Basic Parameters in Patient Profile Form, demographics of the patient, ward round participation, types of laboratory investigations

3. MNEMONICS
• The study and development of systems for
improving and assisting the memory.
• A Mnemonic is something which we can use
to remember things much easier. As is often
the case, it could be a phrase, a short song, or
something that is quite easily remembered,
that we use to remember something that
would otherwise be difficult to remember.

150. Sickle cell disease Signs
Mnemonic: SICKLE
• S- Splenomegaly/Sludging
• I- Infection
• C- Cholelithiasis
• K- Kidney – haematuria
• L- Liver congestion/Leg ulcers
• E- Eye changes

151. Leukaemia Symptoms and sings Mnemonic:
LEUKEMIA (the US spelling!)
• L= Light skin (pallor)
• E- Energy decreased/Enlarged spleen, liver,
lymph nodes
• U- Underweight
• K- Kidney failure
• E- Excess heat (fever)
• M- Mottled skin (haemorrhage)
• I- Infections
• A- Anaemia

152. Immune thromobocytopenic purpura (ITP)
Causes Mnemonic: MAID
• M- Malignancy
• A- Autoimmune diseases: SLE, thyroid
disease, RA
• I- Infections: malaria, EBV, HIV/Idiopathic
(commonest cause)
• D- Drugs, e.g. quinine

153. Thrombocytopenia Causes Mnemonic:
PLATELETS
• P- Platelet disorders: TTP, ITP, DIC
• L- Leukaemia
• A- Anaemia
• T- Trauma
• E- Enlarged spleen
• L- Liver disease
• E- Ethanol
• T- Toxins: benzene, heparin, aspirin,
chemotherapy.
• S- Sepsis

154. Gastroenteritis Causes Mnemonic:
LESS GERMS
• L- Listeria
• E- Escherichia coli
• S- Staphylococcus aureus
• S- Salmonella
• G- Giardia lamblia
• E- Entamoeba histolytica
• R- Rotavirus
• M- Mushrooms
• S- Shigella

155. • Malaria Common early symptoms
Mnemonic: Heard A Mosquito
• H- Headache
• A- Anorexia
• M- Myalgia/Malaise
• Common later symptoms
• Mnemonic: Feel Rather Cold
• F- Fever (peaks every third day, i.e. tertian)
• R- Rigors
• C- Chills

156. • Meningitis Aetiology - Bacterial
Mnemonic: NHS
• N- Neisseria meningitides (children and
adults; meningococcus)
• H- Haemophilus influenzae (children)
• S- Streptococcus pneumoniae (adults and
elderly)/(Streptococcus produces the Severest
meningitis)/Viral

157. • Leprosy Clinical presentation Mnemonic:
LEProsy
• L- Loss of sensation in affected skin/Loss of
function (paralysis)
• E- Enlargement of affected superficial nerves
(tender too)
• P- Positive identification of M. leprae under
microscope

158. • Migraine Features
Mnemonic: EAT FUN
• E- Episodic
• A- Aura – zigzag lines
• T- Throbbing headache
• F- Family history/F(p)hoto-phobia
• U- Unilateral
• N- Nausea and vomiting

159. • Symptoms and signs in psychiatric disorders
Causes of delirium
Mnemonic: DELIRIUM
• D- Degenerative
• E- Epilepsy (post-ictal states)
• L- Liver failure
• I- Intracranial (injury to the head, subarachnoid
haemorrhage, TIA, meningitis, cerebral abscess)
• R- Rheumatic chorea
• I- Infections – pneumonia, septicaemia
• U- Uraemia
• M- Metabolic – electrolyte imbalance

160. • Schizophrenia and delusional disorders Positive
symptoms (sometimes called type I
schizophrenic symptoms)
Mnemonic: THREAD
• T- Thinking may become disturbed, neologism
usage
• H- Hallucinations may occur, usually auditory
• R- Reduced contact with reality, the natural
barrier between subjective and objective
deteriorates
• E- Emotional control may be disturbed with
inappropriate laughter or anger (incongruous
affect)
• A- Arousal may lead to worsening of symptoms
• D- Delusions may occur

161. • Mood (affective) disorders Symptoms of
depression
Mnemonic: SLUMP
• S- Suicidal ideation or plans
• L- Lack of: interest, enjoyment (anhedonia),
energy, appetite or libido
• U- Unworthiness
• M- Early Morning waking
• P- Poor concentration/Psychomotor
retardation or agitation

162. • Clinical presentation of chronic renal failure
Mnemonic: RESIN & 8 Pʼs
• R- Retinopathy
• E- Excoriations (scratch marks)
• S- Skin is yellow
• I- Increased blood pressure
• N- Nails are brown
• P- Pallor
• P- Purpura and bruises
• P- Pericarditis and cardiomegaly
• P- Pleural effusions
• P- Pulmonary oedema
• P- Peripheral oedema
• P- Proximal myopathy
• P- Peripheral neuropathy

163. • Risk factors of asthma
Mnemonic: FEAR UP
• F- Family history
• E- Eczema
• A- Acid reflux
• R- Rhinitis (allergic)
• U- Urticaria
• P- Polyps (nasal)

164. • History of asthma
Mnemonic: WIND
• W- Wheeze
• I- Interferes with schooling, exercise, sleep
and work
• N- Nocturnal cough, or early morning cough
• D- Dyspnoea

165. • Management, Advanced Life Support (ALS)
Mnemonic: CDE (with A after every step)
• C- Cardiac monitor and defibrillator should be
attached to the patient
• A- Assess rhythm and pulse
• D- Defibrillate x 3 if VF or pulseless VT, CPR for
1 min
• A- Assess rhythm and pulse
• E- EMD (no cardiac output despite ECG
showing electrical activity) or asystole
warrants CPR for 3 min
• A- Assess rhythm and pulse

166. • Infestations Clinical presentation of impetigo
Mnemonic: IMPETIGO
• I- Infection with Staphylococcus aureus, Streptococcus
pyogenes or both
• M- Mostly in young children
• P- Particularly around nose and surrounding parts of
face
• E- Erythematous base with honey-coloured crusts
• T- Treat with Topical antibiotic such as fusidic acid for
localized lesions
• I- Individuals are highly contagious from skin-to-skin
contact; Improve hygiene; do not share towels
• G- Gram stain and culture of swab diagnostic
• O -Oral flucloxacillin required for widespread impetigo

167. • Inflammatory bowel disease (IBD) Features of
ulcerative colitis
Mnemonic: ULCERS IN Abdomen
• U- Ulcers (mucosal and submucosal)
• L- Large intestine (rectum always involved. May
extend proximally to involve entire colon)
• C- Clubbing
• E- Extra-intestinal manifestations
• R- Remnants of old ulcers (pseudopolyps)
• S- Stools bloody
• I- Inflamed, red, granular mucosa and sub
mucosa
• N- Neutrophil invasion
• A- Abscesses in crypts

168. • Pneumonia: risk factors INSPIRATION:
Immunosuppression
Neoplasia
Secretion retention
Pulmonary oedema
Impaired alveolar macrophages
RTI (prior)
Antibiotics and cytotoxics
Tracheal instrumentation
IV dug abuse
Other (general debility, immobility)
Neurologic impairment of cough reflex, (eg NMJ
disorders)

169. • Hypoglycaemia: causes "How
to EXPLAIN hypoglycemia":
EXogenous drugs (insulin, oral hypoglycemics,
alcohol, pentamidine,
quinine, quinolones)
Pituitary insufficency (no GH or cortisol)
Liver failure (no glycogen stores)
Adrenal failure (no cortisol)
Insulinomas/ Immune hypoglycemia
Non-pancreatic neoplasms (retroperitoneal
sarcoma)

170. • Asthma: precipitating factors for acute
attack DIPLOMAT:
Drugs (aspirin, NSAIDs, beta blockers, etc)
Infections (URTI/LRTI)
Pollutants (at home, at work)
Laughter(emotion)
Oesophageal reflux (nocturnal asthma)
Mites
Activity and exercise
Temperature (cold)

171. • Strep throat score NO FACE:
NO cough: no cough is +1
Fever: has fever is +1
Age: less than 5 years is -1, 15-45 years is 0,
greater than 45 years is
+1
Cervical nodes: cervical nodes palpable is +1
Exudate: tonsillar exudate is +1
· Scoring interpretation:
Score 0-1: no strep throat.
Score 1-3: possible strep throat, do a swab test.
Score 4-5: strep throat is likely, so treat
empirically.

172. • Strep throat score NO FACE:
NO cough: no cough is +1
Fever: has fever is +1
Age: less than 5 years is -1, 15-45 years is 0,
greater than 45 years is
+1
Cervical nodes: cervical nodes palpable is +1
Exudate: tonsillar exudate is +1
· Scoring interpretation:
Score 0-1: no strep throat.
Score 1-3: possible strep throat, do a swab test.
Score 4-5: strep throat is likely, so treat
empirically.

173. • Pleural effusion: investigations PLEURA:
Pleural fluid (thoracentesis)
Lung, pleural biopsy
ESR
Ultrasound
Radiogram
Analysis of blood

174. • Chronic cough: full differential GASPS AND
COUGH:
GORD
Asthma
Smoking, chronic bronchitis
Post-infection
Sinusitis, post-nasal drip
ACE inhibitor
Neoplasm
Diverticulum
Congestive heart failure
Outer ear
Upper airway obstruction
GI-airway fistula
Hypersensitivity

175. • Dyspnea: causes SHE PANTS:
Stress, anxiety
Heart disease
Emboli
Pulmonary disease
Anaemia
Neuromuscular disease
Trachea obstruction
Sleep disorder

176. • Haemoptysis: causes CAVITATES:
CHF
Airway disease, bronchiectasis
Vasculitis/ Vascular malformations
Infection (eg TB)
Trauma
Anticoagulation
Tumour
Embolism
Stomach
•

177. • Splenomegaly: causes HICCUPS:
Haematological
Infective : Kala azar, malaria, enteric fever
Congestive: CCF, constrictive pericarditis, IVC
thrombosis, Hepatic vein
thrombosis, portal vein thrombosis and
splenic vein thrombosis
Collagen diseases: SLE, Felty's syndrome
Unknown etiology: tropical splenomegaly
Primary malignacies (secondaries are rare)
Storage diseases: Gaucher's disease,
Niemman Pick

178. • Anion gap metabolic acidosis:
causes MUDPILES:
Methanol
Uremia
Diabetic ketoacidosis
Paraldehyde
Infection
Lactic acidosis
Ethylene glycol
Salicylates

179. • Carcinoid syndrome: features FACADE:
Flushing
Asthma
Cor pulmonale
Ascites
Diarrhoea
Endocardial fibrosis

180. • Thromocytopenia: causes SHAPIRO:
Splenectomy
Hodgkin's disease
Arteritis
Polycythemia
Infection
Rheumatoid
Occult malignancy

181. • Dialysis indications HAVE PEE:
Hyperkalemia (refractory)
Acidosis (refractory)
Volume overload
Elevated BUN (> 36 mM)
Pericarditis
Encephalopathy
Edema (pulmonary)

182. • Anemia: non-megaloblastic causes of
macrocytic anemia
HAND LAMP:
Hypothyroidism
Aplastic anaemia
Neonates
Drugs
Liver disease
Alcohol
Myelodyplasia
Pregnancy

183. • Splenomegaly: causes CHICAGO:
Cancer
Hem, onc
Infection
Congestion (portal hypertension)
Autoimmune (RA, SLE)
Glycogen storage disorders
Other (amyloidosis)

184. • Abdominal pain: medical causes "ABDOMENAL PANE"
[abdominal pain]:
Acute rheumatic fever
Blood [purpura, a/c hemolytic crisis]
DKA
cOllagen vascular disease
Migraine [abdominal migraine]
Epilepsy [abdominal epilepsy]
Nephron [uremia]
Abdominal angina
Lead
Porphyria
Arsenic
NSAID's
Enteric fever
•

185. • Toxicity/ sepsis: signs 6 T's:
Tachycardia
Tachypnea
Tremors
Toxic look
Tiredness
Temperature (fever)

186. • ICU management: A to Z A: Asepsis/ Airway
B: Bed sore/ encourage Breathing/ Blood pressure
C: Circulation/ encourage Coughing/ Consciousness
D: Drains
E: ECG
F: Fluid status
G: GI losses/ Gag reflex
H: Head positioning/ Height
I: Insensible losses
J: Jugular venous pulse
K: Kindness
L: Limb care/ Label
M: Mouth care
N: Nociception/ Nutrition
O: Oxygenation/ Orient the patient
P: Pulse/ Peristalsis/ Physiotherapy
Q: Quiet surroundings
R: Respiratory rate/ Restraint
S: Stress ulcer/ Suctioning
T: Temperature
U: Urine
V: Ventilator
W: Wounds/ Weight
X: Xerosis
Y: whY
Z: Zestful care of the patient

187. • Skull bones "STEP OF 6 "
· The 6 skull bones are:
Sphenoid
Temporal
Ethmoid
Parietal
Occipital
Frontal

188. • Asthma acute attack: 5 life threatening
signs SHOCK:
Silent chest
Hypotension
One third of best/predicted PFR
Cyanosis
Konfusion

189. • Unconciousness: differential FISH SHAPED:
Fainted
Illness/ Infantile febrile convulsions
Shock
Head injuries
Stroke (CVE)
Heart problems
Asphxia
Poisons
Epilepsy
Diabetes

190. • Organophosphates poisoning
symptoms MILES:
Miosis
Increased urinary frequency
Lacrimation
Enuresis
Salivation

191. • Resuscitation: basic steps ABCDE:
Airway
Breathing
Circulation
Drugs
Environment

192. • Shock: types RN CHAMPS:
Respiratory
Neurogenic
Cardiogenic
Hemorrhagic
Anaphylactic
Metabolic
Psychogenic
Septic
· Alternatively: "MR. C.H. SNAP", or "NH
CRAMPS"

193. • 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)

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

195. • 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

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

197. • 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

198. • 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.

199. • 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