Mnemonics Flashcards
Neurosyphilis mnemonic?
The patient has tabes dorsalis, which is a form of neurosyphilis seen 10 to 25 years or longer after primary disease. The pupils described are Argyll Robertson pupils, and are strongly associated with neurosyphilis. These pupils are bilaterally small and do not constrict further with light, but do constrict to accommodation (light-near dissociation). The lesion is likely in the pretectal area of the midbrain. (A mnemonic to remember is this a “prostitute’s pupil, which will accommodate but will not react.”) With the advent of antibiotics, this is not commonly seen in developed countries.
Neurosyphilis: “paresis”
Personality Affect Hyperactive Reflexes Argyll-Robertson pupils in the Eyes Defects in the Sensorium Intellectual decline Deficient Speech
Through which foramina do the branches of the trigeminal nerve leave the skull?
A useful mnemonic for the foramina through which the branches of the trigeminal nerve leave the skull is “SRO”—or “Standing Room Only”—for V1 to V3:
Superior orbital fissure—V1
Foramen Rotundum—V2
Foramen Ovale—V3
The mandibular branch (V3) of the trigeminal nerve exits the skull via the foramen ovale.
The glossopharyngeal (IX), vagus (X), and spinal accessory (XI) nerves exit the skull via the jugular foramen.
The facial nerve (VII) enters the skull via the internal auditory meatus (where the greater petrosal nerve branches off), continues in the facial canal (where the chorda tympani branches off), and exits the skull via the stylomastoid foramen.
Nerves that exit the skull through the superior orbital fissure include the ophthalmic branch (V1) of the trigeminal nerve, the oculomotor (III) nerve, the trochlear nerve (IV), and the abducens nerve (VI).
Choosing beta blockers
Most beta blockers whose names start with A-M are beta-1-selective. In addition, a mnemonic to remember some of the more common beta-1 blockers is A BEAM (acebutolol, betaxolol, esmolol, atenolol, and metoprolol).
Beta-blockers are generally not recommended for use in patients with chronic respiratory disorders such as asthma, emphysema, or chronic bronchitis.
If a beta-blocker needs to be prescribed to a patient with emphysema, an agent with beta-1-selective blocking properties should be used.
Beta blockers should also be used cautiously in diabetic patients on insulin products because they can mask the premonitory symptoms of hypoglycemia.
Carpal bones… Go!
A mnemonic for remembering the carpal bones is as follows: So Long To Pinky Here Comes The Thumb
Proximal row, lateral-to-medial, then distal row, medial-to-lateral
Scaphoid Lunate Triquetrum Pisiform Hamate Capitate Trapezoid Trapezium
How do we treat COPDers with beta blockers ?
Beta1-selective antagonists are often used to control hypertension in patients, such as asthmatics, who might experience bronchoconstriction with nonselective beta antagonists (e.g., propranolol). Remember that beta1 receptors predominate in the heart, while beta2 receptors predominate in the lungs. A mnemonic to help you remember the main beta1 blockers is: beta blockers beginning with the letters A through M are beta1 selective, and the ones beginning with letters N through Z are beta-nonselective. Remember that the letters C (carvedilol) and L (labetalol) are exceptions.
What are common side effects of anti-muscarinics?
Red as a beet: flushing
Dry as a bone: dry skin and mucous membranes, e.g., mouth (xerostomia) and eyes
Blind as a bat: blocks parasympathetics to the eye; mydriasis with loss of accommodation; can trigger acute angle-closure glaucoma
Mad as a hatter: delirium (blocks central muscarinic receptors, similar to Jimson weed = Datura)
Hot as a hare: hyperthermia (because sweating is decreased)
These types of medications can also cause a variety of other symptoms such as bradycardia, constipation, and urinary retention.
Normal pressure hydrocephalus.
This patient has normal pressure hydrocephalus (NPH), which is a clinical syndrome produced by the build-up of cerebrospinal fluid (CSF). Patients have enlarged ventricles often with normal opening pressures on lumbar puncture. It is characterized by the classic triad (with the accompanying mnemonic):
- “Wet”: urinary incontinence
- “Wacky”: dementia (memory loss, slowed thought)
- “Wobbly”: gait abnormality (apraxic “magnetic” gait)
NPH is thought to be caused by impaired CSF absorption by arachnoid granulations. It is idiopathic in half of the cases. Secondary causes include meningitis, brain trauma, subarachnoid hemorrhage, or prior brain surgery. The treatment for NPH is ventricular shunting. A ventriculoperitoneal shunt drains excess CSF to the abdomen, where it is absorbed.
Preferred alcohol withdrawal treatment for patients with liver disease?
The preferred benzodiazepines in liver disease are lorazepam, oxazepam, and temazepam (mnemonic: LOT) because these agents are primarily metabolized by phase II processes (conjugation), which are less affected by liver disease than phase I processes. Of these agents, lorazepam and oxazepam are more commonly used for alcohol withdrawal.
Anti-muscarinic side effects
A mnemonic to help remember the action of antimuscarinic agents is that they have anti-SLUDGE properties. They cause decreased Salivation, Lacrimation, Urination, Defecation, Gastrointestinal motility, and Emesis. Therefore, they cause xerostomia (dry mouth) because of the lack of salivation. Other effects of anticholinergic medications are tachycardia, bronchodilation, mydriasis, blurred vision, and fever.
