Cardiology Mnemonics

Cardiology Mnemonics

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

EKG: 12 lead EKG quick interpretation of V1-V6 SSAALL:
· Elevations matched with their classic location of MI:
V1 Septal
V2 Septal
V3 Anterior
V4 Anterior
V5 Lateral
V6 Lateral

Aortic regurgitation: causes MARRIS:
Marfans
Ankylosing spondylitis
Rheumatic fever
Rheumatoid arthritis
Infective endocarditis
Syphilis

Cardiomyopathy: categories Cardiomyopathy is HARD:
Hypertrophic cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy
Restrictive cardiomyopathy
Dilated cardiomyopathy

Sinus tachycardia TACH FEVER:
Tamponade/ Thyrotoxicosis
Anemia
CHF
Hypotension
Fever
Excrutiating pain
Volume depletion
Exercise
Rx (Theo, Dopa, Epi, etc)

CHF: causes of exacerbation A SMITH PEAR:
Anemia
Salt/ Stress/ Stopping meds
MI
Infection/ Ischemia
Thyroid (high/low)
HTN
Pericarditis
Endocarditis (valve disease)
Arrhythmia
Rx (beta blocker, etc)

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

Aortic regurgitation: causes CREAM:
Congenital
Rheumatic damage
Endocarditis
Aortic dissection/ Aortic root dilatation
Marfan's

Heart failure: signs TAPED TORCH:
Tachycardia
Ascites
Pulsus alternans
Elevated jugular venous pressure
Displaced apex beat
Third heart sound
Oedema
Right ventricular heave
Crepitations or wheeze
Hepatomegaly (tender)

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

CHF: Left-sided systolic failure signs and symptoms "Left
Systolic Failure Can Have Dialated Heart
Cause Of Pulmpnary Backflow":
Loss of hair on legs
Skin cold and clammy
Fatigue
Crackles
High heart rate
Dyspnea
HTN
Cyanosis
Orthopnea
Pink Sputum

Acute Coronary Syndrome: initial treatment ABCD:
Aspirin
Beta blocker
Coagulation (anticoagulation with heparin/LMW Heparin)
Double product control (decrease heart rate and blood pressure)

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]

Rheumatic fever: Jones major criteria JONES:
Joints (migrating polyarthritis)
Obvious, the heart (carditis, pancarditis, pericarditis, endocarditis or
valvulits)
Nodes (subcutaneous nodules)
Erythema marginatum
Sydenham's chorea

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

Anti-arrythmics: for AV nodes "Do Block AV":
Digoxin
B-blockers
Adenosine
Verapamil

Murmurs: systolic MR PV TRAPS:
Mitral
Regurgitation and
Prolaspe
VSD
Tricupsid
Regurgitation
Aortic and
Pulmonary
Stenosis

Apex beat: differential for impalpable apex beat DOPES:
Dextrocardia
Obesity
Pericarditis/ Pericardial tamponade/ Pneumothorax
Emphysema
Sinus inversus/ Student incompetence/ Scoliosis/ Skeletal
abnormalities (eg pectus excavatum)

Rheumatic fever: Jones 5 major criteria STREP:
Sydenhams chorea
Transient migratory arthritis
Rheumatic subcutaneous nodules
Erythema marginatum
Pancarditis (endocarditis, myocarditis, pericarditis)
· STREP, since Rheumatic fever is caused by group A strep.

Mitral regurgitation When you hear holosystolic murmurs,
think "MR-THEM ARE holosystolic murmurs".

Sino-atrial node: innervation Sympathetic acts on 
Sodium channels (SS).
Parasympathetic acts on Potassium channels (PS).

Supraventricular tachycardia: treatment ABCDE:
Adenosine
Beta-blocker
Calcium channel antagonist
Digoxin
Excitation (vagal stimulation)

Ventricular tachycardia: treatment LAMB:
Lidocaine
Amiodarone
Mexiltene/ Magnesium
Beta-blocker

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

Sinus bradycardia: aetiology "SINUS BRADICARDIA"
(sinus bradycardia):
Sleep
Infections (myocarditis)
Neap thyroid (hypothyroid)
Unconsciousness (vasovagal syncope)
Subnormal temperatures (hypothermia)
Biliary obstruction
Raised CO2 (hypercapnia)
Acidosis
Deficient blood sugar (hypoglycemia)
Imbalance of electrolytes
Cushing's reflex (raised ICP)
Aging
Rx (drugs, such as high-dose atropine)
Deep anaesthesia
Ischemic heart disease
Athletes

Rheumatic fever: Jones criteria · Major criteria: CANCER:
Carditis
Arthritis
Nodules
Chorea
Erythema
Rheumatic anamnesis
· Minor criteria: CAFE PAL:
CRP increased
Arthralgia
Fever
Elevated ESR
Prolonged PR interval
Anamnesis of rheumatism
Leucocytosis

JVP: wave form ASK ME:
Atrial contraction
Systole (ventricular contraction)
Klosure (closure) of tricusps, so atrial filling
Maximal atrial filling
Emptying of atrium

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

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

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

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

Biochemistry Mnemonics

Biochemistry Mnemonics

Essential amino acids PVT. TIM HALL:
Phe
Val
Thr
Trp
Ile
Met
His
Arg
Leu
Lys
· Pvt. is short for Private in the military.
· Arg and His are considered semiessential.
· Alternatively: "MATT VIL PHLy".

Dicarboxylic acids (alpha, omega) C2 through C10: common names
"Oh My, Such Good Apple Pie, Sweet
As Sugar!":
Oxalic
Malonic
Succinic
Glutaric
Adipic
Pimelic
Suberic
Azelaic
Sebacic

Phosphorylation cascade: action during low glucose "In the
Phasted State, Phosphorylate":
The phosphorylation cascade becomes active when blood glucose is low.

tRNA: molecular shape Fortunately, tRNA (Transfer
RNA) is shaped like a capital T.

Vitamins: which are fat soluble KADE:
Vitamin K
Vitamin A
Vitamin D
Vitamin E

Na/K pump: concentrations of Na vs. K on inside/outside of cell, pump
action, number of molecules moved HIKIN':
There is a HIgh K concentration INside the cell.
From this can deduce that the Na/K pump pumps K into cell and Na out of cell.
Alternatively: When I was learning this pump (circa 1992), a band that was "in"
was Kris Kross, and a band that was "out" was "Sha Na Na
Na":
So pump moves K K (2 K) in and Na Na Na (3 Na) out.
· Sadly, as infectious as their debut album was, Kris Kross can really no longer
be classed as "in".

Insulin: function INsulIN stimulates 2
things to go
IN 2cells: Potassium and Glucose.

Glycolysis steps "Goodness Gracious, Father
Franklin Did Go By Picking Pumpkins
(to) Prepare Pies":
Glucose
Glucose-6-P
Fructose-6-P
Fructose-1,6-diP
Dihydroxyacetone-P
Glyceraldehyde-P
1,3-Biphosphoglycerate
3-Phosphoglycerate
2-Phosphoglycerate (to)
Phosphoenolpyruvate [PEP]
Pyruvate
· 'Did', 'By' and 'Pies' tell you the first part of those three: di-, bi-, and
py-.
· 'PrEPare' tells location of PEP in the process.

Citric acid cycle compounds "Oh Citric Acid
Is Of (course) A SiLly STupid Funny
Molecule":
Oxaloacetate
Citrate
Aconitate
Isocitrate
Oxalosuccinate
Alpha-ketoglutarate
SuccinyL-CoA
SuccinaTe
Fumarate
Malate
· SilLy and sTupid used to differentiate succinyL and succinaTe

B vitamin names "The Rhythm Nearly Proved
Contagious":
· In increasing order:
Thiamine (B1)
Riboflavin (B2)
Niacin (B3)
Pyridoxine (B6)
Cobalamin (B12)

Testosterone conversion to DiHydroTestosterone
Dihydrotestosterone is an active form of testosterone. Its conversion needs an
enzyme :
Five
Alpha
Reductase
· This reaction occurs in the peripheral ("FAR") tissue such as adipose
tissue.

DKA: signs DKA:
Dehydrated
Ketones/ Kussmaul breathing/ K drops
Acidosis

Amino acids: properties · Sung to the Beverly Hillbillies
melody:

Come an' listen to my story about the a-mi-nos
Five Al-i-phats kick off our show
Glycine, Alanine, Valine and then
Leucine and Iso make up half of ten

Well the next thing you know are three aromats
phenylalanine(F) is right off the bat
tYrosine has alcohol next to its ring
And tryptophan(W) has indole double ring thing.

Sulfur in Cysteine; it loves to bond
Sulfur Methionine is much more a snob
Alcoholic Serine, well wouldn't you know,
And Threonine's OH gives a warm glow.

Acid-aspartic(D) and glutamic(E) are ionized
With pK of 4, their protons are lysed,
asparagine(N) and glutamine(Q) play a different role
With amides they're neutral but they both have poles

lysine(K) and aRginine are the basic kind,
But Histidine's imidazole can't make up its mind,
Proline, the last one, coming at the end
It's imine, an oddball, proteins use to bend.

Fabry disease: presentation FABRY:
Ferile episodes
Angiokeratomas/ Alpha galactosidase A deficiency
Burning pain
Renal failure
Youth death

Glycolysis enzymes "High Profile People
Act Too Glamorous, Picture Posing Every
Place":
Hexokinase
Phosphoglucose isomerase
Phosphofructokinase (PFK)
Aldase A
Triose phosphate isomerase
Glyceraldehyde-3-phosphate dehydrogenase
Phosphoglycerate mutase
Enolase
Pyruvate kinase

Porphyrias: acute intermittent porphyria symptoms 5 P's:
Pain in abdomen
Polyneuropathy
Psychologial abnormalities
Pink urine
Precipitated by drugs (eg barbiturates, oral contraceptives, sulpha
drugs)

BUN:creatinine elevation: causes ABCD:
Azotremia (pre-renal)
Bleeding (GI)
Catabolic status
Diet (high protein parenteral nutrition)

G6PD: oxidant drugs inducing hemolytic anemia AAA:
Antibiotic (eg: sufamethoxazole)
Antimalarial (eg: primaquine)
Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)

Vitamin B3 (niacin, nicotinic acid) deficiency: pellagra The
3 D's of pellagra:
Dermatitis
Diarrhea
Dementia
· Note vitamin B3 is the 3D's.

Glycogen storage: Anderson's (IV) vs. Cori's (III) enzyme defect
ABCD:
Anderson's=Branching enzyme.
Cori's=Debranching enzyme.
· Otherwise, can't really distinguish clinically.

Tangier's disease: hallmark "Tangierene tonsils":
Hallmark is large orange tonsils.
· Important clinical note: there is no increased risk of atherosclerosis,
just like eating tangerenes.

Na+/K+ pump: movement of ions and quantity K+ and 
in each consist of 2 characters, so so 2 K+ are pumped in.
Na+ and out each consist of 3 characters, so 3 Na+ are
pumped out.

Hemoglobin binding curve: causes of shift to right "CADET,
face right!":
CO2
Acid
2,3-DPG (aka 2,3 BPG)
Exercise
Temperature

Coagulation common pathway: factors in order 10 + 5 - 2 =
13
Coagulation common pathway:
Factor X to Factor V to Factor II to Factor XIII

Vitamin K dependent cofactors "Several Tend 
To Nicely Stop Clots":
Factor Seven, Ten, Two, Nine.
Protein S, Protein C.

G protein type for respective receptors "KISS and 
KICK till you're SICK of SEX" (QISS and QIQ till you're SIQ of
SQS):
· This gives the G-protein type (Gq, Gi, or Gs) for all the
receptors. Receptors are in alphabetical order:
alpha1=Q
alpha2=I
beta1=S
beta3=S
M1=Q
M2=I
M3=Q
D1=S
D2=I
H1=Q
H2=S
V1=Q
V2=S

Folate deficiency: causes A FOLIC DROP:
Alcoholism
Folic acid antagonists
Oral contraceptives
Low dietary intake
Infection with Giardia
Celiac sprue
Dilatin
Relative folate deficiency
Old
Pregnant

Niacin deficiency: signs and symptoms The famous 4 D's:
Diarrhoea
Dermatitis
Dementia
Death (if untreated)

Citric acid cycle compounds "Our City Is
Kept Safe And Sound From Malice":
Oxaloacetate
Citrate
Isocitrate
alpha-Ketoglutarate
Succinyl-CoA
Succinate
Fumarate
Malate

Galactosaemia: enzyme deficiency GALIPUT:
Galactose 1 Phosphate Uridyl Transferase.
· There is an assay called the Galiput test for this.

Metabolic acidosis (normal anion-gap): causes · With
hyperkalemia: RAISE K+:
RTA type 4
Aldosterone or mineralocorticord deficiency
Iatrogenic: NH4Cl, HCl
"Stenosis": obstructive uropathy
Early uremia
· With hypokalemia: ReDUCE K+:
Renal TA type 1 and 2
Diarrhoea
Urine diversion into gut
Carbonate anhydrase inhibitor
Ex-hyperventilation

Creatine phosphate: amino acid precursors "Nice GAMs!":
Glycine
Arginine
Methionine
· Gam is slang for a person's leg, especiallay an attractive female's leg: "Nice
gams = nice legs!"
· Creatine phosphate is a muscle energy store, and spontaneously converts to
creatinine which is excreted in the urine in direct proportion to muscle mass:
clinically useful, such as in MS Dx.

Nitric oxide: amino acid precursor When the dentist works on
your teeth, you say, "AAArg! (Arginine)" before he administers Nitric
Oxide (NO) to take the pain away.
· Other players necessary for NO synthesis: NO synthase, Ca++, NADPH.

Heme synthesis: amino acid precursors to basic unit of porphyrins,
heme (pyrrole ring) "Dracula wants to Suck a Co-ed's
blood [think heme] with his Glystening teeth!":
Succinyl CoA and Glycine are precursor amino acids to pyrrole
rings, which is the basic unit of porphyrins and heme.

Enzymes: classification "Over The HILL":
Oxidoreductases
Transferases
Hydrolases
Isomerases
Ligases
Lyases

Pompe's disease: type "Police = Po + lys":
Pompe's disease is a lysosomal storage disease (alpha 1,4
glucosidase).

Golgi complex: functions "Golgi Distributes A SPAM":
Distributes proteins and lipids from ER
Add mannose onto specific lysosome proteins
Sulfation of sugars and slected tyrosine
Proteoglycan assembly
Add O-oligosugars to serine and threnonine
Modify N-ologosugars on asparagine

Phenylketonuria: which enzyme is deficient PHenylketonuria
is caused by a deficiency of:
Phenylalanine
Hydroxylase

Malate-aspartate shuttle "MAD commute":
Malate in.
Alpha-ketoglutarate and D(Aspartate) out.

DNA bond strength (nucleotides) "Crazy Glue":
Strongest bonds are between Cytosine and Guanine, strong like Crazy
Glue (3 H-bonds), whereas the A=T only have 2 H-bonds.
· This is relevant to DNA replication, as the weaker A=T will be the site where
RNA primer makes the initial break.

Enzyme kinetics: competitive vs. non-competitive inhibition
With Kompetitive inhibition: Km increases; no change in Vmax.
With Non-kompetitive inhibition: No change in Km; 
Vmax decreases.

Sickle cell anemia: mutation "HbS isn't Very
Good":
At Sixth position of HB beta chain, Valine is present instead of
Glutamic acid.

Hyperglycemia: 3 classic signs and symptoms DKA:
Dehydrated
Ketoacidosis
Acetone breath

Vitamins: which are fat soluble "The FAT cat is in
the ADEK (attic)":
Fat soluble vitamins are A,D,E,K.

Citric acid cycle compounds "Oh! Can I
Keep Some Succinate For Myself?":
Oxaloacetate
Citrate
Isocitrate
Ketoglutarate
Succinyl coA
Succinate
Fumarate
Malate

Carbon monoxide: electron transport chain target "CO blocks
CO":
Carbon monoxide (CO) blocks Cytochrome Oxidase (CO)

Electron transport chain: Rotenone's site of action Rotenone
is a site specific inhibitor of complex one.

Catabolism steps of branched chain amino acids "Truck
hit the Ox to Death":
Transamination
Oxidative decarboxylation
Dehydrogenation

Adrenaline mechanism "ABC of Adrenaline":
Adrenaline--> activates Beta receptors--> increases Cyclic
AMP

Citric acid cycle compounds "Can I Keep
Selling Sex For Money, Officer?":
Citrate
Isocitrate
alpha Ketogluterate
Succinyl CoA
Succinate
Fumerate
Malate
Oxaloacetate

Sickle cell disease pathophysiology SICKle cell
disease is due to a Substitution of the SICKsth amino acid of the
B chain.

Glucagon function "Mr. Gluca has Gone to the
cAMP to bring out some Glucose":
· Glucagon elevates glucose by cAMP mechanism.

Infantile Beriberi symptoms Restlessness
Sleeplessness
Breathlessness
Soundlessness (aphonia)
Eatlessness (anorexia)
Great heartedness (dilated heart)
· Alternatively: Get 5 of 'em with BERI: Breathless/ Big
hearted, Eatless, Restless, Insomnia.

Hypervitaminosis A: signs and symptoms "Increased Vitamin A
makes you HARD":
Headache/ Hepatomegaly
Anorexia/ Alopecia
Really painful bones
Dry skin/ Drowsiness

Fasting state: branched-chain amino acids used by skeletal muscles
"Muscles LIVe fast":
Leucine
Isoleucine
Valine

Essential amino acids "PVT. TIM HALL always argues,
never tires":
Phe
Val
Thr
Trp
Ile
Met
His
Arg
Lue
Lys
· Always argues: the A is for Arg, not Asp.
· 'Never tires': T is not Tyr, but is both Thr and Trp.

Na/K pump action (Sing loudly to the chorus of "Kiss Him
Goodbye"): "Na, Na, Na -- out! Na, Na,
Na -- out! K, K goes...inside!"
Action of pump is 3 Na out and 2 K in

AcetylCoA and acetacetylCoA: amino acids forming them "A
Lighter Lease" (A LyTr LeIs):
A=AcetylCoA or Acetoacetyl CoA
Ly=Lysine
Tr=Tryptophan
Le=Leucine
Is=Isoleucine

Van den Bergh reaction (Jaundice test) "Indirect
reacting bilirubin = Unconjugated bilirubin":
Both start with vowels, so they go together: Indirect & Unconjugated.

Type 1 glycogen storage disease Type 1 = one (Von),
ie Von Giereke's disease

Enzymes: competitive inhibitors "Competition is hard
because we have to travel more kilometers (Km) with the same velocity":
With competitive inhibitors, velocity remains same but Km
increases

Fabry's disease FABRY'S:
Foam cells found in glomeruli and tubules/ Febrile episodes
Alpha galactosidase A deficiency/ Angiokeratomas
Burning pain in extremities/ BUN increased in serum/ Boys
Renal failure
YX genotype (male, X linked recessive)
Sphingolipidoses

Collagen concisely covered COLLAGEN:
C-terminal propeptide (procollagen)/ Covalent Cross links/
C vitamin/ Connective tissue/ Cartilage/ Chondroblasts/
Copper Cofactor (Covalent Cross linking)
Outside the cell is where collagen normally functions/ Osteoblasts/
Osteogenesis imperfecta
Lysyl hydroxylase/ Lysyl oxidase (oxidatively deaminates lysyl and
hydroxylysyl residues to form collagen cross links, last biosynthesis step)
Long triple helical fibers/ Ligaments
Alpha chains/ Attached by H bonds form triple helix/ Ascorbate
for hydroxylation of lysyl and prolyl residues of pro-Alpha chains (postranslational
modification)
Gly in every third position/ Glycosylation of hydroxyl group of
hydroxylysine with Glucose and Galactose; GOlgi allows
procollagen to GO outside of cell
Extracellular matrix/ Eye (cornea, sclera)/ Ehlers-Danlos
Syndrome
N-terminal propeptide (procollagen)/ Nonhelical terminal
extensions
· Note: Procollagen LEAVEs the cell to be cLEAVEd by procollagen peptidases

Metabolism sites "Use both arms to HUG":
Heme synthesis
Urea cycle
Gluconeogenesis
· These reactions occur in bothcytoplasm and mitochondria.

Mitochondrial DNA (mt DNA) properties "mt DNA".
mt stands for:
Maternal Transfer
Mutates Tremendously (high mutation rate)

Orbital names before alphabetical order begins "Sober
People Don't Find Good In Killing":
Orbital names for electrons are S,P,D,F,G,I,K.
After that, alphabetical order begins.

Oxidation vs. reduction: electron gain/loss "LEO the
lion says GER":
Lose Electrons = Oxidation.
Gain Electrons = Reduction.

Benzene ring: order of substituents Meta: the two
sticks representing functional groups make a capital letter M with the
ring.
Otho: can close the top of the functional groups and make a boxy capital
letter O.

Cis/trans (geometric) isomer nomenclature "Zame Zide.
Epposite.":
Z is the 2 functional groups on the same side of double bond.
E is for opposite sides.

Oxidation vs. reduction: electron gain/loss OIL RIG:
Oxidation Is Loss (of electrons).
Reduction Is Gain (of electrons).

Cation vs. anion: positive vs. negative The t in cation
looks like a plus sign: "ca+ion".
Cation is positive, anion is negative.

Oxidation vs. reduction: electrochemical cell and electron gain/loss
AN OIL RIG CAT:
At the ANode, Oxidation Involves Loss of electrons.
Reduction Involves Gaining electrons at the CAThode.

Gibb's free energy formula "Good Honey Tastes
Sweet":
(delta)G = H - T(delta)S

Anion vs. cation charge ANion is A Negative
ion.

Benzene ring: order of substituents "Benzene likes to 
ROMP":
· From R group moving around the ring:
R group
Ortho
Meta
Para

Benzene ring: effects of substituents on further additions
"Benzene likes to ROMP. We HOPED she's be safe, but now she's
knocked up. ADOPt or WEDD'M?":
ROMP: Substituents in order: R-group, Ortho, Meta,
Para.
HOPED: Halogens are Ortho, Para, Electron
withdrawing, Deactivating.
ADOPt: Addititive substituents Direct Ortho & Para.
WEDD'M: Withdrawing Electrons Deactivates, Directs
Meta.

Cathode: what happens during electrolysis Current 
Carries Cations to the Cathode for reduCtion.

Cis/trans (geometric) isomer nomenclature The letter "Z" is
written in a zigzag way. If you draw a vertical line splitting it down the
middle then its the same halves (same sides of double bond). The letter "E" is
written differently so a vertical line splits it into different halves
(different sides of double bond).

Cis/trans (geometric) isomers: arrangement of functional groups
Cis starts with a C and the functional groups form a C.
Trans, therefore is the other one by default.

Acids: Lewis acid vs. Bronsted acid BAD LATE:
BAD: Bronsted Acid Donates hydrogens
LATE: Lewis Acid Takes Electrons

Anesthesiology Mnemonics

Anesthesiology Mnemonics

Spinal anesthesia agents "Little Boys Prefer
Toys":
Lidocaine
Bupivicaine
Procaine
Tetracaine

Xylocaine: where not to use with epinephrine "Nose, Hose,
Fingers and Toes"
· Vasoconstrictive effects of xylocaine with epinephrine are helpful in
providing hemostasis while suturing. However, may cause local ischemic necrosis
in distal structures such as the digits, tip of nose, penis, ears.

General anaesthesia: equipment check prior to inducing 
MALES:
Masks
Airways
Laryngoscopes
Endotracheal tubes
Suction/ Stylette, bougie

Endotracheal intubation: diagnosis of poor bilateral breath sounds
after intubation DOPE:
Displaced (usually right mainstem, pyreform fossa, etc.)
Obstruction (kinked or bitten tube, mucuous plug, etc.)
Pneumothorax (collapsed lung)
Esophagus

Anesthesia machine/room check MS MAID:
Monitors (EKG, SpO2, EtCO2, etc)
Suction
Machine check (according to ASA guidelines)
Airway equipment (ETT, laryngoscope, oral/nasal airway)
IV equipment
Drugs (emergency, inductions, NMBs, etc)

Anesthesia: quick check SOAP:
Suction
Oxygen
Airway
Pharmacology

Anesthetics equipment check MISMADE:
Machine check
IV supplies
Suction
Monitors
Airways
Drugs
Equipment

Failed intubation: causes INTUBATION:
Infections of larynx
Neck mobility abnormalities
Teeth abnormalites (eg poor dentifom, loose and protuberant teeth)
Upper airway abnormalities, strictures, or swellings
Bullsneck deformities
Ankylosing spondylitis
Trauma/ TumourInexperienceOedema of upper airwayNarrowing
of lower airway

Respiratory complications of anaesthesia: patients at risk
COUPLES:
COPD
Obese
Upper abdominal surgery
Prolonged bed rest
Long surgery
Elderly
Smokers