Mnemonics Galore! Flashcards
SNNOUT
sensitivity
highly SeNsitive test, when Negative, rules OUT dz
SPPIN
highly SPecific test, when Positive, rules IN dz
type I (alpha) error
you sAw a difference that didn’t exist (eg, convicting an innocent man)
type II (beta) error
you were Blind to the truth (eg, setting a guilty man free)
PST
disease prevention
primary: prevent
secondary: screen
tertiary: tx
4 parts of Medicare
Part A: hospitAl insurance
Part B: Basic medical Bills (eg, doctor’s fees, dxic testing)
Part C: (Parts A+B) delivered by approved private Companies
Part D: prescription Drugs
Sex, Drugs, & Rock & roll
situations in which parental consent usually not required for minors
Sex (contraception, STIs, pregnancy)
Drugs (addiction, tx for child of minor)
Rock & roll (emergency/trauma)
abortion does require at minimum parental notification in most states
GAG
amino acids necessary for purine synthesis
Glycine, Aspartate, Glutamine
HGPRT
sx of Lesch-Nyhan syndrome (defective HGPRT)
Hyperuricemia (“orange sand” in diaper), Gout, Pissed off (aggression, self-mutilation), Retardation (intellectual disability), dysTonia
eukaryotic DNA polymerases
Alpha - lAgging strand
Beta - Base excision repair
Delta - leaDing strand
GaMMa - Mitochondrial DNA (or gamma for “Gramma”)
APE
positions of active sites on ribosome
A site - incoming Aminoacyl-tRNA
P site - accommodates growing Peptide
E site - holds Empty tRNA as it Exits
Microtubules Get Constructed Very Poorly
drugs that act on microtubules
Mebendazole (antihelminthic)
Griseofulvin (antifungal)
Colchicine (antigout)
Vincristine/Vinblastine (anticancer) - destabilize/inhibit MT formation
Paclitaxel (anticancer) - hyperstabilizes MTs
SCAB or Be (So Totally) Cool, Read Books
types of collagen
Type I: Bone, Skin, Tendon, dentin, fascia, cornea, late wound repair
Type II: Cartilage (including hyaline), vitreous body, nucleus pulposus
Type III: Reticulin - skin, blood vessels uterus, fetal tissue, granulation tissue
Type IV: Basement membrane, basal lamina, lens
SNoW DRoP or Down South, Pools in the West, and Rhode Island to the North
different blotting procedures
Southern blot: DNA sample, DNA probe
Western blot: protein sample, labeled antibody probe
Northern blot: RNA sample, DNA probe
Southwestern blot: DNA-binding protein sample (eg, transcription factor), labeled oligonucleotide probe
Cs of Huntington disease
trinucleotide repeat: CAG Cuatro (chromosome 4) Cuarenta (median age of onset) Choreiform movements Caudate atrophy Cognitive decline decreased ACh in brain
Oblivious Female Will Give Her Boys Her x-Linked Disorders…Oops
X-linked disorders! (duh)
Ocular albinism, Fabry dz, Wiskott-Aldrich syndrome, G6PD deficiency, Hemophilia A and B, Bruton agammaglobulinemia, Hunter syndrome, Lesch-Nyhan syndrome, Duchenne (and Becker) muscular Dystrophy, Ornithine transcarbamylase deficiency
X-Girlfriend’s First Aid Helped Ace My Test
trinucleotide repeat conditions and which mutations Fragile X syndrome: (CGG)n Friedreich ataxia: (GAA)n Huntington dz: (CAG)n Myotonic dystrophy: (CTG)n
CATCH-22
DiGeorge syndrome! microdeletion at chromosome 22q11 Cleft palate Abnormal facies Thymic aplasia -> T cell deficiency Cardiac defects Hypocalcemia (d/t parathyroid aplasia)
FLAMES
findings of kwashiorkor Fatty Liver Anemia/Anasarca Malnutrition Edema Skin lesions
HUGs take two
biosynthetic processes that take place in both cytoplasm and mitochondria
Heme synthesis, Urea cycle, Gluconeogenesis
Citrate Is Krebs’ Starting Substrate For Making Oxaloacetate
order of substrates in TCA cycle Citrate Isocitrate alpha-Ketoglutarate Succinyl-CoA Succinate Fumarate Malate Oxaloacetate
Spleen Purges Nasty Inclusions From Damaged Cells
substances that induce hemolysis in G6PD deficiency Sulfonamides Primaquine Nitrofurantoin Isoniazid Fava beans Dapsone Chloroquine
PriVaTe TIM HaLL
essential amino acids Phenylalanine Valine Tryptophan Threonine Isoleucine Methionine Histidine Lysine Leucine
Ordinarily, Careless Crappers Are Also Frivolous About Urination
order of substrates in urea cycle Ornithine Carbamoyl phosphate Citrulline Aspartate Argininosuccinate Fumarate Arginine Urea
I Love Vermont maple syrup from maple trees w/ branches
maple syrup urine dz
blocked degradation of branched chain aas (Isoleucine, Leucine, Valine) d/t decreased alpha-ketoacid dehydrogenase
Even Some Pretty Nasty Killers Have Shiny Bodies
encapsulated organisms E. coli (some) Streptococcus pneumoniae Pseudomonas aeruginosa Neisseria meningitidis Klebsiella pneumoniae Haemophilus influenzae B Salmonella Group B strep species
These Microbes May Lack Real Color
bugs that don’t Gram stain well
Treponema pallidum (too thin)
Mycobacteria (mycolic acids)
Mycoplasma (no cell wall)
Legionella pneumophila (primarily intracellular)
Rickettsia (intracellular parasite)
Chlamydia (intracellular parasite; low muramic acid)
ENDOTOXIN
effects of endotoxin (LPS, G- bacteria) Edema Nitric oxide DIC/Death Outer membrane TNF-alpha O-antigen eXtremely heat stable IL-1 Neutrophil chemotaxis
ABCDE bacterial toxins
bacterial toxins encoded in lysogenic phage shigA-like toxin Botulinum toxin (certain strains) Cholera toxin Diphtheria toxin Erythrogenic toxin of S. pyogenes
MOPS
Strep pneumo is MCC of: Meningitis Otitis media (in children) Pneumonia Sinusitis
JONES
major criteria for acute rheumatic fever Joints - polyarthritis O (heart) - pancarditis Nodules - subcutaneous and Aschoff bodies (nodules) Erythema marginatum Sydenham chorea
a key Lyme pie to the FACE
cardinal sx of Lyme dz Facial nerve palsy (typically b/l) Arthritis Cardiac block Erythema chronicum migrans
VDRL
things that give false-positive VDRL results
Viral infection (mono, hepatitis, EBV)
Drugs
Rheumatic fever
Lupus and Leprosy (really all autoimmune dzs)
(pregnancy, too)
you drive Kawasaki CARS w/ your hands and feet
conditions that cause palm/sole rashes Kawasaki dz Coxsackie A Rocky mountain spotted fever Secondary Syphilis
black flies, black skin nodules, black sight
findings of Onchocerca volvulus infection
you’ll get sick if you EATT these!
nematodes acquired through ingestion
Enterobius, Ascaris, Toxocara, Trichinella
these get into your feet from the SANd
nematodes acquired through cutaneous infection
Strongyloides, Ancylostoma, Necator
lay LOW to avoid getting bitten
nematodes acquired through bites
Loa loa, Onchocerca volvulus, Wuchereria bancrofti
Attention Slowpokes! Please Vaccinate Young Infants w/ MMR Regularly
live attenuated vaccines
Smallpox, Polio (Sabin - oral), VZV (chickenpox), Yellow fever, Influenza (intranasal), MMR, Rotavirus
RIP Always
killed vaccines
Rabies, Influenza (injected), Polio (Salk - injected), HAV
give PAPP smears and CPR to a naked Heppy
naked (nonenveloped) viruses
DNA: Papillomavirus, Adenovirus, Parvovirus, Polyomavirus
RNA: Calicivirus, Picornavirus, Reovirus, Hepevirus
PERCH viruses
picornaviruses
Poliovirus, Echovirus, Rotavirus, Coxsackievirus, HAV
Always Bring Polymerase Or Fail Replication
negative stranded viruses, must bring own RNA-dependent RNA polymerase
Arenaviruses, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, Filoviruses, Rhabdoviruses
can’t see, can’t pee, can’t hear a buzzing bee
Alport syndrome (mutation in collagen IV)
the terrible Ts
anterior mediastinal masses
Thymoma, Teratoma, Thyroid cancer, (terrible) lymphoma
ampicillin/amoxicillin HHEELPSS kill enterococci
extended coverage offered by aminopenicillins
Hib, H. pyloria, E. coli, Enterococci, Listeria, Proteus, Salmonella, Shigella
LAME
organisms typically not covered by cephalosporins
Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA, Enterococci
ceftaroline covers MRSA
PEcK
1st gen cephalosporin (cefazolin, cephalexin) coverage
Proteus, E. coli, Klebsiella
HEN PEcKS
2nd gen cephalosporin (cefoxitin, cefaclor, cefuroxime) coverage
Hib, Enterobacter, Neisseria spp., Proteus, E. coli, Klebsiella, Serratia
VACUUM THe BedRoom
bugs covered by tetracyclines
Vibrio, Acne, Chlamydia, Ureaplasma urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi, Rickettsia rickettsii
MACRO
ADRs of macrolides
GI Motility issues, Arrhythmia (QT prolongation), acute Cholestatic hepatitis, Rash, eOsinophilia
GET GAP on the Metro
bugs covered by metronidazole
Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes (Bacteroides, C. diff), H. Pylori (part of triple tx)
4 Rs of rifampin
RNA polymerase inhibitor
Ramps up microsomal CYP450
Red/orange body fluids
Rapid resistance if used alone
HCV tx is SRS business
Simeprevir, Ribavirin, Sofosbuvir
SAFe Children and Moms Take Really Good Care
antibiotics to avoid in pregnancy Sulfonamides (kernicterus) Aminoglycosides (ototoxicity) FQs (cartilage damage) Clarithromycin (embryotoxic) Metronidazole (mutagenesis) Tetracyclines (discolored teeth, inhibition of bone growth) Ribavirin (teratogenic) Griseofulvin (teratogenic) Chloramphenicol (gray baby syndrome)
PAIR
seronegative arthropathies (all HLA-B27 related) Psoriatic arthritis, Ankylosing spondylitis, Inflammatory bowel dz associated arthritis, Reactive arthritis (Reiter syndrome)
rule of 8
MHC I x CD8 = 8
MHC II x CD4 = 8
Medical Doctor Gave Extra Antibody
order of isotype switching in B cells
IgM, IgD, IgG, IgE, IgA
once a type has been surpassed, can never create that type again
Hot T-BONE stEAK
cytokines and what they do
IL-1: fever (hot)
IL-2: stimulates T cells
IL-3: stimulates BONE marrow
IL-4: stimulates IgE (and IgG) production
IL-5: stimulates IgA (and eosinophil) production
IL-6: stimulates aKute-phase protein production
To Be Healed Very Rapidly
preformed abs given w/ these exposures
Tetanus toxin, Botulinum toxin, HBV, Varicella, Rabies
ABCD
hypersensitivity types type I: Anaphylactic/Atopic type II: antiBody mediated type III: immune Complex mediated type IV: Delayed (T-cell mediated)
As of selective IgA deficiency
mostly Asymptomatic Airway/GI infections Autoimmune dz Atopy Anaphylaxis to IgA containing products (eg, blood transfusion)
FATED
autosomal dominant hyper-IgE syndrome (Job syndrome)
coarse Facies
cold (noninflamed) staphylococcal Abscesses
retained primary Teeth
increased IgE
Dermatologic problems (eczema)
ATAXIA
ataxia-telangiectasia Ataxia (Atrophy of cerebellum) Telangiectasia/Tracking eye difficulties Acute leukemia/lymphoma (and breast cancer) X-ray sensitivity IgA deficiency/Infections AFP increased
WAITER
Wiskott-Aldrich syndrome Wiskott-Aldrich Immunodeficiency (inability to T cells to reorganize actin cytoskeleton) Thrombocytopenic purpura Eczema Recurrent infections
Potentially Really High (Lethal) Hematocrit
tumors that produce EPO -> polycythemia
Pheochromocytoma, RCC, HCC, Leiomyoma, Hemangioblastoma
PSaMMoma
neoplasms w/ psammoma bodies
Papillary carcinoma of thyroid, Serous papillary cystadenocarcinoma of ovary, Meningioma, Malignant mesothelioma
Lots of Bad Stuff Kill Glia
tumors that send mets to brain
Lung > Breast > (Prostate) > Skin (melanoma) > Kidney > GI
Cancer Sometimes Penetrates Benign Liver
tumors that send mets to liver
Colon»_space; Stomach > Pancreas > Breast > Lung
BLT w/ a Kosher Pickle
tumors that send mets to bone
Breast (mixed), Lung (mixed), Thyroid (lytic), Kidney (lytic), Prostate (blastic)
PEA
drugs eliminated by 0 order kinetics (a pea is round, shaped like “0” in 0 order)
Phenytoin, Ethanol, Aspirin
TITE
therapeutic index calculation
Therapeutic Index = TD50/ED50
Cutesies HAVe 1 M&M
receptors that use Gq/protein kinase C
H1, alpha1, V1, M1, M3
MAD 2s
receptors that use Gi
M2, alpha2, D2
Grandma Doesn’t Remember
indirect ACh agonists/AChEIs
Galantamine, Donepezil, Rivastigmine
DUMBBELSS
effects of organophosphates/muscarinic agonists
Diarrhea/Diaphoresis, Urination, Miosis, Bronchospasm/Bronchorrhea, Bradycardia, Excitation of skeletal muscle and CNS/Emesis, Lacrimation, Salivation
On The Darn Toilet Seat
muscarinic antagonists used to reduce bladder spasms and for urge incontinence (overactive bladder)
Oxybutynin, Tolterodine, Darifenacin, Trospium, Solifenacin
Hot as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter, Bloated as a toad, Tachy as a polyester suit
effects of atropine (antimuscarinic) toxicity (basically anti-DUMBBeLSS)
Taking Pills Necessitates Having blood Checked
drugs that cause hyperglycemia
Tacrolimus, Protease inhibitors, Niacin, HCTZ, Corticosteroids
Drugs Causing A Violent Abdominal Distress
drugs that cause pancreatitis
Didanosine, Corticosteroids, Alcohol, Valproic acid, Azathioprine, Diuretics (furosemide, HCTZ)
Gangs CCCrush Myeloblasts and Promyelocytes
drugs that cause agranulocytosis
Ganciclovir, Clozapine, Carbamazepine, Colchicine, Methimazole, PTU
Can’t Make New Blood Cells Properly
drugs that cause aplastic anemia
Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, PTU
Fat PiG
drugs that cause lipodystrophy
Protease inhibitors, GCs
Painful Tophi and Feet Need Care
drugs that cause hyperuricemia
Pryazinamide, Thiazides, Furosemide, Niacin, Cyclosporine
SAT For Photo
drugs that cause photosensitivity
Sulfonamides, Amiodarone, Tetracyclines, 5-FU
having lupus is SHIPP-E
drugs that cause drug-induced lupus
Sulfa drugs, Hydralazine, INH, Procainamide, Phenytoin, Etanercept
Guinness, Coronas, and PBRS cause chronic alcoholism
inducers of CYP450
Griseofulvin, Carbamazepine, Phenytoin, Barbiturates, Rifampin, St. John’s wort, chronic alcoholism
(also nevirapine, ginseng, green veggies, and OCPs)
CRACK AMIGOS
inhibitors of CYP450
Cimetidine, Ritonavir/PIs, Amiodarone, Ciprofloxacin, Ketoconazole, Acute alcohol ingestion, Macrolides (except azithromycin), INH, Grapefruit juice, Omeprazole, Sulfonamides/Streptogramins
(also NSAIDs, cranberry juice, ginkgo biloba, vE, T3/T4, SSRIs)
Sulfa Pills Frequently Cause Terribly Severe Allergy Sx
sulfa drugs
Sulfonamide abx, Probenecid, Furosemide, Celecoxib, Thiazides, Sulfasalazine, Acetazolamide, Sulfonylureas
Young Liver Synthesizes Blood
fetal erythropoiesis occurs in: Yolk sace (3-8 weeks) Liver (6 weeks-birth) Spleen (10-28 weeks) Bone marrow (18 weeks to adult) in kids, long and flat bones; in adults, axial skeleton
ABCDE
drug-induced long QT syndrome
antiArrhythmics (class Ia, III)
antiBiotics (eg, macrolides, chloroquine)
anti”C”ycotics (eg, haloperidol, risperidone)
antiDepressants (eg, TCAs)
antiEmetics (eg, ondansetron)
methadone, -navirs also do this
if you’re DUMPT, you’re heartbroken
5 lethal causes of CP
Dissection (aorta), Unstable angina, MI, PE, tension PTX
use a LEASH to restrict your dog
major causes of restrictive/infiltrative cardiomyopathy Loffler syndrome (endomyocardial fibrosis w/ prominent eosinophilic infiltrate), Endocardial fibroelastosis (young children), Amyloidosis, Sarcoidosis, Hemochromatosis
JONES PEACE
major and minor criteria for rheumatic fever
Joints (migratory polyarthritis), “O” (pancarditis), Nodules (subcutaneous), Erythema marginatum (serpiginous), Sydenham chorea (St. Vitus’ dance)
Prolonged PR interval, Elevated temperature (fever), Arthralgia, elevated CRP, elevated ESR
CRASH and burn
sx of Kawasaki dz
Conjunctival injection, Rash (polymorphous -> desquamating), Adenopathy (cervical), Strawberry tongue (oral mucositis), Hand-foot changes (edema, erythema), fever
Hypertensive Moms Love Nifedipine
antihypertensives that are approved for use during pregnancy
Hydralazine, Methyldopa, Labetalol, Nifedipine
BanDAIDS
class III antiarrhythmics Bretylium, Dofetilide, Amiodarone, Ibutilide, Dronedarone, Sotalol
FLAT PiG
hormones released by anterior pituitary
FSH, LH, ACTH, TSH, prolactin, MSH (“i”ntermediate), GH
FLAT ChAMP
hormones that utilize cAMP (Gs and Gi)
FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH
also calcitonin, GHRH, glucagon
GOAT HAG
hormones that utilize IP3 (Gq)
GnRH, Oxytoxcin, ADH (V1), TRH, Histamine (H1), ANGII, Gastrin
PIGGlET
hormones that use receptor-associated tyrosine kinase/JAK/STAT pathway
Prolactin, Immunomodulators (eg, cytokines IL-2, IL-6, IFN), GH, G-CSF, EPO, TPO
BAM, CUSHINGOID
sx of cortisol excess/glucocorticoid use
Buffalo hump, Amenorrhea, Moon facies, Crazy, Ulcers, Skin changes (striae), Hypertension, Infections, Necrosis of femoral head, Glaucoma, Osteoporosis, Immunosuppression, Diabetes (insulin resistance)
rule of 10s
pheochromocytoma
10% malignant, 10% b/l, 10% extra-adrenal, 10% calcify, 10% in children
5 Ps of pheochromocytoma
common sx in pheohromocytoma
Pressure (HTN), Pain (HA), Perspiration, Palpitations (tachycardia), Pallor
6 Ps of congenital hypothyroidism
formerly cretinism
Pot-bellied, Pale, Puffy-faced child, Protruding umbilicus, Protuberant tongue, Poor brain development
stones, bones, groans, moans, thrones, and psychiatric overtones
sx of hypercalcemia (and hyperparathryoidism)
Stones: kidney stones (calcium phosphate/oxalate)
Bones: bone pain from Ca2+ reabsorption -> osteoporosis
Groans: lethargy, fatigue
Moans: abdominal pain, constipation, peptic ulcers
Thrones: polyuria, polydipsia
Psychiatric overtones: confusion, depression, anxiety, hallucinations, irritability, etc.
CHIMPANZEES
causes of hypercalcemia
Calcium supplementation, HCTZ/thiazide diuretics, Iatrogenic/Immobilization, MM/Milk alkali syndrome/Medication (eg, lithium), Parathyroid hyperplasia/adenoma, Alcohol, Neoplasm, ZE syndrome, Excess vA, Excess vD, Sarcoidosis
4 Ds of glucagonoma
dermatitis (necrolytic migratory erythema), diabetes (hyperglycemia), DVT, depression
rule of 1/3s
carcinoid syndrome
1/3 metastasize, 1/3 present w/ second malignancy, 1/3 multiple
SADPUCKER
retroperitoneal structures
Suprarenal glands, Aorta (and IVC), Duodenum (2nd-4th parts), Pancreas (except tail), Ureters, Colon (descending and ascending), Kidneys, Esophagus, Rectum
NAVY
order of femoral structures from lateral to medial
Nerve, Artery, Vein, Yin-Yang
WDHA syndrome
also called VIPoma
Watery Diarrhea, Hypokalemia, Achlorhydria
Foamy Whipped cream in a CAN
sx of Whipple dz
foamy macrophages in lamina propria (intestine), Cardiac sx, Arthralgias, Neurologic sx
also weight loss, lymphadenopathy, hyperpigmentation
ULCCCERS
sx of ulcerative colitis
Ulcers, Large intestine, Continuous, Colorectal carcinoma, Crypt abscesses, Extends proximally, Red diarrhea, Sclerosing cholangitis
5 2s of Meckel diverticulum
2 inches long, 2 feet from ileocecal valve, 2% of population, commonly presents in first 2 years of life, may have 2 types of epithelia (gastric/pancreatic)
SBO ABCs
causes of small bowel obstruction
Adhesions (~75%), Bulge (hernia - 2nd MC), Cancer (MC mets from colon)
3-2-1 rule
making dx of Lynch syndrome (HNPCC)
3 relatives w/ Lynch syndrome, associated cancers across 2 generations, 1 of whom must be dx’d before 50
5 Fs of cholelithiasis
Female, Fat, Forty, Fertile, Flatulent!
PANCREATITIS
causes of (you guessed it!) pancreatitis hyperParathyroidism, Alcohol, Neoplasm, Cholelithiasis, Rx, ERCP, Abdominal surgery/Autoimmune, hyperTriglyceridemia, Infection (mumps), Trauma, Idiopathic, Scorpion sting
CANADA-P
causes of eosinophilia
Collagen vascular dz, Atopic dzs, Neoplasm, Adrenal insufficiency, Drugs, Acute interstitial nephritis, Parasites
also Loeffler eosinophilic pneumonitis, HIV, hyper-IgE syndrome, coccidiomycosis, etc.
“HALT,” said the hunter to his target
causes of target cells
HbC dz, Asplenia, Liver dz, Thalassemia
LEAD sucks
sx and tx of lead poisoning
Lead Lines on gingivae (Burton lines) an on metaphyses of long bones, Encephalopathy and Erythrocyte basophilic stippling, Abdomial colic and sideroblastic Anemia, wrist and foot Drop, Dimercaprol and EDTA both 1st line, succimer (sucks) used for kids
5 Ps of AIP
sx of AIP Painful abdomen (neuropathic), Port wine-colored urine, Polyneuropathy, Psychological disturbances, Precipitated by drugs
Nasty Fever Torched His Kidneys or FAT RN
sx of TTP
Neurologic sx, Fever, Thrombocytopenia, microangiopathic Hemolytic anemia (MAHA), Renal sx
classic presentation: childbearing age woman w/ stroke, renal sx, MAHA, increased BUN/Cr
DIC
causes of DIC
Delivery, Infection (G- sepsis), Cancer (adenocarcinoma, AML M3/APL)
CRAB
sx of MM
hyperCalcemia, Renal involvement, Anemia (interference w/ other cell line maturation), Bone lytic lesions/Back pain
1 slow fat red ox, 2 fast skinny white breasts
differentiating the types of muscle fibers
type 1: slow twitch, use fat for energy (oxidative phosphorylation), red d/t lots of mitochondria/myoglobin
type 2: fast twitch, use glucose for energy (anaerobic), white d/t little mitochondria/myoglobin
ASEPTIC
causes of osteonecrosis/avascular necrosis
Alcoholism, SCD, Storage, Exogenous/Endogenous corticosteroids, Pancreatitis, Trauma, Idiopathic (Legg-Calve-Perthes dz), Caisson (“the bends”)
can’t see, can’t spit, can’t climb up shit
triad of Sjogren syndrome
xerophthalmia, xerostomia, arthritis
can’t see, can’t pee, can’t climb a tree
triad of reactive arthritis (seronegative spondyloarthropathy)
conjunctivitis and anterior uveitis, urethritis, arthritis
RASH OR PAIN
sx of SLE
Rash (malar or discoid), Arthritis (synovitis - looks like RA), Soft tissues/Serositis, Hematologic disorders (eg, cytopenias, warm IgG), Oral/nasopharyngeal ulcers, Renal dz/Raynaud phenomenon, Photosensitivity/Positive VDRL/RPR, Antinuclear abs, Immunosuppressants/Immune disorders, Neurologic disorders
A GRUELING Disease
sx of sarcoidosis
ACE increased, Granulomas, Rheumatoid arthritis, Uveitis, Erythema nodosum, Lymphadenopathy, Idiopathic, Noncaseating granulomas, Gammaglobulinemia, increased vD
CREST syndrome
Calcinosis, Raynaud phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia
Come, Let’s Get Sun Burned!
layers of epidermis (superficial -> deep)
Corneum, Lucidum, Granulosum, Spinosum, Basale
DAMN is a vulgar word
sx of pemphigus vulgaris
Desmosomes, Acantholysis, Mouth involvement, Nikolsky sign + (separation of epidermis upon manual stroking of skin)
6 Ps of lichen planus
Pruritic, Purple, Polygonal Planar Papules and Plaques
ABCDEs of melanoma
Asymmetry, Border irregularity, Color variation, Diameter > 6mm, Evolution over time
from low to high, your pons will die; from high to low, your brain will blow
effects of correcting serum Na+ too quickly
hyponatremia: osmotic demyelination syndrome (central pontine myelinolysis)
hypernatremia: cerebral edema/herniation
Don’t Eat Greasy Foods
cerebellar nuclei (lateral -> medial) Dentate, Emboliform, Globose, Fastigial
Parkinson dz TRAPS your body
sx of PD
Tremor (pill-rolling, at rest), Rigidity (cogwheel), Akinesia/bradykinesia, Postural instability, Shuffling gait (festinating)
also mask-like facies
a SUPERIOR at CALCULUS nerd who’s always looking DOWN at his feet
injury to superior colliculus results in Parinaud syndrome (paralysis of upward gaze)
wet, wacky, and wobbly
sx of normal pressure hydrocephalus
urinary incontinence, cognitive dysfunction, ataxia
Climbing On Slippery Slopes Sometimes Feels Funny, So Instead I Just Juggle Jack Hammers (Standing Room Only)
foramina each of the CNs traverse I: Cribriform plate II: Optic canal III/IV/V1/VI: Superior orbital fissure V2: Foramen Rotundum V3: Foramen Ovale VII/VIII: Internal acoustic meatus XI/X/XI: Jugular foramen XII: Hypoglossal canal Standing Room Only: branches of V
Some Say Marry Money But My Brother Says Big Boobs Matter More
types of information each CN carries (S: Sensory, M: Motor, B: Both)
Lovely Bella Had An STD
causes of Bell’s palsy
Lyme dz, Herpes simplex (and herpes zoster, called Ramsay Hunt syndrome), AIDS, Sarcoidosis, Tumors, DM
LR6SO4R3
innervations of the extraocular muscles
VI: Lateral Rectus
IV: Superior Oblique
III: everything else (medial rectus, inferior rectus, superior rectus, inferior obilque, levator palpebrae)
STURGE
sx of Sturge-Weber syndrome
Sporadic/port-wine Stain, Tram track calcifications (opposing gyri), U/l, Retardation, Glaucoma/GNAQ gene, Epilepsy
HAMARTOMAS
sx of tuberous sclerosis
Hamartomas of CNS and skin, Angiofibromas, Mitral regurg, Ash-leaf spots, cardiac Rhabdomyoma, (Tuberous sclerosis), autosomal dOminant, Mental retardation, renal Angiomyolipoma, Seizures/Shagreen patches
MGM Studios
MC brain tumors of adults (in order!)
Metastasis, Glioblastoma multiforme, Meningioma, Schwannoma
Animal kingdom, Magic kingdom, Epcot
MC brain tumors of children (in order!)
pilocytic Astrocytoma, Medulloblastoma, Ependymoma
EFGHIJ
ADRs of Ethosuximide
Fatigue, GI distress, HA, Itching, Stevens-Johnson syndrome
Phenytoin Has Given MDs Frustration
ADRs of phenytoin
Peripheral neuropathy, Hirsutism, Gingival hyperplasia, Megaloblastic anemia, Drug-induced lupus, Fetal hydantoin syndrome
Steve Jobs made APPLE PCS
drugs that cause Stevens-Johnson syndrome
Allopurinol, Phenytoin, Phenobarbital, Lamotrigine, Ethosuximide, PCN, Carbamazepine, Sulfonamides
BALSA
tx of PD
Bromocriptine, Amantadine, Levodopa/carbidopa, Selegiline, Benztropine
mature adults wear a SASH
mature ego defenses
Sublimation, Altruism, Suppression, Humor
DIG FAST
sx of manic episode
Distractability, Irresponsibility, Grandiosity, Flight of ideas, increase in goal-directed Activity/psychomotor Agitation, decreased need for Sleep, Talkativeness or pressured speech
SIGECAPS or DIGS CAPES
sx of MDD
Depressed mood, loss of Interest (anhedonia), Guilt or feelings of worthlessness, Sleep disturbances, Concentration problems, Appetite/weight changes, Psychomotor retardation or agitation, Energy loss or fatigue, Suicidal ideation
must have depressed mood or anhedonia to qualify for MDD
SAD PERSONS are more likely to complete suicide
Sex (male), Age (teenager or elderly), Depression, Previous attempt (single most important determining factor), Ethanol or drug use, loss of Rational thinking, Sickness (medical illness, 3 or more scripts), Organized plan, No spouse (divorced, widowed, or single, especially if childless), Social support lacking
access to firearms/weapons important, too
PANICS
sx of panic attacks
Palpitations, Paresthesias, Abdominal distress, Nausea, Intense fear of dying or losing control, lIght-headedness, Chest pain, Chills, Choking, disConnectedness, Sweating, Shaking, Shortness of breath
FEVER
sx of neuroleptic malignant syndrome
Fever, Encephalopathy, Vitals unstable, Enzymes elevated, Rigidity of muscles
3 Cs of TCAs
Cardiotoxicity (arrhythmias), CNS toxicity (convulsions, coma), antiCholinergic effects
MAO Takes Pride In Red Shanghai
MAOIs
Tranylcypromine, Phenelzine, Isocarboxazid, Rasagiline (MAO-B selective), Selegiline (MAO-B selective)
POTTER
things Potter sequence is associated w/ Pulmonary hypoplasia (cause of death), Oligohydramnios (trigger), Twisted face, Twisted Skin, Extremity defects, Renal failure (in utero)
60-40-20 rule
%age of body weight for average person
60% total body water, 40% ICF, 20% ECF (75% interstitial fluid, 25% plasma)
the kidneys put out FABulous Glittering LiquidS
renal tubular defects (in order!) FAnconi syndrome (PCT), Bartter syndrome (thick ascending loop), Gitelman syndrome (DCT), Liddle syndrome (collecting tubule), Syndrome of apparent mineralocorticoid excess (collecting tubule)
pt w/ hyperkalemia? DO LABS
causes of hyperkalemia (shift K+ OUT of cells)
Digitalis (blocks Na+/K+ ATPase), hyperOsmolarity, Lysis of cells, Acidosis, Beta-blockers, high blood Sugar (insulin deficiency)
(causes of hypokalemia are essentially the opposites; insulin shifts K+ INto cells)
MUDPILES
causes of high anion gap metabolic acidosis (adding acid)
Methanol (formic acid), Uremia, DKA, Propylene glycol, Iron/INH, Lactic acidosis, Ethylene glycol (oxalic acid), Salicylates (late)
HARD-ASS
causes of normal anion gap metabolic acidosis (losing bicarb)
Hyperalimentation, Addison dz, Renal tubular acidosis, Diarrhea, Acetazolamide, Spironolactone, Saline infusion
can’t see, can’t pee, can’t hear a buzzing bee
Alport syndrome (ab against collagen IV, alpha5 subunit)
FEAR the drug-induced interstitial nephritis!
sx of drug-induced interstitial nephritis
Fever, Eosinophilia, Azotemia, Rash
MAD HUNGER
consequences of renal failure
Metabolic Acidosis, Dyslipidemia (hypertriglyceridemia), Hyperkalemia, Uremia, Na+/H2O retention, Growth retardation and developmental delay, EPO failure, Renal osteodystrophy
OH DANG!
ADRs of loop diuretics
Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout
hyperGLUC
ADRs of thiazide diuretics
hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia
captopril’s CATCH
ADRs of ACEIs
Cough (increased bradykinin), Angioedema, Teratogen (fetal renal and cardiac malformations), increased Creatinine, Hyperkalemia/Hypotension
TENitalia
genitalia recognizable on fetus by 10 weeks
MAGIC COPS
derivatives of neural crest
Melanocytes, Aorticopulmonary septum, Ganglia, Iris stroma, Chromaffin cells, CNS, Odontoblasts/Ossicles, Parafollicular “c” cells, Sclerae
VACTERL
mesodermal defects
Vertebral defects, Anal atresia, Cardiac defects, Tracheo-Esophageal fistula, Renal defects, Limb defects (bone and muscle)
ears, tonsils, bottom-to-top
branchial pouch derivatives in order!
1: ear
2: tonsils
3: dorsal (bottom for inferior parathyroids), ventral (to = thymus)
4: top (superior parathyroids)
Point and Shoot!
autonomic innervation of male sexual response
erection: parasympathetic (pelvic nerve)
emission: sympathetic (hypogastric nerve)
ejaculation: visceral and somatic nerves (pudendal nerve)
Menopause Sx wreak HAVOC
sx of menopause
Mood changes, Sleep disturbances, Hot flashes, Atrophy of vagina, Vaginal dryness, Osteoporosis, Coronary artery dz
Serous Epithelial Malignancies are Clearly Bad
types of surface epithelial tumors of the ovary
Serous, Endometrioid, Mucinous, Clear cell, Brenner
high malignant potential
STACKED
drugs that cause gynecomastia
Spironolactone, THC, Alcohol, Cimetidine, Ketoconazole, Estrogens, Digoxin
Eradicate Ball Cancer
common tx regimen for testicular cancer
Etoposide, Bleomycin, Cisplatin
can substitute ifosfamide for bleomycin
RALS
relation of pulmonary artery to bronchus at each lung hilum
R: Anterior
L: Superior
I ate 10 eggs at 12
structures perforating diaphragm (and levels)
T8: IVC
T10: Esophagus, vagus nerve (CN X)
T12: Aorta, Azygos vein, thoracic duct
*bonus! At T-1-2 it’s the red, white, and blue
bifourcations
common carotid: C4
trachea: T4
abdominal aorta: L4
CADET, face Right
things that cause a right shift of hemoglobin dissociation curve
increased CO2, Acid (H+/Cl-)/Altitude, 2,3-DPG, Exercise, Temperature