Free Medical Study

TRAUMA AND ORTHOPAEDICS - Mnemonics
Anatomy 
Cubital fossa contents 
Mnemonic: Please Remember Be Brave Medically 
From lateral to medial: 
P         Posterior interosseus nerve 
R         Radial nerve 
B         Biceps tendon 
B         Brachial artery 
M         Median nerve

Adductor muscles of thigh 
Mnemonic: Post-Graduates Love their Bachelor Of Medicine 
P         Pectineus 
G         Gracilis 
L          Adductor Longus 
B         Adductor Brevis 
O         Obturator nerve innervates all these muscles expect for the pectineus
(femoral nerve). Part of the adductor magnus is supplied by the sciatic nerve 
M         Adductor Magnus 

Clinical conditions 
Painful neck - differentials 
Mnemonic: Jock STRAP 
J          Jerking back of the head and neck, ie whiplash 
S         Spondylosis/Spondylolisthesis of cervical discs 
T         Torticollis (spasmodic/infantile) 
R         Cervical Rib 
A         Abnormal posture 
P         Prolapsed cervical disc 
Carpel tunnel syndrome – causes and risk factors 
Mnemonic: CARPAL 
C         Cardiac failure/Combined OCP use 
A         Acromegaly 
R         Renal disorder – nephrotic syndrome/Raised glucose levels; DM 
P         Pregnancy/Poor thyroid function; hypo-thyroidism 
A         Arthritis of the wrist (rheumatoid, osteoarthritis) 
L          Large size – obesity 

Painful back - differentials 
Mnemonic: TOMS DIScman 
T         Tumours of spine 
O         Osteoporosis/Osteomalacia 
M         Mechanical 
S         Spondylolisthesis 
D         Disc prolapse/lesion 
I           Infection 
S         Stenosis of lumbar spine/lateral recess (due to facet joint osteoarthritis) 

Differential diagnosis of a limp 
Mnemonic: STARTSS HOT 
S         Septic joint 
T         Tumour 
A         Avascular necrosis (Legg–Calve–Pertheʼs) 
R         Rheumatoid arthritis/juvenile rheumatoid arthritis 
T         Tuberculosis 
S         Sickle cell disease
S         Slipped upper femoral epiphysis (SUFE) 
H         HSP 
O         Osteomyelitis 
T         Trauma 

Trauma 
Soft tissue injuries - treatment 
Mnemonic: RICE (protocol employed in the 1 st  24 hours following the injury) 
R         Rest 
I           Ice 
C         Compression 
E         Elevation

SURGERY -Mnemonics

Anatomy
Abdominal wall muscles 
Mnemonic: TIRE 
T         Transversus abdominis 
I           Internal oblique 
R         Rectus abdominis 
E         External oblique 

Bowel components 
Mnemonic: Dr Jones Investigates Carefully And Cuts Randomly 
From proximal to distal: 
D         Duodenum 
J          Jejunum 
I           Ileum 
C         Caecum 
A         Appendix 
C         Colon 
R         Rectum 

Clinical conditions 
Initial management of all surgical emergencies 
Mnemonic: 4 Aʼs, 2 Cʼs, 2 Nʼs (could be remembered as a set of GCSE results!) 
A         ABC assessment 
A         Analgesia, eg morphine 
A         Anti-emetic 
A         Aggressive fluid resuscitation – IV fluids and electrolyte replacement 
C         Central venous pressure (CVP) line – may be needed 
C         Catheter (urinary) 
N         Nil by mouth (NBM) 
N         Nasogastric (NG) tube 

Post-operative complications 
General immediate 
Mnemonic: PROBS 
P         Primary haemorrhage/Pain 
R         Reactive haemorrhage
O         Oliguria – acute urinary retention 
B         Shock/Sepsis 

General early 
Mnemonic: ABCDE 
A         Analgesia- or Anaesthetic-related nausea + vomiting 
B         Breakdown of wound or anastomosis due to infection or haematoma –
dehiscence /  ↓ BP –  ↓ fluid input  →  hypovolaemia  →↓ BP 
C         Confusion – acute 
D         DVT leading possibly to PE 
E         Elevated temperature – pyrexia 

General late 
Mnemonic: RIB 
R         Recurrence of malignancy 
I           Incisional hernia 
B         Bowel obstruction
Lumps and bumps 
Examining 
Mnemonic: 3 Sʼs, 3 Cʼs, 3 Tʼs and the Fʼer 
3Ss     Site, Size, Shape 
3Cs     Colour, Consistency, Contour 
3Ts      Tenderness, Tethering, Transillumination 
Fʼer      Fluctuance 

Hernias 
Groin lump: differential diagnosis 
Mnemonic: Surgeons Like To Manage Various Hernias 
S         Spermatic cord (lipoma, hydrocoele)/Skin (sebaceous cyst) 
L          Lymph nodes 
T         Testicle (ectopic, undescended) 
M         Muscle (psoas abscess) 
V         Vascular (femoral artery aneurysm, saphena varyx) 
H         Hernias (inguinal, femoral)

Rheumatology- Mnemonics

Respiratory System- Mnemonics
Diseases and conditions 
Definition of Acute Respiratory Distress Syndrome (ARDS) 
Mnemonic: ROAR 
R         Reduced lung compliance
O         Oedema, non-cardiogenic pulmonary 
A         Acute respiratory failure 
R         Refractory hypoxaemia 

Causes of Acute Respiratory Distress Syndrome (ARDS) 
Mnemonic: ARDS 
A         Aspiration-gastric/Acute pancreatitis/Amniotic fluid embolus 
R         Raised ICP/Respiratory tract infection – pneumonia 
D         DKA/DIC/Drugs 
S         Sepsis/Shock/Smoke inhalation/Severe burns 

Risk factors of asthma 
Mnemonic: FEAR UP 
F         Family history 
E         Eczema 
A         Acid reflux 
R         Rhinitis (allergic) 
U         Urticaria 
P         Polyps (nasal) 

History of asthma 
Mnemonic: WIND 
W        Wheeze 
I           Interferes with schooling, exercise, sleep and work 
N         Nocturnal cough, or early morning cough 
D         Dyspnoea 

Clinical manifestations of influenza infection 
Mnemonic: FLU 
F         Fever 
L          Lethargy 
U         Upset appetite (nausea and vomiting) 

Features of Tuberculosis (TB) 
Mnemonic: 4 Cʼs 
C         Cough 
C         Caseation 
C         Calcification 
C         Cavitation

 Renal System- Mnemonics
Diseases and conditions 
Detection of acute renal failure (ARF) 
Mnemonic: ACUte 
A         Acute presentation over hours or days 
C         Creatinine rises 
U         Urea rises (±oliguria <400 ml/24 h) 

Causes acute renal failure (ARF) 
Mnemonic: ACUte 
A         ATN/Acute GN 
C         Circulatory dysfunction (i.e. shock – hypovolaemia, sepsis, cardiogenic) 
U         Urinary outflow obstruction 

Clinical presentation of chronic renal failure 
Mnemonic: RESIN & 8 Pʼs 
R         Retinopathy 
E         Excoriations (scratch marks) 
S         Skin is yellow 
I           Increased blood pressure 
N         Nails are brown 
P         Pallor 
P         Purpura and bruises 
P         Pericarditis and cardiomegaly 
P         Pleural effusions 
P         Pulmonary oedema 
P         Peripheral oedema 
P         Proximal myopathy 
P         Peripheral neuropathy

Complicated urinary tract infections (UTIs) 
Mnemonic: MARIO 
M         Male patients 
A         Abnormal renal tract 
R         Renal function is impaired 
I           Impaired host defences 
O         Organism that is virulent 

Risk factors for UTIs 
Mnemonic: UTIs 
U         Urinary tract obstruction or malformation 
T         The menopause 
I           Intercourse (sexual)/Instrumentation/Immunosuppression 
S         female Sex/Stones 

Dialysis 
Indications for 
Mnemonic: AEIOU 
A         Acid–base problems (severe acidosis or alkalosis) 
E         Electrolyte problems (hyperkalaemia) 
I           Intoxications 
O         Overload, fluid 
U         Uraemic symptoms 

Or 

Mnemonic: SHARPE 
S         Severity of condition increases 
H         Hyperkalaemia persistent (K+ >7 mmol/l) 
A         Acidosis is metabolic and worsening (pH <7.2 or base excess <–10) 
R         Refractory pulmonary oedema 
P         Pericarditis (uraemic) 
E         Encephalopathy (uraemic) 

Complications of dialysis 
Mnemonic: CHAIR 
C         Cardiovascular disease 
H         Hypertension 
A         Anaemia 
I           Infections 
R         Renal bone disease 

Urinary tract malignancies 
Features of renal cell carcinoma (RCC) 
Mnemonic: RCC 
R         Renal tubule (proximal) epithelium is involved 
C         Renal Cancers are 90% RCC 
C         Clinical features include haematuria, loin pain, abdominal mass, anorexia,
malaise and weight loss

Mnemonics of Psychiatry

Symptoms and signs in psychiatric disorders 
Causes of delirium 
Mnemonic: DELIRIUM 
D         Degenerative 
E         Epilepsy (post-ictal states) 
L          Liver failure 
I           Intracranial (injury to the head, subarachnoid haemorrhage, TIA, meningitis,
cerebral abscess) 
R         Rheumatic chorea 
I           Infections – pneumonia, septicaemia 
U         Uraemia 
M         Metabolic – electrolyte imbalance 

Disorders due to psychoactive substances 
Alcoholism 
Mnemonic: CAGE questionnaire 
C         Have you ever felt you should Cut down on your drinking? 
A         Have people Annoyed you by commenting on your drinking? 
G         Have you ever felt Guilty about your drinking? 
E         Have you ever needed a drink first thing in the morning to get rid of a
hangover or for nerves (Eye opener)? 

>1 ‘yes’ answer makes alcoholism likely 

Schizophrenia and delusional disorders 
Positive symptoms (sometimes called type I schizophrenic symptoms) 
Mnemonic: THREAD 
T         Thinking may become disturbed, neologism usage 
H         Hallucinations may occur, usually auditory 
R         Reduced contact with reality, the natural barrier between subjective and
objective deteriorates 
E         Emotional control may be disturbed with inappropriate laughter or anger
(incongruous affect) 
A         Arousal may lead to worsening of symptoms 
D         Delusions may occur 

Negative symptoms (sometimes called type II schizophrenic symptoms) 
Mnemonic: LESS 
L          Loss of volition, underactivity and social withdrawal 
E         Emotional flatness, lose normal modulation of mood 
S         Speech is reduced, monosyllabic if at all 
S         Slowness in thought and movement, psychomotor retardation may occur 

Mood (affective) disorders 
Symptoms of depression 
Mnemonic: SLUMP 
S         Suicidal ideation or plans 
L          Lack of: interest, enjoyment (anhedonia), energy, appetite or libido
U         Unworthiness 
M         Early Morning waking 
P         Poor concentration/Psychomotor retardation or agitation
Suicide – risk factors 
Mnemonic: SAD PERSONS 
S         Sex (male) 
A         Age (older) 
D         Depression 

P         Previous attempt 
E         Excessive alcohol or substance abuse 
R         Rational thinking, loss of 
S         Sickness (chronic illness) 
O         Organised plan 
N         No social supports 
S         Stated intention to self-harm 

Paediatrics- Mnemonics

The new born baby 
Resuscitation - Indications 
Mnemonic: IF KEMPT 
I           Instrumental delivery 
F         Fetal distress 
K         Known congenital abnormality 
E         Emergency caesarean section 
M         Multiple births 
P         Prematurity 
T         Thick meconium stains the liquor
Congenital abnormalities 
Features of Downʼs Syndrome 
Mnemonic: DOWNS 
D         Dysplastic ears/Dysplastic pelvis (seen on X-ray)
O         Occiput is flat/Overly large tongue 
W        Widely spaced 1st and 2nd toes and a high-arched palate/Weak/ʼfloppyʼ baby
(hypotonia) 
N         Neck skin abundant 
S         Short, broad hands with single palmar crease/Slanting eyes/Speckled iris
(Brushfieldʼs spots) 

Developmental assessment 
Primitive reflexes 
Mnemonic: MPRAG 
M         Moro 
P         Placing reflex 
R         Rooting 
A         Atonic neck reflex 
G         Grasp reflex 

Infant nutrition 
Breastfeeding - advantages 
Mnemonic: PACES 
P         Psychological satisfaction 
A         Anti-infective property/Atopic disorders risk . 
C         Convenient 
E         Expenseless, ie free 
S         Stimulates growth and development 

Breastfeeding - disadvantages 
Mnemonic: KIDS 
K         vitamin K deficiency in breast-milk 
I           Infection transmission risk eg HIV 
D         Drugs excreted in milk 
S         Stressful and tiring for mother 

Acute presentations – the acutely ill child 
Four main nodes of presentation of serious illness in children 
Mnemonic: SURE 
S         Shock 
U         Unconscious/drowsy/fitting child 
R         Respiratory distress 
E         Emergencies (surgical) 

Clinical presentation of brain tumours 
Mnemonic: BAN HENS 
B         Blurred vision 
A         Ataxia (clumsiness) 
N         Nystagmus 
H         Headache 
E         Endocrine dysfunction
N         Nausea and vomiting
S         Squint (6th nerve palsy) 

Causes of respiratory failure 
Mnemonic: PC FED BRAHMS 
P         Pneumonia 
C         Cystic fibrosis/Croup 
F         Foreign body 
E         Epiglottitis 
D         Drug ingestion 
B         Bronchiolitis 
R         Raised ICP 
A         Asthma 
H         Head injury 
M         Meningitis/muscle weakness 
S         Severe cardiac failure 

Chronic presentations 
Presentation of asthma 
Mnemonic: CWS 
C         Cough (dry/nocturnal/worse with exercise) 
W        Wheeze 
S         Shortness of breath 

Life threatening attack of asthma 
Mnemonic: CHEST 
C         Cyanosis/Confusion/Coma 
H         Hypotension 
E         Exhaustion 
S         Silent chest 
T         Threatening PEFR <33% predicted in those above 5 years old 

Chronic diarrhoea 
Mnemonic: 5 Cʼs 
Inflammatory causes of chronic diarrhoea include: 
C         Crohnʼs disease 
C         Ulcerative Colitis 

Malabsorptive causes of chronic diarrhoea include: 
C         Cystic fibrosis 
C         Coeliac disease 
C         Cowʼs milk intolerance 

Features of Stillʼs disease 
Mnemonic: STILLS 
S         Spiking illness/Severe malaise 
T         There could be myalgia/arthralgia 
I           Increased size of liver/spleen 
L          Lose weight, anaemia 
L          Looks like malignancy 
S         Salmon-pink rash