Internal Medicine Mnemonics

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 NM disorders)
Hypoglycaemia: causes !"o# to EP!AIN hypoglycemia!:
Eogenous drugs (insulin, oral hypoglycemics, alcohol, pentamidine,
$uinine, $uinolones)
Pituitary insufficency (no %" or cortisol)
!iver failure (no glycogen stores)
Adrenal failure (no cortisol)
Insulinomas& Immune hypoglycemia
Non'pancreatic neoplasms (retroperitoneal sarcoma)
Ast"ma: precipitating factors for acute attack #IP!OMAT:
#rugs (aspirin, N()I*s, beta bloc+ers, etc)
Infections (,-TI&.-TI)
Pollutants (at home, at #or+)
!aughter(emotion)
Oesophageal reflux (nocturnal asthma)
Mites
Activity and exercise
Temperature (cold)
Hypernatremia: causes / *0s:
#iuretics
#ehydration
#iabetes insipidus
#ocs (iatrogenic)
#iarrhea
#isease: +idney, sic+le cell, etc
$yanosis: ##% $O!# PA!MS:
1 2eripheral cyanosis:
$old
Obstruction
!V3 and shoc+
#ecreased cardiac output
1 4entral cyanosis:
Polycythemia
Altitude
!ung d5
Met', sulphaemoglobinaemia
Shunt
!ymp"oma: staging of &'cell $!! (RAI) !OATh
I: !ymphadenopathy
II: Organomegaly (splenomegaly)
III: Anemia
IV: Thrombocytopenia
Strep t"roat score NO *A$E:
NO cough: no cough is 67
*ever: has fever is 67
Age: less than 8 years is '7, 78'98 years is :, greater than 98 years is
67
$ervical nodes: cervical nodes palpable is 67
Exudate: tonsillar exudate is 67
1 (coring interpretation:
(core :'7: no strep throat;
(core 7'<: possible strep throat, do a s#ab test;
(core 9'8: strep throat is li+ely, so treat empirically;
*all: differential I SA+E# PAN,S:
Illness
Syncope
Accident
+ision
Epilepsy (or other fit)
#rugs
Psychiatric (eg dementia)
Anaemia
Neurological (2ar+insons, cerebellar, neuropathy)
,lucose (hypoglycemia)
Stro+e
Pleural effusion: in-estigations P!E.RA:
Pleural fluid (thoracentesis)
!ung, pleural biopsy
E(-
.ltrasound
Radiogram
Analysis of blood
$"ronic coug": full differential ,ASPS AN# $O.,H:
,=-*
Asthma
Smo+ing, chronic bronchitis
Post'infection
Sinusitis, post'nasal drip
A4> inhibitor
Neoplasm
#iverticulum
$ongestive heart failure
Outer ear
.pper air#ay obstruction
,I'air#ay fistula
Hypersensitivity
#yspnea: causes SHE PANTS:
Stress, anxiety
Heart disease
Emboli
Pulmonary disease
Anaemia
Neuromuscular disease
Trachea obstruction
Sleep disorder
Haemoptysis: causes $A+ITATES:
$"3
Air#ay disease, bronchiectasis
+asculitis& +ascular malformations
Infection (eg T?)
Trauma
Anticoagulation
Tumour
Embolism
Stomach
/"ee0ing: causes ASTHMA:
Asthma
Small air#ays disease
Tracheal obstruction
Heart failure
Mastocytosis or carcinoid
Anaphylaxis or allergy
Splenomegaly: causes HI$$.PS:
Haematological
Infective : @ala a5ar, malaria, enteric fever
$ongestive: 443, constrictive pericarditis, IV4 thrombosis, "epatic vein
thrombosis, portal vein thrombosis and splenic vein thrombosis
$ollagen diseases: (.>, 3elty0s syndrome
.n+no#n etiology: tropical splenomegaly
Primary malignacies (secondaries are rare)
Storage diseases: %aucher0s disease, Niemman 2ic+
Anion gap meta1olic acidosis: causes M.#PI!ES:
Methanol
.remia
#iabetic +etoacidosis
Paraldehyde
Infection
!actic acidosis
Ethylene glycol
Salicylates
$arcinoid syndrome: features *A$A#E:
*lushing
Asthma
$or pulmonale
Ascites
#iarrhoea
Endocardial fibrosis
T"romocytopenia: causes SHAPIRO:
Splenectomy
Hodg+in0s disease
Arteritis
Polycythemia
Infection
Rheumatoid
Occult malignancy
#ialysis indications HA+E PEE:
Hyper+alemia (refractory)
Acidosis (refractory)
+olume overload
Elevated ?,N (A </ mM)
Pericarditis
Encephalopathy
Edema (pulmonary)
S!E: factors t"at make S!E acti-e .+ PRISM:
.+ (sunshine)
Pregnancy
Reduced drug (eg steroid)
Infection
Stress
More drug
Pruritus 2it"out ras": ##% IT$HIN, #:
Infections (scabies, toxocariasis, etc)
Thyroidal and other endocrinopathies (eg diabetes mellitus)
$ancer
Hematologic diseases (eg iron deficiency)& Hepatopathies& HIV
Idiopathic
Neurotic
,ravid (pruritus of pregancy)
#rugs
ecretory dysfunctions (eg uremia)
Horner3s syndrome: components SAMP!E:
Sympathetic chain inBury
Anhidrosis
Miosis
Ptosis
!oss of ciliospinal reflex
Enophthalmos
$aplan syndrome: c"aracteristics $APlan:
$oal #or+er pneumoconiosis
Arthritis
Pulmonary nodule
Anemia: non'megalo1lastic causes of macrocytic anemia
HAN# !AMP:
Hypothyroidism
Aplastic anaemia
Neonates
#rugs
!iver disease
Alcohol
Myelodyplasia
Pregnancy
Acromegaly symptoms A&$#E*:
Arthralgia& Arthritis
&lood pressure raised
$arpal tunnel syndrome
#iabetes
Enlargemed organs
*ield defect
NSAI#s: contraindications NSAI#:
Nursing and pregnancy
Serious bleeding
Allergy& Asthma& Angioedema
Impaired renal function
#rug (anticoagulant)
A$EI: contraindictions PAR4:
Pregnancy
Allergy
Renal artery stenosis
4increase (hyper+alemia)
Pressure Sore: Norton Score MA,I$:
Mobility
A*.
,eneral condition
Incontinence
$onscious level
&e"cet3s syndrome: diagnostic criteria PROSE:
Pathergy test (i&d saline inBection)
Recurrent genital ulceration
Oral ulceration (recurrent)
S+in lesions
Eye lesions
1 =ral ulceration is central criteria, plus any C others;
Meta1olic acidosis: causes 4.SSMA!:
4etoacidosis
.raemia
Sepsis
Salicylates
Methanol
Alcohol
!actic acidosis
Allopurinol: indications STORE:
Stones (history of renal stones)
Tophaceous gout (chronic)
Over'producers of urate
Renal disease
Elderly
1 ?onus: 2robenecid indications are basically the opposite of (T=-> (no renal
stone history, etc;);
Raynaud3s disease: causes &A# $T:
&lood disorders (eg polycythaemia)
Arterial (eg atherosclerosis, ?uerger0s)
#rugs (eg beta'bloc+ers)
$onnective tissue disorders (rheumatoid arthritis, (.>)
Traumatic (eg vibration inBury)
!ead poisoning (c"ronic): features A&$#E*,HI:
Anaemia& Anorexia& Arthralgia& Abortion& Atrophy
of optic nerve
&asophilic stippling of -?4 (punctate basophilia)& &urtonian line
on gums
$olic& $onstipation& $oprophyrin excess in urine& $erebraloedema
#rop (#rist, foot)
Encephalopathy& Emaciation
*oul smell of breath& *ailure of +idneys& *anconi syndrome
,onadal dysfunction& ,out'li+e picture
High ?2& Headache& Hallucination& Hyperaesthesia
Impotence& Insomnia& Irritability
Splenomegaly: causes $HI$A,O:
$ancer
Hem, onc
Infection
$ongestion (portal hypertension)
Autoimmune (-), (.>)
,lycogen storage disorders
Other (amyloidosis)
SIA#H: causes SIA#H:
Surgery
Intracranial: infection, head inBury, 4V)
Alveolar: 4a, pus
#rugs: opiates,antiepileptics, cytotoxics, anti'psychotics
Hormonal: hypothyroid, lo# corticosteroid level
Ileus: causes M# SP.,ERS:
Mesenteric ischemia
#rugs (see belo#)
Surgical (post'op)
Peritonitis& Pancreatitis (sentinnel loop)
.nresolved mechanical obstruction (eg mass, intussusception, bloc+age)
,ram negative sepsis
Electrolyte imbalance (eg hypo+alemia)
Retroperitoneal bleed or hematoma
Spinal or pelvic fracture
1 *rugs are )luminum hydroxide, ?a66, 4a carbonate, opiates, T4), verapamil;
.lcers: types +AN:
+enous& +asculitic
Arterial
Neuropathic
Pulmonary fi1rosis: causes S$AR:
1 ,pper lobe:
Silicosis& Sarcoidosis
$oal #or+er pneumonconiosis
An+ylosing spondylitis
Radiation
1 .o#er lobe:
Systemic sclerosis
$yptogenic fibrosing alveolitis
Asbetosis
Rheumatoid arthritis
T"yroid storm: initial management P$P3S:
PT, ' 7 gm po
$orticosteroids
Propranolol
S(@I
Renal failure (acute): management Manage AEIO.:
Anemia& Acidosis
Electrolyte and fluids
Infections
Other measures (eg nutrition, nausea, vomiting
.remia
Non'gap acidosis: causes HAR# .P:
Hyperalimentation
Aceta5olamide (carbonic anhydrase inhibitors)
RT)
#iarrhea
.reterosigmoidostomy
Pancreatic fistula
Hemoptysis: causes HEMOPT5SIS:
Haemorrhagic diathesis
Edema D.V3 due to mitral stenosisE
Malignancy
Others Deg: vasculitisE
Pulmonary vascular abnormalities
Trauma
5our treatment DanticoagulantsE
S.>
Infarction in lungs
Septic
A1dominal pain: medical causes !A&#OMENA! PANE!
Dabdominal painE:
Acute rheumatic fever
&lood Dpurpura, a&c hemolytic crisisE
#@)
cOllagen vascular disease
Migraine Dabdominal migraineE
Epilepsy Dabdominal epilepsyE
Nephron DuremiaE
Abdominal angina
!ead
Porphyria
Arsenic
N()I*0s
Enteric fever
Haemo1ilia: features MO&:
Melaena
Obstructive Baundice
&iliary colic
T"ickened ner-es: causes HAN#S:
Hansen0s (leprosy)
Amyloidosis
Neurofibromatosis
#iabetes mellitus
Sarcoidosis
SIA#H: ma6or signs and symptoms SIA#H:
Spasms
Isn0t any pitting edema (+ey **x)
Anorexia
#isorientation (and other psychoses)
Hyponatremia
To%icity7 sepsis: signs / T0s:
Tachycardia
Tachypnea
Tremors
Toxic loo+
Tiredness
Temperature (fever)
Macrocytic anemia: causes A&$#E*:
Alcohol 6 liver disease
&7C deficiency
$ompensatory reticulocytosis (blood loss and hemolysis)
#rug (cytotoxic and )FT)& #ysplasia (marro# problems)
Endocrine (hypothyroidism)
*olate deficieny& *etus (pregnancy)
Respiratory disease: "and signs $ASH:
$lubbing
Asterixis
Small muscle #asting
H2=)
$lu11ing: respiratory causes A&$#E*:
Abcess (lung)
&ronchiectasis (including 43)
$ancer (lung)
#ecreased oxygen (hypoxia)
Empyaema
*ibrosing alveolitis
Pulmonary edema: treatments MA# #O,:
Morphine
)minophylline
#igitalis
#iuretics
Oxygen
,%ases in blood ()?%0s)
Hypercalcemia: causes ,RIM *E#:
,ranulomas (sarcoid, T?),
Renal faliure
Immobility (esp; long term)
Malignancy
*amilial (eg familial hypocalciuric hypercalcemia)
Endocrine (see belo# for subtypes)
#rugs (esp; thia5ide diuretics, lithium)
1 >ndocrine causes are PATH:
Phaeochromocytoma
Addison0s disease
Thyrotoxicosis
Hyperparathyroidism
Acute stridor: differential A&$#E*,H:
1 Gith fever:
Abscess
&acterial tracheitis
$roup
#iphtheria
Epiglottitis
1 Githout fever:
*oreign body
,as (Toxic %as)
Hypersensitivity
Hypercalcemia: differential +ITAMIN TRAPS:
+itamin ) and * intoxication
Immobili5ation
Thyrotoxicosis
Addison0s disease& Acidosis
Mil+'al+ali syndrome
Inflammatory disorders
Neoplastic disease
Thia5ides, other drugs
Rhabdomyolysis
AI*(
Paget0s disease& Parenteral nutrition& Parathyroid disease
Sarcoidosis
Meta1olic acidosis: causes .SE# $AR:
.reteroenterostomy
Saline hydration
Endocrinopathies (hyperparathyroid, hyperthyroid, )ddison0s)
#iarrhea& #@)& #rugs
$arbonic anhydrase inhibitors
Ammonium chloride
Renal tubular acidosis
1 )lternatively: .SE# $ARP, to include Parenteral nutrition& Pancreatic
fistula;
Pulmonary edema: treatment !MNOP:
!asix
Morphine
Nitrates (NT%)
Oxygen
Position (upright vs; flat)
Eosinop"ilia: differential NAA$P:
Neoplasm
Allergy& Asthma
Addison0s disease
$ollagen vascular diseases
Parasites
SIA#H: diagnostic sign (yndrome of INAPPropriate
)nti'*iuretic "ormone:
Increased
Na (sodium)
PP (urine)
1 (I)*" is characteri5ed by increased urinary sodium;
Polycyt"emia Ru1ra +era (PR+): common symptoms PR+:
Plethora& Pruritis
Ringing in ears
+isual blurriness
Ras"es: time of appearance after fe-er onset !Really
Sic+ $hildren Must Ta+e No Exercise!:
1 Number of days after fever onset that a rash #ill appear:
7 *ay: Rubella
C *ays: Scarlet fever& Smallpox
< *ays: $hic+enpox
9 *ays: Measles (and see the @opli+ spots one day prior to rash)
8 *ays: Typhus H ric+ettsia (this is variable)
/ *ays: Nothing
I *ays: Enteric fever (salmonella)
Anion gap meta1olic acidosis: causes A M.#PI!E $AT:
Alcohol
Methanol
.remia
#iabetic +etoacidosis
Paraldehyde
Iron& Isonia5id
!actic acidosis
Ethylene glycol
$arbama5epine
Aspirin
Toluene
&ronc"iectasis: causes A SI$4 AIR/A5:
Air#ay lesion, chronic obstruction
Se$uestration
Infection, inflamation
$ystic fibrosis
4artagners syndrome
Allergic brochopulmonary aspergilliosis
Immunodeficiencies (hypogammaglobinaemia, myeloma, lymphoma)
Reflux, inhalation inBury
/illiam 4ampbell syndrome (and other congenitals)
Aspiration
5ello# nail syndrome& 5oung syndrome
Alkalosis: meta1olic c"anges in alkalosis !)l'4'loss,
)l'$a'loss!:
There is loss of 48 (hypo+alemia) and $a88 (hypocalcemia) in state
of al+alosis;
H1A9: concentration in normal 1lood "b)9:
4oncentration of "b)C is 9J in normal adult blood;
#ucket :o"n3s: ma6or criteria A$NES:
Arthritis
$arditis
Nodule (subcutaneous)
Erythrema marginatum
Sydenham chorea
I$. management: A to ; A: )sepsis& )ir#ay
&: ?ed sore& encourage ?reathing& ?lood pressure
$: 4irculation& encourage 4oughing& 4onsciousness
#: *rains
E: >4%
*: 3luid status
,: %I losses& %ag reflex
H: "ead positioning& "eight
I: Insensible losses
:: ugular venous pulse
4: @indness
!: .imb care& .abel
M: Mouth care
N: Nociception& Nutrition
O: =xygenation& =rient the patient
P: 2ulse& 2eristalsis& 2hysiotherapy
<: Kuiet surroundings
R: -espiratory rate& -estraint
S: (tress ulcer& (uctioning
T: Temperature
.: ,rine
+: Ventilator
/: Gounds& Geight
: Lerosis
5: #hM
;: Festful care of the patient
Hypercalcemia causes M# PIMPS ME:
Malignancy
#iuretics (thia5ide the main culprit)
Parathyroid (hyperparathyroidism)
Immobili5ation& Idiopathic
Megadoses of vitamins ),*
Paget0s disease
Sarcoidosis
Mil+ al+ali syndrome
Endocrine ()ddison0s disease, thyrotoxicosis)
!eft iliac fossa: causes of pain S.PER $!OT:
Sigmoid diverticulitis
.teric colic
PI*
Ectopic pregnancy
Rectus sheath haematoma
$olorectal carcinoma
!eft sided lo#er love pneumonia
Ovarian cyst (rupture, torture)
Threatened abortion& Testicular torsion
Pancytopaenia differential !All Of My
&lood Has Ta+en Some Poison!:
Aplastic anaemias
Over#helming sepsis
Megaloblastic anaemias
&one marro# infiltration
Hypersplenism
T?
S.>
Paroxysmal nocturnal haemoglobinuria
Haematology: key num1ers = and > are +ey in in
haematology:
7;=> cm< of oxygen is carried by a gram of hemoglobin;
There0s =;>mg of iron in each gram of hemoglobin;
There0s an average of =;> lobes per neutrophil;
There0s =>mg bilirubin from each gram of hemoglobin;
&ack trou1le causes O? +ERSA!I.S (Versalius #as the
name of a famous physician):
Osteomyelitis
+ertebral fracture
Extraspinal tumour
Spondylolisthesis
An+ylosing spondylitis
!umbar dis+ increase
Intraspinal tumor
.nhappiness
Stress
Sports in6uries: course of action RI$E:
Rest
Ice
$ompression
Elevation
1 -I4> especially for fractures, sprains, muscle strains, contusions
1 )lternatively: INImmobili5ation, 4N$old compresses;
&ack pain causes #IS4 MASS (since near vertebral
disc):
#egeneration (**, osteoporosis, spondylosis)
Infection (,TI, 2I*, 2ott0s disease, osteomyelitis, prostatitis)& InBury,
fracture or compression fracture
Spondylitis (an+ylosing spondyloarthropathies such as rheumatoid
arthritis, -eiters, (.>)
4idney (stones, infarction, infection)
Multiple myeloma& Metastasis (from cancers of breast, +idney,
lung, prostate, thyroid)
Abdominal pain (referred to the bac+)& Aneurysm
S+in (herpes 5oster)& Strain& Scoliosis and lordosis
Slipped dis+& Spondylolisthesis
&ronc"iectasis: differential &RON$HIE$TASIS:
&ronchial cyst
Repeated gastric acid aspiration
Or due to foreign bodies
Necroti5ing pneumonia
$hemical corrosive substances
Hypogammaglobulinemia
Immotile cilia syndrome
Eosinophilia (pulmonary)
$ystic fibrosis
Tuberculosis (primary)
Atopic bronchial asthma
Streptococcal pneumonia
In Moung0s syndrome
Staphylococcal pneumonia
Sickle cell disease complications SI$4!E:
Stro+es& S#elling of hands and feet& Spleen problems
Infections& Infarctions
$rises (painful, se$uestration, aplastic)& $holelithiasis& $hest
syndrome& $hronic hemolysis& $ardiac problems
4idney disease
!iver disease& !ung problems
Erection (priapism)& Eye problems (retinopathy)
A#P: role in platelet aggregation A#P N Aggregation
from the #ense bodies of Platelets;
,ynecomastia: common causes ,5NE$OMASTIA:
,enetic ,ender disorder (@linefelter)
5oung boy (pubertal)O
NeonateO
Estrogen
$irrhosis& $imetidine& $a $hannel bloc+ers
Old ageO
MariBuana
Alcoholism
Spironolactone
Tumors (Testicular H adrenal)
Isonia5id& Inhibition of testosterone
Antineoplastics (Al+ylating Agents)& Antifungal(+etocona5ole)
1 O )steris+ indicates physiologic cause;
!et"argy? malaise causes *ATI,.E#:
*at& *ood (poor diet)
Anemia
Tumor
Infection ("IV, endocarditis)
,eneral Boint or liver disease
.remia
Endocrine ()ddison0s, myxedema)
#iabetes& #epression& #rugs