Malignancy
Diuretics (thiazide the main culprit)
Parathyroid (hyperparathyroidism)
Immobilization/ Idiopathic
Megadoses of vitamins A,D
Paget’s disease
Sarcoidosis
Milk alkali syndrome
Endocrine (Addison’s disease, thyrotoxicosis)
- Reference: http://medicalmnemonics.com/

Hypercalcemia: causes: GRIM FED:

Granulomas (sarcoid, TB),
Renal faliure
Immobility (esp. long term)
Malignancy
Familial (eg familial hypocalciuric hypercalcemia)
Endocrine (see below for subtypes)
Drugs (esp. thiazide diuretics, lithium)
Endocrine causes are PATH:
Phaeochromocytoma
Addison’s disease
Thyrotoxicosis
Hyperparathyroidism
- Author: Steve London, England

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
- Reference: http://medicalmnemonics.com/

Horner’s syndrome: components: SAMPLE:

Sympathetic chain injury
Anhidrosis
Miosis
Ptosis
Loss of ciliospinal reflex
Enophthalmos
- Author: Harsh Sharma BJMC, Pune, India

Hemoptysis: causes: HEMOPTYSIS:

Haemorrhagic diathesis
Edema [LVF due to mitral stenosis]
Malignancy
Others [eg: vasculitis]
Pulmonary vascular abnormalities
Trauma
Your treatment [anticoagulants]
SLE
Infarction in lungs
Septic
- Author: Sonali Vadi

I

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
- Author: Sonali Vadi

L

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
- Author: The Cashman University of Queensland, Australia

Left iliac fossa: causes of pain: SUPER CLOT:

Sigmoid diverticulitis
Uteric colic
PID
Ectopic pregnancy
Rectus sheath haematoma
Colorectal carcinoma
Left sided lower love pneumonia
Ovarian cyst (rupture, torture)
Threatened abortion/ Testicular torsion
- Author: Sushant Varma Medical student, University of Sheffield, UK

M

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)
- Author: Anthony Chan

Metabolic acidosis: causes: KUSSMAL:

Ketoacidosis
Uraemia
Sepsis
Salicylates
Methanol
Alcohol
Lactic acidosis
- Author: Steve Gust Gove District Hospital, NT Australia

N

Non-gap acidosis: causes: HARD UP:

Hyperalimentation
Acetazolamide (carbonic anhydrase inhibitors)
RTA
Diarrhea
Ureterosigmoidostomy
Pancreatic fistula
- Author: James Reeves Emory University School of Medicine

P

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
- Author: Trisan W. Graham

Pressure Sore: Norton Score: MAGIC:

Mobility
ADL
General condition
Incontinence
Conscious level
- Author: Anthony Chan

Pruritus without rash: DDx: ITCHING DX:

Infections (scabies, toxocariasis, etc)
Thyroidal and other endocrinopathies (eg diabetes mellitus)
Cancer
Hematologic diseases (eg iron deficiency)/ Hepatopathies/ HIV
Idiopathic
Neurotic
Gravid (pruritus of pregancy)
Drugs
eXcretory dysfunctions (eg uremia)
- Reference: http://medicalmnemonics.com/

Polycythemia Rubra Vera (PRV): common symptoms: PRV:

Plethora/ Pruritis
Ringing in ears
Visual blurriness
- Author: Rinku S. Uberoi UNIBE

Pleural effusion: investigations: PLEURA:

Pleural fluid (thoracentesis)
Lung, pleural biopsy
ESR
Ultrasound
Radiogram
Analysis of blood
- Author: Huiquan Zhao Children Hospital, Cincinnati

Pulmonary edema: treatment: LMNOP:

Lasix
Morphine
Nitrates (NTG)
Oxygen
Position (upright vs. flat)
- Author: Jeff Gilfor, M.D.

Pulmonary edema: treatments: MAD DOG:

Morphine
Aminophylline
Digitalis
Diuretics
Oxygen
GGases in blood (ABG’s)
- Reference: http://medicalmnemonics.com/

Pulmonary fibrosis: causes: SCAR:

Upper lobe:
Silicosis/ Sarcoidosis
Coal worker pneumonconiosis
Ankylosing spondylitis
Radiation
Lower lobe:
Systemic sclerosis
Cyptogenic fibrosing alveolitis
Asbetosis
Rheumatoid arthritis
- Author: Anthony Chan

R

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)
- Author: Gajan Rajeswaran Final Year Medical Student, Imperial College School Of Medicine, London

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)
- Author: Rivka Zieff Hospital Dept. of Pediatrics, Tzfat, Israel

Renal failure (acute): management: Manage AEIOU:

Anemia/ Acidosis
Electrolyte and fluids
Infections
Other measures (eg nutrition, nausea, vomiting
Uremia
- Author: Malik Tariq Rahim King Edward Medical College, Lahore, Pakistan

S

SIADH: causes: SIADH:

Surgery
Intracranial: infection, head injury, CVA
Alveolar: Ca, pus
Drugs: opiates,antiepileptics, cytotoxics, anti-psychotics
Hormonal: hypothyroid, low corticosteroid level
- Author: Steve Gust Gove District Hospital, NT, Australia