Saturday, August 15, 2015

Rheumatology Mnemonics


Rheumatology Mnemonics


Ankylosing spondylitis: extra-articular manifestations 6
A's:
Atlanto-axial subluxation
Anterior uveitis
Apical lung fibrosis
Aortic incompetence
Amyloidosis (kidneys)
Autoimmune bowel disease (UC)


Gout: drugs and foods raising uric acid levels Drugs are 
FACT
:
Frusemide
Aspirin/ Alcohol
Cytotoxic drugs
Thiazide diuretics
Foods are SALTS:
Shellfish
Anchovies
Liver and kidney
Turkey
Sardines


Joint pain causes SOFTER TISSUE:
Sepsis
Osteoarthritis
Fractures
Tendon/muscle
Epiphyseal
Referred
Tumor
Ischaemia
Seropositive arthritides
Seronegative arthritides
Urate
Extra-articular rheumatism (such as polymylagia)


SLE (Systemic Lupus Erythematosus) diagnosis "MD SOAP 'N
HAIR
":
Malar rash
Discoid rash
Serositis
Oral ulcer
Arthritis
Photosensitivity
Neurologic abnormality
Hematologic abnormality
ANA (+)
Immunologic abnormality
Renal involvement


Asthma: treatment ASTHMA:
Adrenergics
Steroids
Theophylline
Hydration
Mask [O2 at 24%]
Antibiotics


Osteoporosis risk factors ACCESS:
Alcohol
Corticosteroid
Calcium low
Estrogen low
Smoking
Sedentary lifestyle


SLE (Systemic Lupus Erythematosus) diagnosis (ARA criteria)
DAMP AS RHINO:
Discoid rash
ANA (+)
Malar rash
Photosensitivity
Arthritis
Serositis (pleural, pericardial)
Renal involvement
Hematologic abnormality
Immunologic abnormality
Neurologic abnormality (seizures, psychosis)
Oral / nasal ulcer, Observed


Henoch schonlein purpura: signs and symptoms NAPA:
Nephritis
Arthritis, arthralgias
Purpura, palpable (especially on buttocks and lower extremities)
Abdominal pain (need to rule out intussusception)


Arthritis: juvenile idiopathic: differential ARTHRITIS:
Anxiety
Rickets and metabolic
Tumor
Hematological
Reactive arthritis
Immunological (SLE)
Trauma
Injury
Sepsis


Felty's syndrome: components SANTA:
Splenomegaly
Anaemia
Neutropenia
Thrombocytopenia
Arthritis (rheumatoid)


Carpal tunnel syndrome TINel's sign:
TINgling sensation after
Tapping on
Traumatized nerve in carpal
Tunnel syndrome


Arthritis: seronegative spondyloarthropathies PEAR:
Psoriatic arthritis
Enteropathic arthritis
Ankylosing sponylitis
Reiter's/ Reactive

Radiology Mnemonics


Radiology Mnemonics


Chest X-ray interpretation · Preliminary is ABCDEF:
AP or PA
Body position
Confirm name
Date
Exposure
Films for comparison
· Analysis is ABCDEF:
Airways (hilar adenopathy or enlargement)
Breast shadows/ Bones (rib fractures, lytic bone lesions)
Cardiac silhoutte (cardiac enlargement)/ Costophrenic angles
(pleural effusions)
Diaphragm (evidence of free air)/ Digestive tract
Edges (apices for fibrosis, pneumothorax, pleural thickening or plaques)/
Extrathoracic tissues
Fields (evidence of alveolar filling)/ Failure (alveolar air space
disease with prominent vascularity with or without pleural effusions)


Chest X-ray: cavitating lesions differential "If you see 
HOLES
 on chest X-ray, they are WEIRD":
Wegener's syndrome
Embolic (pulmonary, septic)
Infection (anaerobes, pneumocystis, TB)
Rheumatoid (necrobiotic nodules)
Developmental cysts (sequestration)
Histiocytosis
Oncological
Lymphangioleiomyomatosis
Environmental, occupational
Sarcoid
· Alternatively: L=Left atrial myxoma


T2 vs. T1 MRI scan "WW 2" (World War II):
· Water is White in a T2 scan.
· Conversely, a T1 scan shows fat as being whiter.


Elbow ossification centers, in sequence CRITOE:
Capitellum
Radial head
Internal epicondyle
Trochlea
Olecranon
External epicondyle
· In order: appear at 1357911
years; each closes 2 years later.


Chest radiograph: checklist to examine ABCDEFGHI:
Aorta
Bronchus
Cord, spinal
Diaphragm (look for hyperinflation)
Eosphagus (look for foreign body)
Fracture (ribs)
Gas (look for pneumothorax)
Heart (look for cardiomegaly)
Iatrogenic (subclavian line, pacemakers)


Osteoarthritis: x-ray signs LOSS:
Loss of joint space
Osteopyhtes
Subcondral sclerosis
Subchondral cysts


MR imaging/ spectroscopy: important metabolites "Lying
Lazy NGood Crooks Collected My insurance":
Lipid: abnormal
Lactate: abnormal
NAA
Glutamine/glutamate
Creatinine/phosphocreatinine
Choline containing compounds
Myoinositol


Chest x-ray: differential diagnoses of shadow on the upper zones of
lung fields
 5 Ts:
Thymoma
Thyroid (retrosternal)
Tuberculosis
Terrible lymphoma
Teratoma


Neck sagittal x-ray: examination checklist ABCD:
Anterior: look for swelling
Bones: examine each bone for fractures
Cartilage: look for slipped discs
Dark spots: ensure not abnormally big, or could mean excess blood


Head CT scan: evaluation checklist "Blood Can
BVery Bad":
Blood
Cistern
Brain
Ventricles
Bone


Anterior mediastinal masses 4 T's:
Teratoma
Thymoma
Testicular-type
T-cell / Hodgkin's lymphoma


Chest radiograph: checklist to examine "Pamela Found
Our Rotation Particularly Exciting; Very Highly
Commended Mainly 'Cus She Arouses":
Patient details
Film details
Objects (eg. lines, electrodes)
Rotation
Penetration
Expansion
Vessels
Hila
Costophrenic angles
Mediastinum
Cardiothoracic Ratio
Soft tissues and bones
Air (diaphragm, pneumothorax, subcut. emphysema)


Upper/apical lobe infiltration/shadowing/fibrosis: causes 
BREASTS
:
Beryllium
Radiation
Extrinsic allergic alveolitis
Ankylosing spondylitis/ Aspergillus
Sarcoidosis
TB
Siliconiosis

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 = 
A
typical. 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: 
P
atient'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, SClaim 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
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