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 مهم جدا قبل امتحانات الشفوي mnimonics in medicine :part I

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كاتب الموضوعرسالة
dr saad

عدد المساهمات : 176
تاريخ التسجيل : 12/12/2010
العمر : 37
الموقع : http://medsurgery.ba7r.org

مُساهمةموضوع: مهم جدا قبل امتحانات الشفوي mnimonics in medicine :part I   السبت 03 سبتمبر 2011, 15:47

This document contains mnemonics on the following topics:




















Full Medical History

When taking a history:

Mnemonic: OPERATES

O Onset of complaint

P Progress of complaint

E Exacerbating factors

R Relieving factors

A Associated symptoms

T Timing

E Episodes of being symptom-free

S Relevant Systemic and general inquiry can be added here


Mnemonic: PILLS

P Pills, is the patient taking any?

I Injections/Insulin/Inhalers (as some patients forget to mention when asked

about their medications)

LL ILLicit drug use

S Sensitivities to anything, ie allergies

In every history, donʼt forget to ask about the ʻFAWRʼ non-specific symptoms that the

patient may exhibit

Mnemonic: FAWR

F Fever

A Appetite

W Weight loss (unintentional)

R Reduced energy (i.e. fatigue/lethargy)

When assessing psychological state:

Mnemonic: SAD CASE

S Suicidal ideations

A Anxiety

D Decreased mood/Delusions/Disordered thought

C Difficulty Concentrating

A Auditory or other hallucinations?

S Difficulties Sleeping

E Eating normally?

Information organization

When asked to discuss a particular disease, the following surgical sieve is widely

regarded as the best way to proceed:

Mnemonic: Dressed In a Surgeons Gown A Physician Might Make Progress

D Definition

I Incidence

S Sex

G Geography

A Aetiology

P Pathogenesis

M Macroscopic pathology

M Microscopic pathology

P Prognosis



To remember heart valve auscultation sites:

Mnemonic: All Patients Take Medications

Starting from top left:

Aortic – 2nd intercostal space, right sternal edge

Pulmonary – 2nd intercostal space, left sternal edge

Tricuspid – 4th intercostal space, right sternal edge

Mitral – 5th intercostal space, mid-clavicular line


Management through lifestyle alterations

Mnemonic: SLEW

S Smoking cessation

L Low-fat diet

E Exercise

W Weight loss

Management of acute unstable angina

Mnemonic: 2 As and BALI

A Admit, bed rest, high-flow oxygen

A Analgesia

A Aspirin and clopidogrel

B Beta blockers

A Angiography with or without angioplasty/CABG if symptoms fail to improve

L Low molecular weight heparin (LMWH)

I Infusion of nitrates


Mnemonic: SCAR

S Sudden central pain, ʻtearingʼ in nature, may radiate to the back

C Coronary artery occlusion can lead to chest pain, MI or angina

pectoris/Carotid obstruction can lead to hemiparesis, dysphasia or blackouts

A Anterior spinal artery can be affected leading to paraplegia

R Renal artery can be affected leading to anuria or renal failure

Cardiac arrest

Management, Basic Life Support (BLS)

Mnemonic: ABC

A Airway: clear and maintain with chin lift/jaw thrust/head tilt (if no spinal injury)

B Breathing: look, listen and feel, if not breathing give two life saving breaths


C Circulation: carotid pulse for at least 10 s, if absent give 15 chest

compressions at 100/min

Continue the cycle of 2 breaths and 30 compressions and check the circulation every

minute, proceed to more advanced life support when possible.

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



Mnemonic: ABCD

A ACE inhibitors/Angiotensin-II-anta

gonists (sometimes Alpha-agonists also)

B Beta blockers

C Calcium channel blockers

D Diuretics (Thiazides)



Aspirin overdose – early symptoms

Mnemonic: DAFT HID

D Deafness

A Appear flushed

F Fever

T Tinnitus

H Hyperventilation

I Increased sweating

D Dizziness

Metabolic acidosis


Mnemonic: UK SLAMS

U Uraemia

K Ketoacidosis

S Salicylates

L Lactic acidosis

A Alcohol

M Methanol

S Sepsis


Paracetamol overdose – (the most common intentional drug overdose in the UK).

Risk factors

Mnemonic: COMAH

C Chronic alcohol abusers

O On drugs that increase cytochrome P450 activity, anti-TB drugs

M Malnourished individuals

A Anorexic patients

H HIV patients



Functions of the skin

Mnemonic: SKIN

S Specialised sensory innervation/Synthesise Vitamin D/Secretes pheromones

for Sex

K Keeps out unwanted molecules, microbes or radiation/Keeps in water,

electrolytes and solutes

I Immunological function; contains antigen-presenting cells

N Normalises heat regulation

Common allergens for allergic contact dermatitis

Mnemonic: CONTACT

C Cutaneous type IV reaction

O Ointments and cosmetics containing lanolin

N Nickel

T Topical antibiotics can cause it (e.g. neomycin)

A Autosensitisation can occur (secondary spread elsewhere)

C Chromates (cement, leather)/Colophony (plasters, glues, inks)

T Topical antihistamines and topical anaesthetics (haemorrhoid creams) can

cause it


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

Squamous cell carcinoma

Clinical presentation

Mnemonic: S, CELL, C

S Sun-exposed areas are usually affected: ears, dorsum of the hands, bald


C Crusted, firm, irregular lesion

E Excision used as treatment

L Lower lip can be affected in smokers

L Less likely to metastasise

C Associated with Chronic inflammation such as venous leg ulcers


Thyroid gland

Symptoms of hypothyroidism

Hypothyroidism is 10 times more common in females & occurs mainly in middle life.

Mnemonic: MOMʼS SO TIRED

M Memory loss

O Obesity

M Malar flush/Menorrhagia

S Slowness

S Skin and hair become dry

O Onset is gradual

T Tired

I Intolerance to cold

R Raised blood pressure

E Energy levels are low

D Depressed

Symptoms of hyperthyroidism

Mnemonic: SWEATING

S Sweating

W Weight loss

E Emotional lability

A Appetite is increased

T Tremor/Tachycardia due to AF

I Intolerance to heat/Irregular menstruation/Irritability

N Nervousness

G Goitre and Gastrointestinal problems (loose stools/diarrhoea)

Adrenal glands

Causes of Addisonʼs Disease

Mnemonic: ADDISON

A Autoimmune (90% cases)

D Degenerative (amyloid)

D Drugs (ketoconazole)

I Infections (TB, HIV)

S Secondary (low ACTH); hypopituitarism

O Others – adrenal bleeding

N Neoplasia (secondary carcinoma)


Complications of diabetes mellitus

Mnemonic: KEVINS

K Kidney: Nephropathy

E Eye disease: retinopathy and cataracts

V Vascular: coronary artery disease, cerebrovascular disease, peripheral

vascular disease

I Infective: TB, recurrent UTIs

N Neuromuscular; Peripheral neuropathy

S Skin: Necrobiosis lipoidica diabeticorum, granuloma annulare, diabetic



Abdomen distension


Mnemonic: 6 Fʼs

F Fat

F Fetus

F Flatus

F Faeces

F Fluid

F Flipping great tumour

Chronic liver disease



A Asterixis (ʻliver flapʼ)/Ascites/Ankle oedema/Atrophy of testicles

B Bruising/BP.

C Clubbing/Colour change of nails; white (leuconychia)

D Dupuytrenʼs contracture

E Erythema (palmar)/Encephalopathy

F hepatic Foetor

G Gynaecomastia

H Hepato splenomegaly

I Increase in size of parotids

J Jaundice

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

Complications of ulcerative colitis

Mnemonic: How To Perform GI Colonoscopy

H Haemorrhage

T Toxic megacolon

P Perforation

G Gallstones

C Colorectal carcinoma (in those with extensive disease for > 10 years)

Morphology and symptoms of Crohnʼs disease

Mnemonic: CHRIS Has Too Much Diarrhoea and Abdominal pain

C Cobblestone appearance of mucosa

H High temperature

R Reduced lumen/Rose-thorn ulcers

I Intestinal fistulae/Ileo-caecal region commonly involved (40% of cases)

S Skip lesions

H Hyperplasia of mesenteric lymph nodes

T Transmural inflammation (all layers, may ulcerate)

M Malabsorption

D Diarrhoea (watery)

A Abdominal pain


Sickle cell disease


Mnemonic: SICKLE

S Splenomegaly/Sludging

I Infection

C Cholelithiasis

K Kidney – haematuria

L Liver congestion/Leg ulcers

E Eye changes


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




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

Immune thromobocytopenic purpura (ITP)


Mnemonic: MAID

M Malignancy

A Autoimmune diseases: SLE, thyroid disease, RA

I Infections: malaria, EBV, HIV/Idiopathic (commonest cause)

D Drugs, e.g. quinine


Mnemonic: BBC

B Bruising

B Bleeding: mucosal and nasal

C Cycles heavy; menorrhagia




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


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


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


Groups at high risk of developing infection

Mnemonic: HIV

H Homosexuals (note the rising incidence in Heterosexuals too)/Haemophiliacs

IV IV drug abusers



Cranial bones

Mnemonic: PEST OF 6

P Parietal

E Ethmoidal

S Sphenoid

T Temporal

O Occipital

F Frontal

6 This indicates the number of bones

Branches of the facial nerve

Mnemonic: To Zanzibar By Motorcar

T Temporal nerve

Z Zygomatic nerve

B Buccal nerve

M Marginal mandibular nerve

C Cervical nerve

Clinical conditions

Stroke – investigations

Mnemonic: The 4 Ps

P Plasma: FBC, U&E, ESR, glucose, lipids

P Pump, i.e heart (ECG, echocardiogram)

P Pipes: carotid Doppler ultrasound

P Picture of brain: CT/MRI; detects ischaemia or haemorrhages

Stroke – management


A Advice – lifestyle changes e.g. stop smoking, reduce alcohol intake, lose


B BP control

C Cholesterol control

D Diabetes control

E Elastic stockings (prophylaxis for DVT, PE)

F Fibrillation (anticoagulate, rate control and cardiovert as required)

G Guardian drugs (aspirin, ACE inhibitors, etc)

H Help from occupational therapy (OT), speech and language therapy (SALT)

and specialist stroke nurse

I Incontinence care and limit Immobility (pressure sores and contractures may

develop otherwise)


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

Aetiology - Viral

Mnemonic: V MECH


M Mumps

E Enterovirus/EBV

C Coxsackie virus types A and B

H Haemophilus influenzae/HIV/HSV

Aetiology - Fungal

Mnemonic: 2 Cʼs

C Cryptococcus (associated with HIV infection)

C Candida



Mnemonic: EAT FUN

E Episodic

A Aura – zigzag lines

T Throbbing headache

F Family history/F(p)hoto-phobia

U Unilateral

N Nausea and vomitin
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مهم جدا قبل امتحانات الشفوي mnimonics in medicine :part I
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