Mnemonic

Question 1

Causes/triggers of atrial fibrillation

Answer 1

: PIRATES
Pulmonary embolism, pulmonary disease, post-operative
Ischemic heart disease, idiopathic (“lone atrial fibrillation”)
Rheumatic valvular disease (mitral stenosis or regurgitation)
Anemia, alcohol (“holiday heart”), age, autonomic tone (vagal atrial fibrillation)
Thyroid disease (hyperthyroidism)
Elevated blood pressure (hypertension), electrocution
Sleep apnea, sepsis, surgery

Question 2

History structure

Answer 2

CHAMPS
Complaint (presenting)
History of presenting complaint
Allergies
Medications
Past medical history
Social history

Question 3

Drug history

Answer 3

APRICOTS
Allergies
Prescriptions
Recreational drugs
Inhalers/Injections/insulin
Contraceptives
Over the counter
Topical
Supplements

Question 4

History taking in syncope

Answer 4

“The Five Ps”
Precipitant
Prodrome
Position
Palpitations
Post-event phenomen

Question 5

Focus history in emergencies

Answer 5

SAMPLE
Signs and symptoms
Allergies
Medication
Past medical history
Last oral intake
Events leading up to the illness or injury

Question 6

Handover

Answer 6

SBAR
Situation
Background
Assessment
Recommendation

Question 7

ECG lead placement

Answer 7

“Ride Your Green Bike”
Placement of limb leads, starting clockwise from the right wrist:
Red
Yellow
Green
Blue

Question 8

General inspection from the end of the bed

Answer 8

ABC
Appearance (colour, pain, breathlessness etc)
Behaviour (calm, agitated etc)
Connections (oxygen, catheters, cannulas, surgical drains etc)

Question 9

Neurological examination structure

Answer 9

: “Is The Physician Really So Cool?”
Inspection
Tone
Power
Reflexes
Sensation
Co-ordination

Question 10

Cerebellar signs

Answer 10

DANISH
Dysdiadochokinesia & Dysmetria
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

Question 11

Tendon reflex nerve roots

Answer 11

Count upwards from the ankles:
S1 S2: ankle jerk
L3 L4: knee jerk
C5 C6: biceps and brachioradialis
C7 C8: triceps

Question 12

Chest X ray findings in heart failure

Answer 12

ABCDE
Alveolar oedema (perihilar/bat-wing opacification)
Kerley B lines (interstitial oedema)
Cardiomegaly (cardiothoracic ratio >50%) – may be difficult to assess on an AP film
Dilated upper lobe vessels
Effusions (i.e. pleural effusions – blunted costophrenic angles with meniscus sign)

Question 13

Features of aortic stenosis

Answer 13

SAD
Syncope (exertional)
Angina
Dyspnoea

Question 14

Cardiac temponade

Answer 14

Becks’s triade (Three Ds):
Distant heart sounds
Distended jugular veins
Decreased arterial pressure (low BP)

Question 15

Management of hypertension

Answer 15

ABCD
Angiotensin-converting enzyme inhibitors
Beta-blockers (no longer first line)
Calcium channel blockers
Diuretics

Question 16

Features of infective endocarditis:

Answer 16

FROM JANE
Fever
Roth’s spots
Osler’s nodes
Murmur
Janeway lesions
Anaemia
Nail bed haemorrhage
Embolism

Question 17

Features of Asthma

Answer 17

CRAB
Chronic inflammation of the airways
Reversible airway obstruction
Airway hyper-responsiveness
Bronchial inflammation

Question 18

Management of tuberculosis

Answer 18

RIPE
Rifampicin
Isoniazid (+ pyridoxine)
Pyrazinamide
Ethambutol

Question 19

Diabetic ketoacidosis precipitants

Answer 19

“The 5 Is”
Infection
Ischaemia
Infarction
Ignorance (poor diabetic control)
Intoxication

Question 20

Features of hypercalcaemia

Answer 20

“Bones, Stones, Groans and Moans”
Painful bones
Renal stones
Abdominal groans (pain)
Psychiatric moans (depression, confusion, lethargy)

Question 21

Indication for renal replacement therapy

Answer 21

I UEFA
Acidosis
Electrolyte abnormalities
Ingested toxins
Fluid Overload
Uraemia

Question 22

Management of acute kidney injury

Answer 22

ABCDE
Address drugs (nephrotoxics)
Boost blood pressure
Calculate fluid balance
Dip urine
Exclude obstruction

Question 23

Functions of the kidney (and complications of CKD)

Answer 23

A WET BED
Acid-base balance: metabolic acidosis
Water removal: pulmonary oedema
Erythropoiesis: anaemia
Toxin removal: uraemia
Blood pressure control: hypertension
Electrolyte balance: hyperkalaemia
Vitamin D activation: bone-mineral disorder of chronic kidney disease (CKD-BMD)