Psychiatry Mnemonics

Psychiatry Mnemonics

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

Middle adolescence (14-17 years): characteristics HERO:
Heterosexual crushes/ Homosexual Experience
Education regarding short term benefits
Risk taking
Omnipotence
· And there is interest in being a Hero (popular).

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

Male Erectile Dysfunction (MED): drugs causing it "STOP
erection":
SSRI (fluoxtine)
Thioridazone
methyldOpa
Propranalol

Premature ejaculation: treatment 2 S's:
SSRIs [eg: fluoxitime]
Squeezing technique [glans pressure before climax]
· More detail with 2 more S's:
Sensate-focus excercises [relieves anxiety]
Stop and start method [5-6 rehearsals of stopping stimulation before
climax]

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

Reinforcement schedules: variable ratio SLOT machines
show SLOwesTextinction.

Depression: major episode DSM-IV criteria · First, of course
depressed mood is one. Then:
SIG E CAPS:
Sleep disturbance
Interest loss
Guilt (or intense worthlessness)
Energy loss
Concentration loss
Appetite changes
Psychomotor agitation or retardation
Suicidal tendency

HM: this classic patient's lesion HM had Hippocampus
Missing.
Hippocampus and surrounding areas were removed surgically: prevented formation
of new memories.

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

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

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

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

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

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

Kubler-Ross dying process: stages "Death Always
Brings Great Acceptance":
Denial
Anger
Bargaining
Grieving
Acceptance

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

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

Yalom's therapeutic factors ICU CAGES:
I still hope (installation of hope)
I'm part of information (imparting information)
Imitate behavior
Interpersonal learning
Corrective recapitulation of primary
Universality
Catharsis
Altruism
Group cohesiveness (glue)
Existential factors
Socializing techniques development

Borderline personality: traits PRAISE:
Paranoid ideas
Relationship instability
Affective instability/ Abandonment fears/ Angry outbursts
Impulsiveness/ Identity disturbance
Suicidal behaviour/ Self-harming behaviour
Emptiness

Substance dependence: features (DSM IV) "WITHDraw 
IT":
· 3 of 7 within 12 month period:
Withdrawal
Interest or Important activities given up or reduced
Tolerance
Harm to physical and psychosocial known but continue to use
Desire to cut down, control
Intended time, amount exceeded
Time spent too much

Dementia: main causes VITAMIN D VEST:
Vitamin deficiency (B12, folate, thiamine)
Intracranial tumour
Trauma (head injury)
Anoxia
Metabolic (diabetes)
Infection (postencephalitis, HIV)
Normal pressure hydrocephalus
Degenerative (Alzheimer's, Huntington's, CJD, etc)
Vascular (multi infarct dementia)
Endocrine (hypothyroid)
Space occupying lesion (chronic subdural haematoma)
Toxic (alcohol)

Mania: cardinal symptoms DIG FAST:
Distractibility
Indiscretion (DSM-IV's "excessive involvement in pleasurable activities")
Grandiosity
Flight of ideas
Activity increase
Sleep deficit (decreased need for sleep)
Talkativeness (pressured speech)

Depression criteria/symptoms A SAD FACES:
Appetite, weight changes
Sleep changes
Anhedonia
Dysphoria (low mood)
Fatigue
Agitation (psychomotor)
Concentration
Esteem
Suicide

Mania: diagnostic criteria Must have 3 of MANIAC:
Mouth (pressure of speech)/ Moodl
Activity increased
Naughty (disinhibition)
Insomnia
Attention (distractability)
Confidence (grandiose ideas)

Neuroleptic side effects onset The rule of 4's:
Dystonia: 4 hours-4 days
Akathesia: 4 days-40 days
Extrapyramidal symptoms: 4 days-4 weeks
Tardive dyskinesia: 4 months (greater than)
· Note that tardive is obviously the latest one to happen (tardive=tardy/late).
· Note that the first letters of these four classic symptoms spell "DATE", and
this mnemonic is the dates when they occur.

Anxiety disorders: physical illnesses mimicking them "Physical
Health Hazards That Appear Panciky":
Phaeochromocytoma
Hyperthyroidism
Hypoglycaemia
Temporal lobe epilepsy
Alcohol
Paroxysmal arrhythmias

Ganser syndrome: key diagnostic feature The word "Ganser"
is close to but not quite the word "Answer".
Ganser's syndrome is when patient gives an answer that is close to, but not
quite. For example 2+2=5.

Conversion disorder: etiology Conversion disorder: 
convert a conflict to a symptom.

Hallucinations: hypnogogic vs. hypnopompic definition "Hypnogogic
= go to sleep":
Hypnogogic hallucinations arise when go to sleep, hypnopompic arise when awaken.

Depression: major depression criteria DEAD SWAMP:
Depressed mood most of the day
Energy loss or fatigue
Anhedonia
Death thoughts (recurrent), suicidal ideation or attempts
Sleep disturbances (insomnia, hypersomnia)
Worthlessness or excessive guilt
Appetite or weight change
Mentation decreased (ability to think or concentrate, indecisiveness)
Psychomotor agitation or retardation

Schizophrenia: negative features 4 A's:
Ambivalence
Affective incongruence
Associative loosening
Autism

Erikson's developmental stages "The sad tale of Erikson
Motors":
· The stages in order by age group:
Mr. Trust and MsTrust had an auto they were ashamed
of. She took the initiative to find the guilty party. She found
the industry was inferior. They were making cars with dents
[identity] and rolling fuses [role confusion]. Mr. N.T. Macy
[intimacy] isolated the problem, General TVT absorbed the
cost. In the end, they found the tires were just gritty and the should
have used de- spare!

Conduct disorder vs. Antisocial personality disorder Conduct
disorder is seen in Children.
Antisocial personality disorder is seen in Adults.

Parasomnias: time of onset SLeep terrors and SLeepwalking
occur during SLow-wave sleep (stages 3 & 4).
NightmaRE occurs during REM sleep (and is REMembered).

Depression: symptoms and signs (DSM-IV criteria) AWESOME:
Affect flat
Weight change (loss or gain)
Energy, loss of
Sad feelings/ Suicide thoughts or plans or attempts/ Sexual
inhibition/ Sleep change (loss or excess)/ Social withdrawal
Others (guilt, loss of pleasure, hopeless)
Memory loss
Emotional blunting

Biological symptoms in psychiatry SCALED:
Sleep disturbance
Concentration
Appetite
Libido
Energy
Diurnal mood variation

Psychiatric review of symptoms "Depressed Patients
Seem Anxious, So Claim Psychiatrists":
Depression and other mood disorders (major depression, bipolar disorder,
dysthymia)
Personality disorders (primarily borderline personality disorder)
Substance abuse disorders
Anxiety disorders (panic disorder with agoraphobia, obssessive-compulsive
disorder)
Somatization disorder, eating disorders (these two disorders are combined
because both involve disorders of bodily perception)
Cognitive disorders (dementia, delirium)
Psychotic disorders (schizophrenia, delusional disorder and psychosis
accompanying depression, substance abuse or dementia)

Depression UNHAPPINESS:
Understandable (such as bereavement, major stresses)
Neurotic (high anxiety personalities, negative parental upbringing
Hypochondriasis
Agitation (usually organic causes such as dementia
Pseudodementia
Pain
Importuniing (whingeing, complaining)
Nihilistic
Endogenous
Secondary (ie cancer at the head of the pancreas, bronchogenic cancer)
Syndromal

Depression: melancholic features (DSM IV) MELANcholic:
Morning worsening of symptoms/ psychoMotor agitation, retardation/
early Morning wakening
Excessive guilt
Loss of emotional reactivity
ANorexia/ ANhedonia

Podiatry Mnemonics

Podiatry Mnemonics

Diabetic neuropathy types DPM:
Distal, symmetric, polyneuropathy
Proximal diabetic neuropathy
Mononeuritis muliplex

TIA: internal carotid vs. vertebrobasilar MD vs. DPM
· Internal carotid:
Monocular blindness (amaurox fugax)
Dominant hemisphere (apahsia)
· The weakness or numbness is still less in the legs.
· Vetebrobasilar:
Diplopia/ Double blindness
Paralysis (quadriplesia)
Motor weakness (ipsilateral)
· Ataxia is characteristic in veterbrobasilar lesions.

Coritcal vs. subcortical brain disease "MD vs. DPM":
· Coritcal brain:
Memory
Discrimination (2 point)
· Subcortical brain:
Devoid of seizure
Primary sensation through thalamus
Movement disorders (most)
· Lower extremities manifestations are characteristic of the subcortical brain
lesions.

Proprioception and stereognosis deficits: causes D.P.M.:
Tabes Dorsalis
Pernicious anemia
Mutiple sclerosis

Skeletal disease: differential diagnosis VITAMIN:
Vascular disease
Infection
Tumor
Arthritis
Metabolic bone disease
Injury
Neurodevelopmental disorders

Peripheral vascular diseases ABCDEF:
Atherosclerosis.
Buerger's disease (TAO)
Cyanosis/ Cold agglutinin/ Connective tissue disease (Raynaud's
phenomenon)
Deep vein phlebothrombosis
Embolism
inFlammation of veins

Blue toe (microembolic toe) CAVEMAN:
Cholesterol embolizations
Atrial fib with electricity or digitoxin
Valvular problems
Endocarditis
Mural thrimbosis
Aneurysm/ AV fistula
Nothing

White toe (arterial insufficiency toe) 5 P's:
Pale coloration
Pain (excruciating)
Paresthesia
Pulselessness
Warm compression and vasodilatory Patch to Proximal area

Arthritides: the six classifications "Round COINS":
Rheumatoid diseases (inflammation of synovium)
Crystal depositions (gout, pseudogout)
Osteoarthritis
Infections
Neuropathy
SLE, mixed scleroderma

Charcot's joints: common disorders "Come See
A Handsome DPM":
Congenital insenisitivity to pain
Syringomyelia/ Spina bifida
Alcoholism
Hansen's disease
Diabetes mellitus
Peripheral nerve injury
Menigomyelocele

Physiology Mnemonics

Physiology Mnemonics

Skin vasoconstriction and temperature When the skin needs to
CONServe heat, the
blood vessels of the skin CONStrict.
When the skin is COld, the blood
vessels of the skin COnstrict.

Vitamin D: site of conversion Vitamin D is made in
the Dermis

Fluid compartments: volumes 12345:
12 liters of interstitial fluid
3 liters plasma volume and 30 liters inside cells
45liters total body water

Potassium: causes of potassium leaving cells A$$E$
Acidosis: H+ ions move in.
Starvation: catabolism of cells.
Stress: catabolism of cells (postoperative).
Exercise: catabolism of cells.
Sodium chloride lost: K+ replaces it and is then excreted.

Heart valves: placement of valves on standard heart anterior view
"Try before you Buy": When read across the page, the tricuspid
valve comes before the bicuspid valve.
Also, the lunar valves are near the top (in the sky), like the moon.

Aldosterone: regulation of secretion from adrenal cortex 
RNAs
Renin-angiotensin m echanism
Na concentraton in blood
ANP (atrial natriuretic peptide)
Stress

LH vs FSH: function in male LH: Leydig cells
stimulated to produce testosterone.
FSH: Spermatogenesis stimulated.

Alkalosis vs. acidosis: directions of pH and HCO3 ROME:
Respiratory= Opposite:
· pH is high, PCO2 is down (Alkalosis).
· pH is low, PCO2 is up (Acidosis).
Metabolic= Equal:
· pH is high, HCO3 is high (Alkalosis).
· pH is low, HCO3 is low (Acidosis).

Adrenal cortex layers and products "Great Attire
And Fast Cars Are Really Sexy Attributes":
Granulosa secretes Aldosterone in response to Angiotensin
II.
Fasiculata secretes Cortisol in response to ACTH.
Reticularis secretes Sex steroids in response to ACTH.

Adrenal cortex layers and products "Get My 
Freakin' Gun Right Away":
Glomerulosa: Mineralcorticoid (aldosterone)
Fasiculata: Glucocorticoid (cortisol)
Reticularis: Androgens

Heart electrical conduction pathway "If patient's family are
all having Heart attacks, you must SAVe HIS KIN!"
SA node --->
AV node --->
His (bundle of) -->
PurKINje fibers

Osteoblast vs. osteoclast OsteoBlast Builds
bone.
OsteoClast Consumes bone.

Heart valves: closure sequence "Many Things 
Are Possible":
Mitral, Tricuspid, Aortic, Pulmonic

Oestrogen: functions OESTROGEN SUX:
Organ development (sex organs)
Endocrine: FSH and LH regulation
Secondary sex characteristics development
Tropic for pregnancy
Receptor synthesis (of progesterone, oestrogen, LH)
Osteoporosis decrease (inhibits bone reabsorption)
Granulosa cell development
Endocrine: increases prolactin secretion, but then blocks its effect
Nipple development
Sex drive increase
Uterine contractility increase
oXytocin sensitivity increase

Electrical conductivity of tissues "Be Careful
To Shock My Best Nerve":
In order of least conductive to most conductive:
Bones
Cartilage
Tendon
Skin
Muscle
Blood
Nerve

Prolactin and oxytocin: functions PROlactin
stimulates the mammary glands to PROduce milk.
Oxytocin stimulates the mammary glands to Ooze (release) milk.

Gut intrinsic innervation: myenteric plexus vs. submucosal plexus
function Myenteric: Motility.
Submucosal: Secretion and blood flow.

V/Q gradient in lung Infinity, a lung and a zero stack
nicely.
V/Q is lowest at bottom, highest at top.

Prostaglandins: dilatation abilities Prospectors keep
mineshafts open:
Mineshaft 1: Patent ductus ateriosus.
Mineshaft 2: renal afferent arteriole dilatation.

Hyperthyroidism: signs and symptoms THYROIDISM:
Tremor
Heart rate up
Yawning [fatigability]
Restlessness
Oligomenorrhea & amenorrhea
Intolerance to heat
Diarrhea
Irritability
Sweating
Musle wasting & weight loss

Adrenal gland: functions ACTH:
Adrenergic functions
Catabolism of proteins/ Carbohydrate metabolism
T cell immunomodulation
Hyper/ Hypotension (blood pressure control)

MAO isoenzyme form locations · MAO-A in:
Adrenergic peripheral structures
Alimentary mucosa [intestine]
· MAO-B in:
Brain
Blood platelets

Carotid sinus vs. carotid body function carotid SinuS:
measures preSSure.
carotid bO2dy measures O2.

Hemoglobin and myoglobin: binding strengths, sites "ABC"
of glycosylated Hb (Hb1c):
· Glucose binds to Amino terminal of Beta Chain.
"HbF binds Forcefully":
· HbF binds oxygen more forcefully than HbA, so Oxy-Hb dissociation curve shifts
to left.
Stored blood is SOS:
· Stored blood Hb binds to Oxygen Strongly because of
decrease in 2,3 BPG.
2,3 BPG binding site is BBC:
· BPG binds to Beta Chain of Hb.
Myoglobin binding strength is MOM:
· Myoglobin binds Oxygen More strongly than Hb.

Pepsin-producing cells "Chief of Pepsi-Cola":
· Chief cells of stomach produce Pepsin.

Hb-oxygen dissociation curve shifts: effect, location Left
shift: causes Loading of O2 in Lungs.
Right shift: causes Release of O2 from Hb.

Rods vs. cone function RoD: Dim light.
Cones: Color.

Pituitary: anterior hypophysis hormones FLATPiG:
FSH
LH
ACTH
TSH
Prolactin
ignore GH

Heart valves: sequence of flow TRIPS BIAS:
TRIcuspid
Pulmonary
Semilunar
BIcuspid
Aortic
Semilunar
Alternatively: "TRIPS, MI ASs!" (uses MItral instead of BIcuspid)

Adrenal cortex layers and products "Get your Facts
Right, Men are Glued to their Gonads":
Glomerulosa
Fasciculata
Reticularis
Mineralocorticoids
Glucocorticoids
Gonadocorticoids [androgens]

Intrinsic vs. extrinsic pathway tests "PeT PiTTbull":
PeT: PT is for extrinsic pathway.
PiTTbull: PTT is for intrinsic pathway.

Compliance of lungs factors COMPLIANCE:
Collagen deposition (fibrosis)
Ossification of costal cartilages
Major obesity
Pulmonary venous congestion
Lung size
Increased expanding pressure
Age
No surfactant
Chest wall scarring
Emphysema
· All but L/A/E decrease compliance.

Diabetes Insipidous: diagnosing subtypes After a
desmopression injection:
Concentrated urine = Cranial.
No effect = Nephrogenic.

Progesterone: actions PROGESTE:
Produce cervical mucous
Relax uterine smooth muscle
Oxycotin sensitivity down
Gonadotropin [FSH, LH] secretions down
Endometrial spiral arteries and secretions up
Sustain pregnancy
Temperature up / Tit development
Excitability of myometrium down

Oxytocin-producing nucleus of hypothalamus Paraventricular
nucleus--> Parturition (childbirth is oxytocin's most important role).

Temperature control: cerebral regions "High Power
Air Conditioner":
Heating = Posterior hipothalamo [hypothalamus].
Anterior hipothalamo [hypothalamus] = Cooling.

Cochlea: inner vs. outer hair cell function "Outer
cells are Out of the brain. Inner cells are Into the
brain":
Outer hair cells are motor efferents to amplify signal.
Inner hair cells are sensory afferents that actually pick up the sound.

Nervous stimulus: the 4 ways to classify "A MILD
stimulus":
Modality
Intensity
Location
Duration

Muscle spindle: origin of primary vs. secondary endings "1
from 1, 2 from 2":
Primary ending is from Group Ia.
Secondary ending from Group II.

Pituitary hormones FLAGTOP:
Follicle stimulating hormone
Lutinizing hormone
Adrenocorticotropin hormone
Growth hormone
Thyroid stimulating hormone
Oxytocin
Prolactin
Alternatively: GOAT FLAP with the second 'A' for Anti-diruetic
homone/vasopressin
· Note: there is also melanocyte secreting homone and Lipotropin, but they are
not well understood.

Adrenal cortex layers and products "Go Find 
Rex, Make Good Sex":
· Layers:
Glomerulosa
Fasiculata
Reticulata
· Respective products:
Mineralcorticoids
Glucocorticoids
Sex hormones
· Alternatively for layers: GFR (Glomerular Filtration Rate, convenient
since adrenal glands are atop kidney).

Balance organs Utricle and Saccule keep US
balanced.

VO2 normal value is 250 mL/min "V02" is the numbers,
just need to rearrange the order.
V is roman numeral for 5, so rearrange to 2V0, or 250mL/min.

PGI2 vs. TxA2 coagulation function TxA2 Aggregates
platelets.
PGI2 Inhibits aggregation.
· Note: full name of PGI2 is prostaglandin I2 or prostacyclin, full name of TxA2
is thromboxane A2.

Einthoven's Triangle: organization Corners are at RA (right
arm), LA (left arm), LL (left leg).
Number of L's at a corner tell how many + signs are at that corner [eg LL
is ++].
Sum of number of L's of any 2 corners tells the name of the lead [eg LL-LA
is lead III].
For reference axes, the negative angle hemisphere is on the half of the
triangle drawing that has all the negative signs; positive angle
hemisphere contains only positive signs.

Heart: -tropic definitions Lusitropic: loose
is relaxed. Definition: relax heart.
Inotropic: when heart wall contracts, moves inward.
Definition: contract heart.
Chronotropic: 'chrono-' means 'time'. Defintion: heart rate (of SA node
impulses).
Dromotropic: only one left, it must be conduction speed by default.