Mnemonics and triads and buzz words from USMLE

Signs of a MCA stroke: Mnemonic: MCA stroke can cause CHANGes

C-contralateral paresis and sensory loss in face and arm H- homonymous hemianopia A- aphasia (dominant) N- neglect (nondominant) G-gaze preference toward side of lesion

What cranial nerve sign is associated with berry aneurysms?

CN III with pupillary involvement

What does CREST syndrome consist of?

Calcinosis Raynaud's phenomenon Esophageal dysmotility Sclerodactyly Telangiectasia

What condition is the BRC-ABL translocation due to t(9,22) of the Philadelphia chromosome associated with?

Chronic Myelogenous Leukaemia

what are smudge cells associated with?

Chronic lymphocytic leukaemia (CLL) due to fragile leukaemia cells being crushed by coverslip

What is charcot's triad?

Classic triad of MS: scanning speech, intranuclear ophthalmoplegia, and nystagmus

What are the classic radiographic findings in Osteosarcoma?

Codman's triangle: periosteal new-bone formation at the diaphyseal end of the bone lesion Sunburst pattern of osteosarcoma

Causes of pericarditis Mnemonic CARDIAC RIND

Collagen vascular disease Aortic dissection Radiation Drugs Infections Acute renal failure Cardiac (MI) Rheumatic fever Injury Neoplasms Dressler's syndrome

What does B12 deficiency lead to?

Combined systems disease. Subacute degeneration of the posterior and lateral columns of the spinal cord and peripheral neuropathy.

TCAs toxicity: Tri-Cs

Convulsions Coma Cardiac arrhythmias

Bleeding episodes in Mild haemophilia and vonWillebrand's disease can be treated with what agent?

Desmopressin, helps the body to release extra factor VIII

4 deadly Ds of posterior circulation stroke:

Diplopia Dizziness Dysphagia Dysarthria

Symptoms of mania DIG FAST

Distractibility Insomnia (decreased need for sleep) Grandiosity Flight of ideas Agitation (psychomotor) Sexual indiscretions Talkativeness (pressured speech)

What is the classic triad of symptoms in Wernicke's encephalopathy?

Encephalopathy: disorientation, inattentiveness, confusion, coma Ophthalmoplegia: nystagmus, lateral rectus palsy, conjugate gaze palsy, vertical gaze palsy Ataxia: polyneuropathy, cerebellar and vestibular dysfunction leading to problems standing or walking.

Characteristics of a personality disorder: MEDIC

Maladaptive Enduring Deviate from cultural norms Inflexible Cause impairments in social or occupational functioning

What is the first and second most common primary tumours of bone?

Most common is multiple myeloma, Osteosarcoma is second most common primary.

What is Medullary thyroid carcinoma associated with?

Multiple Endocrine Neoplasia (MEN) type 2 and postive family history

What ages of presentation and chromosomes are associated with neurofibromatosis type 1 and 2?

NF1: 15 years and CS 17 NF2: 20 years and CS 22

What is Libman-Sack's endocarditis?

NONinfectious vegetations often seen on the MITRAL valve in association with SLE and antiphospholipid syndrome.

What are the causes of secondary eosinophilia? NAACP

Neoplasm Allergies Asthma Collagen vascular disease Parasites

What is the most common haematopoietic neoplasm?

Non-Hodgkins lymphoma

Type of fibres carried in the cranial nerves Mnemonic: some say marry money but my brother says big brains matter most.

Olfactory: sensory Ophthalmic: sensory Oculomotor: motor Troclear: motor Trigeminal: both Abducens: motor Facial: both Vestibulocochlear: sensory Glossopharyngeal: both Vagus: both Accessory: motor Hypoglossal: motor

What is the most common benign bone tumour?

Osteochondroma

What are Dutcher bodies and what condition are they associated with?

PAS +ive IgM deposits around nucleus of plasma cells in Waldenstrom's Macroglobulinemia

What organs does Multiple Endocrine Neoplasias 1 (MEN1) affect? P organs

Pancreas Parathyroid glands Pituitary

Thyroid Neoplasms (4 types)

Papillary (most common and best prognosis) Follicular Medullary Anaplastic (most rare and worse prognosis)

There are 4 PaRTS to Parkinson's: what are they?

Postural instability, Rigidity (cogwheeling), Tremor (pill-rolling), Slowed movements (bradykinesia)

the 5 Ps of Pheochromocytoma presentation:

Pressure (BP) Pain (headache) Perspiration Palpitations Pallor

What conditions are spherocytes seen in?

RBCs which lack aread of central pallor Seen in autoimmune haemolysis and in hereditary spherocytosis

Symptoms of a depressive episode SIG E CAPS

Sleep (hypersomnia or insomnia) Interest (anhedonia) Guilt (feelings of worthlessness or inappropriate guilt) Energy decreased Concentration decreased Appetite up or down (weight up or down) Psychomotor agitation or retardation Suicidal ideation

What is Lhermitte's sign?

Vibratory/ electrical sensations traveling up or down the neck and back with flexion, generally suggesting the presence of cervical myelitis

Classic triad in Normal Pressure Hydrocephalus?

Wet (urinary incontinence), Wobbly (gait apraxia) and Wacky (dementia)

After ABCs, what is the treatment indicated for someone in a coma? Mnemonic DONT

administer: D-dextrose, O- oxygen, N-naloxone, T-thiamine

What are the differentials for dementia? Mnemonic: DEMENTIAS

neuroDegenerative diseases Endocrine Metabolic Exogenous Neoplasm Trauma Infection Affective disorders Stoke/Structural

Damage to which area of the brain causes Broca's aphasia?

posterior inferior frontal gyrus

What are the 4 aspects of capacity for decision making?

1. Ability to understand the information given to them and the nature of the decision 2. Are able to make choices 3. Can reason through the consequences of their choices 4. Can communicate their choice.

Triad in Still's disease:

1. Arthritis 2. Daily high spiking fevers 3. maculopapular, evanescent salmon rash

What are the three skin lesions seen in Tuberous Sclerosis?

1. Ash leaf hypopigmented lesion 2. Sebaceous adenomas (small red nodules in shape of butterfly on cheeks and nose) 3. Shagreen patch (rough papule in lumbosacral region)

What is the triad suggesting multiple myeloma?

1. Bone pain 2. Anaemia 3. Renal failure

What are the features of serotonin syndrome? (4)

1. Fever 2. Myoclonus 3. Mental state changes 4. Cardiovascular collapse Can occur if SSRIs are used with MAOIs

What are the three causes of microangiopathic haemolytic anaemia?

1. Haemolytic-uremic syndrome (HUS) 2. Thrombotic Thrombocytopenic purpura (TTP) 3. DIC

What are the questions in the CAGE questionairre for alcoholism screening?

1. Have you ever felt the need to Cut down on your drinking? 2. Have you ever felt Annoyed by criticism about your drinking? 3. Have you ever felt Guilty about your drinking? 4. Have you ever had to have a morning Eye opener drink? 1 or more positive answers means that alcoholism is likely

Conn's syndrome triad (Conn's = excess aldosterone)

1. Hypertension 2. Unexplained hypokalemia 3. Metabolic alkalosis

What features are seen in haemolytic anaemia?

1. Jaundice 2. Haemoglobinuria 3. Elevated reticulocyte count

What is the triad of signs in ECG in cardiac tamponade?

1. Low voltage 2. Tachycardia 3. Electrical alternans

The 6 Ps of Acute ischemia:

1. Pain 2. Pallor 3. Paralysis 4. Pulse deficit 5. Paraesthesia 6. Poikilothermia

What is the triad in Horner's syndrome?

1. Ptosis 2. Miosis 3. Anhidrosis (dryer due to reduced sweating)

What is the triad seen in Felty's syndrome?

1. RA 2. splenomegaly 3. neutropenia

Pheochromocytoma rule of 10s (there are 5)

10% are extra-adrenal 10% bilateral 10% malignant 10% occur in children 10% familial

Under microscopy, what are Auer's rods associated with?

Acute myelogenous leukaemia (AML) especially acute promyelocytic leukaemia (APL)

What are the 4 As of Dementia (the progression of cognitive impairment follows this order)

Amnesia: partial or total memory loss Aphasia: language impairment Apraxia: inability to perform motor activities Agnosia: inability to recognize previously known objects/places/people

What result on tissue biopsy confirms diagnosis of amyloidosis?

Apple-green birefringence under polarized light on Congo red staining.

What additional symptoms occur in Korsakoff's dementia to Wernicke's encephalopathy?

As well as encephalopaty, ophthalmoplegia and ataxia, get horizontal nystagmus, confabulations, anterograde and retrograde amnesia.

What is MEN type 2B associated with? (4)

-Medullary carcinoma of the thyroid -Pheochromocytoma -Oral and Intestinal ganglioneuromatosis -Marfanoid habitus

What are the 5 As of Guillain-Barre syndrome?

Acute inflammatory demyelinating polyradiculopathy Ascending paralysis Autonomic neuropathy Arrythmias Albuminocytologic dissociation

What is the classic diagnostic criteria for multiple myeloma?

1. >10% plasma cells in bone marrow 2. M protein in plasma or urine 3. Lytic bone lesions

What are the features of Extrapyramidal Side effects? Think 4 and A (and one T)

4 hours: Acute dystonia (sustained muscle contractions frequently causing neck torticollis) 4 days: Akinesia (loss of voluntary motor control) 4 weeks: Akathisia (feeling of inner restlessness and need to be in constant motion) 4 months: Tardive dyskinesia (involuntary movements of the tongue, lips, face, trunk and extremities)

Criteria for SLE: DOPAMINE RASH

4+ make SLE likely Discoid rash Oral ulcers Photosensitivity Athritis Malar rash Immunologic criteria Neurological symptoms (lupus cerebritis and seizures) Elevated ESR Renal disease ANA + Serositis (pleural or pericardial effusion) Haematologic abnormalities

Bell's palsy can be idiopathic or a complication in which conditions? Mnemonic: ALexander Bell with STD

AIDS, Lyme, sarcoidosis, tumors,diabetes

What is the age of presentation typically for ALL, AML, CML and CLL?

ALL: <13 years but can occur in any age AML: 13-40 years but can occur at any age CML: 40-60 years CLL: >60 years

What should you consider if ALP and GGT are elevated?

A biliary disorder

Acute cardiac tamponade presents with what triad if signs?

Beck's triad 1. JVD 2. Hypotension 3. Distant heart sounds

What needs to be talked about when obtaining Informed Consent? BRAIN

Benefits Risks Alternatives Indications Nothing (what would happen if no intervention occurred)

A child 10-20 years of age with a multilayered "onion-skinning" finding on Xray in the diaphyseal regions of the femur.

Ewing's sarcoma

What are the VitK dependent coagulation factors, inhibited by Warfarin? 1972

Factors, II, VII, IX and X

What is the most common cause of mild elevation of liver transmaminases?

Fatty liver/ hepatic steatosis

What is Lennox-Gastaut syndrome

Form of childhood onset seizures, appearing between 2-6years with multiple daily seizures and nocturnal clinic seizures. Refractory to treatment.

What is West syndrome?

Form of generalized epilepsy presenting within 6 months of births. Affects males more than females and has a positive family history.

What conditions are Schistocytes associated with?

Fragmented RBCs seen in microangiopathic haemolytic anaemia and mechanical haemolysis

A femal 20-40 years with knee pain and a mass, along with "soap bubble" appearance on xray in the metaphyseal/epiphyseal region of long bones.

Giant cell tumour of bone

What condition does MALT gastric lymphoma (a NHL) have a strong association with?

H. Pylori infection.

What are the differential diagnosis of thrombocytopenia? HIT SHOC

HIT SHOC HIT or HUS ITP TTP or Treatment (meds) Splenomegaly Hereditary (Wiskott-Aldrich syndrome) Oncological e.g. malignancy Chemotherapy

What deficiency is seen in Haemophilia B and Haemophilia A? Clue: Haemophilia is not BENIGN and is not caused by what they ATE

Haemophilia B- factor IX deficiency Haemophilia A- factor VIII deficiency

What condition are hairy cells, with Tartrate-resistant acid phosphatase (TRAP) staining associated with?

Hairy cell Leukaemia

What condition are Reed-Sternberg cells associated with?

Hodgkins lymphoma

What is the most common immunologic disorder in women of childbearing age?

Idiopathic Thrombocytopenic Purpura (IgG formed against patient's own platelets)

What is the treatment of CML in the chronic phase? (has to do with BRA-ABL)

Imatinib, which is a selective inhibitor of the BCR-ABL tyrosine kinase

Major causes of delerium: I WATCH DEATH

Infection Withdrawal Acute metabolic/substance Abuse Trauma CNS pathology Hypoxia Deficiencies Endocrine Acute vascular/MI Toxins/Drugs Heavy metals

What is Sipple's syndrome?

MEN type 2A - Medullary carcinoma of the thyroid -pheochromocytoma or adrenal hyperplasia -Parathyroid gland hyperplasia

What condition are doughnut cells associated with?

Iron defiency anaemia (enlarged area of central pallor)

What should you consider in a child with Gout and unexplained injuries?

Lesh-Nyhan syndrome

What cancers typically metastasise to the brain?

Lung and Skin Go to the BRain: Lung, Skin, GI, Breast, Renal

Conditions associated with berry aneurysm which can MAKE an SAH more likely:

M- marfan's syndrome A- aortic coarctation K- kidney disease (AD, polycystic) E- ehlers-danlos syndrome S- sickle cell anaemia A- atherosclerosis H- history (family)

What is Wermer's syndrome?

MEN type 1 -Pancreatic islet cell tumours -Parathyroid hyperplasia -Pituitary adenomas

What condition is Hypersegmentation of neutrophils associated with?

Megaloblastic anaemia

What is an Austin Flint murmur?

Mid diastolic rumble heard in aortic regurgitation

Contraindications to tPA therapy in Acute stroke Mnemonic: sample stages

S- stroke or head trauma within the last 3 months A- anticoagulation with INR >1.7 or prolonged PTT M-MI recently P- prior intracranial haemorrhage L- low platelet count <100,000 S- surgery in the past 14 days T-TIA A- age <18 G- GI or urinary bleeding E- elevated or decreased blood glucose S- seizures present at onset of stroke

Mnemonic for differentials of paediatric limp: STARTSS HOTT

S: septic joint T: tumour A: AVN (perthes) R: Rheumatoid arthritis/ JIA T: Tuberculosis S: sickle cell disease S: SUFE H: Henloch-schoenlein purpura O: Osteomyelitis T: Trauma T: Transient synovitis (irritable hip)

Mnemonic for types of fracture in Salter Harris classification of paediatric fractures: SMACK!

S: slipped (type 1) M: metaphyseal (type 2) A: Articular and epiphyseal (type 3) C: Complete- epiphyseal and metaphyseal, and physeal (type 4) K: Krushed! type 5

What are the 4 S's of adrenal crisis management?

Salt (0.9% saline) Steroids: IV hydrocortisone 100mg q8h Support Search for the underlying illness

Haematuria plus eosinophila makes you consider?

Schistosomiasis -parasitic infection with trematodes aka snail fever

What condition are target cells associated with?

Sickle cell anaemia

What T score for bone mass density represents Osteoporosis?

T = <-2.5

What are the common causes of microcytic anaemia? TICS

Thalassemia Iron deficiency Chronic disease Sideroblastic anaemia

What vitamin deficiency leads to Wernicke's encephalopathy and Korsakoff's dementia?

Thiamine/B1

What are the features of substance dependance? WITHDraw IT

Three or more of 7 within a 12 month period: Withdrawal Interest or Important activities given up or reduced Tolerance Harm (physical and psycosocial) with continued use Desire to cut down/control Intended time/amount exceeded Time spent using/obtaining substance is increased.

What is Virchow's triad?

Triad of risk factors for thrombus formation: 1. Haemostasis 2. Endothelial damage 3. Hypercoagulability

What condition is an "ash leaf" hypopigmented lesion seen in?

Tuberous Sclerosis

What do infantile spasms in the setting of a hypopigmented lesion on the child's trunk make you think of?

Tuberous sclerosis

Damage to which area of the brain causes Wernicke's aphasia?

left posterior superior temporal gyrus