Neurology Mnemonics

Neurology Mnemonics

Peripheral nervous examination "Tall People 
Run-over Small Children":
Tone
Power
Reflexes
Sensation
Co-ordination/ Clonus

Alzheimer's disease: progressive phases ABCD:
Amnesic phase (forgetting keys, leaving cooker on)
Behavioural problems (antisocial, wandering)
Cortical phase (incontinence, falls)
Decerebrate phase (return of primitive reflexes)

Hydrocephalus: Normal pressure hydrocephalus DDx 3 W's:
Wet: urinary incontinence
Wobbly: gait abnormality
Wacky: dementia, memory problems

Cerebellar signs PINARD'S:
Past pointing
Intention tremor
Nystagmus
Ataxia
Rebound
Dysdiadokinesia
Slurred speech
[Note: If you haven't done Obs yet, a Pinard's is for listening to a baby's
heart on mother's abdomen]

Multiple sclerosis: signs and symptoms INSULAR:
Intention tremor
Nystagmus
Slurred speech
Uthoff's phenomenon
Lhermitte's sign
Ataxia
Rebound

Conscious change: causes AEIOU TIPS:
Alcohol
Encephalopathy
Infection
Opioid
Uremia
Trauma
Insulin
Psychosis
Syncope

Decreased level of consciousness: metabolic causes 
METABOLIC:
Major end organs (liver, kidney)
Endocrine/ Electrolytes
Toxins
Acid
Base disorders
Oxygenation
Lung (PE, pneumonia)
Infection/ Inflammatory/ Iatrogenic
Calcium

Peripheral neuropathy: differential STAGLAND:
Sarcoid
Thyroid
Amyloid
Guillian-Barre
Lead
Alcohol
Nutritional
Drugs/ Diabetes

Dementia: treatable causes DEMENTIA:
Drug toxicity
Emotional (depression, anxiety, OCD, etc.)
Metabolic (electrolytes, liver dz, kidney dz, COPD)
Eyes/ Ears (peripheral sensory restrictions)
Nutrition (vitamin, iron deficiencies/ NPH [Normal Pressure
Hydrocephalus]
Tumors/ Trauma (including chronic subdural hematoma)
Infection (meningitis, encephalitis, pneumonia, syphilis)
Arteriosclerosis and other vascular disease

Whipple's disease: features [for neurologists] A WHIPPLES
DOOM:
Arthralgias
Whipplei (organism)
Hypothalamic involvement
Intestinal involvement/ Intestinal biopsy required
PAS positive macrophages
PCR positivity
Lymphadenopathy
Extrapyramidal involvement
Septran treat with
Dementia
Ocular abnormalities (vertical gaze palsy)
Oculomasticatory myorhythmia
Myoclonus

Congenital myopathy: features DREAMS:
Dominantly inherited, mostly
Reflexes decreased
Enzymes normal
Apathetic floppy baby
Milestones delayed

Chorea: common causes St. VITUS'S DANCE:
Sydenhams
Vascular
Increased RBC's (polycythemia)
Toxins: CO, Mg, Hg
Uremia
SLE
Senile chorea
Drugs
APLA syndrome
Neurodegenerative conditions: HD, neuroacanthocytosis, DRPLA
Conception related: pregnancy, OCP's
Endocrine: hyperthyroidism, hypo-, hyperglycemia

Status epilepticus: treatment "Thank Goodness
All Cerebral Bursts Dissipate":
Thiamine
Glucose
Ativan
Cerebyx
Barbiturate
Diprivan

Balint's syndrome SOOT:
Simultagnosia
Optic ataxia
Ocular apraxia
Tunnel vision

Visual loss: persistent bilateral sudden onset visual loss
differential FLOP:
Functional
Leber's hereditary neuropathy
Occipital infarctions
Pituitary apoplexy

Perinaud's syndrome: clinical features PERINAUD'S:
Pseudo 6th nerve palsy/ Penial region
Eyelid Retraction
Internuclear ophthalmoplegia
Nystagmus
Accomodation reflex present
Upward gaze palsy
Defective convergence/ Decerebrate rigidity
Skew deviation

Benidict's syndrome: site affected Benidict's test
for sugar gives red precipitate.
Similarly, Benidict's syndrome affects rednucleus.

Stroke: basic work up The 3 P's:
Pump
Pipes
Plasma

Neurofibromatosis: diagnostic criteria ROLANDO:
Relative (1st degree)
Osseous fibromas
Lisch nodules in eyes
Axillary freckling
Neurofibromas
Dime size cafe au lait spots
Optic gliomas

Proximal myopathy: differential PEACH PODS:
Polymyositis
Endocrine: hyper, hypothyroidism, Cushing's syndrome, acromegaly
Alcohol
Carcinoma
HIV infection
Periodic hypokalemic paralysis
Osteomalacia
Drugs: steroids, statins
Sarcoidosis

Dementia: reversible dementia causes DEMENTIA:
Drugs/ Depression
Elderly
Multi-infarct/ Medication
Environmental
Nutritional
Toxins
Ischemia
Alcohol

Stroke: young patient's likely causes 7 C's:
Cocaine
Consanguinity [familial such as neurofibromatosis and von Hippel-Lindau]
Cancer
Cardiogenic embol
hyperCoagulation
CNS infection [eg: HIV conditions]
Congenital arterial lesion

Encephalitis: differential HE'S LATIN AMERICAN:
Herpesviridae
Enteroviridae (esp. Polio)
Slow viruses (esp. JC, prions)
Syphilis
Legionella/ Lyme disease/ Lymphocytic meningoencephalitis
Aspergillus
Toxoplasmosis
Intracranial pressure
Neisseria meningitidis
Arboviridae
Measles/ Mumps/ Mycobacterium tuberculosis/ Mucor
E. coli
Rabies/ Rubella
Idiopathic
Cryptococcus/ Candida
Abscess
Neoplasm/ Neurocysticercosis
· Neurocysticercosis should be assumed with recent Latin American immigrant
patient unless proven otherwise.

Head trauma: rapid neuro exam · 12 P's:
Psychological (mental) status
Pupils: size, symmetry, reaction
Paired ocular movememts
Papilloedema
Pressure (BP, increased ICP)
Pulse and rate
Paralysis, Paresis
Pyramidal signs
Pin prick sensory response
Pee (incontinent)
Patellar relex (and others)
Ptosis
· Reevaluate patient every 8 hrs.

Neurofibromatosis: diagnositic criteria (type-1) CAFE
SPOT:
Cafe-au-lait spots
Axillary, inguinal freckling
Fibroma
Eye: lisch nodules
Skeletal (bowing leg, etc)
Pedigree/ Positive family history
Optic Tumor (glioma)

Pupillary dilatation (persistent): causes 3AM:
3rd nerve palsy
Anti-muscarinic eye drops (eg to facilitate fundoscopy)
Myotonic pupil (Holmes Adie pupil): most commonly in young women, with
absent/delayed reaction to light and convergence, and of no pathological
significance.

Ocular bobbing vs. dipping "Breakfast is fast,
Dinner is slow, both go down":
Bobbing is fast.
Dipping is slow.
In both, the initial movement is down.

Huntington's: chromosome, involvement HUNT 4 DATE:
HUNTington's on chromosome 4, with cauDATE nucleus
involvement.

Pin-point pupil causes Pin-Point Pupils
are due to oPioids and Pontine Pathology

Babinski and LMN signs: conditions exhibiting them "D
MASTS":
Diabetes
Motor neuron disease
Ataxia (friedrichs)
Subacute combined degeneration of cord
Tabo paresis
Syringobulbia

Peripheral neuropathies: differential DANG THERAPIST:
Diabetes
Amyloid
Nutritional (eg B12 deficiency)
Guillain-Barre
Toxic (eg amiodarone)
Heriditary
Endocrine
Recurring (10% of G-B) Alcohol
Pb (lead)
Idiopathic
Sarcoid
Thyroid

Dementia: some common causes DEMENTIA:
Diabetes
Ethanol
Medication
Environmental (eg CO poisoning)
Nutritional
Trauma
Infection
Alzheimer's

Vertigo: differential VOMITS:
Vestibulitis
Ototoxic drugs
Meniere's disease
Injury
Tumor
Spin (benign positional vertigo)

Ramsay-Hunt syndrome: cause and common feature "Ramsay
Hunt":
· Etiology:
Reactivated
Herpes zoster
· Complication:
Reduced
Hearing

Stroke risk factors HEADS:
Hypertension/ Hyperlipidemia
Elderly
Atrial fib
Diabetes mellitus/ Drugs (cocaine)
Smoking/ Sex (male)

Multiple sclerosis (MS): epidemiology MS is a
feminine title (Ms.) and is female predominant.

Neuropathy: diagnosis confirmation NEuropathy:
Nerve conduction velocity
Electromyography

Battle sign BattlE:
Behind Ear

Parkinson's disease: signs and symptoms SMART:
Shuffling gait
Mask-like facies
Akinesia
Rigidity
Tremor

Alzheimer's disease: common characteristics ALZHEIMER'S:
Anterograde amnesia is usually first sign
Life expectancy increase shows more cases in recent years
Zapped (loss of) acetylcholinergic neurons
Hereditary disease
Entire hippocampus becomes affected
Identified by neurofibrillary tangles
Mutation in amyloid genes associated w/ disease
Entorhinal areas degenerate first
Retrograde amnesia ultimaltely develops
Senile plaques are formed at synapse

Thalamic boundaries "I HIT PPL (people)":
· Directions are in alphabetical order:
Anterior: Interventricular Foramen
Inferior: Hypothalamic nuclei (plane connecting them)
Lateral: Internal capsule (posterior limb)
Medial: Third ventricle
Posterior: free Pole of Pulvinar
Superior: Lateral ventricle
· Posterior has 2 P's.

Afferent vs. efferent neurons Afferent = Arrive
Efferent = Exit

Spinal cord: afferent vs. efferent neurons "Confusing
because they both sound the SAME":
Sensory=Afferent
Motor=Efferent

Dysphasia: Broca's vs. Wernicke's causing expressive vs. receptive
BEWARE:
Broca's area: Expressive dysphasia.
Wernicke's Area: REceptive dysphasia

ALS: symptoms ALS:
Anterior horn neuron loss
Lower motor dominant effects
Spino-cortical tract (cortico-spinal tract)

Meningitis: site of TB meningitis attack TB
meningitis attacks The Base of the brain

Cerebellar deep nuclei "Fat Girls Eat
Doritos":
· From medial to lateral:
Fastigial
Globose
Emboliform
Dentate

Cerebellar peduncles: afferent vs efferent SEMA:
Superior cerebellar peduncle
Efferent (fibres)
Middle cerebellar peduncle
Afferent (fibres)

Geniculate bodies: paired to respective colliculi SLIM:
Superior colliculi: Lateral geniculate body.
Inferior colliculi: Medial geniculate body.

Cerebellar damage signs DANISH:
Dysdiadochokinesis
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

Cerebellar functional areas Anatomical shape/location of
cerebellar areas is a key to their function and related tract.
· Vermis = Spinocerebellar = Axial equilibrium.
Vermis: right down the axis of cerebellum, and vertically
segmented like a spinal column.
· Flocculonodular lobe = Vestibulocerebellar = Ear, eye, body
coordination.
Flocculonodular lobe: flares out to the edges, just like ears.
· Hemispheres of cerebellum = Cerebrocerebellar = Peripheral
coordination.
Hemispheres: around periphery of cerebellum, and tract to 
cerebral hemispheres.

Auditory pathway: mandatory stops "Come In 
My Baritone":
Cochlear nucleus
Inferior colliculus
Medial geniculate nucleus
Brodmann's 41 (cortex)

Olivary nuclei: ear vs. eye roles Superior Olivary
nucleus: SOund localization.
· Inferior olivary nucleus is therefore the one for sight [tactile,
proprioception also].

Geniculocalcarine tract Lower bank of calcarine
sulcus is the Lingual gyrus: it receives input from Lower retinal
quadrants.
Therefore, Cuneus is the Upper bank of calcarine sulcus: it
receives input from Upper retinal quadrants.
· Remember: lower retinal quadrants represent superior visual field quadrants
and viceversa.

Basal ganglia: D1 vs. D2 connections D1 has 1
connection (Striatum-GPi/SNpr).
D2 has 2connections (Striatum-GPe-GPi/SNpr).

Meninges: layers in order PAD:
Piamater
Arachnoid
Dura

Coronal section of brain: structures "In Extreme
Conditions Eat People's Guts Instead of Their
Hearts":
· From insula to midline:
Insula
Extreme capsule
Claustrum
External capsule
Putamen
Globis pallidus
Internal capsule
Thalamus
Hypothalamus

Cranial nerves: sensory, motor or both [1950s style] "Some
Say Marilyn Monroe But My Brother Says
Bridget Bardot Mmm, Mmm!":
· From I to XII:
Sensory
Sensory
Motor
Motor
Both
Motor
Both
Sensory
Both
Both
Motor
Motor

Cranial nerves "One Octopus Offered 
Two Toddlers And Five Virgins Great Valium
And Hash":
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
V>estibulocochlear
Glossopharyngeal
Vagus
Accesory
Hypoglossal

Cranial nerves [for those with a vegetable fetish] "Oh
Oh Oh To Touch And Feel Very 
Green Vegetables, Ah Heaven!":
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibulocochlear
Glossopharyngeal
Vagus
Accesory
Hypoglossal

Thirst/water balance control centre: location in hypothalamus
"You look up (supra...optic) at the clouds, to check if it's going to 
rain (water)":
Therefore, water balance is in supraoptic nucleus.

Geniculate bodies: medial vs. lateral system "Lateral=Light.
Medial=Music.":
Lateral geniculate body is for visual system.
Medial geniculate is for auditory system.

Cranial nerves "Old Opticians Operate
To Try Adding Fortune And Getting Vegas
Another Hotel!":
· In order from 1 to 12:
Olfactory
Optic
Occulomotor
Trochlear
Trigeminal
Abducens
Facial
Auditory
Glossopharyngeal
Vagus
Accessory
Hypoglossal

Cranial nerves [for political Americans] "Our Oval
Office Tomorrow Teeters As Florida Adds
George Versus Al's Handcounts":
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducent
Facial
Acoustic
Glossopharyngeal
Vagus
Accessory
Hypoglossal

Auditory pathway "Hungry Girls 8(ate)
Nothing To SLIM Themselves":
Hair cells
spiral Ganglion
cranial nerve 8
cochlear Nuclei
Trapezoid body (decussation of ventral nuclei)
Superior olivary nucleus
Lateral leminiscus
Inferior colliculus
Medial geniculate body
Transverse temporal gyrus

Spinothalamic tracts: function of lateral vs. ventral "Lumbago
is conveyed by the Lateral tract":
Lumbago is lower back pain. Therefore lateral tract conveys pain, so by default,
ventral tract conveys light touch.

Geniculate bodies: medial vs. lateral system MALE:
Medial=Auditory. Lateral=Eye.
Medial geniculate body is for auditory system, lateral geniculate body is for
visual system.
Can expand to MALES to remember Lateral=Eye=Superior
colliculus (thus medial is inferior colliculus by default).

Purkinje cells in cerebellum are inhibitory to deep nuclei
Shape of a purkinje cell in 3 dimensions is same as a policeman's hand saying
"Stop".
Therefore, purkinje cells are inhibitory.

Dysphagia vs. dysphasia DysphaSia is for Speech
DysphaGia is for your Gut [swallowing].

Hypothalamus: feeding vs. satiety center "Stim the lat,
get fat":
· Stimulating lateral increases hunger.
"Stim the ven, get thin":
· Stimulating ventromedial increases satiety.

Argyll-Robertson Pupil features Argyll Robertson Pupil (ARP)
Read it from front to back: it is ARP, standing for Accomodation
Reflex Present.
Read it from back to front: it is PRA, standing for Pupillary Reflex
Absent.

Cerebellar deep nuclei "Ladies Demand Exceptional
Generosity From Men":
· The 4 nuclei, from lateral to medial:
[Lateral]
Dentate
Emboliform
Globose
Fastigial
[Medial]

Dorsal= afferent, Ventral= efferent and their functions "My
friend DAVE got kicked in the behind and screamed":
Dorsal/Afferent component is the sensation of pain coming
from the rear.
Ventral/Efferent component is the motor action of screaming
(which is done at frontof body).

Cranial nerves [for those under stress] "Oh Once
One Takes The Anatomy Final A Good
Vacation Seems Heavenly":
Olfactory
Optic
Occulomotor
Trochlear
Trigeminal
Abducens
Facial
Auditory
Glossopharyngeal
Vagus
Spinal root of the accessory
Hypoglossal

Cerebellar damage signs DASHING:
Dysdiadochokinesia
Ataxia
Speech
Hypotonia
Intention tremor
Nystagmus
Gait

Hypothalamus: general functions "TALE of the
hypothalamus":
Temperature
Appetite
Libido
Emotion

Argyll-Robertson Pupil features Look at the math signs
around the two parts of the name: A-R.
The A has no sign in front, which in math means +A (+ Accommodate).
There is a subtract sign in front of the R (- React).
Therefore, pupil can accommodate, but can't react.

Spinal cord: converting ventral/ anterior/ motor/ efferent and
dorsal/ posterior/ sensory/ afferent A limousine:
The motor of limo is ventral and anterior on the car.
The Aerial is sensory and on the dorsal and posterior
of the limo.
· Note 1: 'A' is Afferent, and also, in a limo, the aerial on the
top of the trunk has a capital 'A' shape.
· Note 2: An aerial is a sensory thing: picks up radio waves.
· Note 3: If picked a limo up in your hand, can only see motor on ventral, since
dorsal is covered by the hood/bonnet.

Optic chiasma: what it looks like if you're a genetics star
The optic chiasma looks the same as a chiasma in meiosis, making
it easy to spot on the dissected brain.

Parasympathetic vs. sympathetic function Sympathetic nervous
system: "Fight or Flight".
Parasympathetic nervous system: "Rest and Digest".

Chemoreceptor trigger zone "Syringes Help Men
On Drugs":
Serotonin
Histamine
Muscarinic
Opioids
Dopamine

Cerebellar damage symptoms VANISHED:
Vertigo
Ataxia
Nystagmus
Intention tremor
Slurred (or Staccato) speech
Exagerrated broad based gait
Hypotonic reflexes
Dysdiadochokinesia.

Hypothalamus: feeding vs.satiety center "Late night
snack":
LATEral is snacking [feeding] center.
Therefore, ventromedial is satiety center.

Spinal tracts: simplified geography 2 posterior:
cross at the medulla.
2 lateral: ipsilateral (same side).
2 anterior: cross at the spinal level.
· See diagram.
· Note 1: Descending tracts on left of figure, ascending tracts on right.
· Note 2: For ipsilaterals: one never crosses, one crosses at the level then
doubles back farther up. The ipsilateral that crosses at the level (ventral
spinocerebellar) is the ipsilateral closest to the 2 anterior ones, which also
cross at the level.
· Tract names in each group:
Posterior 2: lateral corticalspinal, dorsal columns. Lateral 2: dorsal
spinocerebellar, ventral spinocerebellar. Anterior 2: ventral corticospinal,
spinothalamic.

Spinal tracts: Gracilus vs. Cuneatus: origin from upper vs. lower
limbs Gracilus is the name of a muscle in the legs, so
Fasciculus Gracilus is for the lower limbs.
By default, Fasciculus Cuneatus must be for upper limbs.

Precentral vs. postcentral gyrus: motor vs. sensory Just an
extension of the rule that anterior = ventral = efferent = motor.
The precentral gyrus is on the anterior side of the brain, so is therefore
motor.

Branchial arches: cranial nerve innervation In
Sensory/Motor/Both mnemonic 'Some Say Marry Money But My Brother
Says Big Boobs Matter More', the B's also give Brancial
arch nerves in order:
But (CN 5): 1st arch
Brother (CN7): 2nd arch
Big (CN9): 3rd arch
Boobs (CN 10): 4th arch

Temporal lobe: location of high vs. low frequency recognition
The bass clef looks like an ear.
Therefore, the bass clef [low frequency] is closer to the ear, and
the treble clef [high frequency] is more medial.

Cranial nerves: olfactory and optic numbers "You have two
eyes and one nose":
Optic nerve is cranial nerve two.
Olfactory nerve is cranial nerve one.
· Alternatively, note alphabetical order: oLfactory, and oPtic.

Ventricle aperatures: converting the two nomenclature types
Magendie foramen is the Medial aperture.
Luschka foramen is the Lateral aperture.

Basal ganglia: indirect vs. direct pathway The Indirect
pathway Inhibits.
Direct pathway is hence the excitatory one.

CSF circulation: function of choroid vs. arachnoid granules
Choroid Creates CSF.
Arachnoid granules Absorb CSF.

GABA vs. Glu: the excitatory vs. inhibitory transmitter in brain (eg
in basal ganglia) When you Glue two things together, you add (+)
those things together, therefore Glu is the excitatory one (+).
GABA is therefore the negative one.

Pituitary: which half is the adenohypophysis The Anterior
pituitary is the Adenohypophysis.

Broca's vs. Wernick's area: effect of damage to speech center
"Broca": your speech machinery is Broken.
· Broca is wanting to speak, but articulation doesn't work, and very slow.
"Wer-nick": "were" and "nick" are both words of
English language, but together they are nonsensical.
· Wernick is having good articulation, but saying words that don't make sense
together.

Lower vs. upper motor neuron lesion effects 1. "STORM,
Baby"
2. 'In a Lower motor neuron lesion, everything goes Down:
· STORM Baby tells you effects:
Strength
Tone
Other
Reflexes
Muscle mass
Babinski's sign
· In Lower all things go down: strength, tone, reflexes, muscle mass, and the
big toe down in plantar reflex (Babinski's sign is big toe up: toe up = UMNL).

Nephrology Mnemonics

Nephrology Mnemonics

Polycystic kidney: genetic marker "P" is the 16th
letter of the alphabet.
· Autosomal dominant Polycystic kidney disease is associated with
abberation on the 16th chromosome.

Glomerular disease with a reduced complement level 
PELICAN:
Post-streptococcal glomerulonephritis
Endocarditis (sub-acute)
Lupus erythematosus
Idiopatic membranoproliferative glomerulonephritis
Cryoglobulinemia
Abscess (visceral)
Nephritis

Renal tubular acidosis: type with common nephrocalcinosis
The stONE (nephrocalcinosis) is common in type ONE.

Urinary incontinence: differential DIAPERS:
Delirium
Infection
Atrophic urethritis and vaginitis
Pharmaceuticals/ Psychologic
Excessive urine output
Restricted mobility
Stool impaction

Metabolic waste products retention: clinical features 
ABCDEFGHI:
Apathy/ Anorexia/ Anemia
Bleeding
Confusion/ Coma
Dizziness
Emesis/ Edema of the lung
Fits
Gastrointestinal bleeding
Hiccups
Infection

Hematuria: differential HEMATURIA:
Hereditary (PCK and OWR) / Henoch Schonlein purpura
Embolism (infective endocarditis)
Malignant HTN
Acute and chronic glomerulonephritis / IgA nephropathy
Tumors / Trauma / Toxic drugs
Urolithiasis
Renal papillary necrosis
Infection (pyelonephritis, cystitis, urethritis)
Anti-coagulants

Nephrectomy: indications 4 T's:
Trauma
Tumor
TB
Transplantation

Urinary incontinence: causes of acute and reversible DRIP:
Delirium
Restricted mobility/ Retention
Inflammation / Infection/ Impaction [fecal]
Pharmaceuticals / Polyuria
· "Drip" is convenient since it is urinary incontinence, so urine only drips
out.

Nephrotic syndrome: causes for secondary nephrotic syndrome
DAVID:
Diabetes mellitus
Amyloidosis
Vasculitis
Infections
Drugs

Pyelonephritis (acute): predisposing factors SCARRIN' UP:
Sex (females <40, males >40)
Catheterization
Age (infant, elderly)
Renal lesions
Reflux (vesciouteral)
Immunodeficienct
NIDDM, IDDM
Urinary obstuction
Pregnant
· Acute pyelonephritis heals by scarrin' up the area (pyelonephritic scar).

Epididmyitis: bacterial causes CENT:
Chlamydia trachomatis
E. coli
Nisseria gonorrhoeae
Tuberculos bacteria

Hydronephrosis: differential · Unilateral is PACT:
Pelvic-uteric obstruction (congenital or acquired)
Aberrant renal vessels
Calculi
Tumours of renal pelvis
· Bilateral is SUPER:
Stenosis of the urethra
Urethral valve
Prostatic enlargement
Extensive bladder tumour
Retro-peritoneal fibrosis

Testicular atrophy: differential TESTES SHRINK:
Trauma
Exhaustional atrophy
Sequelae
Too little food
Elderly
Semen obstruction
Sex hormone therapy
Hypopituitarism
Radiation
Inflammatory orchitis
Not descended
Kleinfelter's

Dialysis: indications AEIOU:
Acid-base problems (severe acidosis or alkalosis)
Electrolyte problems (hyperkalemia)
Intoxications
Overload, fluid
Uremic symptoms

Enlarged kidneys: causes SHAPE:
Sclerderma
HIV nephropathy
Amyloidosis
Polycystic kidney disease
Endocrinophathy (diabetes)

Prostatism: initial symptoms "Prostatism is initially FUN":
Frequency
Urgency
Nocturia

Renal Cell Cancer (RCC): genetic marker "RCC" equals 
three. Or, "C" is the third letter of the alphabet.
· RCC is associated with genetic abberations on the third chromosome (VHL
gene)

Microbiology Mnemonics

Microbiology Mnemonics

Meningitis: most common organisms NHS:
Neisseria meningitidis
Hemophilus Influenzae
Streptococcus pneumonia
·The cause of the most Severe meningitis is Streptococcus.
· Note: NHS is an acronym for National Health Service in several countries.

Syphilis vs. H. ducreyi (chancroid): which ulcer is painful
"In du-crey-i, you do cry (because it is painful)":
In H. ducreyi, the ulcer is painful, in syphilis the ulcer is painless.

Diphtheria toxin properties ABCDEF:
A/B-type toxin. Made by
Corynebacterium diphtheriae, which binds to
EF-2 (elongation factor 2).

RNA viruses: negative stranded "Always Bring
Polymerase Or Fail Replication":
Arena
Bunya
Paramyxo
Orthomyxo
Filo
Rhabdo
· Note: Negative RNA viruses need there own polymerase.

Picorna viridae: members PEECoRnA (Picorna is
pronounced 'pee-corna')
Poliovirus
Echovirus
Enterovirus
Coronavirus
"R'novirus" (Rhinovirus)
Hepatitis A

Streptococcus pneumoniae: diseases caused COMPS:
Conjunctivitis
Otitis media
Meningitis
Pneumonia
Sinusitis

Catalase positive organims SPACE:
Staphylococcus aureus
Pseudomonas
Aspergillus
Candida
Enterobacter

Urease positive organisms PUNCH:
Proteus (leads to alkaline urine)
Ureaplasma (renal calculi)
Nocardia
Cryptoccocus (the fungus)
Helicobacter pylori

Vaccines: types STARK:
Subunit
Toxoid
Attenuated [live]
Recombinant
Killed [inactivated]

AIDS pathogens (T-cell suppression) worth knowing "The
Major Pathogens Concerning Complete T-Cell
Collapse":
Toxoplasma gondii
M. avium intracellulare
Pneumocystis carinii
Candida albicans
Cryptococcus neoformans
Tuberculosis
CMV
Cryptosporidium parvum

Tetanus: treatment for infection SAD RAT:
Sedation
Antitoxin
Debridement
Relaxant
Antibiotic
Tracheostomy

Placenta-crossing organisms/ antenatal Infections STARCH:
Syphilis
Toxoplasmosis
AIDS (HIV)
Rubella
CMV
Herpes/ Hepatitis

Typhus: Epidemic Typhus: etiologic agent, vector ePidemic
typhus:
Etiological agent: Rickettsia Prowazekii.
Vector: Pediculus corporis (human body louse).
· This is in contrast to Endemic typhus.

Capsulated bacteria "Some Bacteria Have
An Effective Paste Surrounding Membrane Yielding
Pseudo Fort, Bypassing Killing":
Strep pneumonia
Bacteroides
H. influenza
Anthrax (B. anthracis)
E. coli
Pasteurella
Salmonella
Menigitidis (N. Menigitidis)
Yersinia pestis
Pseudomonas
Francisella
Brucella
Klebsiella

Hepatitis: transmission routes "Vowels are bowels":
Hepatitis A and E transmitted by fecal-oralroute.

Capsulated microbes "Some Nasty Killers
Have Some Capsule Protection":
Streptococcus pneumoniae
Neisseria meningitidis
Klebsiella pnemoniae
Haemophilus influenzae
Salmonella typhi
Cryptococcus neoformans
Pseudomanas aerigenosa

Pneumonia: causes: gram negative vs. gram positive Gram Negatives
(eg coliforms) are responsible mainly for Nosocomial pneumonia.
Gram positives (eg strep pneumonia, staph) are thus more responsible for
community acquired pneumonia.

Influenza infection: clinical manifestations "Having
Flu Symptoms Can Make Moaning Children
A Nightmare":
Headache
Fever
Sore throat
Chills
Myalgias
Malaise
Cough
Anorexia
Nasal congestion

UTI-causing microorganisms KEEPS:
Klebsiella
Enterococcus faecalis/ Enterobacter cloacae
E. coli
Pseudomonas aeroginosa/ Proteus mirabilis
Staphylococcus saprophyticcus/ Serratia marcescens

Psedomonas aeruginosa: features AERUGINOSA:
Aerobic
Exotoxin A
Rod/ Resistance
UTIs, burns, injuries
Green-blue dressings
Iron-containing lesions
Negative gram
Odor of grapes
Slime capsule sometimes (in CF pt)
Adherin pili

Toxoplasma gondii: manifestations "My Cat Eats
Mice":
Mononucleosis-like illness
Chorioretinits/ Congenital infection
Encephalitis
Myocarditis

Chlamydia: elementary vs. initial body location Elementary:
Extracellular
Initial: Intracellular

Trypanosoma brucei: disease caused "I went on a TRYP
to AFRICA":
TRYPanosoma brucei causes AFRICAn sleeping sickness

RNA enveloped viruses FORT ABC, Puerto Rico:
Flavivirus/ Filo
Orthomyxo
Retro
Toga
Arena
Bunya
Corona
Paramyxo
Rhabdo

Teratogens: placenta-crossing organisms ToRCHeS:
Toxoplasma
Rubella
CMV
Herpes simplex, Herpes zoster (varicella), Hepatitis B,C,E
Syphilis
· Alternatively: TORCHES: with Others (parvo, listeria), add HIV
to H's, Enteroviruses.

E. coli: major subtypes, key point of each "HIT by E.
coli outbreak":
EnteroHemorrhagic:
· HUS from Hamburgers
EnteroInvasive:
· Immune-mediated Inflammation
EnteroToxigenic:
· Traveller's diarrhea

Obligate anaerobes: members worth knowing ABC:
Actinomyces
Bacteroides
Clostridium

Common cold: viral causes "Common cold (acute infectious
rhinitis, coryza) is PRIMArily caused by":
Paramyxoviruses
Rhinoviruses
Influenza viruses
Myxoviruses
Adenoviruses

Streptococcus pyogenes: diseases caused NIPPLES:
Necrotising fasciitis and myositis
Impetigo
Pharyngitis
Pneumonia
Lymphangitis
Erysipelas and cellulitis
Scarlet fever/ Streptococcal TSS

Picornavirus: features PICORNAvirus:
Positive sense
ICOsahedral
RNAvirus

Neisseria: fermentation of N. gonorrhoeae vs. N. meningitidis
Gonorrhoeae: Glucose fermenter only.
MeninGitidis: Maltose and Glucose fermenter.
· Maltose fermentation is a useful property to know, since it's the classic test
to distinguish the Neisseria types.

RNA viruses: negative stranded "Orthodox Rhabbi's
Party Around Fine Bunnies":
Orthomyxo
Rhabdo
Paramyxo
Arena
Filo
Bunya

RNA viruses: positive stranded "Pico Called 
Flavio To Return Renzo's Corona":
Picorna
Calici
Flavi
Toga
Retro
Reo
Corona

Endocarditis: lab results suggesting it "High Tech
Lab Results Point At Endocarditis":
Hematuria
Thrombocytopenia
Leukocytosis, -penia
Red blood cell casta
Proteinuria
Anemia
Elevated ESR

Endocarditis: causes of culture negative endocarditis "With
Negative Tests, Investigators Should Focus 
Attention Somewhere Meaningful":
Wrong diagnosis
Noninfectious endocarditis
Timing (cultures drawn at end of chronic course)
obligate Intracellular organisms
Slow growing fastidious organisms
Fungal infection
Antibiotic used previously
Subacute right-sided endocarditis
Mural endocarditis

Endocarditis: indications for surgery PUS RIVER:
Prosthetic valve endocarditis (most cases)
Uncontrolled infection
Supporative local complications with conduction abnormalities
Resection of mycotic aneurysm
Ineffective antimicrobial therapy (eg Vs fungi)
Valvular damage (significant)
Embolization (repeated systemic)
Refractory congestive heart failure

Meningitis: risk factors "Can Induce Severe
Attacks Of Head PAINS":
Cancer
Immunocompromised state
Sinusitis
Age extremes
Otitis
Head trauma
Parameningeal infection
Alcoholism
Infections (systemic, esp. respiratory)
Neurosurgical procedures
Splenectomy

HIV infection: high-risk groups HIV:
Homosexuals/ Hemophiliacs
IVdrug abusers

Trichomaniasis: features · 5 F's:
Flagella
Frothy discharge
Fishy odor (sometimes)
Fornication (STD)
Flagyl (metronidazole) Rx

Nematodes: ones spreading by egg ingestion "ATE eggs":
Ascaris Lumbricoides
Trichuris trichuira
Enterobius vermicularis
spread by ingestion of eggs (vs skin invasion or insect bite)

Food poisoning: bugs inducing "Eating Contaminated
Stuff Causes Very Big Smelly Vomit":
E. coli O157-H7 [undercooked meat, esp. hamburgers]
Clostridium botulinum [canned foods]
Salmonella [poultry, meat, eggs]
Vibrio parahaemolyticus [seafood]
Bacillus cereus [reheated rice]
Staphylococcus aureus [meats, mayo, custard]
Clostridium perfringens [reheated meat]
Vibrio vulnificus [seafood]

B19 virus: at-risk groups B19 affects 3 B's:
Babies (5th disease, infectiousum erythematosa)
Black Bleeders (sickle cell anemics - anaplastic anemic crisis)
Bearing Babies [pregnant women] (hydrops fetalis)

IgA protease-producing bacteria "Nice Strip of Ham":
Neisseria
Streptococcus pneumonia
Haemophilus influenza

Hemophilius: culture requirements Read Hemophilus as "HemoFive":
· Needs Heme with Factors Fiveand Ten.

DNA viruses: morphology rule of thumb DNA:
Double-stranded
Nuclear replication
'Anhedral symmetry
· Rule breakers: pox (cytoplasmic), parvo (single-stranded).

Streptococcus pyogenes: virulence factors SMASHED:
Streptolysins
M protein
Anti-C5a peptidase
Streptokinase
Hyaluronidase
Exotoxin
DNAses

Gram positive stain Gram Positives
Stain Purple (violet-blue)
because of their thick Peptidoglycan layer

Gram+: bacterial cell wall · Gram+ has:
+hick pepidoglycan layer.
+eichoic acid in wall.

Listeria: motility Istanbul sounds like Listambul =
list + tumble.
Listeria has tumblingmotility.

Staphylococci: novobiocin test to distinguish coagulase negative
staphylococci Staph epidermidis stays away from the novobiocin
disc like an epidemic.
· Therefore, epidermidis is sensitive to novobiocin.
Staph saprophyticus, much friendlier, comes up to the disc and says, "'sap?'"
[short for "whassup?", ie "what's up"].
· Therefore, saprophyticus is novobiocin resistant.

Acute post-streptococcal glomerulonephritis: classic presentation
"Sore throat, Face bloat, Pi$$ coke":
Sore throat: 1 week ago
Face bloat: facial edema
Pi$$ coke: coke-coloured urine
· Alternatively, short version: "Throat, bloat and coke".

Streptococci: classification by hemolytic ability Gamma:
Garbage (no hemolytic activity).
Alpha: Almost (almost lyse, but incomplete).
Beta: Best (complete lysis).

Streptococci: Quellung reaction: positive sign, Strep type confirmed
"Quell-lung":
Quell: Capsules swell [+ve test].
Lung: S. pnuemonia [type confirmed].
· You get pneumonia in your lung.

E. coli: diseases caused in presence of virulence factors 
DUNG:
Diarrhea
UTI
Neonatal meningitis
Gram negative sepsis
· Dung, since contract E. coli from dung-contaminated water.

Streptococcus pyrogenes: antibody SPAM:
Streptococcus Pyogenes: Antibody to Mprotein.

Staphylococcus aureus: diseases caused SOFT PAINS:
Skin infections
Osteomyelitis
Food poisoning
Toxic shock syndrome
Pneumonia
Acute endocarditis
Infective arthritis
Necrotizing fasciitis
Sepsis

Gram staining: mechanism "Murein gets the red out" [Allusion
to an old eye-wash slogan]:
Peptidoglycan (aka murein) remains purple during Gram staining. The Gram
negatives, devoid of murein, are red.
Thus, murein prevents redness and are purple (positive).

Entameoba histolytica: disease caused, action EntAmoeba
causes Amoebic dysEntery.
Action: histo (cell) lytic (burst), so it bursts cells.

Clostridium difficile: disease caused "Difficult to
be in a Closet with someone having explosive foul smelling
diarrhea, because it would smell and there would be no air in there.
Clostridium Difficile causes explosive foul smelling diarrhea
and is an anaeorbe (no air).

Pneumonia: acute pneumonia infiltrates from different causes
"Pyrogenic=PMN, Miscellaneous=Mononuclear":
Acute pneumonia caused by Pyogenic bacteria: PMN infiltrate.
Acute pneumonia caused by Miscellaneous microbes: Mononuclear
infiltrate.

Klebsiella details You tell the patient: "Get UPS you
fat alcoholic":
UTI
Pneumonia
Sepsis
Fat capsule
Get up=nonmotile since no flagella.
Alcoholic=commonly seen in alcoholicand nosocomial patients.

Pseudomonas details · See diagram of patient.
Patient: bug commonly infects nosocomial.
Oxygen tank: oxidase positive.
IV bag: has glucose and lactose, so its OK to give because its a nonlactose
fermenter.
Why giving oxygen? Because it commonly caused pneumonia.
IV in the arm: supposed to signify sepsis.
The foley: UTI.
Burn on his foot: can infect burns.

Leprosy: early signs diagnostic criteria "LEProsy":
Loss of sensation in affected skin/ Loss of function (paralysis)
Enlargement of affected superficial nerves (tender too)
Positive identification of M. leprae under microscope

Kidney transplant virus "Borrowed Kidney":
BKvirus is associated with kidney transplants.

Endotoxin features ENDOTOXIN:
Endothelial cells/ Edema
Negative (gram- bacteria)
DIC/ Death
Outer membrane
TNF
O-antigen
X-tremely heat stable
IL-1
Nitric oxide/ Neutrophil chemotaxis

Mycobacterium tuberculosis: culture identification "Rough,
Tough, Buff":
Rough: colony isn't smooth but rough like breadcrumbs.
Tough: colony stuck to plate well, and tough to remove.
Buff: buff is a color, a cream/coffee shade.

Vibrio: motility "Vibrio Vibrates":
Vibrio is a genus of actively motile bacteria.