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About This Presentation
This book on mnemonics has been writen in view of problems
faced by PG aspirants and MBBS students. All the hard
work comes to naught if a student confuses while giving
examination. Mnemonics has been prepared to eliminate the
confusion one encounters during memorizing the points in a
topic. This bo...
Slide Content
Presents600 high quality mnemonics
Enhancesquick recall and recollection of
high value facts
Provides“cutting-edge” technique in
remembering “long-winding”
statements/particulars/facts
Packsmnemonics that count
MNEMONICS
for Sure Success in
PG Medical Entrance Examinations
Second Edition
Enhancesquick recall and recollection of
high value facts
Provides“cutting-edge” technique in
remembering “long-winding”
statements/particulars/facts
Packsmnemonics that count
MNEMONICS
for Sure Success in
PG Medical Entrance Examinations
Second Edition
Presents600 high quality mnemonics
Enhancesquick recall and recollection of
high value facts
Provides“cutting-edge” technique in
remembering “long-winding”
statements/particulars/facts
Packsmnemonics that count
Enhancesquick recall and recollection of
high value facts
Provides“cutting-edge” technique in
remembering “long-winding”
statements/particulars/facts
Packsmnemonics that count
Arun Kumar MBBS DNB(s)
CBS Publishers & Distributors Pvt Ltd
New Delhi•Bengaluru• Chennai •Kochi •Kolkata •Mumbai
Hyderabad •Nagpur •Patna•Pune •Vijayawada
MNEMONICS
for Sure Success in
PG Medical Entrance Examinations
Second Edition
CBS Publishers & Distributors Pvt Ltd
New Delhi•Bengaluru• Chennai •Kochi •Kolkata •Mumbai
Hyderabad •Nagpur •Patna•Pune •Vijayawada
MNEMONICS
for Sure Success in
PG Medical Entrance Examinations
Second Edition
ISBN: 978-93-85915-33-8
Copyright © Author and Publisher
First Edition: 2015
Second Edition: 2016
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system without permission, in writing, from the
author and the publisher.
Published by Satish Kumar Jain and produced by Varun Jain for
CBS Publishers & Distributors Pvt Ltd
4819/XI Prahlad Street, 24 Ansari Road, Daryaganj, New Delhi 110 002, India.
Ph: 23289259, 23266861, 23266867
Website: www.cbspd.com
Fax: 011-23243014 e-mail: [email protected]; [email protected].
Corporate Office: 204 FIE, Industrial Area, Patparganj, Delhi 110 092
Ph: 4934 4934 Fax: 4934 4935 e-mail: [email protected]; [email protected]
Branches
•Bengaluru: Seema House 2975, 17th Cross, K.R. Road,
Banasankari 2nd Stage, Bengaluru 560 070, Karnataka
Ph: +91-80-26771678/79 Fax : +91-80-26771680 e-mail : [email protected]•Chennai: 7, Subbaraya Street, Shenoy Nagar, Chennai 600 030, Tamil Nadu
Ph: +91-44-26680620, 26681266 Fax : +91-44-42032115 e-mail: [email protected]
•Kochi: Ashana House, No. 39/1904, AM Thomas Road, Valanjambalam,
Ernakulam 682 018, Kochi, Kerala
Ph: +91-484-4059061-65 Fax : +91-484-4059065 e-mail: [email protected]•Kolkata: 6/B, Ground Floor, Rameswar Shaw Road, Kolkata-700 014, West Bengal
Ph: +91-33-22891126, 22891127, 22891128 e-mail: [email protected]
•Mumbai: 83-C, Dr E Moses Road, Worli, Mumbai-400018, Maharashtra
Ph: +91-22-24902340/41 Fax : +91-22-24902342 e-mail: [email protected]
Representatives
•Hyderabad 0-9885175004•Nagpur 0-9021734563 •Patna0-9334159340
•Pune 0-9623451994•Vijayawada 0-9000660880
Printed at
Disclaimer
Science and technology are constantly changing
fields. New research and experience broaden
the scope of information and knowledge. The
author has tried his best in giving information
available to him while preparing the material for
this book. Although, all efforts have been made
to ensure optimum accuracy of the material, yet
it is quite possible that some errors might have
been left. The publisher, the printer and the
author will not be held responsible for any
inadvertent errors or inaccuracies.
MNEMONICS
for Sure Success in
PG Medical Entrance Examinations
Copyright © Author and Publisher
First Edition: 2015
Second Edition: 2016
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system without permission, in writing, from the
author and the publisher.
Published by Satish Kumar Jain and produced by Varun Jain for
CBS Publishers & Distributors Pvt Ltd
4819/XI Prahlad Street, 24 Ansari Road, Daryaganj, New Delhi 110 002, India.
Ph: 23289259, 23266861, 23266867
Website: www.cbspd.com
Fax: 011-23243014 e-mail: [email protected]; [email protected].
Corporate Office: 204 FIE, Industrial Area, Patparganj, Delhi 110 092
Ph: 4934 4934 Fax: 4934 4935 e-mail: [email protected]; [email protected]
Branches
•Bengaluru: Seema House 2975, 17th Cross, K.R. Road,
Banasankari 2nd Stage, Bengaluru 560 070, Karnataka
Ph: +91-80-26771678/79 Fax : +91-80-26771680 e-mail : [email protected]•Chennai: 7, Subbaraya Street, Shenoy Nagar, Chennai 600 030, Tamil Nadu
Ph: +91-44-26680620, 26681266 Fax : +91-44-42032115 e-mail: [email protected]
•Kochi: Ashana House, No. 39/1904, AM Thomas Road, Valanjambalam,
Ernakulam 682 018, Kochi, Kerala
Ph: +91-484-4059061-65 Fax : +91-484-4059065 e-mail: [email protected]•Kolkata: 6/B, Ground Floor, Rameswar Shaw Road, Kolkata-700 014, West Bengal
Ph: +91-33-22891126, 22891127, 22891128 e-mail: [email protected]
•Mumbai: 83-C, Dr E Moses Road, Worli, Mumbai-400018, Maharashtra
Ph: +91-22-24902340/41 Fax : +91-22-24902342 e-mail: [email protected]
Representatives
•Hyderabad 0-9885175004•Nagpur 0-9021734563 •Patna0-9334159340
•Pune 0-9623451994•Vijayawada 0-9000660880
Printed at
Disclaimer
Science and technology are constantly changing
fields. New research and experience broaden
the scope of information and knowledge. The
author has tried his best in giving information
available to him while preparing the material for
this book. Although, all efforts have been made
to ensure optimum accuracy of the material, yet
it is quite possible that some errors might have
been left. The publisher, the printer and the
author will not be held responsible for any
inadvertent errors or inaccuracies.
MNEMONICS
for Sure Success in
PG Medical Entrance Examinations
To
my elder brother
Ajay Kumar Ajit
who shaped my career and life
my elder brother
Ajay Kumar Ajit
who shaped my career and life
???
Preface to the Second Edition
Preface to the Second Edition
T
his book on mnemonics has been writen in view of problems
faced by PG aspirants and MBBS students. All the hard
work comes to naught if a student confuses while giving
examination. Mnemonics has been prepared to eliminate the
confusion one encounters during memorizing the points in a
topic. This book is sure to improve your rank in any PG
entrance examination especially the one based on factual
questions like DNB and state PG entrance examinations. Only
600 mnemonics has been included in this edition to enable
students to complete and revise the book in a short time.
Students are also encouraged to point out the mistakes in
this book for which they will be given the incentive of ` 50/-
recharge done in their mobile number provided they are the
first to point out the mistake and give reference for the same.
One lucky student will also get to avail free discussion and
explanation with the author every week. For this they need to
provide their name, college name, batch of MBBS admission to
author’s contact number.
Readers are also advised to give their valuable opinions and
suggestions which will be appreciated and acknowledged.
Arun Kumar
Contact: 9718161947
Email.id: [email protected]
Preface to the First Edition
his book on mnemonics has been writen in view of problems
faced by PG aspirants and MBBS students. All the hard
work comes to naught if a student confuses while giving
examination. Mnemonics has been prepared to eliminate the
confusion one encounters during memorizing the points in a
topic. This book is sure to improve your rank in any PG
entrance examination especially the one based on factual
questions like DNB and state PG entrance examinations. Only
600 mnemonics has been included in this edition to enable
students to complete and revise the book in a short time.
Students are also encouraged to point out the mistakes in
this book for which they will be given the incentive of ` 50/-
recharge done in their mobile number provided they are the
first to point out the mistake and give reference for the same.
One lucky student will also get to avail free discussion and
explanation with the author every week. For this they need to
provide their name, college name, batch of MBBS admission to
author’s contact number.
Readers are also advised to give their valuable opinions and
suggestions which will be appreciated and acknowledged.
Arun Kumar
Contact: 9718161947
Email.id: [email protected]
Preface to the First Edition
F
irst I want to thank all my teachers in both school and college
who have encouraged and inspired me for hard work.
I also want to thank Dr Nitish, Dr Aporva, Dr Rajdeep and
Dr Puneet who have been very supportive of me to write this
book. I took the inspiration to write the book from my teacher
‘Dr Arup Kumar Kundu’ who has been a leading writer in
medical field.
My heartfelt thanks to my fiancée who contributed
significantly in writing this book.
I also like to take this opportunity to thanks my parents, sisters,
my brothers, brothers-in-law and all family members who have
always had faith in my abilities.
I would also like to thank CBS Publishers & Distributors,
Mr YN Arjuna
(Senior Vice President—Publishing, Editorial and Publicity),
Mrs Ritu Chawla
(Assistant General Manager—Production) and
Mr Vikrant Sharma
(DTP Operator) to help me realize my dream of
writing the book and publishing the book so beautifully.
I would also like to thank my friend Pawan, Bipulji and Dr
Pradeep for their valuable support.
I would also like to thank my teachers Dr MP Sharma for his
guidance. Finally with all my humbleness and sincerity, I thank
one and all who have helped me directly and indirectly in
completing this book.Arun Kumar
Acknowledgements
irst I want to thank all my teachers in both school and college
who have encouraged and inspired me for hard work.
I also want to thank Dr Nitish, Dr Aporva, Dr Rajdeep and
Dr Puneet who have been very supportive of me to write this
book. I took the inspiration to write the book from my teacher
‘Dr Arup Kumar Kundu’ who has been a leading writer in
medical field.
My heartfelt thanks to my fiancée who contributed
significantly in writing this book.
I also like to take this opportunity to thanks my parents, sisters,
my brothers, brothers-in-law and all family members who have
always had faith in my abilities.
I would also like to thank CBS Publishers & Distributors,
Mr YN Arjuna
(Senior Vice President—Publishing, Editorial and Publicity),
Mrs Ritu Chawla
(Assistant General Manager—Production) and
Mr Vikrant Sharma
(DTP Operator) to help me realize my dream of
writing the book and publishing the book so beautifully.
I would also like to thank my friend Pawan, Bipulji and Dr
Pradeep for their valuable support.
I would also like to thank my teachers Dr MP Sharma for his
guidance. Finally with all my humbleness and sincerity, I thank
one and all who have helped me directly and indirectly in
completing this book.Arun Kumar
Acknowledgements
Preface to the Second Edition vii
Preface to the First Edition ix
1. Anatomy 1
2. Biochemistry 17
3. Physiology 26
4. Pharmacology 35
5. Microbiology 72
6. Pathology 81
7. Forensic Medicine and Toxicology (FMT) 93
8. Preventive and Social Medicine (PSM) 99
9. Eye 111
10. Ear, Nose and Throat (ENT) 117
11. Medicine 122
12. Surgery 152
13. Gynecology and Obstetrics (G and O) 162
14. Pediatrics 170
15. Skin 177
16. Anesthesia 180
17. Radiology 184
18. Psychiatry 186
19. Orthopedics 189
Contents
Preface to the First Edition ix
1. Anatomy 1
2. Biochemistry 17
3. Physiology 26
4. Pharmacology 35
5. Microbiology 72
6. Pathology 81
7. Forensic Medicine and Toxicology (FMT) 93
8. Preventive and Social Medicine (PSM) 99
9. Eye 111
10. Ear, Nose and Throat (ENT) 117
11. Medicine 122
12. Surgery 152
13. Gynecology and Obstetrics (G and O) 162
14. Pediatrics 170
15. Skin 177
16. Anesthesia 180
17. Radiology 184
18. Psychiatry 186
19. Orthopedics 189
Contents
• Floor of third ventricle (formed primarily by hypothalamic
structures)
Optic chiasma
Infundibular recess (which extends into pituitary stalk)
Tuber cinereum
Mammillary bodies
Posterior perforated substance
Tegmentum of the midbrain
Mnemonic: Opin Tuma Posteg
• Muscles of gluteal region
Gamellus superior—Nerve to obturator internus (L5, S 1, S2)
Mnemonic: GSOI 512
Gamellus inferior—Nerve to quadratus femoris (L4, L5, SI)
Mnemonic: IQ 451
• Foramen magnum—Structures passing through its anterior
part
Apical ligament of Dens
Vertical band of cruciate ligament
Membrane tectoria
Mnemonic: AVM
• Foramen ovale
Mandibular nerve
Accessory meningeal artery (A for Artery)
Lesser petrosal nerve
Emissary vein (cavernous sinus to pterygoid plexus)
Mnemonic: MALE
1
Anatomy
1
structures)
Optic chiasma
Infundibular recess (which extends into pituitary stalk)
Tuber cinereum
Mammillary bodies
Posterior perforated substance
Tegmentum of the midbrain
Mnemonic: Opin Tuma Posteg
• Muscles of gluteal region
Gamellus superior—Nerve to obturator internus (L5, S 1, S2)
Mnemonic: GSOI 512
Gamellus inferior—Nerve to quadratus femoris (L4, L5, SI)
Mnemonic: IQ 451
• Foramen magnum—Structures passing through its anterior
part
Apical ligament of Dens
Vertical band of cruciate ligament
Membrane tectoria
Mnemonic: AVM
• Foramen ovale
Mandibular nerve
Accessory meningeal artery (A for Artery)
Lesser petrosal nerve
Emissary vein (cavernous sinus to pterygoid plexus)
Mnemonic: MALE
1
Anatomy
1
Mnemonics2
• Foramen spinosum
Middle meningeal artery and vein (posterior trunk)
Emissary vein
Nervus spinosus (meningeal branch of mandibular nerve)
Mnemonic: MENS
• Foramen rotundum—Maxillary nerve
Mnemonic: Max
m
round
Maxillary nerve passes through fossa, fissure and foramen
Foramen Foramen rotundum
Fissure inferior orbital fissure
Fossa pterygopalatine fossa
Mnemonic: RIP
• Internal acoustic meatus
Facial N (VIIIth/7th)
Vestibulocochlear N (VIIIth/8th)
Nervus
intermedius or pars intermedia of Wrisburg
Labyrinthine vessels
Mnemonic: 78 Intermediate Lab
• Foramen lacerum
Meningeal branch of ascending pharyngeal artery
Emissary vein
Mnemonic: MAPEL
• Jugular foramen
Anterior part Middle part Posterior part
Inferior petrosal 9th cranial nerveInternal jugular vein
sinus 10th cranial nerve Sigmoid sinus junction
11th cranial nerveEmissary vein (sigmoid
Meningeal branch sinus to occipital veins)
of ascending Occipital artery
pharyngeal (meningeal branch)
artery
Mnemonic:
IPS IS evaluating Our 9, 10, 11 MAP
• Foramen spinosum
Middle meningeal artery and vein (posterior trunk)
Emissary vein
Nervus spinosus (meningeal branch of mandibular nerve)
Mnemonic: MENS
• Foramen rotundum—Maxillary nerve
Mnemonic: Max
m
round
Maxillary nerve passes through fossa, fissure and foramen
Foramen Foramen rotundum
Fissure inferior orbital fissure
Fossa pterygopalatine fossa
Mnemonic: RIP
• Internal acoustic meatus
Facial N (VIIIth/7th)
Vestibulocochlear N (VIIIth/8th)
Nervus
intermedius or pars intermedia of Wrisburg
Labyrinthine vessels
Mnemonic: 78 Intermediate Lab
• Foramen lacerum
Meningeal branch of ascending pharyngeal artery
Emissary vein
Mnemonic: MAPEL
• Jugular foramen
Anterior part Middle part Posterior part
Inferior petrosal 9th cranial nerveInternal jugular vein
sinus 10th cranial nerve Sigmoid sinus junction
11th cranial nerveEmissary vein (sigmoid
Meningeal branch sinus to occipital veins)
of ascending Occipital artery
pharyngeal (meningeal branch)
artery
Mnemonic:
IPS IS evaluating Our 9, 10, 11 MAP
3Anatomy
• Anatomical snuff box—when thumb is fully extended,
depression seen on lateral aspect of wrist, immediately distal
to radial styloid process
Content—
Cephelic vein
Superficial radial nerve
Radial artery
Mnemonic: CSR
Floor—Base of first metacarpal
Radial styloid
Scaphoid
Trapezium
Mnemonic: BRST
Note:Proximal to distal order is RSTB.
Boundaries:
Lateral wall (anterior wall): Abductor pollicis longus
Extensor pollicis brevis
Medial wall (Posterior wall):Extensor pollicis longus
Mnemonic: EPL is MP
• Secretomotor pathway for parotid gland
Pons
Inferior Salivatory nucleus
Glossopharyngeal nerve
Tympanic branch and plexus
Lesser petrosal nerve
Otic ganglion
Auriculo temporal nerve
Parotid gland
Mnemonic: PINS
GLOTY LEPO ATP
• Structure passing through superior orbital fissure
Lateral to annulus of Zinn:Lacrimal nerve
Frontal nerve
Trochlear nerve
Superior ophthalmic vein
• Anatomical snuff box—when thumb is fully extended,
depression seen on lateral aspect of wrist, immediately distal
to radial styloid process
Content—
Cephelic vein
Superficial radial nerve
Radial artery
Mnemonic: CSR
Floor—Base of first metacarpal
Radial styloid
Scaphoid
Trapezium
Mnemonic: BRST
Note:Proximal to distal order is RSTB.
Boundaries:
Lateral wall (anterior wall): Abductor pollicis longus
Extensor pollicis brevis
Medial wall (Posterior wall):Extensor pollicis longus
Mnemonic: EPL is MP
• Secretomotor pathway for parotid gland
Pons
Inferior Salivatory nucleus
Glossopharyngeal nerve
Tympanic branch and plexus
Lesser petrosal nerve
Otic ganglion
Auriculo temporal nerve
Parotid gland
Mnemonic: PINS
GLOTY LEPO ATP
• Structure passing through superior orbital fissure
Lateral to annulus of Zinn:Lacrimal nerve
Frontal nerve
Trochlear nerve
Superior ophthalmic vein
Mnemonics4
Meningeal branch of lacrimal
artery
Mnemonic: LFT
Through annulus of Zinn:Nasociliary nerve
Oculomotor nerve (superior and
inferior division) (3rd CN)
Abducens nerve (6th CN)
Mnemonic:NOA 36
Inferomedial to annulus—inferior ophthalmic vein
•Anterior and Middle superior alveolar nerves are branches of
Infraorbital (terminal branch of maxillary nerve)
Posterior superior alveolar nerve is direct branch of maxillary
nerve
Mnemonic: IAM
Appendices epiploicae are small sacs of peritoneum filled
with fat (adipose projections) over the whole colon except
caecum
appendix (vermiform)
rectum
Mnemonic: CAR
Note:Taenia coli are absent in distal sigmoid colon and
rectum.
• Femoral triangle content
Lateral to medial
Femoral nerve
Femoral artery
Femoral vein
Lymphatic vessels and deep inguinal lymph node of Cloquet
Mnemonic: NAVEL
Boundaries
Laterally—medial border of sartorius
Medially—medial border of adductor longus
Superiorly—inguinal ligament
Mnemonic: SAIL
Branches of third part of maxillary artery
Infraorbital A
Meningeal branch of lacrimal
artery
Mnemonic: LFT
Through annulus of Zinn:Nasociliary nerve
Oculomotor nerve (superior and
inferior division) (3rd CN)
Abducens nerve (6th CN)
Mnemonic:NOA 36
Inferomedial to annulus—inferior ophthalmic vein
•Anterior and Middle superior alveolar nerves are branches of
Infraorbital (terminal branch of maxillary nerve)
Posterior superior alveolar nerve is direct branch of maxillary
nerve
Mnemonic: IAM
Appendices epiploicae are small sacs of peritoneum filled
with fat (adipose projections) over the whole colon except
caecum
appendix (vermiform)
rectum
Mnemonic: CAR
Note:Taenia coli are absent in distal sigmoid colon and
rectum.
• Femoral triangle content
Lateral to medial
Femoral nerve
Femoral artery
Femoral vein
Lymphatic vessels and deep inguinal lymph node of Cloquet
Mnemonic: NAVEL
Boundaries
Laterally—medial border of sartorius
Medially—medial border of adductor longus
Superiorly—inguinal ligament
Mnemonic: SAIL
Branches of third part of maxillary artery
Infraorbital A
5Anatomy
Posterior superior alveolar A
Pharyngeal A
Artery of pterygoid canal A
Greater palatine A
Sphenopalatine A
Mnemonic: Inferoposterior pharyngeal artery of greater
sphenoid
• Bipolar neurons are located in the retina, olfactory epithe-
lium, cochlear and vestibular ganglia (all three are sensory
pathway for vision, smell and hearing)
• Triangle of auscultation
Scapula
Latissimus dorsi
Trapezius
Mnemonic: Scalattra
•Alar plate derivatives become sensory nuclei while basal
plate derivatives become motor nuclei
Mnemonic: Sailor/Ala senses
• Branch of first part of subclavian artery
Vertebral artery
Internal thoracic artery
Thyrocervical trunk
Mnemonic: VIT
• Branch of thyrocervical trunk
Suprascapular A
Inferior thyroid A
Transverse cervical A
Mnemonic: SIT
• Axillary artery
First part—Superior thoracic artery
Second part—Acromiothoracic artery
Lateral thoracic artery
Mnemonic: SALT
Posterior superior alveolar A
Pharyngeal A
Artery of pterygoid canal A
Greater palatine A
Sphenopalatine A
Mnemonic: Inferoposterior pharyngeal artery of greater
sphenoid
• Bipolar neurons are located in the retina, olfactory epithe-
lium, cochlear and vestibular ganglia (all three are sensory
pathway for vision, smell and hearing)
• Triangle of auscultation
Scapula
Latissimus dorsi
Trapezius
Mnemonic: Scalattra
•Alar plate derivatives become sensory nuclei while basal
plate derivatives become motor nuclei
Mnemonic: Sailor/Ala senses
• Branch of first part of subclavian artery
Vertebral artery
Internal thoracic artery
Thyrocervical trunk
Mnemonic: VIT
• Branch of thyrocervical trunk
Suprascapular A
Inferior thyroid A
Transverse cervical A
Mnemonic: SIT
• Axillary artery
First part—Superior thoracic artery
Second part—Acromiothoracic artery
Lateral thoracic artery
Mnemonic: SALT
Mnemonics6
• Adductor magnus is a composite muscle and is doubly
innervated by the obturator nerve and tibial nerve
Mnemonic: MagOT
• Biceps femoris: Long head—Tibial nerve
Short head—common peroneal nerve
Mnemonic: Long tibial
• Bronchial artery
Left—two bronchial arteries arising directly from descending
thoracic aorta Mnemonic:
Directly descending
Right—One bronchial artery arises indirectly from descending
thoracic aorta either from
i. Third posterior intercostal artery
ii. Upper left bronchial artery
• Branches of anterior division of internal iliac artery
Superior vesical artery
Obturator artery
Middle rectal artery
Uterine artery (only in females)
Inferior vesical artery (replaced by vaginal in females)
Inferior gluteal artery
Internal pudendal artery
Mnemonic: SOMU and 3IV
• Nasal septum—osseous part
Vomer
Sphenoid
Nasal bone
Frontal bone
Ethmoid
Palatine
Maxillary
Mnemonic: Very special news for Ethiopian PM
• Large opening of diaphragm
T8—Venacaval opening
T10—Oesophageal opening
• Adductor magnus is a composite muscle and is doubly
innervated by the obturator nerve and tibial nerve
Mnemonic: MagOT
• Biceps femoris: Long head—Tibial nerve
Short head—common peroneal nerve
Mnemonic: Long tibial
• Bronchial artery
Left—two bronchial arteries arising directly from descending
thoracic aorta Mnemonic:
Directly descending
Right—One bronchial artery arises indirectly from descending
thoracic aorta either from
i. Third posterior intercostal artery
ii. Upper left bronchial artery
• Branches of anterior division of internal iliac artery
Superior vesical artery
Obturator artery
Middle rectal artery
Uterine artery (only in females)
Inferior vesical artery (replaced by vaginal in females)
Inferior gluteal artery
Internal pudendal artery
Mnemonic: SOMU and 3IV
• Nasal septum—osseous part
Vomer
Sphenoid
Nasal bone
Frontal bone
Ethmoid
Palatine
Maxillary
Mnemonic: Very special news for Ethiopian PM
• Large opening of diaphragm
T8—Venacaval opening
T10—Oesophageal opening
7Anatomy
T12— Aortic opening
Mnemonic: Voice of America
Aortic opening
Aorta
Thoracic duct
Azygos vein
Mnemonic: ATA
Vena caval opening—Right phrenic nerve
Inferior vena cava
Mnemonic: RP in Cave
Oesophageal opening—Left vagus
Right vagus
Oesophagus
Oesophageal branch of left gastric
artery
Mnemonic: Vagus, phagus, gas
• Supports of uterus
Muscular supports/active supports
Perineal body
Urogenital diaphragm
Levator ani (pelvic diaphragm)
Mnemonic: PULP
Mechanical supports
Transverse cervical ligament (Mackenrodt’s ligament)
Uterosacral ligament (most strong)
Round ligament of uterus
Uterine axis
Pubocervical ligament
Mnemonic: TURUP (T and P are cervical)
• Branches of cerebral part of internal carotid artery
Anterior cerebral artery
Middle cerebral artery
Ophthalmic artery
Anterior choroidal artery
Posterior communicating artery
Mnemonic: AM OCP
T12— Aortic opening
Mnemonic: Voice of America
Aortic opening
Aorta
Thoracic duct
Azygos vein
Mnemonic: ATA
Vena caval opening—Right phrenic nerve
Inferior vena cava
Mnemonic: RP in Cave
Oesophageal opening—Left vagus
Right vagus
Oesophagus
Oesophageal branch of left gastric
artery
Mnemonic: Vagus, phagus, gas
• Supports of uterus
Muscular supports/active supports
Perineal body
Urogenital diaphragm
Levator ani (pelvic diaphragm)
Mnemonic: PULP
Mechanical supports
Transverse cervical ligament (Mackenrodt’s ligament)
Uterosacral ligament (most strong)
Round ligament of uterus
Uterine axis
Pubocervical ligament
Mnemonic: TURUP (T and P are cervical)
• Branches of cerebral part of internal carotid artery
Anterior cerebral artery
Middle cerebral artery
Ophthalmic artery
Anterior choroidal artery
Posterior communicating artery
Mnemonic: AM OCP
Mnemonics8
• Branches of cavernous part of internal carotid artery
Meningeal branches
Cavernous branches
Hypophyseal branches
Mnemonic: MCH
• Secondary curves: Adult curvatures of spinal cord
Anteriorly Mn
Cervical spine Convex X Lordosis
Thoracic spine Concave Cave Kyphosis
Lumbar spine Convex X Lordosis
Pelvic curve Concave Cave Kyphosis
(sacrococcygeal)
Lumbar: Lordosis (L for L)
Convex anteriorly: Lordosis
Mnemonic:
XL
• Shoulder abduction
0–15° Supraspinatus (suprascapular nerve)
15°–90° Deltoid (axillary nerve)
90°–120°Deltoid (+ short external rotators) (axillary nerve)
120°–180° Serratus anterior (nerve to serratus anterior)
Trapezius (spinal accessory nerve)
• Subclavian triangle
Nerve contents
Three trunks of brachial plexus
Nerve to serratus anterior
Nerve to subclavius
Suprascapular nerve
Mnemonic: 3S in subclavian Triangle
• Maxillary A (branch of external carotid artery)
Branches of first part
Middle meningeal artery
Accessory meningeal artery
Inferior alveolar artery
Deep auricular artery
• Branches of cavernous part of internal carotid artery
Meningeal branches
Cavernous branches
Hypophyseal branches
Mnemonic: MCH
• Secondary curves: Adult curvatures of spinal cord
Anteriorly Mn
Cervical spine Convex X Lordosis
Thoracic spine Concave Cave Kyphosis
Lumbar spine Convex X Lordosis
Pelvic curve Concave Cave Kyphosis
(sacrococcygeal)
Lumbar: Lordosis (L for L)
Convex anteriorly: Lordosis
Mnemonic:
XL
• Shoulder abduction
0–15° Supraspinatus (suprascapular nerve)
15°–90° Deltoid (axillary nerve)
90°–120°Deltoid (+ short external rotators) (axillary nerve)
120°–180° Serratus anterior (nerve to serratus anterior)
Trapezius (spinal accessory nerve)
• Subclavian triangle
Nerve contents
Three trunks of brachial plexus
Nerve to serratus anterior
Nerve to subclavius
Suprascapular nerve
Mnemonic: 3S in subclavian Triangle
• Maxillary A (branch of external carotid artery)
Branches of first part
Middle meningeal artery
Accessory meningeal artery
Inferior alveolar artery
Deep auricular artery
9Anatomy
Anterior tympanic artery
Mnemonic: MAIDA
Branches of second part
Deep temporal
Pterygoid
Masseteric
Buccal
Mnemonic:
All muscular branches
• Prostate
Median lobe—benign
Posterior lobe—Malignant/carcinomatous transformation
Mnemonic: PMC (Patna Medical College)
•Least dilatable and narrowest part of male urethra =
Membranous (except external urethral orifice)
Mnemonic: LMN
• Branches of external carotid artery
Anterior:Superior thyroid artery
Facial artery
Lingual artery
Posterior:Occipital artery
Posterior auricular artery
Medial:Ascending pharyngeal artery
Terminal:Maxillary artery
Superficial temporal artery
Mnemonic: SFL (Safal) OP Ascends Max STep
•Primary cartilaginous joint/hyaline cartilaginous joint/
synchondrosis
Joint between epiphysis and diaphysis of long bone
Spheno-occipital joint
First chondrosternal joint
Costochondral joint
Mnemonic:
PHC
• Secondary cartilaginous joint/fibrocartilaginous joint/
symphysis
–Symphysis pubis
–Symphysis menti
Anterior tympanic artery
Mnemonic: MAIDA
Branches of second part
Deep temporal
Pterygoid
Masseteric
Buccal
Mnemonic:
All muscular branches
• Prostate
Median lobe—benign
Posterior lobe—Malignant/carcinomatous transformation
Mnemonic: PMC (Patna Medical College)
•Least dilatable and narrowest part of male urethra =
Membranous (except external urethral orifice)
Mnemonic: LMN
• Branches of external carotid artery
Anterior:Superior thyroid artery
Facial artery
Lingual artery
Posterior:Occipital artery
Posterior auricular artery
Medial:Ascending pharyngeal artery
Terminal:Maxillary artery
Superficial temporal artery
Mnemonic: SFL (Safal) OP Ascends Max STep
•Primary cartilaginous joint/hyaline cartilaginous joint/
synchondrosis
Joint between epiphysis and diaphysis of long bone
Spheno-occipital joint
First chondrosternal joint
Costochondral joint
Mnemonic:
PHC
• Secondary cartilaginous joint/fibrocartilaginous joint/
symphysis
–Symphysis pubis
–Symphysis menti
Mnemonics10
– Intervertebral joint between vertebral bodies (sacro-
coccygeal joint)
–Manubriosternal Joint
–Xiphisternal Joint
Mnemonic: 2SIMa–X
Fibrous joints
Sutures: Skull
Gomphosis: Tooth in its sockets
Syndesmosis:
Inferior tibiofibular joint, middle radioulnar joint,
tympanostapedial joint
Mnemonic: Iti Mira Tysta
• Synovial joint
Plane synovial joint: Joint between articular process of
vertebra
Inter
carpal and intertarsal
Mnemonic: Art of car and tar are plane
Hinge joint
Interphalangeal
Elbow
Ankle
Mnemonic: HIPEA
Pivot (trochoid)
Median atlanto-axial joint
Inferior and superior radioulnar joint
Mnemonic: MAA and ISRU
Ellipsoid: Metacarpophalangeal joint
Atlanto-occipital joint
Wrist joint
Mnemonic: MCP AO, wrist
Condylar (bicondylar):Knee joint
Right and left jaw joint
Mnemonic: J and K are bicondylar
Saddle (sellar):Sternoclavicular joint
1st carpometacarpal joint
Calcaneocuboid joint
Mnemonic: Stern 1st CM of Calca is sad
Ball and socket: Shoulder joint
– Intervertebral joint between vertebral bodies (sacro-
coccygeal joint)
–Manubriosternal Joint
–Xiphisternal Joint
Mnemonic: 2SIMa–X
Fibrous joints
Sutures: Skull
Gomphosis: Tooth in its sockets
Syndesmosis:
Inferior tibiofibular joint, middle radioulnar joint,
tympanostapedial joint
Mnemonic: Iti Mira Tysta
• Synovial joint
Plane synovial joint: Joint between articular process of
vertebra
Inter
carpal and intertarsal
Mnemonic: Art of car and tar are plane
Hinge joint
Interphalangeal
Elbow
Ankle
Mnemonic: HIPEA
Pivot (trochoid)
Median atlanto-axial joint
Inferior and superior radioulnar joint
Mnemonic: MAA and ISRU
Ellipsoid: Metacarpophalangeal joint
Atlanto-occipital joint
Wrist joint
Mnemonic: MCP AO, wrist
Condylar (bicondylar):Knee joint
Right and left jaw joint
Mnemonic: J and K are bicondylar
Saddle (sellar):Sternoclavicular joint
1st carpometacarpal joint
Calcaneocuboid joint
Mnemonic: Stern 1st CM of Calca is sad
Ball and socket: Shoulder joint
11Anatomy
Hip joint
Talocalcaneonavicular joint
• Epiphysis
Pressure epiphysis:Head of femur
Condyles of tibia
Lower end of radius
Mnemonic:Press HCL
Traction epiphysis:Tubercles of humerus—Mastoid process
Trochanters of femur
Mnemonic: TMT
Atavistic epiphysis: Coracoid process of scapula
Osmium trigonum
Aberrant epiphysis: Head of first metacarpal
Base of other metacarpals
• Veins of heart
Contents of coronary sulcus:
Great cardiac vein
Coronary sinus
Small cardiac vein
Mnemonic: GCS
Anterior cardiac vein drains directly into right atrium
Mnemonic: ADDRA
Smallest cardiac vein/Thesbian veins/venae cordis minimi
drains directly into the cavity in all four chambers.
Rest drains into coronary sinus, i.e, great cardiac vein
(Anterior Interventricular septum)
Middle cardiac vein (Posterior interventricular septum)
Mnemonic: Middle Post
Small cardiac vein
Posterior vein of LV
Oblique vein of LA
Right marginal vein
• Muscles of mastication
Pterygoid—lateral and medial
Masseter
Temporalis
Mnemonic: PMT
Hip joint
Talocalcaneonavicular joint
• Epiphysis
Pressure epiphysis:Head of femur
Condyles of tibia
Lower end of radius
Mnemonic:Press HCL
Traction epiphysis:Tubercles of humerus—Mastoid process
Trochanters of femur
Mnemonic: TMT
Atavistic epiphysis: Coracoid process of scapula
Osmium trigonum
Aberrant epiphysis: Head of first metacarpal
Base of other metacarpals
• Veins of heart
Contents of coronary sulcus:
Great cardiac vein
Coronary sinus
Small cardiac vein
Mnemonic: GCS
Anterior cardiac vein drains directly into right atrium
Mnemonic: ADDRA
Smallest cardiac vein/Thesbian veins/venae cordis minimi
drains directly into the cavity in all four chambers.
Rest drains into coronary sinus, i.e, great cardiac vein
(Anterior Interventricular septum)
Middle cardiac vein (Posterior interventricular septum)
Mnemonic: Middle Post
Small cardiac vein
Posterior vein of LV
Oblique vein of LA
Right marginal vein
• Muscles of mastication
Pterygoid—lateral and medial
Masseter
Temporalis
Mnemonic: PMT
Mnemonics12
• Structures derived from the neural crest
C- cells of thyroid
Conotruncal septum
(Chromaffin tissue) (adrenal medulla)
Neurons: The neurons of
Spinal dorsal root ganglia
Sensory ganglia of 5th, 7th, 8th, 9th and 10th
cranial nerves
Sympathetic ganglia
Pia-arachnoid mater
Schwann cells
Melanoblasts (mesenchyme of dental papilla and pharyngeal
arches)
Mnemonic: 3C 3S PSM
• Yellow elastic cartilage forms:External ear
External auditory canal
Eustachian tube
Epiglottis
Tip of arytenoids
Tip of nose
Corniculate cartilage
Cuneiform cartilage
Mnemonic: E
4T
2C
2
• Hyaline cartilage forms: (Type 2 collagen)
Costal
Nasal
Some laryngeal
Tracheobronchial
All temporary and most articular
cartilages
Mnemonic: ATMA
• Femoral artery: Superficial branches
Superficial external pudendal
Superficial epigastric
Superficial circumflex iliac
Deep branches
Profunda femoris
• Structures derived from the neural crest
C- cells of thyroid
Conotruncal septum
(Chromaffin tissue) (adrenal medulla)
Neurons: The neurons of
Spinal dorsal root ganglia
Sensory ganglia of 5th, 7th, 8th, 9th and 10th
cranial nerves
Sympathetic ganglia
Pia-arachnoid mater
Schwann cells
Melanoblasts (mesenchyme of dental papilla and pharyngeal
arches)
Mnemonic: 3C 3S PSM
• Yellow elastic cartilage forms:External ear
External auditory canal
Eustachian tube
Epiglottis
Tip of arytenoids
Tip of nose
Corniculate cartilage
Cuneiform cartilage
Mnemonic: E
4T
2C
2
• Hyaline cartilage forms: (Type 2 collagen)
Costal
Nasal
Some laryngeal
Tracheobronchial
All temporary and most articular
cartilages
Mnemonic: ATMA
• Femoral artery: Superficial branches
Superficial external pudendal
Superficial epigastric
Superficial circumflex iliac
Deep branches
Profunda femoris
13Anatomy
Deep external pudendal
Muscular branches
Mnemonic: PDM
External iliac artery:Branches
Inferior epigastric artery
Deep circumflex iliac artery
Note:1. Inferior epigastric artery anastomoses with
superior epigastric artery (a branch of internal
thoracic artery).
2. Profunda femoris is the largest branch of femoral
artery. It is the chief artery to supply all 3
compartments of thigh. lts branches
1. Medial circumflex femoral artery
2. Lateral circumflex femoral artery
3. Four perforating arteries
• Sites of narrowing of normal ureter
Ureteric orifice
Uretero
vesical junction
Juxtaposition of the vas deferens or broad ligament
Crossing of the iliac artery
Ureteropelvic junction
Mnemonic: Ureteric orifice is VVIP
•Anterior belly of digastric is supplied by mandibular nerve
Postserior belly of digastric is supplied by facial nerve
Mnemonic: ADM and PDF
• Mandibular nerve (lst arch): Mylohyoid
Muscles of mastication
Anterior belly of digastric
Tensor tympani
Tensor veli palati
Mnemonic: My Mast Ant digest Tension
• Facial Nerve (2nd arch):Stapedius
Stylohyoid
Posterior belly of digastric
Muscles of facial expression
Mnemonic: Stupid style Dip muscles of facial expression
Deep external pudendal
Muscular branches
Mnemonic: PDM
External iliac artery:Branches
Inferior epigastric artery
Deep circumflex iliac artery
Note:1. Inferior epigastric artery anastomoses with
superior epigastric artery (a branch of internal
thoracic artery).
2. Profunda femoris is the largest branch of femoral
artery. It is the chief artery to supply all 3
compartments of thigh. lts branches
1. Medial circumflex femoral artery
2. Lateral circumflex femoral artery
3. Four perforating arteries
• Sites of narrowing of normal ureter
Ureteric orifice
Uretero
vesical junction
Juxtaposition of the vas deferens or broad ligament
Crossing of the iliac artery
Ureteropelvic junction
Mnemonic: Ureteric orifice is VVIP
•Anterior belly of digastric is supplied by mandibular nerve
Postserior belly of digastric is supplied by facial nerve
Mnemonic: ADM and PDF
• Mandibular nerve (lst arch): Mylohyoid
Muscles of mastication
Anterior belly of digastric
Tensor tympani
Tensor veli palati
Mnemonic: My Mast Ant digest Tension
• Facial Nerve (2nd arch):Stapedius
Stylohyoid
Posterior belly of digastric
Muscles of facial expression
Mnemonic: Stupid style Dip muscles of facial expression
Mnemonics14
•Glossopharyngeal nerve (3rd arch): Stylopharyngeus
Mnemonic: Gloss style-pharyngeal common)
• Superior laryngeal nerve (4th arch)
Muscles of pharynx
(except stylopharyngeus)
Muscles of palate
(except tensor veli palati)
• Recurrent laryngeal nerve (6th arch): Muscles of larynx
(except cricothyroid)
Note:Cricothyroid muscle is supplied by external branch of
superior laryngeal nerve.
Mnemonic: Ex Cricketer
•Stapes—Smallest
Mnemonic: S for S
Malleus: Largest
• Direction of nasolacrimal duct: Downward, backward and
laterally.
Mnemonic: DBL, i.e. double
•Inferior meatus: Nasolacrimal duct
Mnemonic: INLD
Middle meatus: 4 openings:
Middle ethmoidal air cells
Maxillary sinus
Anterior ethmoidal air cells
Frontal sinus
Superior meatus: Posterior ethmoidal sinus.
Mnemonic: SuPES
Sphenoethmoidal recess—Sphenoid air cells.
Mnemonic: SERS
•Coronal suture—between 2 ears (Can in hindi)
Mnemonic: C for C
Sagittal suture—between 2 parietal bones.
Asterion—parietomastoid occipital (PMO).
•Glossopharyngeal nerve (3rd arch): Stylopharyngeus
Mnemonic: Gloss style-pharyngeal common)
• Superior laryngeal nerve (4th arch)
Muscles of pharynx
(except stylopharyngeus)
Muscles of palate
(except tensor veli palati)
• Recurrent laryngeal nerve (6th arch): Muscles of larynx
(except cricothyroid)
Note:Cricothyroid muscle is supplied by external branch of
superior laryngeal nerve.
Mnemonic: Ex Cricketer
•Stapes—Smallest
Mnemonic: S for S
Malleus: Largest
• Direction of nasolacrimal duct: Downward, backward and
laterally.
Mnemonic: DBL, i.e. double
•Inferior meatus: Nasolacrimal duct
Mnemonic: INLD
Middle meatus: 4 openings:
Middle ethmoidal air cells
Maxillary sinus
Anterior ethmoidal air cells
Frontal sinus
Superior meatus: Posterior ethmoidal sinus.
Mnemonic: SuPES
Sphenoethmoidal recess—Sphenoid air cells.
Mnemonic: SERS
•Coronal suture—between 2 ears (Can in hindi)
Mnemonic: C for C
Sagittal suture—between 2 parietal bones.
Asterion—parietomastoid occipital (PMO).
15Anatomy
Bregma—Anterior fontanelle
Mnemonic: AB
Lambda—Posterior fontanelle
• Routine opening of mouth: Lateral pterygoid.
Forceful opening of mouth:Digastric
Geniohyoid
Myelohyoid
Mnemonic: DGM
• Infrahyoid muscles— also known as strap muscles:
Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid
• Ansa cervicalis is nerve supply of:
Omohyoid
Sternothyroid
Sternohyoid
Mnemonic: OH Anshu SiT on Shoe
•C
1 is the nerve supply of:Thyrohyoid
Geniohyoid
Mnemonic: C
1 is The GHar
• Male internal genitalia
S: Seminal vesicles
E: Epididymis
E: Ejaculatory duct
D: Ductus deferens (Vas deferens)
Mnemonic: SEED
• Paranasal sinuses
Maxillary sinus—develops at birth
Ethmoidal sinus—develops at birth
Frontal sinus—develops at 2 years
Sphenoid sinus—develops at 3–5 years.
Mnemonic: MEFS
• The inferior turbinate is a separate bone, while rest of the
turbinates are a part of ethmoidal bone.
Mnemonic: Inferior—Independent
Bregma—Anterior fontanelle
Mnemonic: AB
Lambda—Posterior fontanelle
• Routine opening of mouth: Lateral pterygoid.
Forceful opening of mouth:Digastric
Geniohyoid
Myelohyoid
Mnemonic: DGM
• Infrahyoid muscles— also known as strap muscles:
Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid
• Ansa cervicalis is nerve supply of:
Omohyoid
Sternothyroid
Sternohyoid
Mnemonic: OH Anshu SiT on Shoe
•C
1 is the nerve supply of:Thyrohyoid
Geniohyoid
Mnemonic: C
1 is The GHar
• Male internal genitalia
S: Seminal vesicles
E: Epididymis
E: Ejaculatory duct
D: Ductus deferens (Vas deferens)
Mnemonic: SEED
• Paranasal sinuses
Maxillary sinus—develops at birth
Ethmoidal sinus—develops at birth
Frontal sinus—develops at 2 years
Sphenoid sinus—develops at 3–5 years.
Mnemonic: MEFS
• The inferior turbinate is a separate bone, while rest of the
turbinates are a part of ethmoidal bone.
Mnemonic: Inferior—Independent
Mnemonics16
• Cerebellum
Cerebellar cortex—five cells:
Granule cells
Golgi cells
Purkinje cells
Stellate cells
Basket cells
Mnemonic:
Garm gol puri in steel basket
Deep cerebellar nuclei:
Dentate
Emboliform
Fastigial
Globose
Mnemonic: DEFG
Note:The axons of Purkinje cells are the only output from
the cerebellar cortex, generally pass to the deep nuclei.
•Appendix of testis—Paramesonephric duct
Mnemonic: ATP
Appendix of epididymis—Mesonephric duct
Mnemonic: MEA
• Cerebellum
Cerebellar cortex—five cells:
Granule cells
Golgi cells
Purkinje cells
Stellate cells
Basket cells
Mnemonic:
Garm gol puri in steel basket
Deep cerebellar nuclei:
Dentate
Emboliform
Fastigial
Globose
Mnemonic: DEFG
Note:The axons of Purkinje cells are the only output from
the cerebellar cortex, generally pass to the deep nuclei.
•Appendix of testis—Paramesonephric duct
Mnemonic: ATP
Appendix of epididymis—Mesonephric duct
Mnemonic: MEA
• Inhibitors of TCA cycle
Fluoroacetate inhibits aconitase (non-competitive >
competitive)
Arsenite inhibits α-Ketoglutarate dehydrogenase (non-
competitive)
Malonate inhibits succinate dehydrogenase (competitive)
Mnemonic: FAM inhibits AKS
• Transamination reaction
Aspartate + α-ketoglutarate → oxaloacetate + glutamate
Mnemonic: ASO
Alanine + α-ketoglutarate → pyruvate + glutamate
Mnemonic: PyAl
G for G—Glutamate–ketoglutarate
• Sphingolipidosis: X-linked recessive → Fabry’s disease
Mnemonic: Fab X
• Biochemical tests
•Sugars (reducing sugars)
Fehling’s test
Benedict’s test
Mnemonic: FBS (or fasting blood sugar)
• Bile pigments
Gmelin test
Fouchet test
Rosenbach’s test
Mnemonic: Pig GFR
17
Biochemistry
2
Fluoroacetate inhibits aconitase (non-competitive >
competitive)
Arsenite inhibits α-Ketoglutarate dehydrogenase (non-
competitive)
Malonate inhibits succinate dehydrogenase (competitive)
Mnemonic: FAM inhibits AKS
• Transamination reaction
Aspartate + α-ketoglutarate → oxaloacetate + glutamate
Mnemonic: ASO
Alanine + α-ketoglutarate → pyruvate + glutamate
Mnemonic: PyAl
G for G—Glutamate–ketoglutarate
• Sphingolipidosis: X-linked recessive → Fabry’s disease
Mnemonic: Fab X
• Biochemical tests
•Sugars (reducing sugars)
Fehling’s test
Benedict’s test
Mnemonic: FBS (or fasting blood sugar)
• Bile pigments
Gmelin test
Fouchet test
Rosenbach’s test
Mnemonic: Pig GFR
17
Biochemistry
2
Mnemonics18
Also remember
Ketone bodies
Rothera test (Nitroprusside test)—Roth Nite
Gerhardt test (Ferric chloride test)
Mnemonic: GF
•SGPT – ALT – Cytosolic
Mnemonic: CLP
Also remember: SGOT (AST)—80% mitochondrial and 20%
cytosolic
•Water soluble vitamins: Vitamins B and C
Mnemonic: WBC
Vit. B complex energy releasing
Thiamine (B
1)
Riboflavin (B
2)
Niacin (B
3)
Mnemonic: 123-TRN (Tarun in Hindi)
Biotin
Pantothenic acid
Pyridoxine B
6
Mnemonic: six pyre
• Blot transfer techniques
Southern blot DNA
Northern blot RNA
Western blot Protein
Mnemonic:
South – Dakshin – DNA
Western – Paschim – Protein
• Respiratory chain inhibitors
Complex IV inhibitors: Cyanide (CN)
Carbon monoxide (CO)
Hydrogen sulphide (H
2S)
Sodium azide
Mnemonic: ides are complex IV inhibitors
• Location of major glycosaminoglycans
Hyaluronic acid:Synovial fluid
Loose connective tissue
Also remember
Ketone bodies
Rothera test (Nitroprusside test)—Roth Nite
Gerhardt test (Ferric chloride test)
Mnemonic: GF
•SGPT – ALT – Cytosolic
Mnemonic: CLP
Also remember: SGOT (AST)—80% mitochondrial and 20%
cytosolic
•Water soluble vitamins: Vitamins B and C
Mnemonic: WBC
Vit. B complex energy releasing
Thiamine (B
1)
Riboflavin (B
2)
Niacin (B
3)
Mnemonic: 123-TRN (Tarun in Hindi)
Biotin
Pantothenic acid
Pyridoxine B
6
Mnemonic: six pyre
• Blot transfer techniques
Southern blot DNA
Northern blot RNA
Western blot Protein
Mnemonic:
South – Dakshin – DNA
Western – Paschim – Protein
• Respiratory chain inhibitors
Complex IV inhibitors: Cyanide (CN)
Carbon monoxide (CO)
Hydrogen sulphide (H
2S)
Sodium azide
Mnemonic: ides are complex IV inhibitors
• Location of major glycosaminoglycans
Hyaluronic acid:Synovial fluid
Loose connective tissue
19Biochemistry
Vitreous humor
Cartilage
Mnemonic: Hy SyL Vi in Car
Chondroitin sulphate:Cartilage
Bone
Cornea
Mnemonic: CBC
Karatan sulphate: Cornea (KS I)
Loose connective tissue (KS II)
Heparin: Mast cells
Heparan
sulphate: Aortic wall
Skin fibroblasts
Dermatan sulphate: Wide distribution
• Catabolism of carbon skeletons of amino acids
Oxaloacetate forming amino acid—Asparagine (aspartate)
Mnemonic: Ox in spa
Fumarate forming amino acids—Phenylalanine, tyrosine
Mnemonic: PheTyr fumes
Succinyl CoA: Threonine, valine, isoleucine, methionine
Mnemonic: Three successful VIM
• Ketoglutarate: Proline, histidine, arginine, glutamine
Mnemonic: ααααα PHAG
Pyruvate: Cystine, threonine, glycine, alanine, serine
Mnemonic: CT GAS in Peru
Acetyl CoA /Acetoacetyl CoA forming amino acids: Leucine,
isoleucine, lysine, tryptophan, phenylalanine, tyrosine
Mnemonic: Lily Try Phe Tyr in AC
• Transport of ammonia to liver
Muscle—uses alanine
Mnemonic: Amma ki Mala
Other tissues use glutamine
• Metabolic role of vitamin B
12
Methylation of homocysteine to methionine
Isomerization of methyl malonyl CoA to succinyl CoA
Methylation of pyrimidine ring to form thymine
Vitreous humor
Cartilage
Mnemonic: Hy SyL Vi in Car
Chondroitin sulphate:Cartilage
Bone
Cornea
Mnemonic: CBC
Karatan sulphate: Cornea (KS I)
Loose connective tissue (KS II)
Heparin: Mast cells
Heparan
sulphate: Aortic wall
Skin fibroblasts
Dermatan sulphate: Wide distribution
• Catabolism of carbon skeletons of amino acids
Oxaloacetate forming amino acid—Asparagine (aspartate)
Mnemonic: Ox in spa
Fumarate forming amino acids—Phenylalanine, tyrosine
Mnemonic: PheTyr fumes
Succinyl CoA: Threonine, valine, isoleucine, methionine
Mnemonic: Three successful VIM
• Ketoglutarate: Proline, histidine, arginine, glutamine
Mnemonic: ααααα PHAG
Pyruvate: Cystine, threonine, glycine, alanine, serine
Mnemonic: CT GAS in Peru
Acetyl CoA /Acetoacetyl CoA forming amino acids: Leucine,
isoleucine, lysine, tryptophan, phenylalanine, tyrosine
Mnemonic: Lily Try Phe Tyr in AC
• Transport of ammonia to liver
Muscle—uses alanine
Mnemonic: Amma ki Mala
Other tissues use glutamine
• Metabolic role of vitamin B
12
Methylation of homocysteine to methionine
Isomerization of methyl malonyl CoA to succinyl CoA
Methylation of pyrimidine ring to form thymine
Mnemonics20
Interconversion of glutamate and β-methyl aspartate in
bacteria
Conversion of
ribonucleotides to deoxyribonucleotides in
DNA synthesis
Metabolism of
diols
Mnemonic: HMP and GRD in B
12
• HGPRTase deficiency
Partial def: Kelly Siegmiller’s syndrome
No CNS involvement
Complete def: Lesch-Nyhan syndrome
Mnemonic:
Kelly is Partial
• Classification of amino acids
Amino acids with aliphatic side chain
Glycine
Alanine
Valine
Leucine
Isoleucine
Mnemonic: GAVLI
With side chain containing OH (hydroxyl) group
Tyrosine
Threonine
Serine
Mnemonic: oh tie three Sari
With side chain containing sulphur atoms
Methionine
Cysteine
Mnemonic: MSC
Containing aromatic rings
Histidine
Tryptophan
Phenylalanine
Tyrosine
Mnemonic: Histry Phe Tyr
Interconversion of glutamate and β-methyl aspartate in
bacteria
Conversion of
ribonucleotides to deoxyribonucleotides in
DNA synthesis
Metabolism of
diols
Mnemonic: HMP and GRD in B
12
• HGPRTase deficiency
Partial def: Kelly Siegmiller’s syndrome
No CNS involvement
Complete def: Lesch-Nyhan syndrome
Mnemonic:
Kelly is Partial
• Classification of amino acids
Amino acids with aliphatic side chain
Glycine
Alanine
Valine
Leucine
Isoleucine
Mnemonic: GAVLI
With side chain containing OH (hydroxyl) group
Tyrosine
Threonine
Serine
Mnemonic: oh tie three Sari
With side chain containing sulphur atoms
Methionine
Cysteine
Mnemonic: MSC
Containing aromatic rings
Histidine
Tryptophan
Phenylalanine
Tyrosine
Mnemonic: Histry Phe Tyr
21Biochemistry
• RNA polymerase transcribes
Type 1—rRNA
Types 2—mRNA
Type 3—tRNA
Mnemonic: RMT = Remote
• Homozygous substitution with other amino acids in place of
Valine at position 67 of β-chain
Glutamate—Hb milwaukee
Mnemonic: Gala Milo
Aspartic acid—Hb bristol
Mnemonic: Brass
Alanine—Hb sydney
Mnemonic: Alan border of sydney
• CPK-1-CPK BB—brain (Mnemonic: BB no. 1)
CPK-2-CPK MB—myocardium
Mnemonic: MB Heart attack
CPK-3-CPK MM—skeletal muscle
CPK-MB 1—extra cardiac form
CPK-MB 2—cardiac form
Mnemonic:
Heart attack especially in 2nd MB
• Fructose 2, 6-bisphosphate
+ ve on PFK 1
– ve on PFK 2
– ve on fructose 1, 6-bisphosphatase
Note:PFK 2 is bifunctional (2 is bi.)
• Ehrlich’s aldehyde reagent test
Chloroform layer turns pink—Urobilinogen (Mnemonic: CPU)
Aqueous layer turns pink—porphobilinogen
•Mg
2+
(Magnesium) is required in covalent modification of
enzymes by phosphorylation, dephosphorylation of seryl
residues.
It is required in:
Ribonuclease
• RNA polymerase transcribes
Type 1—rRNA
Types 2—mRNA
Type 3—tRNA
Mnemonic: RMT = Remote
• Homozygous substitution with other amino acids in place of
Valine at position 67 of β-chain
Glutamate—Hb milwaukee
Mnemonic: Gala Milo
Aspartic acid—Hb bristol
Mnemonic: Brass
Alanine—Hb sydney
Mnemonic: Alan border of sydney
• CPK-1-CPK BB—brain (Mnemonic: BB no. 1)
CPK-2-CPK MB—myocardium
Mnemonic: MB Heart attack
CPK-3-CPK MM—skeletal muscle
CPK-MB 1—extra cardiac form
CPK-MB 2—cardiac form
Mnemonic:
Heart attack especially in 2nd MB
• Fructose 2, 6-bisphosphate
+ ve on PFK 1
– ve on PFK 2
– ve on fructose 1, 6-bisphosphatase
Note:PFK 2 is bifunctional (2 is bi.)
• Ehrlich’s aldehyde reagent test
Chloroform layer turns pink—Urobilinogen (Mnemonic: CPU)
Aqueous layer turns pink—porphobilinogen
•Mg
2+
(Magnesium) is required in covalent modification of
enzymes by phosphorylation, dephosphorylation of seryl
residues.
It is required in:
Ribonuclease
Mnemonics22
Kinase
Transketolase
Peptidases
Ca carboxylase
Adenyl cyclase
Phosphatase
Mnemonic: RiKi Trap Car, add phos
• Tryptophan → Serotonin → Melatonin
Niacin (nicotinic acid/nicotinamide)
Tryptophan contains indole functional group.
• Tyrosine is formed from phenylalanine (Enz-phenylalanine
hydroxylase)
Tyrosine is also precursor for
Dopa
Dopamine
Epinephrine
Norepinephrine
Thyroxine
Triiodothyronine
Melamine
Note:Codon for tyrosine are UAC and UAU.
In Papaver somniferum, the opium poppy, tyrosine is used to
produce the alkaloid morphine.
• Substrate level phosphorylation
1, 3-bisphosphoglycerate to 3-phosphoglycerate (phospho-
glycerate kinase), glycolysis
Phosphoenol pyruvate to pyruvate (pyruvate kinase)-
glycolysis
Succinyl CoA to succinate (succinyl CoA synthetase or
succinate thiokinase), Kreb’s cycle
• Basic amino acid Pka of ‘R’
Histidine 6
Lysine 10.8
Arginine 12.5
Kinase
Transketolase
Peptidases
Ca carboxylase
Adenyl cyclase
Phosphatase
Mnemonic: RiKi Trap Car, add phos
• Tryptophan → Serotonin → Melatonin
Niacin (nicotinic acid/nicotinamide)
Tryptophan contains indole functional group.
• Tyrosine is formed from phenylalanine (Enz-phenylalanine
hydroxylase)
Tyrosine is also precursor for
Dopa
Dopamine
Epinephrine
Norepinephrine
Thyroxine
Triiodothyronine
Melamine
Note:Codon for tyrosine are UAC and UAU.
In Papaver somniferum, the opium poppy, tyrosine is used to
produce the alkaloid morphine.
• Substrate level phosphorylation
1, 3-bisphosphoglycerate to 3-phosphoglycerate (phospho-
glycerate kinase), glycolysis
Phosphoenol pyruvate to pyruvate (pyruvate kinase)-
glycolysis
Succinyl CoA to succinate (succinyl CoA synthetase or
succinate thiokinase), Kreb’s cycle
• Basic amino acid Pka of ‘R’
Histidine 6
Lysine 10.8
Arginine 12.5
23Biochemistry
Higher the Pka, more basic will be amino acid.
Mnemonic: Increasing order HLA
•Guanine to cytosine G ≡ C (3 hydrogen bonds) adenosine to
thymidine A = T (2 hydrogen bonds)
Mnemonic: 3G
• Named mutations
Nonsense mutation: Sense codon to change into nonsense
stop codon, causing premature termination of translation.
Missense mutation: Change of one sense codon into another
sense codon, for different amino acids
Mnemonic: Different Miss
Silent mutation: Change of one sense codon into another
sense codon for same amino acids (Mnemonic: S for S)
Null mutation: Leads to no functional gene product (complete
loss of function)
Loss of function mutation: Results of gene product having less
or no function.
Gain of function mutation: Change the gene product such that
it gains a new and abnormal function.
Neutral mutation: Different but chemically similar amino
acid.
• Insulin receptor: Two subunits
•α subunit: It is extracellular and its function is to bind insulin.
•β subunit: It is a transmembrane protein and its function is
signal transduction.
Note:The cytoplasmic portion of subunit has tyrosine
kinase activity (enzymatic receptor).
• Three steps in glycolysis that are physiologically irreversible.
These reactions are catalyzed by
–Hexokinase–glucokinase (glucose to glucose 6-phosphate)
–Phosphofructokinase (fructose 6 phosphate to fructose 1,
6-bisphosphate)
–Pyruvate kinase (phosphoenol pyruvate to pyruvic acid)
To remember: All three are kinases.
One involves glucose, another fructose and third one
pyruvate.
Higher the Pka, more basic will be amino acid.
Mnemonic: Increasing order HLA
•Guanine to cytosine G ≡ C (3 hydrogen bonds) adenosine to
thymidine A = T (2 hydrogen bonds)
Mnemonic: 3G
• Named mutations
Nonsense mutation: Sense codon to change into nonsense
stop codon, causing premature termination of translation.
Missense mutation: Change of one sense codon into another
sense codon, for different amino acids
Mnemonic: Different Miss
Silent mutation: Change of one sense codon into another
sense codon for same amino acids (Mnemonic: S for S)
Null mutation: Leads to no functional gene product (complete
loss of function)
Loss of function mutation: Results of gene product having less
or no function.
Gain of function mutation: Change the gene product such that
it gains a new and abnormal function.
Neutral mutation: Different but chemically similar amino
acid.
• Insulin receptor: Two subunits
•α subunit: It is extracellular and its function is to bind insulin.
•β subunit: It is a transmembrane protein and its function is
signal transduction.
Note:The cytoplasmic portion of subunit has tyrosine
kinase activity (enzymatic receptor).
• Three steps in glycolysis that are physiologically irreversible.
These reactions are catalyzed by
–Hexokinase–glucokinase (glucose to glucose 6-phosphate)
–Phosphofructokinase (fructose 6 phosphate to fructose 1,
6-bisphosphate)
–Pyruvate kinase (phosphoenol pyruvate to pyruvic acid)
To remember: All three are kinases.
One involves glucose, another fructose and third one
pyruvate.
Mnemonics24
• Metabolic fuels
Organ Fed Fasting Starvation Mnemonics
Brain Glucose Glucose Ketone bodies Gul Gul Ke
Heart Fatty acid Fatty acid Ketone bodies FFK (Fafakna in
Hindi)
Liver Glucose Fatty acid Amino acid GFA (Girl Friend
Ayi rahne)
Muscles Glucose Fatty acid Fatty acid GFF (is muscil in
Hindi)
RBC Glucose Glucose Glucose Only glucose
• DNA
Purines—Adenine, guanine
Pyrimidines—Cytosine, thymine
Mnemonic:
Y for Y
• Amino acids
Ketogenic—Leucine
Lysine
Mnemonic: KiLL
Both glucogenic and ketogenic—Isoluecine
Tryptophan
Phenylalanine
Tyrosine
Mnemonic:
GK Is trying phenyl on tyre
• Protein degeneration in eukaryotes
1. Protein degeneration in lysosomes—involves lysosomal
proteins. This process does not involve ATP.
2. Protein degradation in proteosomes—involves ubiquitin-
proteosome pathway. This process requires ATP, i.e. ATP
dependent.
Mnemonic:
UPA
• Trypsin—a proteolytic enzyme (proteinase)
It acts in an alkaline medium.
• Metabolic fuels
Organ Fed Fasting Starvation Mnemonics
Brain Glucose Glucose Ketone bodies Gul Gul Ke
Heart Fatty acid Fatty acid Ketone bodies FFK (Fafakna in
Hindi)
Liver Glucose Fatty acid Amino acid GFA (Girl Friend
Ayi rahne)
Muscles Glucose Fatty acid Fatty acid GFF (is muscil in
Hindi)
RBC Glucose Glucose Glucose Only glucose
• DNA
Purines—Adenine, guanine
Pyrimidines—Cytosine, thymine
Mnemonic:
Y for Y
• Amino acids
Ketogenic—Leucine
Lysine
Mnemonic: KiLL
Both glucogenic and ketogenic—Isoluecine
Tryptophan
Phenylalanine
Tyrosine
Mnemonic:
GK Is trying phenyl on tyre
• Protein degeneration in eukaryotes
1. Protein degeneration in lysosomes—involves lysosomal
proteins. This process does not involve ATP.
2. Protein degradation in proteosomes—involves ubiquitin-
proteosome pathway. This process requires ATP, i.e. ATP
dependent.
Mnemonic:
UPA
• Trypsin—a proteolytic enzyme (proteinase)
It acts in an alkaline medium.
25Biochemistry
Activators: Enterokinase
Calcium
Trypsin itself
Mnemonic: ECT
Inhibitors:Human and bovine colostrums
Egg white (contains water soluble mucoprotein)
Raw soyabean
Alpha antiproteinase/α-1 antitrypsin
Diisopropyl flurophosphate (DFP)
Mnemonic: HERALD
•Helicase—Unwinds dsDNA to provide ssDNA
Mnemonic: HU
Topoisomerase—Relieves torsional strain that results from
helicase induced unwinding.
Mnemonic: T for T
Activators: Enterokinase
Calcium
Trypsin itself
Mnemonic: ECT
Inhibitors:Human and bovine colostrums
Egg white (contains water soluble mucoprotein)
Raw soyabean
Alpha antiproteinase/α-1 antitrypsin
Diisopropyl flurophosphate (DFP)
Mnemonic: HERALD
•Helicase—Unwinds dsDNA to provide ssDNA
Mnemonic: HU
Topoisomerase—Relieves torsional strain that results from
helicase induced unwinding.
Mnemonic: T for T
• Papez circuit
Cingulate gyrus Anterior thalamic
(limbic system) nucleus (thalamus)
↓↑
Hippocampus Mammillary body
(limbic system) (hypothalamus)
Mnemonic: HiMaAnCi
• Limbic system
Cingulate gyrus (rim of cortical tissue around hilum of
cerebral hemisphere)
Amygdala
Septal nuclei
Hippocampus formation
Mnemonic: CASH
• Precursors of
Clotting factorsCarboxylase Mature clotting
II, VII, IX and X factors II, VII, IX, X
(inactive- Vitamin K (active γ-carboxy-
glutamyl glutamyl) Gla
residues) (Hydroxyquinone) residues
This reaction requires
CO
2 and hydroxyquinone form of vit. K
Mnemonic: CHK
• Phase of minimum cardiac motion
At low/intermediate heart rates—Mid-diastole
Mnemonic: Mid day minimum
At high heart rates: Late systole
26
→
←
→
Physiology
3
Cingulate gyrus Anterior thalamic
(limbic system) nucleus (thalamus)
↓↑
Hippocampus Mammillary body
(limbic system) (hypothalamus)
Mnemonic: HiMaAnCi
• Limbic system
Cingulate gyrus (rim of cortical tissue around hilum of
cerebral hemisphere)
Amygdala
Septal nuclei
Hippocampus formation
Mnemonic: CASH
• Precursors of
Clotting factorsCarboxylase Mature clotting
II, VII, IX and X factors II, VII, IX, X
(inactive- Vitamin K (active γ-carboxy-
glutamyl glutamyl) Gla
residues) (Hydroxyquinone) residues
This reaction requires
CO
2 and hydroxyquinone form of vit. K
Mnemonic: CHK
• Phase of minimum cardiac motion
At low/intermediate heart rates—Mid-diastole
Mnemonic: Mid day minimum
At high heart rates: Late systole
26
→
←
→
Physiology
3
27Physiology
• Nitric oxide synthase
NOS 1 ( Endothelial NOS): Constitutive/Calcium dependent
NOS 2 (Inducible NOS): Inducible/Calcium Independent
NOS 3 (Neuronal NOS): Constitutive/Calcium dependent
Mnemonic: EIN—Alphabetically and In for In
• Intestinal hormone stimulating insulin secretion
Gastrin
Gastric inhibitory peptide (GIP)
Glucagon
Glucagon like peptide (GLP)
Cholecystokinin (CCK)
Secretin
Mnemonic: 4GCS
• Features of cerebellar function/lesion
Past pointing
Hypotonia
Cerebellar nystagmus
Dysmetria
Dysarthria
Dysdiadochokinesia
Intention tremor
Ataxia
Mnemonic: PHC D
3
I
2
A
1
•Pain insensitive structure
Parenchyma of brain
Plexus (choroid)
Ependymoma
Pia-arachnoid
Dura over convexity of skull
Mnemonic: PCS is insensitive
Also remember: Vasomotor center (VMC)
Excitatory: Cortex
Pain pathway
Carotid and aortic chemoreceptors
Direct stimulators: CO
2
Hypoxia
• Nitric oxide synthase
NOS 1 ( Endothelial NOS): Constitutive/Calcium dependent
NOS 2 (Inducible NOS): Inducible/Calcium Independent
NOS 3 (Neuronal NOS): Constitutive/Calcium dependent
Mnemonic: EIN—Alphabetically and In for In
• Intestinal hormone stimulating insulin secretion
Gastrin
Gastric inhibitory peptide (GIP)
Glucagon
Glucagon like peptide (GLP)
Cholecystokinin (CCK)
Secretin
Mnemonic: 4GCS
• Features of cerebellar function/lesion
Past pointing
Hypotonia
Cerebellar nystagmus
Dysmetria
Dysarthria
Dysdiadochokinesia
Intention tremor
Ataxia
Mnemonic: PHC D
3
I
2
A
1
•Pain insensitive structure
Parenchyma of brain
Plexus (choroid)
Ependymoma
Pia-arachnoid
Dura over convexity of skull
Mnemonic: PCS is insensitive
Also remember: Vasomotor center (VMC)
Excitatory: Cortex
Pain pathway
Carotid and aortic chemoreceptors
Direct stimulators: CO
2
Hypoxia
Mnemonics28
• Cells within gastric glands
Chief Zudge fund of pepsi—chief cells/zymogenic cells—
fundus of stomach—pepsin
Ox and Pari are intrinsic to HCL—oxyntic cells or parietal
cells—secrete HCL.
• Abnormal Hb with decreased solubility
Hb
S (β6-GLU-VAL)
HbC (β6-GLU-LYS)
HbD (β6-GLU-GLM)
Mnemonic: Supreme Court Decision-Very Long Gap
• Parasympathetic fibres carrying cranial nerves—3, 7, 9, 10
Pure motor—3, 4, 6, 11, 12
Pure sensory—1, 2, 8
• The Dorsal spinocerebellar tract enters the cerebellum
through inferior cerebellar peduncle. The ventral tract enters
into the cerebellum through superior cerebellar peduncle.
Mnemonic: DIN
• Medullary respiratory centres:
Dorsal respiratory group (DRG), located in the dorsal portion
of the medulla, which mainly causes inspiration
Mnemonic: Din
Ventral respiratory group (VRG) located in the ventrolateral
part of the medulla, which mainly causes expiration.
• Hormones with second messenger cGMP
Atrial natriuretic factor
Nitric oxide
Mnemonic: NAG
Hormones with second messenger Creatine Kinase
Growth hormone
Erythropoietin
Prolactin
Insulin
Insulin like growth factors I and II
Chorionic somatomammotropin
Mnemonic: Growing EPICK
• Cells within gastric glands
Chief Zudge fund of pepsi—chief cells/zymogenic cells—
fundus of stomach—pepsin
Ox and Pari are intrinsic to HCL—oxyntic cells or parietal
cells—secrete HCL.
• Abnormal Hb with decreased solubility
Hb
S (β6-GLU-VAL)
HbC (β6-GLU-LYS)
HbD (β6-GLU-GLM)
Mnemonic: Supreme Court Decision-Very Long Gap
• Parasympathetic fibres carrying cranial nerves—3, 7, 9, 10
Pure motor—3, 4, 6, 11, 12
Pure sensory—1, 2, 8
• The Dorsal spinocerebellar tract enters the cerebellum
through inferior cerebellar peduncle. The ventral tract enters
into the cerebellum through superior cerebellar peduncle.
Mnemonic: DIN
• Medullary respiratory centres:
Dorsal respiratory group (DRG), located in the dorsal portion
of the medulla, which mainly causes inspiration
Mnemonic: Din
Ventral respiratory group (VRG) located in the ventrolateral
part of the medulla, which mainly causes expiration.
• Hormones with second messenger cGMP
Atrial natriuretic factor
Nitric oxide
Mnemonic: NAG
Hormones with second messenger Creatine Kinase
Growth hormone
Erythropoietin
Prolactin
Insulin
Insulin like growth factors I and II
Chorionic somatomammotropin
Mnemonic: Growing EPICK
29Physiology
Hormones with second messenger cAMP
α2 adrenergic catecholamines
β adrenergic catecholamines
Adrenocorticotropichormone (ACTH)—pituitary
Antidiuretic hormone (V2)—2 ampoule
Calcitonin—parafollicular ‘C’ cell of thyroid
Chorionic gonadotropin, human
Corticotropin release hormone
Dopamine
Glucagon—pancreas
FSH—pituitary
LH—pituitary
MSH
PTH—parathyroid
Somatostatin
TSH—pituitary (FLAT)
Mnemonic: ACD GF LM PST
Second messenger is Ca
2+
/PIP
Oxytocin
ADH (V1A and V1B)
TRH
Gonadotropin releasing hormone
Gastrin
Cholecystokinin
Acetylcholine
α1-adrenergic catecholamine
• Intrinsic muscle control
Golgi
tendon organ—detects muscle tension—inverse stretch
reflex—lengthening reaction
Mnemonic: T for T
Muscle spindle—detects muscle length—stretch reflex
Mnemonic: S for S
• Vestibular cerebellum—equilibrium
spinocerebellum—Smoothens and coordinates
Mnemonic: S for S
Neocerebellum—planning and programming
Hormones with second messenger cAMP
α2 adrenergic catecholamines
β adrenergic catecholamines
Adrenocorticotropichormone (ACTH)—pituitary
Antidiuretic hormone (V2)—2 ampoule
Calcitonin—parafollicular ‘C’ cell of thyroid
Chorionic gonadotropin, human
Corticotropin release hormone
Dopamine
Glucagon—pancreas
FSH—pituitary
LH—pituitary
MSH
PTH—parathyroid
Somatostatin
TSH—pituitary (FLAT)
Mnemonic: ACD GF LM PST
Second messenger is Ca
2+
/PIP
Oxytocin
ADH (V1A and V1B)
TRH
Gonadotropin releasing hormone
Gastrin
Cholecystokinin
Acetylcholine
α1-adrenergic catecholamine
• Intrinsic muscle control
Golgi
tendon organ—detects muscle tension—inverse stretch
reflex—lengthening reaction
Mnemonic: T for T
Muscle spindle—detects muscle length—stretch reflex
Mnemonic: S for S
• Vestibular cerebellum—equilibrium
spinocerebellum—Smoothens and coordinates
Mnemonic: S for S
Neocerebellum—planning and programming
Mnemonics30
• Trichromatic theory
Red—protanomaly
Green—deuteranomaly
Blue—tritanomaly
Mnemonic:
Red-Green-Blue (Ragbi)
• General somatic efferents: Motor functions of skeletal muscles
derived from somites: Cranial nerves
III (Oculomotor nucleus)
IV (Trochlear nucleus)
VI (Abducens nucleus): Supplies extraocular muscles
XII (Hypoglossal nucleus): Supplies tongue muscles
Mnemonic:
Tongue muscles and Extraocular muscles
• General visceral efferents: Motor function of smooth muscles
and glands of head and viscera that receive parasympathetic
supply
Cranial nerves
Superior salivatory nucleus (VII) Superior Seven
Inferior salivatory nucleus (IX) Inferior Nine
Dorsal motor nucleus (X) Dorsal ~ Das (Hindi)
Edinger-Westphal nucleus (III)
Mnemonic: SIDE
• Bronchial efferents/special visceral efferents
Ambiguous nucleus (IX, X, XI)
Masticatory nucleus (V)
Spinal accessory nucleus (XI)
Facial nucleus (VII)
Mnemonic: Ambi Ka Mast Special accessory face
•Axon reflex contributes only to the Flare component of triple
response.
Mnemonic: Flaxon
• Sarcolemmal proteins localized to the cytoplasmic side of
sarcolemma
Dysferlin
Dystrophin
Calpain
Mnemonic:
Fer pin Pain
• Trichromatic theory
Red—protanomaly
Green—deuteranomaly
Blue—tritanomaly
Mnemonic:
Red-Green-Blue (Ragbi)
• General somatic efferents: Motor functions of skeletal muscles
derived from somites: Cranial nerves
III (Oculomotor nucleus)
IV (Trochlear nucleus)
VI (Abducens nucleus): Supplies extraocular muscles
XII (Hypoglossal nucleus): Supplies tongue muscles
Mnemonic:
Tongue muscles and Extraocular muscles
• General visceral efferents: Motor function of smooth muscles
and glands of head and viscera that receive parasympathetic
supply
Cranial nerves
Superior salivatory nucleus (VII) Superior Seven
Inferior salivatory nucleus (IX) Inferior Nine
Dorsal motor nucleus (X) Dorsal ~ Das (Hindi)
Edinger-Westphal nucleus (III)
Mnemonic: SIDE
• Bronchial efferents/special visceral efferents
Ambiguous nucleus (IX, X, XI)
Masticatory nucleus (V)
Spinal accessory nucleus (XI)
Facial nucleus (VII)
Mnemonic: Ambi Ka Mast Special accessory face
•Axon reflex contributes only to the Flare component of triple
response.
Mnemonic: Flaxon
• Sarcolemmal proteins localized to the cytoplasmic side of
sarcolemma
Dysferlin
Dystrophin
Calpain
Mnemonic:
Fer pin Pain
31Physiology
Also remember: Transmembrane sarcolemmal proteins
Dystroglycans, integrins, sarcoglycans and caveolin
Mnemonic: DISC
• The dorsal column ascends such that it remains ipsilateral
along the entire length of spinal cord (its branch cross over in
medulla)
Mnemonic: DCM-Dorsal column cross over in medulla
Sensations transmitted by spinothalamic tract
Anterior spinothalamic tract
Mnemonic: Crude ATP-Crude touch and pressure in anterior
Spinothalamic tract
Lateral spinothalamic tract
Pain (pin prick)
Temperature
Mnemonic: PLT
Note:The spinothalamic tract crosses more or less at point
of entry itself such that it remains contralateral along the
whole length of spinal cord.
• When compared to plasma
Serum has no fibrinogen, clotting factors II, V and VIII but has
higher serotonin content because of platelet breakdown in
serum
Mnemonic: S for S
• Frequency of sleep waves
Gamma oscillations 30–80 Hz Great
Beta waves 18–30 Hz B
Alpha waves 8–12 Hz A
Theta waves 4–7 Hz T
Delta waves < 4 Hz Dance
Awake person
Eyes opened Beta waves
Mnemonic: Opening batsman
Eyes closed Alpha waves
Also remember: Transmembrane sarcolemmal proteins
Dystroglycans, integrins, sarcoglycans and caveolin
Mnemonic: DISC
• The dorsal column ascends such that it remains ipsilateral
along the entire length of spinal cord (its branch cross over in
medulla)
Mnemonic: DCM-Dorsal column cross over in medulla
Sensations transmitted by spinothalamic tract
Anterior spinothalamic tract
Mnemonic: Crude ATP-Crude touch and pressure in anterior
Spinothalamic tract
Lateral spinothalamic tract
Pain (pin prick)
Temperature
Mnemonic: PLT
Note:The spinothalamic tract crosses more or less at point
of entry itself such that it remains contralateral along the
whole length of spinal cord.
• When compared to plasma
Serum has no fibrinogen, clotting factors II, V and VIII but has
higher serotonin content because of platelet breakdown in
serum
Mnemonic: S for S
• Frequency of sleep waves
Gamma oscillations 30–80 Hz Great
Beta waves 18–30 Hz B
Alpha waves 8–12 Hz A
Theta waves 4–7 Hz T
Delta waves < 4 Hz Dance
Awake person
Eyes opened Beta waves
Mnemonic: Opening batsman
Eyes closed Alpha waves
Mnemonics32
• Oxygen toxicity
Acute—Bert effect—CNS effects are predominant (muscle
twitching, convulsions, coma) (Mnemonic: ABC)
Chronic—Smith effect—pulmonary effects (pulmonary
edema, lung atelectasis)
• Hormones produced in kidney
Renin
Erythropoietin
1, 25-Dihydroxycholecalciferol—vit. D
Mnemonic: RED
• Testis
Interstitial cells of Leydig—secrete testosterone
Mnemonic: Lete
Most other functions—Sertoli cells
Y-Chromosome—small acrocentric
Mnemonic: Yac
• Naturally occurring estrogens
Estrone: Major estrogen in postmenopausal women
Mnemonic: NM
Estradiol: Major and most potent estrogen in women
Estriol: Major estrogen in pregnancy, marker for fetoplacental
unit.
Mnemonic: PT
• Clasp knife spasticity: Upper motor neuron lesion
(corticospinal pyramidal system involved)
Mnemonic: Up in Spa
Lead pipe and cogwheel rigidity occurs in extrapyramidal
syndrome, e.g. Parkinsonism.
Mnemonic: Extra rigid in Parkinsonism
Paratonia/gegenhalten—bilateral frontal lobe damage
Mnemonic: FG
Cerebrovascular disease.
•Sympathetic outflow: Thoracolumbar outflow
Mnemonic: SLT
Parasympathetic outflow: Craniosacral outflow
Mnemonic: PCS
• Oxygen toxicity
Acute—Bert effect—CNS effects are predominant (muscle
twitching, convulsions, coma) (Mnemonic: ABC)
Chronic—Smith effect—pulmonary effects (pulmonary
edema, lung atelectasis)
• Hormones produced in kidney
Renin
Erythropoietin
1, 25-Dihydroxycholecalciferol—vit. D
Mnemonic: RED
• Testis
Interstitial cells of Leydig—secrete testosterone
Mnemonic: Lete
Most other functions—Sertoli cells
Y-Chromosome—small acrocentric
Mnemonic: Yac
• Naturally occurring estrogens
Estrone: Major estrogen in postmenopausal women
Mnemonic: NM
Estradiol: Major and most potent estrogen in women
Estriol: Major estrogen in pregnancy, marker for fetoplacental
unit.
Mnemonic: PT
• Clasp knife spasticity: Upper motor neuron lesion
(corticospinal pyramidal system involved)
Mnemonic: Up in Spa
Lead pipe and cogwheel rigidity occurs in extrapyramidal
syndrome, e.g. Parkinsonism.
Mnemonic: Extra rigid in Parkinsonism
Paratonia/gegenhalten—bilateral frontal lobe damage
Mnemonic: FG
Cerebrovascular disease.
•Sympathetic outflow: Thoracolumbar outflow
Mnemonic: SLT
Parasympathetic outflow: Craniosacral outflow
Mnemonic: PCS
33Physiology
• LH surge: Ovulation—hormone picture
High estrogen
Low progesterone
Mnemonic: HELP
•IRV + TV = Inspiratory capacity (Mn: ITI)
ERV + RV = Functional residual capacity (Mnemonic: FER)
IRV + TV + ERV = Vital capacity
IRV + TV + ERV + RV = Total lung capacity
VC + RV = TLC (Mnemonic: VRT)
•Positive feedback mechanisms
Parturition
Action potential initiation
Blood clotting/clot formation
LH surge
Ca
2+
mediated contraction
Shock
Mnemonic: PABLCS
• Sympathetic cholinergic system serves two important
functions:
a. Sweat gland—secretion of sweat.
b. Vasodilatation in skeletal muscles—a part of the neurons
to blood vessels in skeletal muscles is anatomically
sympathetic but secrete acetylcholine. Stimulation of this
system of neurons produces vasodilatation in skeletal
muscles.
• Stimulus for CCK-PZ secretion:
a. Presence of peptides and amino acids in contact with
mucosa of small intestine.
b. Presence in the duodenum of fatty acids having more
than 10 carbon atoms.
Stimulus for secretin secretion:
a. Acidity of chyme
b. Products of protein digestion
• Stage IV: NREM sleep disorders:
Sleep walking (somnambulism)
• LH surge: Ovulation—hormone picture
High estrogen
Low progesterone
Mnemonic: HELP
•IRV + TV = Inspiratory capacity (Mn: ITI)
ERV + RV = Functional residual capacity (Mnemonic: FER)
IRV + TV + ERV = Vital capacity
IRV + TV + ERV + RV = Total lung capacity
VC + RV = TLC (Mnemonic: VRT)
•Positive feedback mechanisms
Parturition
Action potential initiation
Blood clotting/clot formation
LH surge
Ca
2+
mediated contraction
Shock
Mnemonic: PABLCS
• Sympathetic cholinergic system serves two important
functions:
a. Sweat gland—secretion of sweat.
b. Vasodilatation in skeletal muscles—a part of the neurons
to blood vessels in skeletal muscles is anatomically
sympathetic but secrete acetylcholine. Stimulation of this
system of neurons produces vasodilatation in skeletal
muscles.
• Stimulus for CCK-PZ secretion:
a. Presence of peptides and amino acids in contact with
mucosa of small intestine.
b. Presence in the duodenum of fatty acids having more
than 10 carbon atoms.
Stimulus for secretin secretion:
a. Acidity of chyme
b. Products of protein digestion
• Stage IV: NREM sleep disorders:
Sleep walking (somnambulism)
Mnemonics34
Sleep terorr or night terror (pavor nocturnus)
Sleep related enuresis (bed wetting)
Bruxism (tooth grinding)
Sleep talking (somniloquy)
• REM sleep disorders:
RBD-
REM sleep behaviour disorder
Nightmares
Narcolepsy (hallmark—decreased sleep latency)
Note:Penile tumescence is seen in REM sleep.
Mnemonic: RML Pens REM
• Difference between T3 and T4
T3 is more potent.
T3 has faster onset of action.
T3 binds more avidly to nuclear receptors.
T4 is more secreted by thyroid.
T4 is major circulating hormone.
T4 binds more avidly to plasma proteins (15 times).
T4 has more plasma t½
To remember: T4 = Pharmacokinetics
T3 = Pharmacodynamics
Note:About 1/3 of T4 is converted to T3 in peripheral
tissues.
• Ions predominant in ICF:
Potassium
Phosphate (organic)
Protein
Magnesium
Mnemonic: 3PM
Ions predominant in ECF—Na
+
/Cl
–
/HCO
3
–/Ca
2+
Sleep terorr or night terror (pavor nocturnus)
Sleep related enuresis (bed wetting)
Bruxism (tooth grinding)
Sleep talking (somniloquy)
• REM sleep disorders:
RBD-
REM sleep behaviour disorder
Nightmares
Narcolepsy (hallmark—decreased sleep latency)
Note:Penile tumescence is seen in REM sleep.
Mnemonic: RML Pens REM
• Difference between T3 and T4
T3 is more potent.
T3 has faster onset of action.
T3 binds more avidly to nuclear receptors.
T4 is more secreted by thyroid.
T4 is major circulating hormone.
T4 binds more avidly to plasma proteins (15 times).
T4 has more plasma t½
To remember: T4 = Pharmacokinetics
T3 = Pharmacodynamics
Note:About 1/3 of T4 is converted to T3 in peripheral
tissues.
• Ions predominant in ICF:
Potassium
Phosphate (organic)
Protein
Magnesium
Mnemonic: 3PM
Ions predominant in ECF—Na
+
/Cl
–
/HCO
3
–/Ca
2+
•Therapeutic Index =
D50
D50
L
E
or LD50/ED50
Mnemonic: TILE
• Selective phosphodiesterase 4 (PDE4) inhibitors
Roflumilast
Cilomilast
Tofimilast
Mnemonic: RCT-Milast
• Small molecule tyrosine kinase inhibitors
HER1 (EGFR) Erb B1:Erlotinib (reversible)
Canertinib (Irreversible)
Gefitinib
Mnemonic: I Can do ECG
•VGFR TK inhibitors—Sorafenib—Renal cell cancer
Sunitinib—Renal cell cancer
Mnemonic: VRS
• Drugs used for acute gout
NSAIDS
Colchicine
Corticosteroids
Mnemonic: NCC
• Relative potency of same steroid at equivalent concentrations
in different formulation
Ointment > Emollient > Gel > Cream > Lotion
Mnemonic: OEGCL
35
Pharmacology
4
D50
D50
L
E
or LD50/ED50
Mnemonic: TILE
• Selective phosphodiesterase 4 (PDE4) inhibitors
Roflumilast
Cilomilast
Tofimilast
Mnemonic: RCT-Milast
• Small molecule tyrosine kinase inhibitors
HER1 (EGFR) Erb B1:Erlotinib (reversible)
Canertinib (Irreversible)
Gefitinib
Mnemonic: I Can do ECG
•VGFR TK inhibitors—Sorafenib—Renal cell cancer
Sunitinib—Renal cell cancer
Mnemonic: VRS
• Drugs used for acute gout
NSAIDS
Colchicine
Corticosteroids
Mnemonic: NCC
• Relative potency of same steroid at equivalent concentrations
in different formulation
Ointment > Emollient > Gel > Cream > Lotion
Mnemonic: OEGCL
35
Pharmacology
4
Mnemonics36
• Anticancer cells: Cell cycle specific
G2 phase specific: Daunorubicin
Etoposide
Bleomycin
Topotecan and Irinotecan
Mnemonic: DEBT
S-phase specific agent: Antimetabolites
Mtx
6MP
6TG
5-FU
Cytarabine
Hydroxyurea
M-phase specific: Vinca alkaloids
Paclitaxel and Docetaxel
G1 phase: Vinblastine
• Drugs causing hyperuricemia
L-Dopa
Ethambutol
Aspirin
Diuretic
Cyclosporine
Alcohol
Nicotinic acid
Pyrazinamide
Mnemonic: LEAD CAN poison
• Anti-TNF-α drugs
Etanercept
Adalimumab
Infliximab
Mnemonic: Etalion adalat Ka Insaf
• Clomiphene citrate
Enclomiphene—trans-antagonist
Zuclomiphene—cis-weak agonist
Mnemonic: N for N
• Anti-anxiety Benzodiazepines
Diazepam
Chlordiazepoxide
• Anticancer cells: Cell cycle specific
G2 phase specific: Daunorubicin
Etoposide
Bleomycin
Topotecan and Irinotecan
Mnemonic: DEBT
S-phase specific agent: Antimetabolites
Mtx
6MP
6TG
5-FU
Cytarabine
Hydroxyurea
M-phase specific: Vinca alkaloids
Paclitaxel and Docetaxel
G1 phase: Vinblastine
• Drugs causing hyperuricemia
L-Dopa
Ethambutol
Aspirin
Diuretic
Cyclosporine
Alcohol
Nicotinic acid
Pyrazinamide
Mnemonic: LEAD CAN poison
• Anti-TNF-α drugs
Etanercept
Adalimumab
Infliximab
Mnemonic: Etalion adalat Ka Insaf
• Clomiphene citrate
Enclomiphene—trans-antagonist
Zuclomiphene—cis-weak agonist
Mnemonic: N for N
• Anti-anxiety Benzodiazepines
Diazepam
Chlordiazepoxide
Pharmacology 37
Oxazepam
Lorazepam
Alprazolam
Mnemonic: Dia Ka CHOLA
• Anti-pseudomonal penicillins
Azlocillin
Mezlocillin
Carbenicillin
Piperacillin
Ticarcillin
Mnemonic: (Az) (Mez) pe Car Ka Pipe Tica
• Penicillinase susceptible penicillins
Penicillin G: Acid labile
Penicillin V: Acid stable
Mnemonic: Galib
• Penicillinase resistant
Nafcillin
Methicillin
Flucloxacillin
Oxacillin
Cloxacillin
Dicloxacillin
Mnemonic: Name Flu of OCD (last four are—oxa)
• Intramuscular penicillins
Benzathine penicillin G
Procaine penicillin G
Mnemonic: BP (measured on muscle)
Intravenous intramuscular
Penicillin G
Crystalline penicillin G or sodium penicillin G
• Anti-fungal drugs
Systemic azoles
Itraconazole
Voriconazole
Fluconazole
Mnemonic: IVF
Oxazepam
Lorazepam
Alprazolam
Mnemonic: Dia Ka CHOLA
• Anti-pseudomonal penicillins
Azlocillin
Mezlocillin
Carbenicillin
Piperacillin
Ticarcillin
Mnemonic: (Az) (Mez) pe Car Ka Pipe Tica
• Penicillinase susceptible penicillins
Penicillin G: Acid labile
Penicillin V: Acid stable
Mnemonic: Galib
• Penicillinase resistant
Nafcillin
Methicillin
Flucloxacillin
Oxacillin
Cloxacillin
Dicloxacillin
Mnemonic: Name Flu of OCD (last four are—oxa)
• Intramuscular penicillins
Benzathine penicillin G
Procaine penicillin G
Mnemonic: BP (measured on muscle)
Intravenous intramuscular
Penicillin G
Crystalline penicillin G or sodium penicillin G
• Anti-fungal drugs
Systemic azoles
Itraconazole
Voriconazole
Fluconazole
Mnemonic: IVF
Mnemonics38
Note:Ketoconazole is both topical and systemic.
• Side effects: Tacrolimus versus cyclosporine
Tacrolimus causes more
Neurotoxicity
Nephrotoxicity
Diabetes mellitus
Diarrhoea
Mnemonic: N
2D
2: ND Tiwari
Cyclosporine causes more
Hirsutism
Hyperplasia of gums
Hypertension
Hepatotoxicity
(4H: First two are absent in tacrolimus)
• Management of PSVT
Adenosine > beta (β) blocker > calcium channel blocker
(verapamil) > digoxin
Mnemonic: ABCD
• Beta agonists—side effects
Tolerance
Tachycardia
Tremor
Mnemonic: 3T
• Effects mediated through β2 receptor agonists
Relaxation of smooth muscles
Airway (bronchial muscles) Bronchodilatation (relaxation)
Blood vessels Vasodilatation (relaxation)
(Arterioles and Veins)
Ciliary muscles in eye Relaxation
Detrusor muscles in bladder Relaxation
Gall bladder and duct Relaxation
Gastrointestinal tract Relaxation
Uterus Relaxation
Splenic capsule Relaxation
Mnemonic: ABCD G2US (i.e. ABCD GO TO US)
Note:Ketoconazole is both topical and systemic.
• Side effects: Tacrolimus versus cyclosporine
Tacrolimus causes more
Neurotoxicity
Nephrotoxicity
Diabetes mellitus
Diarrhoea
Mnemonic: N
2D
2: ND Tiwari
Cyclosporine causes more
Hirsutism
Hyperplasia of gums
Hypertension
Hepatotoxicity
(4H: First two are absent in tacrolimus)
• Management of PSVT
Adenosine > beta (β) blocker > calcium channel blocker
(verapamil) > digoxin
Mnemonic: ABCD
• Beta agonists—side effects
Tolerance
Tachycardia
Tremor
Mnemonic: 3T
• Effects mediated through β2 receptor agonists
Relaxation of smooth muscles
Airway (bronchial muscles) Bronchodilatation (relaxation)
Blood vessels Vasodilatation (relaxation)
(Arterioles and Veins)
Ciliary muscles in eye Relaxation
Detrusor muscles in bladder Relaxation
Gall bladder and duct Relaxation
Gastrointestinal tract Relaxation
Uterus Relaxation
Splenic capsule Relaxation
Mnemonic: ABCD G2US (i.e. ABCD GO TO US)
Pharmacology 39
• Oral drug therapy for treatment of erectile dysfunction
PPentoxyfylline
OOpoid antagonist (naltrexone)
DDopamine agonist (bomocriptine, apomorphine)
AAlpha blockers (yohimbine, idaxozan)
Mnemonic: PODA
• Prostaglandin E1 (PGE1) analogues
Riopristil
Alprostadil
Misoprostol
Mnemonic: RAM
Prostaglandin F2α (PGF2α) analogues
Dinoprost
Carboprost
Latanoprost
Mnemonic: Prost
• Hormones acting through cell membrane receptors
G protein coupled receptors
Enzymatic receptors
• G protein coupled receptors act either
Through alteration in CAMP concentration, or
Through IP3/DAG generation
CAMP altering hormones are (another Mnemonic: ABCD GF
LMPST)
Pancreas: Glucagon, somatostatin (delta cells)
Pituitary: FSH, LH, ACTH, TSH (Mnemonic: FLAT—CAMP)
Parathyroid: PTH
Parafollicullar C cells of thyroid: Calcitonin
Posterior pituitary: Vasopressin (V2)
Plus hypothalamic releasing hormones (CRH, dopamine)
Placenta: hCG
Peptide of intermediate pituitary: MSH
Through IP3/DAG: Oxytocin TRH gastrin Acetylcholine
Vasopressin Gn RH Angiotensin II
(V1)
• Oral drug therapy for treatment of erectile dysfunction
PPentoxyfylline
OOpoid antagonist (naltrexone)
DDopamine agonist (bomocriptine, apomorphine)
AAlpha blockers (yohimbine, idaxozan)
Mnemonic: PODA
• Prostaglandin E1 (PGE1) analogues
Riopristil
Alprostadil
Misoprostol
Mnemonic: RAM
Prostaglandin F2α (PGF2α) analogues
Dinoprost
Carboprost
Latanoprost
Mnemonic: Prost
• Hormones acting through cell membrane receptors
G protein coupled receptors
Enzymatic receptors
• G protein coupled receptors act either
Through alteration in CAMP concentration, or
Through IP3/DAG generation
CAMP altering hormones are (another Mnemonic: ABCD GF
LMPST)
Pancreas: Glucagon, somatostatin (delta cells)
Pituitary: FSH, LH, ACTH, TSH (Mnemonic: FLAT—CAMP)
Parathyroid: PTH
Parafollicullar C cells of thyroid: Calcitonin
Posterior pituitary: Vasopressin (V2)
Plus hypothalamic releasing hormones (CRH, dopamine)
Placenta: hCG
Peptide of intermediate pituitary: MSH
Through IP3/DAG: Oxytocin TRH gastrin Acetylcholine
Vasopressin Gn RH Angiotensin II
(V1)
Mnemonics40
Through cGMP—NO
ANF
Mnemonic: NAG (NO, ANF through cGMP)
• Rapid acting human insulin analogues
Insulin aspart
Insulin lispro
Insulin glulisine
Mnemonic: Asli Glu
Also Remember: Long acting human insulin analogues
Insulin glargine
Insulin detemir
• Mechanism of action of antiepileptic agents
Facilitation of
GABA mediated chloride channel opening
Barbiturates
Benzodiazepines
Gabapentin
Tiagabine
Topiramate
Vigabatrin
Valproate
Mnemonic: BaBe Girl Tia Top in Viva of GABA class
• Inhibition of T type Ca
2+
current
Valproate
Trimethadione
Ethosuximide
Mnemonic: Vallore try ethical current
• Prolongation of Na
+
channel inactivation
Valproate
Lamotrigine
Zonisamide
Phenytoin
Carbamazepine
Topiramate
Mnemonic: Very long zone of Na
+
in PCT
Through cGMP—NO
ANF
Mnemonic: NAG (NO, ANF through cGMP)
• Rapid acting human insulin analogues
Insulin aspart
Insulin lispro
Insulin glulisine
Mnemonic: Asli Glu
Also Remember: Long acting human insulin analogues
Insulin glargine
Insulin detemir
• Mechanism of action of antiepileptic agents
Facilitation of
GABA mediated chloride channel opening
Barbiturates
Benzodiazepines
Gabapentin
Tiagabine
Topiramate
Vigabatrin
Valproate
Mnemonic: BaBe Girl Tia Top in Viva of GABA class
• Inhibition of T type Ca
2+
current
Valproate
Trimethadione
Ethosuximide
Mnemonic: Vallore try ethical current
• Prolongation of Na
+
channel inactivation
Valproate
Lamotrigine
Zonisamide
Phenytoin
Carbamazepine
Topiramate
Mnemonic: Very long zone of Na
+
in PCT
Pharmacology 41
• Gp II b/III a antagonist
Eptifibatide
Tirofiban
Abciximab
Mnemonic: EpTiAb
• All Navirs are protease inhibitors
• NNRTI: Efavirenz
Etravirine
Nevirapine
Delaviridine
Mnemonic: 2END
• Didanosine Stavudine Zalcitabine
(20%) (71%) (15%)
Similar toxic profiles
Peripheral neuropathy (% in bracket)
Lactic acidosis
Pancreatitis
Liver: Hepatomegaly with steatosis
Mnemonic: PLPL
• Anti-metabolite acting by hypomethylation (inhibit DNA
methyl transferase)
Azacitidine
Decitabine
Mnemonic: Hypo Aza D
• Thymine less death (inhibit DNA synthesis by blocking
synthesis of thymidylate) causing anti-metabolites
5-Fluorouracil (5-Fu)
Capecitabine (5-Fu analogues)
• Anti-metabolite acting by inhibition of DNA elongation (DNA
intercalating agent)
Cytarabine or cytosine arabinoside (pyrimidine-cytidine
analogue)
Gemcitabine (Pyrimidine-cytidine analogue)
Mnemonic: Arab Gem inhibit elongation
• Gp II b/III a antagonist
Eptifibatide
Tirofiban
Abciximab
Mnemonic: EpTiAb
• All Navirs are protease inhibitors
• NNRTI: Efavirenz
Etravirine
Nevirapine
Delaviridine
Mnemonic: 2END
• Didanosine Stavudine Zalcitabine
(20%) (71%) (15%)
Similar toxic profiles
Peripheral neuropathy (% in bracket)
Lactic acidosis
Pancreatitis
Liver: Hepatomegaly with steatosis
Mnemonic: PLPL
• Anti-metabolite acting by hypomethylation (inhibit DNA
methyl transferase)
Azacitidine
Decitabine
Mnemonic: Hypo Aza D
• Thymine less death (inhibit DNA synthesis by blocking
synthesis of thymidylate) causing anti-metabolites
5-Fluorouracil (5-Fu)
Capecitabine (5-Fu analogues)
• Anti-metabolite acting by inhibition of DNA elongation (DNA
intercalating agent)
Cytarabine or cytosine arabinoside (pyrimidine-cytidine
analogue)
Gemcitabine (Pyrimidine-cytidine analogue)
Mnemonic: Arab Gem inhibit elongation
Mnemonics42
•Filgrastim is recombinant GCSF (glycoprotein) produced in
E. coli
Mnemonic: EFG
• High dose methotrexate is used for osteosarcoma, brain
tumors and hematological malignancies.
Mnemonic: Bone, Brain, Blood
• Filgrastim: GCSF/(Gra for granulocyte)
Sargramostim GM-CSF (Gramo for granulocyte monocyte)
• Drugs associated with SIADH
Vasopressin or desmopressin
Chlorpropamide
Oxytocin, high dose
Vincristine
Carbamazepine
Nicotine
Phenothiazines
Cyclophosphamide
TCA
MAO inhibitors
SSRI
Mnemonic: VCO VCN PC, TMS
• Drugs causing constipation
Aluminium hydroxide
Barium sulphate
Calcium carbonate
Ferrous sulphate
Ganglionic blockers
Ion exchange resins
Opiates
Phenothiazines
Tricyclic antidepressants
Verapamil (calcium channel blockers)
Mnemonic: ABC, FGI, OP, TV)
Note:Mg
2+
is laxative.
•Filgrastim is recombinant GCSF (glycoprotein) produced in
E. coli
Mnemonic: EFG
• High dose methotrexate is used for osteosarcoma, brain
tumors and hematological malignancies.
Mnemonic: Bone, Brain, Blood
• Filgrastim: GCSF/(Gra for granulocyte)
Sargramostim GM-CSF (Gramo for granulocyte monocyte)
• Drugs associated with SIADH
Vasopressin or desmopressin
Chlorpropamide
Oxytocin, high dose
Vincristine
Carbamazepine
Nicotine
Phenothiazines
Cyclophosphamide
TCA
MAO inhibitors
SSRI
Mnemonic: VCO VCN PC, TMS
• Drugs causing constipation
Aluminium hydroxide
Barium sulphate
Calcium carbonate
Ferrous sulphate
Ganglionic blockers
Ion exchange resins
Opiates
Phenothiazines
Tricyclic antidepressants
Verapamil (calcium channel blockers)
Mnemonic: ABC, FGI, OP, TV)
Note:Mg
2+
is laxative.
Pharmacology 43
• Benzodiazepines that do not produce active metabolites
Oxazepam
Midazolam
Lorazepam
Tamazepam
Triazolam
Mnemonic: OMLTT (Omlette)
• Drugs acting on GABA A (intrinsic ion channel receptors)
Agonist: Muscimol
Antagonist: Bicuculline
Agonist:Baclofen (B for B)
Antagonist: Saclofen
Drugs acting on GABA B (
G protein coupled receptors) (Mn:
GB)
Mnemonic: MBBS
(Muscimol, Bicuculline, Baclofen, Saclofen)
• Absence seizure: Drug of choice
< 3 yrs of age: Ethosuximide
> 3 yrs of age: Valproic acid
• Interactions of valproate
May precipitate phenobarbitone toxicity by inhibiting
metabolism
May precipitate phenytoin toxicity by displacing it from
protein binding sites and inhibiting metabolism.
May precipitate absence status when used with clonazepam.
• Immunosuppression with triple therapy: Nice guidelines
Cyclosporine (calcineurin inhibitor)
Azathioprine (anti-proliferative agent)
Prednisolone (corticosteroid)
Mnemonic: CAP
Note: Azathioprine may be replaced by mycofenolate
mofetil.
• Adverse effects of amiodarone (iodine containing long acting
anti-arrhythmic belong to class III)
Thyroid—hypothyroidism and hyperthyroidism
• Benzodiazepines that do not produce active metabolites
Oxazepam
Midazolam
Lorazepam
Tamazepam
Triazolam
Mnemonic: OMLTT (Omlette)
• Drugs acting on GABA A (intrinsic ion channel receptors)
Agonist: Muscimol
Antagonist: Bicuculline
Agonist:Baclofen (B for B)
Antagonist: Saclofen
Drugs acting on GABA B (
G protein coupled receptors) (Mn:
GB)
Mnemonic: MBBS
(Muscimol, Bicuculline, Baclofen, Saclofen)
• Absence seizure: Drug of choice
< 3 yrs of age: Ethosuximide
> 3 yrs of age: Valproic acid
• Interactions of valproate
May precipitate phenobarbitone toxicity by inhibiting
metabolism
May precipitate phenytoin toxicity by displacing it from
protein binding sites and inhibiting metabolism.
May precipitate absence status when used with clonazepam.
• Immunosuppression with triple therapy: Nice guidelines
Cyclosporine (calcineurin inhibitor)
Azathioprine (anti-proliferative agent)
Prednisolone (corticosteroid)
Mnemonic: CAP
Note: Azathioprine may be replaced by mycofenolate
mofetil.
• Adverse effects of amiodarone (iodine containing long acting
anti-arrhythmic belong to class III)
Thyroid—hypothyroidism and hyperthyroidism
Mnemonics44
Peripheral neuropathy
Myocardial depression
Pulmonary alveolitis and fibrosis (lung)—dry cough
Corneal microdeposits
Liver toxicity
Photosensitization
Mnemonic: The Periphery of My lung cornea live with
photosensitivity
• Fluoroquinolones excreted primarily by non-renal
mechanism
Pefloxacin
Trovafloxacin
Grepofloxacin
Nalidixic acid
Mnemonic: Petro Grenal
Note:Sparfloxacin has 50% renal and 50% fecal route of
excretion.
• Anti-pseudomonal cephalosporins
Ceftazidime
Cefoperazone
Cefepime
Cefotaxine
• Second line anti-tubercular drugs
Old drugs
PAS
Ethionamide
Cycloserine
Thioacetazone
Mnemonic: PECT
Amikacin
Kanamycin
Capreomycin
Mnemonic: Ami KC
New drugs
Ciprofloxacin
Ofloxacin
Peripheral neuropathy
Myocardial depression
Pulmonary alveolitis and fibrosis (lung)—dry cough
Corneal microdeposits
Liver toxicity
Photosensitization
Mnemonic: The Periphery of My lung cornea live with
photosensitivity
• Fluoroquinolones excreted primarily by non-renal
mechanism
Pefloxacin
Trovafloxacin
Grepofloxacin
Nalidixic acid
Mnemonic: Petro Grenal
Note:Sparfloxacin has 50% renal and 50% fecal route of
excretion.
• Anti-pseudomonal cephalosporins
Ceftazidime
Cefoperazone
Cefepime
Cefotaxine
• Second line anti-tubercular drugs
Old drugs
PAS
Ethionamide
Cycloserine
Thioacetazone
Mnemonic: PECT
Amikacin
Kanamycin
Capreomycin
Mnemonic: Ami KC
New drugs
Ciprofloxacin
Ofloxacin
Pharmacology 45
Clarithromycin
Azithromycin
Rifabutin
Mnemonic: COCA-Rafa
• Chelating agents in heavy metal poisoning
Dimercaprol (BAL):Bismuth
Antimony
Lead
Mercury
Arsenic
Copper
Nickel
Gold
Mnemonic: BALMA CNG
• Calcium disodium edetate (CaNa
2EDTA)
Lead poisoning
Mnemonic: Ledta
Zn, Cd, Mn, Cu, Fe poisoning
• Penicillamine
Copper
Mercury
Lead
Mnemonic: CML
Note:BAL: Not in iron and cadmium poisoning
Mnemonic: BANIC
EDTA: Not in mercury poison
Mnemonic: ENM
Penicillamine: Not in iron poisoning
Mnemonic: PNI
•Phenytoin—side effects
Hyperplasia of gums
Hyperglycemia
Hirsutism
Hypersensitivity reaction
Hydantoin syndrome: Teratogenicity
Clarithromycin
Azithromycin
Rifabutin
Mnemonic: COCA-Rafa
• Chelating agents in heavy metal poisoning
Dimercaprol (BAL):Bismuth
Antimony
Lead
Mercury
Arsenic
Copper
Nickel
Gold
Mnemonic: BALMA CNG
• Calcium disodium edetate (CaNa
2EDTA)
Lead poisoning
Mnemonic: Ledta
Zn, Cd, Mn, Cu, Fe poisoning
• Penicillamine
Copper
Mercury
Lead
Mnemonic: CML
Note:BAL: Not in iron and cadmium poisoning
Mnemonic: BANIC
EDTA: Not in mercury poison
Mnemonic: ENM
Penicillamine: Not in iron poisoning
Mnemonic: PNI
•Phenytoin—side effects
Hyperplasia of gums
Hyperglycemia
Hirsutism
Hypersensitivity reaction
Hydantoin syndrome: Teratogenicity
Mnemonics46
Lymphadenopathy
Megaloblastic anaemia
Neurological symptoms
Osteomalacia
Mnemonic: 5H + LMNOP
•Valproate—side effects
Anorexia, vomiting
Alopecia (transient)
Ataxia, sedation
Ammonemia (hyper)
Thrombocytopenia
Tremor
Hepatotoxicity
Neural tube defect
Weight gain
Mnemonic: VAT + HNW
• Antidote of warfarin (oral anticoagulants): Vitamin K
1
(phytonadione)
Antidote of heparin—protamine sulphate
• Drugs acting on cell membrane and promoting leakage from
membranes
Polyenes:Amphotericin B
Hamycin
Nystatin
Polypeptides:Polymyxin
Colistin
Mnemonic: AB HaNy and PoCo leak membrane
• Mechanism of action of anti-microbial agents
Inhibition of DNA gyrase: Fluoroquinolones
Mnemonic: FG
Misreading of mRNA code: Aminoglycoside (Mn:Amina
misread code)
Inhibition of protein synthesis
Chloramphenicol 50S
Erythromycin 50S
Lymphadenopathy
Megaloblastic anaemia
Neurological symptoms
Osteomalacia
Mnemonic: 5H + LMNOP
•Valproate—side effects
Anorexia, vomiting
Alopecia (transient)
Ataxia, sedation
Ammonemia (hyper)
Thrombocytopenia
Tremor
Hepatotoxicity
Neural tube defect
Weight gain
Mnemonic: VAT + HNW
• Antidote of warfarin (oral anticoagulants): Vitamin K
1
(phytonadione)
Antidote of heparin—protamine sulphate
• Drugs acting on cell membrane and promoting leakage from
membranes
Polyenes:Amphotericin B
Hamycin
Nystatin
Polypeptides:Polymyxin
Colistin
Mnemonic: AB HaNy and PoCo leak membrane
• Mechanism of action of anti-microbial agents
Inhibition of DNA gyrase: Fluoroquinolones
Mnemonic: FG
Misreading of mRNA code: Aminoglycoside (Mn:Amina
misread code)
Inhibition of protein synthesis
Chloramphenicol 50S
Erythromycin 50S
Pharmacology 47
Clindamycin 50S
Mnemonic: CEC 50
Tetracycline 30S
Aminoglycoside 30S
•Beta adrenergic agonists, nitrates, digitalis and diuretics are
best avoided during treatment of HOCM.
Mnemonic: BeNi DiDi avoid HOCM
• Contraceptive failure may occur if any of the following drugs
is used concurrently:
Enzyme inducers: Phenytoin, phenobarbitone primidone,
carbamazepine, rifampicin, griseofulvin.
Suppression of intestinal microflora tetracycline, ampicillin
• Drugs following
zero order kinetics
Warfarin
Ethyl alcohol
Theophylline
Tolbutamide
Phenytoin
Aspirin (salicylate)
Propranolol
Mnemonic: Zero WATT PAP
• Adrenaline: α
1 + α
2 + β
1 + β
2
Noradrenaline: α
1 + α
2 + β
1 (no β
2 action)
Dopamine: D
1 + D
2 + α
1 + α
2 + β
1 (no β
2)
Isoprenaline: β
1 + β
2 (no α action)
Dobutamine relatively β
1 selective (no dopamine receptor
action)
Mnemonic:
DONO has no B2 action
• Adrenaline: Systolic BP increased
Diastolic BP decreased
Heart rate increased
Noradrenaline: Systolic BP increased
Diastolic BP increased
Heart rate decreased
Clindamycin 50S
Mnemonic: CEC 50
Tetracycline 30S
Aminoglycoside 30S
•Beta adrenergic agonists, nitrates, digitalis and diuretics are
best avoided during treatment of HOCM.
Mnemonic: BeNi DiDi avoid HOCM
• Contraceptive failure may occur if any of the following drugs
is used concurrently:
Enzyme inducers: Phenytoin, phenobarbitone primidone,
carbamazepine, rifampicin, griseofulvin.
Suppression of intestinal microflora tetracycline, ampicillin
• Drugs following
zero order kinetics
Warfarin
Ethyl alcohol
Theophylline
Tolbutamide
Phenytoin
Aspirin (salicylate)
Propranolol
Mnemonic: Zero WATT PAP
• Adrenaline: α
1 + α
2 + β
1 + β
2
Noradrenaline: α
1 + α
2 + β
1 (no β
2 action)
Dopamine: D
1 + D
2 + α
1 + α
2 + β
1 (no β
2)
Isoprenaline: β
1 + β
2 (no α action)
Dobutamine relatively β
1 selective (no dopamine receptor
action)
Mnemonic:
DONO has no B2 action
• Adrenaline: Systolic BP increased
Diastolic BP decreased
Heart rate increased
Noradrenaline: Systolic BP increased
Diastolic BP increased
Heart rate decreased
Mnemonics48
Isoprenaline: Systolic BP normal/decreased
Diastolic BP decreased
Heart rate increased
• Dopamine: D1 receptors in renal and mesenteric blood
vessels are very sensitive
IV infusion of low doses of DA dilates mesenteric vessels and
improves renal perfusion.
Dobutamine: Inotropic action
• Selective MAO-A inhibitor:Clorgiline
Maclobemide
Selective MAO-B inhibitor: Selegiline
Non-selective MAO inhibitor Isocarboxazid
Tranylcypromine
Phenelzine
Mnemonic: ITP
• Hemodialysis is not used in
Benzodiazepines (BZD)
Digitalis
Organophosphates
Copper sulphate
Kerosene
Mnemonic: BZD DOCK
• Diagnostic test for myasthenia gravis
a. Ameliorative test: Edrophonium (anti-cholinesterase)
b. Provocative test—d-tubocurarine
• Pheochromocytoma
α-blockage is the basis of management in preoperative
period. Phenoxybenzamine is the agent of choice.
β-blockers should not be employed prior to establishing
effective α-receptor blockage, since unopposed β receptor
blockage could theoretically cause blood pressure elevation
from increased vasoconstriction.
Atenolol however is a selective β
1 agonist, and acts on the
heart and not on peripheral blood vessels.
Isoprenaline: Systolic BP normal/decreased
Diastolic BP decreased
Heart rate increased
• Dopamine: D1 receptors in renal and mesenteric blood
vessels are very sensitive
IV infusion of low doses of DA dilates mesenteric vessels and
improves renal perfusion.
Dobutamine: Inotropic action
• Selective MAO-A inhibitor:Clorgiline
Maclobemide
Selective MAO-B inhibitor: Selegiline
Non-selective MAO inhibitor Isocarboxazid
Tranylcypromine
Phenelzine
Mnemonic: ITP
• Hemodialysis is not used in
Benzodiazepines (BZD)
Digitalis
Organophosphates
Copper sulphate
Kerosene
Mnemonic: BZD DOCK
• Diagnostic test for myasthenia gravis
a. Ameliorative test: Edrophonium (anti-cholinesterase)
b. Provocative test—d-tubocurarine
• Pheochromocytoma
α-blockage is the basis of management in preoperative
period. Phenoxybenzamine is the agent of choice.
β-blockers should not be employed prior to establishing
effective α-receptor blockage, since unopposed β receptor
blockage could theoretically cause blood pressure elevation
from increased vasoconstriction.
Atenolol however is a selective β
1 agonist, and acts on the
heart and not on peripheral blood vessels.
Pharmacology 49
• Diuretics, which do not promote bicarbonate excretion
Thiazide like diuretics, e.g. metazoline, indapamide,
chlorthalidone, Ethacrynic acid (unlike other loop diuretics)
Mnemonic: MICE
Most marked kaliuresis: Acetazolamide
Mnemonic: AK
Most marked natriuresis: Furosemide
Mnemonic: FuNa
• Pharmacokinetics
ADME
Absorption
Distribution
Metabolism
Excretion
• Plasma protein binding is associated with—
Duration
Distribution
Disease (hypoalbuminemia)
Displacement
Dialysis
• Area outside blood–brain barrier (circumventricular organs)
Subfornical organ
OVLT (organum vasculosum of lamina terminalis)
Area postrema
Posterior pituitary
Mnemonic: SOAP
Note:CTZ (Chemoreceptor trigger zone) is also outside
blood–brain barrier and responsible for vomiting.
• Enzyme inducers—
G—Griseofulvin
P—Phenytoin, Primidone
R—Rifampicin
S—Smoking (PAH—polycyclic aromatic hydrocarbons)
Car—Carbamazepine
Phone—phenobarbitone
• Diuretics, which do not promote bicarbonate excretion
Thiazide like diuretics, e.g. metazoline, indapamide,
chlorthalidone, Ethacrynic acid (unlike other loop diuretics)
Mnemonic: MICE
Most marked kaliuresis: Acetazolamide
Mnemonic: AK
Most marked natriuresis: Furosemide
Mnemonic: FuNa
• Pharmacokinetics
ADME
Absorption
Distribution
Metabolism
Excretion
• Plasma protein binding is associated with—
Duration
Distribution
Disease (hypoalbuminemia)
Displacement
Dialysis
• Area outside blood–brain barrier (circumventricular organs)
Subfornical organ
OVLT (organum vasculosum of lamina terminalis)
Area postrema
Posterior pituitary
Mnemonic: SOAP
Note:CTZ (Chemoreceptor trigger zone) is also outside
blood–brain barrier and responsible for vomiting.
• Enzyme inducers—
G—Griseofulvin
P—Phenytoin, Primidone
R—Rifampicin
S—Smoking (PAH—polycyclic aromatic hydrocarbons)
Car—Carbamazepine
Phone—phenobarbitone
Mnemonics50
• Enzyme inhibitors—
Valla’s—Valproate
Kit—Ketoconazole
Can—Cimetidine
Cause—Ciprofloxacin
Enzyme—Erythromycin
Inhibition—INH (Isoniazid)
• Order of kinetics
First order— CHF constant
Clearance
Half life
Fraction excreted
Zero order—RA constant
Rate of elimination
Amount eliminated
• Nuclear hormones—
S—Sex hormones (Estrogen, Progesterone and Testosterone)
A—Vitamin A
T—Thyroid hormones
Mnemonic: SATurday Night
Cytoplasmic receptor hormones—Corticosteroids
Vitamin D
Mnemonic: CCD
• Drugs metabolized by acetylation—
S—Sulfonamide including dapsone
H—Hydralazine
I—INH (Isoniazid)
P—Procainamide (antiarrhythmic drug)
Note:They can cause SLE.
• Parasympathetic fibres are long in preganglionic.
Mnemonic: Para-Pre—long
• Preganglionic fibres release acetylcholine in both sympathetic
and parasympathetic systems.
• Enzyme inhibitors—
Valla’s—Valproate
Kit—Ketoconazole
Can—Cimetidine
Cause—Ciprofloxacin
Enzyme—Erythromycin
Inhibition—INH (Isoniazid)
• Order of kinetics
First order— CHF constant
Clearance
Half life
Fraction excreted
Zero order—RA constant
Rate of elimination
Amount eliminated
• Nuclear hormones—
S—Sex hormones (Estrogen, Progesterone and Testosterone)
A—Vitamin A
T—Thyroid hormones
Mnemonic: SATurday Night
Cytoplasmic receptor hormones—Corticosteroids
Vitamin D
Mnemonic: CCD
• Drugs metabolized by acetylation—
S—Sulfonamide including dapsone
H—Hydralazine
I—INH (Isoniazid)
P—Procainamide (antiarrhythmic drug)
Note:They can cause SLE.
• Parasympathetic fibres are long in preganglionic.
Mnemonic: Para-Pre—long
• Preganglionic fibres release acetylcholine in both sympathetic
and parasympathetic systems.
Pharmacology 51
• Sympathetic system—
Postganglionic fibres release noradrenaline
Exceptions—
Sympathetic nerve fibres going to kidney secrete dopamine.
Sympathetic nerve fibres going to sweat glands release
acetylcholine (sympathetic cholinergic)
Mnemonic:
Kid is sympathetic to dopa
•Heart rate—Chronotropic
Mnemonic: HR
Conduction—Dromotropic
Mnemonic: D for D
Contractility—Ionotropic
• Hemicholinium—inhibits uptake of choline.
Vesamichol—inhibits entry of acetylcholine in the vesicle
Botulinum toxin—inhibits release of acetylcholine.
•M
1—Stomach (increases acid secretion)
M
2—Heart (Bradycardia)
M
3—Rest organs like eye, GIT, urinary bladder, bronchus,
glands
M
4—CNS
M
5—CNS
Mnemonic:
Ma says—First eat, Second heart and rest work
later on
• Drugs directly acting on parasympathetic system
Pilocarpine acts on Pupil (M
3)—miosis in glaucoma.
Mnemonic: P for P
Bethanichol acts on Bladder (M
3)—contracts urinary bladder
in urinary retention.
Mnemonic: B for B
Methacholine acts on Myocardium (M
2)—used in tachyarrhy-
thmia.
Carbachol action—Common action—acts both on nicotinic
and muscarinic receptors.
Mnemonic: C for C
• Sympathetic system—
Postganglionic fibres release noradrenaline
Exceptions—
Sympathetic nerve fibres going to kidney secrete dopamine.
Sympathetic nerve fibres going to sweat glands release
acetylcholine (sympathetic cholinergic)
Mnemonic:
Kid is sympathetic to dopa
•Heart rate—Chronotropic
Mnemonic: HR
Conduction—Dromotropic
Mnemonic: D for D
Contractility—Ionotropic
• Hemicholinium—inhibits uptake of choline.
Vesamichol—inhibits entry of acetylcholine in the vesicle
Botulinum toxin—inhibits release of acetylcholine.
•M
1—Stomach (increases acid secretion)
M
2—Heart (Bradycardia)
M
3—Rest organs like eye, GIT, urinary bladder, bronchus,
glands
M
4—CNS
M
5—CNS
Mnemonic:
Ma says—First eat, Second heart and rest work
later on
• Drugs directly acting on parasympathetic system
Pilocarpine acts on Pupil (M
3)—miosis in glaucoma.
Mnemonic: P for P
Bethanichol acts on Bladder (M
3)—contracts urinary bladder
in urinary retention.
Mnemonic: B for B
Methacholine acts on Myocardium (M
2)—used in tachyarrhy-
thmia.
Carbachol action—Common action—acts both on nicotinic
and muscarinic receptors.
Mnemonic: C for C
Mnemonics52
• Oximes (enzyme reactivators) are acetylcholinesterase
reactivators.
Oximes are used only for organophosphorous poisoning.
Mnemonic: OOO
For example,
Pralidoxime (PAM)—acts only in periphery.
Mnemonic: P for P
Diacetyl monoxime (DAM)—acts on both sites.
• Anticholinergic drugs act as cycloplegic.
Ciliary muscle contracts to cause accommodation.
Its nerve supply is short ciliary nerve—branch of oculomotor
nerve (3rd cranial nerve). So, it is a part of parasympathetic
system.
That is why anticholinergic drugs cause cycloplegia by
blocking ciliary muscle contraction and causing loss of
accommodation.
Anticholinergic drugs are—
Atropine—strongest cycloplegic drug. Very long acting. Used
for refraction testing in children.
Homatropine
Cyclopentolate
Tropicamide (Shortest acting. Preferred in adults.)
Mnemonic:
D for adult
• Anticholinergic drugs acting on urinary bladder (M
3)—
block—less contraction.
Cause urinary retention (side effect)
Used in overactive bladder/incontinence/detrusser instability.
Drugs used are—
S—Solifenacin
O—Oxybutynin
F—Flavoxate
T—Tolterodine, Trospium
bladder—Darifenacin
Mnemonic: SOFT bladder
• Oximes (enzyme reactivators) are acetylcholinesterase
reactivators.
Oximes are used only for organophosphorous poisoning.
Mnemonic: OOO
For example,
Pralidoxime (PAM)—acts only in periphery.
Mnemonic: P for P
Diacetyl monoxime (DAM)—acts on both sites.
• Anticholinergic drugs act as cycloplegic.
Ciliary muscle contracts to cause accommodation.
Its nerve supply is short ciliary nerve—branch of oculomotor
nerve (3rd cranial nerve). So, it is a part of parasympathetic
system.
That is why anticholinergic drugs cause cycloplegia by
blocking ciliary muscle contraction and causing loss of
accommodation.
Anticholinergic drugs are—
Atropine—strongest cycloplegic drug. Very long acting. Used
for refraction testing in children.
Homatropine
Cyclopentolate
Tropicamide (Shortest acting. Preferred in adults.)
Mnemonic:
D for adult
• Anticholinergic drugs acting on urinary bladder (M
3)—
block—less contraction.
Cause urinary retention (side effect)
Used in overactive bladder/incontinence/detrusser instability.
Drugs used are—
S—Solifenacin
O—Oxybutynin
F—Flavoxate
T—Tolterodine, Trospium
bladder—Darifenacin
Mnemonic: SOFT bladder
Pharmacology 53
•Belladonna poisoning = Atropine poisoning = Dhatura
poisoning.
Mnemonic: BAD
•β
1: Heart
Mnemonic: Heart is 1 in number
β
2: Lungs
Mnemonic: Lungs are 2 in number
•α
1: Vasoconstriction
α
2: Vasodilatation
Mnemonic:
A 1–C
B 2–D
•M
3: Circular muscles—Constrictor pupillae—supplied by
short ciliary nerve—active miosis—parasympathomimetic.
Mnemonic: MCC MAO
α
1: Radial muscles—dilator pupillae—supplied by long ciliary
nerve—active mydriasis—sympathomimetics.
•Dopamine acts on: μg/kg/min
D
1: Low dose < 2
β
1 + D
1: Intermediate dose 2–10
α
1 + β
1 + D
1: High dose > 10
Mnemonic: DBA
• Dopa in name stimulates D
1
For example, Dopamine
Fenoldopam
Note:Dobutamine mainly acts on β
1.
• Adrenaline acts on all 4 receptors (α
1, α
2, β
1 and β
2)
Noradrenaline—not all (α
1, α
2, β
1)
Isoprenaline—only β—β
1and β
2
•β
2 agonists
Salbutamol
Terbutaline
•Belladonna poisoning = Atropine poisoning = Dhatura
poisoning.
Mnemonic: BAD
•β
1: Heart
Mnemonic: Heart is 1 in number
β
2: Lungs
Mnemonic: Lungs are 2 in number
•α
1: Vasoconstriction
α
2: Vasodilatation
Mnemonic:
A 1–C
B 2–D
•M
3: Circular muscles—Constrictor pupillae—supplied by
short ciliary nerve—active miosis—parasympathomimetic.
Mnemonic: MCC MAO
α
1: Radial muscles—dilator pupillae—supplied by long ciliary
nerve—active mydriasis—sympathomimetics.
•Dopamine acts on: μg/kg/min
D
1: Low dose < 2
β
1 + D
1: Intermediate dose 2–10
α
1 + β
1 + D
1: High dose > 10
Mnemonic: DBA
• Dopa in name stimulates D
1
For example, Dopamine
Fenoldopam
Note:Dobutamine mainly acts on β
1.
• Adrenaline acts on all 4 receptors (α
1, α
2, β
1 and β
2)
Noradrenaline—not all (α
1, α
2, β
1)
Isoprenaline—only β—β
1and β
2
•β
2 agonists
Salbutamol
Terbutaline
Mnemonics54
Salmetrol
Formetrol
Mnemonic:Metro is long acting.
Salmetrol is slow onset (S for S)
Formetrol is fast onset (F for F)
Side effects—Tremor
Tachycardia
Tolerance
Mnemonic: 3T
• Selective α
1 blocker—Zosine
•α
1A—Prostate
α
1B—
Blood vessels
Mnemonic: B for blood vessels
Note:Selective α
1A blocker—Tamsulosin, Silodosin.
•β
1 blockers/cardioselective/2nd generation
New—Nebivolol
Beta—Betaxolol
Blockers—Bisoprolol
Act—Acebutolol
Exclusively—Esmolol
At—Atenolol
Myo—Metoprolol
Cardium—Celiprolol
•β blockers with intrinsic sympathomimetic activity (partial
agonist)
Contain—Celiprolol
Partial—Pindolol
Agonistic—Alprenolol
Activity—Acebutolol
Mnemonic:
All pind sell ace intrinsically
•β blockers with membrane stabilizing property
Possess—Propranolol
Membrane stabilizing or—Metoprolol
Salmetrol
Formetrol
Mnemonic:Metro is long acting.
Salmetrol is slow onset (S for S)
Formetrol is fast onset (F for F)
Side effects—Tremor
Tachycardia
Tolerance
Mnemonic: 3T
• Selective α
1 blocker—Zosine
•α
1A—Prostate
α
1B—
Blood vessels
Mnemonic: B for blood vessels
Note:Selective α
1A blocker—Tamsulosin, Silodosin.
•β
1 blockers/cardioselective/2nd generation
New—Nebivolol
Beta—Betaxolol
Blockers—Bisoprolol
Act—Acebutolol
Exclusively—Esmolol
At—Atenolol
Myo—Metoprolol
Cardium—Celiprolol
•β blockers with intrinsic sympathomimetic activity (partial
agonist)
Contain—Celiprolol
Partial—Pindolol
Agonistic—Alprenolol
Activity—Acebutolol
Mnemonic:
All pind sell ace intrinsically
•β blockers with membrane stabilizing property
Possess—Propranolol
Membrane stabilizing or—Metoprolol
Pharmacology 55
Local—Labetalol
Anesthetic—Acebutolol
Property—Pindolol
• Water soluble β blockers—contraindicated in renal failure:
A—Atenolol
N—Nadolol
S—Sotalol
Mnemonic: SoNaAta
• Nadolol is the longest acting β blocker
Esmolol is the shortest acting β blocker.
• 3rd generation β blockers: β blockers with any additional
cardiovascular advantage (vasodilatation)
a.α + β blockade—Labetalol, Carvedilol
b. NO release—Nebivolol.
Mnemonic: N for N
c. Ca
2+
channel blocker—Carvedilol
Mnemonic: C for C
d. K
+
channel blocker—Tilisilol
e.β
2 agonist—Celiprolol
• Carvedilol—α blocker
Ca
2+
channel blocker
Antioxidant
• Celiprolol—β
2 agonist
Cardioselective
Intrinsic sympathomimetic activity.
• Loop and thiazide diuretics
Na
+
, K
+
, Mg
2+
, H
+
—decrease
Sugar, lipid, uric acid—increase
Mnemonic:
Loop looses calcium. It causes hypocalcemia.
But thiazides cause hypercalcemia
• Digoxin—contraindicated in renal failure.
Digitoxin—contraindicated in hepatic failure.
Mnemonic: Toxin is metabolized in liver
Local—Labetalol
Anesthetic—Acebutolol
Property—Pindolol
• Water soluble β blockers—contraindicated in renal failure:
A—Atenolol
N—Nadolol
S—Sotalol
Mnemonic: SoNaAta
• Nadolol is the longest acting β blocker
Esmolol is the shortest acting β blocker.
• 3rd generation β blockers: β blockers with any additional
cardiovascular advantage (vasodilatation)
a.α + β blockade—Labetalol, Carvedilol
b. NO release—Nebivolol.
Mnemonic: N for N
c. Ca
2+
channel blocker—Carvedilol
Mnemonic: C for C
d. K
+
channel blocker—Tilisilol
e.β
2 agonist—Celiprolol
• Carvedilol—α blocker
Ca
2+
channel blocker
Antioxidant
• Celiprolol—β
2 agonist
Cardioselective
Intrinsic sympathomimetic activity.
• Loop and thiazide diuretics
Na
+
, K
+
, Mg
2+
, H
+
—decrease
Sugar, lipid, uric acid—increase
Mnemonic:
Loop looses calcium. It causes hypocalcemia.
But thiazides cause hypercalcemia
• Digoxin—contraindicated in renal failure.
Digitoxin—contraindicated in hepatic failure.
Mnemonic: Toxin is metabolized in liver
Mnemonics56
• Drugs causing gynaecomastia—
Di—Digitalis
S—Spironolactone
C—Cimetidine
O—Oestrogen
• Drug interactions of digitalis—
Quinidine
Verapamil
Amiodarone
Thiazides
Mnemonic: Queen’s VAT digitally
• Vasodilators
Mainly vein—Nitrates
Mainly artery—Hydralazine
Mnemonic: Hydra is artist
Both—α blockers
ACE inhibitors
AT receptor blockers
Sodium nitroprusside
• Drugs causing hirsutism—
Cyclosporine
Phenytoin
Minoxidil
Mnemonic: CPM ka Hero
• Diazoxide—decrease Insulin
•Ca
2+
channel—
L type—in CVST type—in Thalamus (brain)
Mnemonic: T for T
• Renin inhibitor
Approved for the treatment of hypertension
Can be given orally
Aliskiren
• Drugs causing gynaecomastia—
Di—Digitalis
S—Spironolactone
C—Cimetidine
O—Oestrogen
• Drug interactions of digitalis—
Quinidine
Verapamil
Amiodarone
Thiazides
Mnemonic: Queen’s VAT digitally
• Vasodilators
Mainly vein—Nitrates
Mainly artery—Hydralazine
Mnemonic: Hydra is artist
Both—α blockers
ACE inhibitors
AT receptor blockers
Sodium nitroprusside
• Drugs causing hirsutism—
Cyclosporine
Phenytoin
Minoxidil
Mnemonic: CPM ka Hero
• Diazoxide—decrease Insulin
•Ca
2+
channel—
L type—in CVST type—in Thalamus (brain)
Mnemonic: T for T
• Renin inhibitor
Approved for the treatment of hypertension
Can be given orally
Aliskiren
Pharmacology 57
Remikiren
Enalkiren
Mnemonic: Inhibitor of Renin
• Prils are ACE inhibitors.
Depines are calcium channel blockers.
Mnemonic: CD
• ACE inhibitors
A—Active
C—Captopril
L—Lisinopril
• ACE inhibitors—Captopril
C—Cough
A—Angioedema
P—Prodrug (except Captopril and Lisinopril)
T—Taste alteration (dysguesia)
O—Orthostatic hypotension/Postural hypotension
P—Pregnancy is absolute contraindication
R—Renal artery stenosis (bilateral) is absolute contraindication
I—Increase in K
+
—hyperkalemia is contraindication
L—Lowers the risk of diabetic complications
Note:Angiotensin receptor blockers also follow these
except first 3 (CAP).
• Sartans are angiotensin receptor blockers (block AT
1 only).
Sartans are selective AT
1 receptor antagonist.
• Drugs safe in pregnancy
Better—Beta blockers
Mother—Methyldopa
Care—Clonidine
During—Dihydroperidine
Hypertensive—Hydralazine
Pregnancy—Prazosin
Note:Antihypertensive drugs contraindicated in pregnancy
are ACE inhibitors and ARB.
Remikiren
Enalkiren
Mnemonic: Inhibitor of Renin
• Prils are ACE inhibitors.
Depines are calcium channel blockers.
Mnemonic: CD
• ACE inhibitors
A—Active
C—Captopril
L—Lisinopril
• ACE inhibitors—Captopril
C—Cough
A—Angioedema
P—Prodrug (except Captopril and Lisinopril)
T—Taste alteration (dysguesia)
O—Orthostatic hypotension/Postural hypotension
P—Pregnancy is absolute contraindication
R—Renal artery stenosis (bilateral) is absolute contraindication
I—Increase in K
+
—hyperkalemia is contraindication
L—Lowers the risk of diabetic complications
Note:Angiotensin receptor blockers also follow these
except first 3 (CAP).
• Sartans are angiotensin receptor blockers (block AT
1 only).
Sartans are selective AT
1 receptor antagonist.
• Drugs safe in pregnancy
Better—Beta blockers
Mother—Methyldopa
Care—Clonidine
During—Dihydroperidine
Hypertensive—Hydralazine
Pregnancy—Prazosin
Note:Antihypertensive drugs contraindicated in pregnancy
are ACE inhibitors and ARB.
Mnemonics58
• Nitrate with minimum first pass metabolism—IMN
Mnemonic: Iska Metabolism Nahi hota
Longest acting nitrate—PETN
Mnemonic: Longest name
Shortest acting nitrate—AN
Mnemonic: Shortest name
• Coronary steal phenomenon can be caused by—
Hydralazine
Dipyridamol
Isoflurane
Mnemonic: HDI steal from Heart
• Ivabradine
I—I
F blocker (funny current, which opens in hyperpolarisation
instead of depolarization)
Va—Visual field defect
Bradi—cause bradycardia
Ne—Na
+
channel blocker
• Rho kinase inhibitor—Fasudil
Mnemonic:
Dil me fas—ro mat
• Myocardial infarction
Non-ST elevation MI—
M—Morphine
O—Oxygen
N—Nitrates
A—Aspirin
ST elevation MI—
S—Streptokinase
O—Oxygen
N—Nitrate
A—Aspirin
M—Morphine
• Antiarrhythmic drugs—Vaughan William classification:
I—
Sodium channel blockers
II—Beta blockers
• Nitrate with minimum first pass metabolism—IMN
Mnemonic: Iska Metabolism Nahi hota
Longest acting nitrate—PETN
Mnemonic: Longest name
Shortest acting nitrate—AN
Mnemonic: Shortest name
• Coronary steal phenomenon can be caused by—
Hydralazine
Dipyridamol
Isoflurane
Mnemonic: HDI steal from Heart
• Ivabradine
I—I
F blocker (funny current, which opens in hyperpolarisation
instead of depolarization)
Va—Visual field defect
Bradi—cause bradycardia
Ne—Na
+
channel blocker
• Rho kinase inhibitor—Fasudil
Mnemonic:
Dil me fas—ro mat
• Myocardial infarction
Non-ST elevation MI—
M—Morphine
O—Oxygen
N—Nitrates
A—Aspirin
ST elevation MI—
S—Streptokinase
O—Oxygen
N—Nitrate
A—Aspirin
M—Morphine
• Antiarrhythmic drugs—Vaughan William classification:
I—
Sodium channel blockers
II—Beta blockers
Pharmacology 59
III—Potassium channel blockers
IV—Calcium channel blockers
V—Others
Mnemonic:
SBP
• Class III antiarrhythmic drugs
B—Bretylium
I—Ibutilide
D—Dofetilide
A—Amioderone
S—Sotalol
Note:They can cause Torased des pointes.
• Benzodiazepines
GABA facilitatory
Increases frequency of chloride channel opening
DRC flat
Specific antidote—Flumazenil
Mnemonic:
4F
• Short acting benzodiazepines
T—Triazolam, Temazepam
O—Oxazepam
L—Lorazepam
E—Estazolam
Note:Short acting BZD are—safe in elderly, liver disease,
no hangover and no active metabolite.
• Vigabatrin
Vi—Visual field defect
Gaba—GABA
Tr—Transaminase
In—inhibitor. ‘In’ also stands for infantile spasm
Note:Vigabatrin is the drug of choice for infantile spasm
with tuberous sclerosis. ACTH is drug of choice for infantile
spasm.
III—Potassium channel blockers
IV—Calcium channel blockers
V—Others
Mnemonic:
SBP
• Class III antiarrhythmic drugs
B—Bretylium
I—Ibutilide
D—Dofetilide
A—Amioderone
S—Sotalol
Note:They can cause Torased des pointes.
• Benzodiazepines
GABA facilitatory
Increases frequency of chloride channel opening
DRC flat
Specific antidote—Flumazenil
Mnemonic:
4F
• Short acting benzodiazepines
T—Triazolam, Temazepam
O—Oxazepam
L—Lorazepam
E—Estazolam
Note:Short acting BZD are—safe in elderly, liver disease,
no hangover and no active metabolite.
• Vigabatrin
Vi—Visual field defect
Gaba—GABA
Tr—Transaminase
In—inhibitor. ‘In’ also stands for infantile spasm
Note:Vigabatrin is the drug of choice for infantile spasm
with tuberous sclerosis. ACTH is drug of choice for infantile
spasm.
Mnemonics60
• Tiagabine
Mnemonic: Transport inhibitor of GABA
It is GABA reuptake inhibitor by inhibiting GAT1
• Drug decreasing alcohol craving—
N—Naltrexone
A—Acamprosate
T—Topiramate
O—Ondansetron
• Atypical antipsychotics—5HT
2A/2C blockers, e.g. pine, done
and aripiprazole.
• Uses of topiramate—all seizures except absence.
Migraine prophylaxis
Obesity
Smoking
Alcohol addiction
Mnemonic:
MOSA
• Uses of antipsychotic drugs—
Anti—Antiemetic property
Psy—psychosis
Cho—chorea (Huntington’s chorea)
Tic—Tic disorder like Gille de La Tourette syndrome
• Agonist (κ)—antagonist (μ)
P—Pentazocine
N—Nelbuphine
D—Dezocine
• Partial agonist—
Buprenorphine, Butorphenol.
Mnemonic: 2B
• Drugs inhibiting cell wall
Firmly—Fosfomycin
Bind to—Bacitracin
Bacterial—β lactum
Cell—Cycloserine
Wall—Vancomycin
• Tiagabine
Mnemonic: Transport inhibitor of GABA
It is GABA reuptake inhibitor by inhibiting GAT1
• Drug decreasing alcohol craving—
N—Naltrexone
A—Acamprosate
T—Topiramate
O—Ondansetron
• Atypical antipsychotics—5HT
2A/2C blockers, e.g. pine, done
and aripiprazole.
• Uses of topiramate—all seizures except absence.
Migraine prophylaxis
Obesity
Smoking
Alcohol addiction
Mnemonic:
MOSA
• Uses of antipsychotic drugs—
Anti—Antiemetic property
Psy—psychosis
Cho—chorea (Huntington’s chorea)
Tic—Tic disorder like Gille de La Tourette syndrome
• Agonist (κ)—antagonist (μ)
P—Pentazocine
N—Nelbuphine
D—Dezocine
• Partial agonist—
Buprenorphine, Butorphenol.
Mnemonic: 2B
• Drugs inhibiting cell wall
Firmly—Fosfomycin
Bind to—Bacitracin
Bacterial—β lactum
Cell—Cycloserine
Wall—Vancomycin
Pharmacology 61
Note:β lactum antibiotics—Penicillins
Cephalosporins
Carbapenems
Monobactum
• Penicillinase inhibitor or β lactumase inhibitor
C—Clavulanic acid—with amoxicillin
S—Sulbactum—with ampicillin
T—Tazobactum—with piperacillin
• Uses of penicillin G
L—Listeria
A—Actinomyces
S—Syphilis
T—Tetanus
M—Meningococcus
An—Anthrax
Go—Gonococcus (drug of choice is ceftriaxone)
Mnemonic:
A men act on the list of gone sipohi
• No β lactum is effective against MRSA except 5th generation
cephalosporin.
• 1st generation cephalosporin
Cefazolin
Cefalexin
Cefadroxil
Cefalothin
Cefaloridine
Mnemonic: Cefa
Exception: Cefaclor is 2nd generation.
• 4th generation cephalosporin
Cefepime
Cefpirome
• 5th generation cephalosporin
Ceftaroline
Ceftibiprole
Mnemonic:
rol
Note:β lactum antibiotics—Penicillins
Cephalosporins
Carbapenems
Monobactum
• Penicillinase inhibitor or β lactumase inhibitor
C—Clavulanic acid—with amoxicillin
S—Sulbactum—with ampicillin
T—Tazobactum—with piperacillin
• Uses of penicillin G
L—Listeria
A—Actinomyces
S—Syphilis
T—Tetanus
M—Meningococcus
An—Anthrax
Go—Gonococcus (drug of choice is ceftriaxone)
Mnemonic:
A men act on the list of gone sipohi
• No β lactum is effective against MRSA except 5th generation
cephalosporin.
• 1st generation cephalosporin
Cefazolin
Cefalexin
Cefadroxil
Cefalothin
Cefaloridine
Mnemonic: Cefa
Exception: Cefaclor is 2nd generation.
• 4th generation cephalosporin
Cefepime
Cefpirome
• 5th generation cephalosporin
Ceftaroline
Ceftibiprole
Mnemonic:
rol
Mnemonics62
• Cephalosporins secreted by bile
Ceftriaxone
Cefoperazone
Mnemonic: Bile per try
• Cephalosporins effective against pseudomonas—
Cefepime
Cefepirome
Cefoperazone
Ceftazidime
Mnemonic: 3P and ziddi
• Cefoperazone—
Secreted by bile
Effective against pseudomonas
Disulfiram like reaction
hypoprothrombinemia
• Mechanism of action of tetracycline—prevents tRNA to bind
to A site.
Mnemonic:
T for T
• Antimicrobial drug preventing translocation—
M—Macrolides
C—Clindamycin
Q—Quinapristin
• Buy AT 30S
SELL @ 50S
AT— Aminoglycoside
Tetracycline
SELL— Streptogramin (Quinapristine)
Erythromycin (Macrolides)
Linezolid
Lincosamide
• Uses of tetracycline
S—SIADH
R—Rickettsial infection
• Cephalosporins secreted by bile
Ceftriaxone
Cefoperazone
Mnemonic: Bile per try
• Cephalosporins effective against pseudomonas—
Cefepime
Cefepirome
Cefoperazone
Ceftazidime
Mnemonic: 3P and ziddi
• Cefoperazone—
Secreted by bile
Effective against pseudomonas
Disulfiram like reaction
hypoprothrombinemia
• Mechanism of action of tetracycline—prevents tRNA to bind
to A site.
Mnemonic:
T for T
• Antimicrobial drug preventing translocation—
M—Macrolides
C—Clindamycin
Q—Quinapristin
• Buy AT 30S
SELL @ 50S
AT— Aminoglycoside
Tetracycline
SELL— Streptogramin (Quinapristine)
Erythromycin (Macrolides)
Linezolid
Lincosamide
• Uses of tetracycline
S—SIADH
R—Rickettsial infection
Pharmacology 63
I—Inguinale granuloma
L—Lymphogranuloma venerum
A—Atypical
N—pNeumonia
C—Cholera
A—Amoebiasis
• Tetracyclines—contraindications and adverse effects—
K—contraindicated in Kidney failure
A—Antianabolic action
P—Phototoxicity
I—Insipidus—DI
L—Liver failure is C/I
D—Dental—affects growing bone and teeth. C/I in pregnancy
and child < 8 years.
E—Expiry date—causes Fanconi syndrome after expiry date
V—Vestibular dysfunction
• Macrolides is the drug of choice for—
C—Chancroid
L—Legionella
A—Atypical pneumonia
P—Pertussis
Can also be used for—
C—Corynebacterium diphtheria
H—Haemophilus influenzae
A—Atypical mycobacteria
T—Toxoplasmosis
Side effects of macrolides—
M—Motilin receptor stimulation
A—Allergy
C—Cholestatic jaundice
R—Reversible
O—Ototoxicity
Note:Vancomycin and aminoglycosides cause irreversible
ototoxicity.
I—Inguinale granuloma
L—Lymphogranuloma venerum
A—Atypical
N—pNeumonia
C—Cholera
A—Amoebiasis
• Tetracyclines—contraindications and adverse effects—
K—contraindicated in Kidney failure
A—Antianabolic action
P—Phototoxicity
I—Insipidus—DI
L—Liver failure is C/I
D—Dental—affects growing bone and teeth. C/I in pregnancy
and child < 8 years.
E—Expiry date—causes Fanconi syndrome after expiry date
V—Vestibular dysfunction
• Macrolides is the drug of choice for—
C—Chancroid
L—Legionella
A—Atypical pneumonia
P—Pertussis
Can also be used for—
C—Corynebacterium diphtheria
H—Haemophilus influenzae
A—Atypical mycobacteria
T—Toxoplasmosis
Side effects of macrolides—
M—Motilin receptor stimulation
A—Allergy
C—Cholestatic jaundice
R—Reversible
O—Ototoxicity
Note:Vancomycin and aminoglycosides cause irreversible
ototoxicity.
Mnemonics64
• Aminoglycoside
Neomycin— Most nephrotoxic
Most neuromuscular blockade
Used only topically
After neomycin,
Gentamycin is most nephrotoxic
Mnemonic: G affects GFR
Streptomycin affects neuromuscular blockade
Mnemonic: S affects Skeletal muscle
Note:Maximum hearing loss—Amikacin
Mnemonic: A affects auditory
Maximum vestibular damage—Streptomycin
• Side effects of Sulfonamide—
A—Aplastic anemia
B—Bilirubiun displacement—Kernicterus
C—Crystalluria
R—Rash
A—Acetylation
S—SLE
H—Hemolysis in G6PD deficiency
• Pyrimethamine—Antiparasite
Mnemonic:
P for P
Methotrexate—Anticancer
Mnemonic: M for M
Trimethoprim—Antibacterial
• Fluoroquinolones are contraindicated in renal failure except—
P—Pefloxacin
M—Moxifloxacin
T—Trovafloxacin
• Respiratory flouroquinolones—can kill any bacteria causing
respiratory tract infection
O—Ofloxacin and levofloxacin
M—Moxifloxacin
G—Gemifloxacin
• Aminoglycoside
Neomycin— Most nephrotoxic
Most neuromuscular blockade
Used only topically
After neomycin,
Gentamycin is most nephrotoxic
Mnemonic: G affects GFR
Streptomycin affects neuromuscular blockade
Mnemonic: S affects Skeletal muscle
Note:Maximum hearing loss—Amikacin
Mnemonic: A affects auditory
Maximum vestibular damage—Streptomycin
• Side effects of Sulfonamide—
A—Aplastic anemia
B—Bilirubiun displacement—Kernicterus
C—Crystalluria
R—Rash
A—Acetylation
S—SLE
H—Hemolysis in G6PD deficiency
• Pyrimethamine—Antiparasite
Mnemonic:
P for P
Methotrexate—Anticancer
Mnemonic: M for M
Trimethoprim—Antibacterial
• Fluoroquinolones are contraindicated in renal failure except—
P—Pefloxacin
M—Moxifloxacin
T—Trovafloxacin
• Respiratory flouroquinolones—can kill any bacteria causing
respiratory tract infection
O—Ofloxacin and levofloxacin
M—Moxifloxacin
G—Gemifloxacin
Pharmacology 65
•Gatifloxacin—Glucose—withdrawn because it causes
hypoglycemia and hyperglycemia.
Mnemonic: G for G
• Multibacillary leprosy—treatment
OCD—Once daily Clofazimine (50 mg) and Dapsone (100 mg)
RCM—Rifampicin (600 mg) and Clofazimine (300 mg)
Note:Monthly dose are supervised.
Paucibacillary leprosy—Treatment -????
• Bactericidal drugs—β lactum
Aminoglycoside Flouroquinolones Vancomycin
• Fast acting antimalarial drugs—
M—Mefloquine A—Atovaquine
C—Chloroquine
H—Halofantrine, lumefantrine
A—Artemisin group
R—Res Q (Quinine)
Slow acting
Proguanil
Pyrimethamine
Sulphadoxine
Tetracycline
• Fluconazole—DOC for Candida, Cryptococcus
Mnemonic:
Flue can treat cry
Note:Fluconazole is also the DOC for prophylaxis of febrile
neutropenia in immunosuppressants.
• Terbinafine—DOC for dermatophytosis. • Posaconazole—DOC for mucormycosis
• Voriconazole—DOC for invasive aspergillosis, treatment of
febrile neutropenia.
• Itraconazole—DOC for all non-serious fungal infection
except Candida and Cryptococcus.
•Gatifloxacin—Glucose—withdrawn because it causes
hypoglycemia and hyperglycemia.
Mnemonic: G for G
• Multibacillary leprosy—treatment
OCD—Once daily Clofazimine (50 mg) and Dapsone (100 mg)
RCM—Rifampicin (600 mg) and Clofazimine (300 mg)
Note:Monthly dose are supervised.
Paucibacillary leprosy—Treatment -????
• Bactericidal drugs—β lactum
Aminoglycoside Flouroquinolones Vancomycin
• Fast acting antimalarial drugs—
M—Mefloquine A—Atovaquine
C—Chloroquine
H—Halofantrine, lumefantrine
A—Artemisin group
R—Res Q (Quinine)
Slow acting
Proguanil
Pyrimethamine
Sulphadoxine
Tetracycline
• Fluconazole—DOC for Candida, Cryptococcus
Mnemonic:
Flue can treat cry
Note:Fluconazole is also the DOC for prophylaxis of febrile
neutropenia in immunosuppressants.
• Terbinafine—DOC for dermatophytosis. • Posaconazole—DOC for mucormycosis
• Voriconazole—DOC for invasive aspergillosis, treatment of
febrile neutropenia.
• Itraconazole—DOC for all non-serious fungal infection
except Candida and Cryptococcus.
Mnemonics66
• Hepatitis B— DOC—Entecavir
Alternate drugs—oral—
Lamivudine
Emtricitabine
Tenofovir
Injectable—
Interferon α
• NRTI used in hepatitis B—
L—Lamivudine
E—Emtricitabine
T—Tenofovir
• Hepatitis C—DOC—Interferon and ribavarin
• NNRTI—1st generation
E—Efavirenz
N—Nevirapine
D—Delaviridine
2nd generation
Etravirine
Rilpivirine
• Metronidazole is DOC for
G—Giardiasis
U—Ulcer—peptic ulcer
P—Pseudomembranous colitis
T—Trichomoniasis
A—Anaerobic bacterial infection
G—Gardenella vaginalis (bacterial vaginosis)
• Antihelminthic drugs
Platyhelminths—Flukes and tapeworm—DOC—Praziquentel.
Mnemonic:
P for P
Nemathelminthes—DOC—Albendazole
Exceptions to platyhelminthes—
Liver fluke (Fasciola hepatica)
Dog tapeworm (Echinococcus)
• Hepatitis B— DOC—Entecavir
Alternate drugs—oral—
Lamivudine
Emtricitabine
Tenofovir
Injectable—
Interferon α
• NRTI used in hepatitis B—
L—Lamivudine
E—Emtricitabine
T—Tenofovir
• Hepatitis C—DOC—Interferon and ribavarin
• NNRTI—1st generation
E—Efavirenz
N—Nevirapine
D—Delaviridine
2nd generation
Etravirine
Rilpivirine
• Metronidazole is DOC for
G—Giardiasis
U—Ulcer—peptic ulcer
P—Pseudomembranous colitis
T—Trichomoniasis
A—Anaerobic bacterial infection
G—Gardenella vaginalis (bacterial vaginosis)
• Antihelminthic drugs
Platyhelminths—Flukes and tapeworm—DOC—Praziquentel.
Mnemonic:
P for P
Nemathelminthes—DOC—Albendazole
Exceptions to platyhelminthes—
Liver fluke (Fasciola hepatica)
Dog tapeworm (Echinococcus)
Pharmacology 67
Exceptions to Nemathelminthes—
Filaria—DOC—DEC
Strongyloides—DOC—Ivermectin
Onchocerca (river blindness)—DOC—Ivermectin
Mnemonic:
iver for river
• Pulsatile GnRH is indicated in—
C—Cryptoorchidism
H—Hypogonadotrophic hypogonadism
A—Anovulatory infertility
N—uNdescended testis
D—Delayed puberty
Note:Continuous GnRH is indicated in Precocious puberty Cancer like breast carcinoma, prostate carcinoma
Endometriosis
Fibroid liomyoma (symptomatically)
• GnRH agonist
Leuprolide—First drug
Gonadorelin
Nafarelin—Nasally
Mnemonic: N for N
Gosarelin
Busurelin
Histarelin
• GnRH antagonist—relix
Cetrorelix
Ganirelix
Abarelix
Degarelix
Mnemonic: X means cross means antagonist
• Thyroid inhibitors
Peripheral conversion inhibitors— 5’ deiodinase inhibitors—
Propylthiouracil
Exceptions to Nemathelminthes—
Filaria—DOC—DEC
Strongyloides—DOC—Ivermectin
Onchocerca (river blindness)—DOC—Ivermectin
Mnemonic:
iver for river
• Pulsatile GnRH is indicated in—
C—Cryptoorchidism
H—Hypogonadotrophic hypogonadism
A—Anovulatory infertility
N—uNdescended testis
D—Delayed puberty
Note:Continuous GnRH is indicated in Precocious puberty Cancer like breast carcinoma, prostate carcinoma
Endometriosis
Fibroid liomyoma (symptomatically)
• GnRH agonist
Leuprolide—First drug
Gonadorelin
Nafarelin—Nasally
Mnemonic: N for N
Gosarelin
Busurelin
Histarelin
• GnRH antagonist—relix
Cetrorelix
Ganirelix
Abarelix
Degarelix
Mnemonic: X means cross means antagonist
• Thyroid inhibitors
Peripheral conversion inhibitors— 5’ deiodinase inhibitors—
Propylthiouracil
Mnemonics68
Propranolol
Prednisolone
Mnemonic: 3P
•Metformin—used for Obese patient
Sulfonylurea—used for Thin patient
Mnemonic: MOST
• PTH causes partiality—
Increases serum Ca
2+
Decreases serum phosphate
Note:Vitamin D decreases both while calcitonin increases
both.
• Tamoxifen is a SERM and has beneficial action on
Bone—increases formation
Blood—decreases LDL, increases HDL
Breast—decreases risk of carcinoma
Note:Doloxifen and Toremifen has similar action.
Raloxifen—only unfavorable action is thromboembolism.
• Thromboxane A
2—aggregate platelets
Mnemonic: A for A
Prostaglandin I
2—Inhibits aggregation of platelets
Mnemonic: I for I
• Uses of colchicine—
G—Gout
C—Cirrhosis
M—Acute Mediterranean fever
S—Sarcoidosis
• Acute gout—
N—NSAIDS
C—Colchicine
C—Corticosteroids
Propranolol
Prednisolone
Mnemonic: 3P
•Metformin—used for Obese patient
Sulfonylurea—used for Thin patient
Mnemonic: MOST
• PTH causes partiality—
Increases serum Ca
2+
Decreases serum phosphate
Note:Vitamin D decreases both while calcitonin increases
both.
• Tamoxifen is a SERM and has beneficial action on
Bone—increases formation
Blood—decreases LDL, increases HDL
Breast—decreases risk of carcinoma
Note:Doloxifen and Toremifen has similar action.
Raloxifen—only unfavorable action is thromboembolism.
• Thromboxane A
2—aggregate platelets
Mnemonic: A for A
Prostaglandin I
2—Inhibits aggregation of platelets
Mnemonic: I for I
• Uses of colchicine—
G—Gout
C—Cirrhosis
M—Acute Mediterranean fever
S—Sarcoidosis
• Acute gout—
N—NSAIDS
C—Colchicine
C—Corticosteroids
Pharmacology 69
• Indications of chloroquine—
R—RA
E—Extraintestinal amoebiasis
D—DLE
L—Lepra reaction
I—Infectious mononucleosis
P—Photogenic reactions
Mala—Malaria
G—Giardiasis
•
Anakinra—IL 1 receptor antagonist.
Mnemonic: A1
• Oprelvekin is IL 11 used in anticancer drug induced thrombo-
cytopenia.
Mnemonic: Eleven kin
•Ticlopedine causes thrombocytopenia
Mnemonic: T for T
• Side effects of heparin—
A—Alopecia
B—Bleeding
H—Hyperkalemia
O—Osteoporosis
T—Thrombocytopenia
• Mast cell stabilizers
K—Ketotifen
N—Nedocromil
S—Sodium cromoglycate
• Busulfan—side effects—
S—Skin pigmentation
U—Uric acid increased
LF—Lung fibrosis
A—Adrenal insufficiency
• Indications of chloroquine—
R—RA
E—Extraintestinal amoebiasis
D—DLE
L—Lepra reaction
I—Infectious mononucleosis
P—Photogenic reactions
Mala—Malaria
G—Giardiasis
•
Anakinra—IL 1 receptor antagonist.
Mnemonic: A1
• Oprelvekin is IL 11 used in anticancer drug induced thrombo-
cytopenia.
Mnemonic: Eleven kin
•Ticlopedine causes thrombocytopenia
Mnemonic: T for T
• Side effects of heparin—
A—Alopecia
B—Bleeding
H—Hyperkalemia
O—Osteoporosis
T—Thrombocytopenia
• Mast cell stabilizers
K—Ketotifen
N—Nedocromil
S—Sodium cromoglycate
• Busulfan—side effects—
S—Skin pigmentation
U—Uric acid increased
LF—Lung fibrosis
A—Adrenal insufficiency
Mnemonics70
• TOC for Hodgkin’s lymphoma—
Earlier:
M—Mechlorethamine
O—Oncovin (Vincristine)
P—Prednisolone
P—Procarbazine
Now preferred:
A—Adriamycin/Doxorubicin
B—Bleomycin
V—Vinblastin
D—Dacarbazine
• TOC for NHL—
C—Cyclophosphamide
H—Hydroxydaunorubicin/Doxorubicin
O—Oncovin/Vincristine
P—Prednisolone
+/– R—Rituximab
• TOC for colorectal carcinoma—
FOLFOX or FOLFIRI
FOL—Folinic acid
F—5FU
OX—Oxaliplatin or
IRI—Irinotecan
• Uses of methotrexate—
C—Choriocarcinoma
A—Abortion
N—NHL
C—Crohn’s disease
E—Ectopic pregnancy
R—RA
• Etoposide is used in—
T—Testicular carcinoma
O—Oat cell carcinoma
P—Prostate carcinoma
• TOC for Hodgkin’s lymphoma—
Earlier:
M—Mechlorethamine
O—Oncovin (Vincristine)
P—Prednisolone
P—Procarbazine
Now preferred:
A—Adriamycin/Doxorubicin
B—Bleomycin
V—Vinblastin
D—Dacarbazine
• TOC for NHL—
C—Cyclophosphamide
H—Hydroxydaunorubicin/Doxorubicin
O—Oncovin/Vincristine
P—Prednisolone
+/– R—Rituximab
• TOC for colorectal carcinoma—
FOLFOX or FOLFIRI
FOL—Folinic acid
F—5FU
OX—Oxaliplatin or
IRI—Irinotecan
• Uses of methotrexate—
C—Choriocarcinoma
A—Abortion
N—NHL
C—Crohn’s disease
E—Ectopic pregnancy
R—RA
• Etoposide is used in—
T—Testicular carcinoma
O—Oat cell carcinoma
P—Prostate carcinoma
Pharmacology 71
• Side effects of cytotoxic drugs—
B—Bone marrow suppression
A—Alopecia
D—Diarrhea
H—Hyperuricemia
• Hypolipidemic drugs—bile acid binding agent
Cholestyramine
Cholestipol
Cholesevalam
Mnemonic: Chole
• Ketamine
K—Kids. Induction agent of choice in children.
E—Emergency reaction
T—Thalamocortical junction is site of action causing dissociative
anesthesia
A—Analgesia (profound)
M—Meals—can be given after meals
I—Increase all pressures (BP, IOP, ICP)
N—NMDA receptor blocker of glutamate
E—Excellent bronchodilator—preferred in asthamatics.
• Side effects of cytotoxic drugs—
B—Bone marrow suppression
A—Alopecia
D—Diarrhea
H—Hyperuricemia
• Hypolipidemic drugs—bile acid binding agent
Cholestyramine
Cholestipol
Cholesevalam
Mnemonic: Chole
• Ketamine
K—Kids. Induction agent of choice in children.
E—Emergency reaction
T—Thalamocortical junction is site of action causing dissociative
anesthesia
A—Analgesia (profound)
M—Meals—can be given after meals
I—Increase all pressures (BP, IOP, ICP)
N—NMDA receptor blocker of glutamate
E—Excellent bronchodilator—preferred in asthamatics.
• Class I MHC molecules: CD8 T cells 1 × 8 = 8
Class II MHC molecules: CD4 T cells 2 × 4 = 8
Peptide binding site on Class IMHC molecules is located in a
groove between distal domains of α subunits (between α
1 and
α
2 domains)
Mnemonic:
1dααααα
• Mechanism of resistance
Production of βββββ-lactamase: Both gram +ve and gram –ve
Alteration in PBP: Gram-positive
Impaired permeability: Gram-negative
Mnemonic: Beta both
PBP: Positive (2P is positive)
• Hepatitis virus
Hep A Hep B Hep C Hep D Hep E Hep G
PicornaHepa DNAFlavivirusIncompleteCalcivirusCalcivirus
Mnemonic: PH FICC (Pic of Hema Fall In Class)
• Dengue hemorrhagic fever
Serotype 1 followed by serotype 2 is more dangerous than
Serotype 4 followed by:
Serotype 2
Mnemonic: 12 >42
Also remember: Serotype 2 is more dangerous than other
serotypes.
• Lysogenic conversion
Salmonella typhi
72
Microbiology
5
Class II MHC molecules: CD4 T cells 2 × 4 = 8
Peptide binding site on Class IMHC molecules is located in a
groove between distal domains of α subunits (between α
1 and
α
2 domains)
Mnemonic:
1dααααα
• Mechanism of resistance
Production of βββββ-lactamase: Both gram +ve and gram –ve
Alteration in PBP: Gram-positive
Impaired permeability: Gram-negative
Mnemonic: Beta both
PBP: Positive (2P is positive)
• Hepatitis virus
Hep A Hep B Hep C Hep D Hep E Hep G
PicornaHepa DNAFlavivirusIncompleteCalcivirusCalcivirus
Mnemonic: PH FICC (Pic of Hema Fall In Class)
• Dengue hemorrhagic fever
Serotype 1 followed by serotype 2 is more dangerous than
Serotype 4 followed by:
Serotype 2
Mnemonic: 12 >42
Also remember: Serotype 2 is more dangerous than other
serotypes.
• Lysogenic conversion
Salmonella typhi
72
Microbiology
5
Microbiology 73
Clostridium botulinum
Corynebacterium diphtheriae
Mnemonic: Salmon bottles corn for lysogeny
• Nuclear inclusion bodies
Cowdry type A:Herpesvirus
Yellow fever virus
Mnemonic: HAY
Cowdry type B:Adenovirus
Poliovirus
Mnemonic: BAP
• Methods for sterilization of endoscopes
Rigid endoscope
Autoclave
Mnemonic: RiA
Flexible endoscope
Glutaraldehyde peracetic acid (20% cidex)
Mnemonic: EFG
•Dimorphic fungi
Penicillium marneffei
Blastomyces
Histoplasma capsulatum
Paracoccidiomyces
Candida albicans (not other Candida)
Sporothrix
Mnemonic: Dimorphic Penicillin Blast his Para’s albi spores
• Culture media for isolation of Leptospira
Korthof medium
EMJH medium
Fletcher medium
Stuart medium
Mnemonic: KEFS
• Man is the definitive host in most of the parasitic infections
except the following parasites where it is an intermediate host
Hydatid worm (Echinococcus granulosus)
Malaria (Plasmodium)
Clostridium botulinum
Corynebacterium diphtheriae
Mnemonic: Salmon bottles corn for lysogeny
• Nuclear inclusion bodies
Cowdry type A:Herpesvirus
Yellow fever virus
Mnemonic: HAY
Cowdry type B:Adenovirus
Poliovirus
Mnemonic: BAP
• Methods for sterilization of endoscopes
Rigid endoscope
Autoclave
Mnemonic: RiA
Flexible endoscope
Glutaraldehyde peracetic acid (20% cidex)
Mnemonic: EFG
•Dimorphic fungi
Penicillium marneffei
Blastomyces
Histoplasma capsulatum
Paracoccidiomyces
Candida albicans (not other Candida)
Sporothrix
Mnemonic: Dimorphic Penicillin Blast his Para’s albi spores
• Culture media for isolation of Leptospira
Korthof medium
EMJH medium
Fletcher medium
Stuart medium
Mnemonic: KEFS
• Man is the definitive host in most of the parasitic infections
except the following parasites where it is an intermediate host
Hydatid worm (Echinococcus granulosus)
Malaria (Plasmodium)
Mnemonics74
Taenia solium (both definitive and intermediate host)
Toxoplasma gondii
Sarcocystis lindemanii
Mnemonic: HMT goli
• Parasites malabsorption
Common to adults and children:
Entamoeba histolytica
Giardia lamblial
Hymenolepis nana
Mnemonic: EGH
Only adults
Strongyloides
Cyclospora
Mnemonic: Strong Cycle of adults
Only Children:Ancylostoma duodenale
Isospora belli
Cryptosporidium
Mnemonic: An Iso Cry of Children
• Antigen–antibody reaction
Ascending part: Prozone or zone of antibody excess
Peak—zone of equivalence
Descending part—post zone or zone of antigen excess
Mnemonic:
A Probe
• Oocyst size of acid fast parasites causing malabsorption
Cryptosporidium—5 μm
Cyclospora—10 μm
Isospora—25 μm
(Alphabetically arranged, size increases)
• Parasite causing autoinfection
Mnemonic: Strong Heman cryptically enters Philippines for
Taenia solium auto infection.
Strongyloides stercoralis
Hymenolepis nana
Cryptosporidium parvum
Enterobius vermicularis
Taenia solium (both definitive and intermediate host)
Toxoplasma gondii
Sarcocystis lindemanii
Mnemonic: HMT goli
• Parasites malabsorption
Common to adults and children:
Entamoeba histolytica
Giardia lamblial
Hymenolepis nana
Mnemonic: EGH
Only adults
Strongyloides
Cyclospora
Mnemonic: Strong Cycle of adults
Only Children:Ancylostoma duodenale
Isospora belli
Cryptosporidium
Mnemonic: An Iso Cry of Children
• Antigen–antibody reaction
Ascending part: Prozone or zone of antibody excess
Peak—zone of equivalence
Descending part—post zone or zone of antigen excess
Mnemonic:
A Probe
• Oocyst size of acid fast parasites causing malabsorption
Cryptosporidium—5 μm
Cyclospora—10 μm
Isospora—25 μm
(Alphabetically arranged, size increases)
• Parasite causing autoinfection
Mnemonic: Strong Heman cryptically enters Philippines for
Taenia solium auto infection.
Strongyloides stercoralis
Hymenolepis nana
Cryptosporidium parvum
Enterobius vermicularis
Microbiology 75
Capillaria Philippinensis
Taenia solium
• Worms that do not multiply in host.
Ancylostoma duodenale
Enterobius vermicularis
Wuchereria bancrofti
Mnemonic: Duodenum bans entry and multiplication
Also remember
Worms that crawl out
Enterobius vermicularis
T. saginata
Mnemonic: Crawling entry of saginata
•Microaerophilic bacteria
Helicobacter pylori
Borrelia burgdorferi
Campylobacter
Mnemonic: Hell Boy in Micro Camp
• Viruses associated with blood transfusion
Parvovirus B-19
Hepatitis B
Hepatitis C
Hepatitis G
HIV type 1
HTLV type 1
Cytomegalovirus
Mnemonic: 19 BCG transfuses type 1 of Cytomegalovirus
•Transport media for Vibrio cholerae
Venkatraman Ramkrishnan (VR) media
Alkaline peptone water
Monsur’s taurocholate tellurite peptone water
Mnemonic: Venkat transport Alkaline water to Maissur
• Obligate intracellular parasite
Virus
Chlamydia
Rickettsiae
Capillaria Philippinensis
Taenia solium
• Worms that do not multiply in host.
Ancylostoma duodenale
Enterobius vermicularis
Wuchereria bancrofti
Mnemonic: Duodenum bans entry and multiplication
Also remember
Worms that crawl out
Enterobius vermicularis
T. saginata
Mnemonic: Crawling entry of saginata
•Microaerophilic bacteria
Helicobacter pylori
Borrelia burgdorferi
Campylobacter
Mnemonic: Hell Boy in Micro Camp
• Viruses associated with blood transfusion
Parvovirus B-19
Hepatitis B
Hepatitis C
Hepatitis G
HIV type 1
HTLV type 1
Cytomegalovirus
Mnemonic: 19 BCG transfuses type 1 of Cytomegalovirus
•Transport media for Vibrio cholerae
Venkatraman Ramkrishnan (VR) media
Alkaline peptone water
Monsur’s taurocholate tellurite peptone water
Mnemonic: Venkat transport Alkaline water to Maissur
• Obligate intracellular parasite
Virus
Chlamydia
Rickettsiae
Mnemonics76
Legionella
Mnemonic: VCRL (Viru Chalne ke liye Rickshaw lega)
•Selective media in which substances that inhibit or poison all
but a few microorganisms are added to a solid media (S for S).
Enrichment media are produced by adding selective
substances to liquid media.
Enrich
ed media are basal media enriched with blood, serum
or egg.
• Classification of streptococci: Hemolytic (P) streptococci are
classified by Lancefield classification—based on nature of a
carbohydrate ‘C’ antigen (Group A to K without I and J)
Griffith typing—‘M’ Protein
Mnemonic: GMP
•01 Vibrio cholerae
Classical: Polymixin, Phage 4
Mnemonic: Polyphagic class
Eltor: Eltor, chick embryo
•Mycobacterium tuberculosis complex
No environmental source
M. tuberculosis
M. bovis
M. africanum
M. microti
• Non-tuberculous mycobacteria
(
Atypical mycobacteria)
Environmental source is postulated
M. avium intracellulare complex
M. kansasii
Mnemonic: Kans ka avium in atypical environment
• Enteropathogenic E.coli or Enteroadhesive E. coli—attaches
intimately to enterocyte membrane, Infants and Children,
Epidemic
Mnemonic: Infant attaches ad for epidemic in Patho.
Enterotoxigenic E.coli: Traveller’s diarrhea
Mnemonic: T for T—Produces enterotoxin (Labile/Stable)
Legionella
Mnemonic: VCRL (Viru Chalne ke liye Rickshaw lega)
•Selective media in which substances that inhibit or poison all
but a few microorganisms are added to a solid media (S for S).
Enrichment media are produced by adding selective
substances to liquid media.
Enrich
ed media are basal media enriched with blood, serum
or egg.
• Classification of streptococci: Hemolytic (P) streptococci are
classified by Lancefield classification—based on nature of a
carbohydrate ‘C’ antigen (Group A to K without I and J)
Griffith typing—‘M’ Protein
Mnemonic: GMP
•01 Vibrio cholerae
Classical: Polymixin, Phage 4
Mnemonic: Polyphagic class
Eltor: Eltor, chick embryo
•Mycobacterium tuberculosis complex
No environmental source
M. tuberculosis
M. bovis
M. africanum
M. microti
• Non-tuberculous mycobacteria
(
Atypical mycobacteria)
Environmental source is postulated
M. avium intracellulare complex
M. kansasii
Mnemonic: Kans ka avium in atypical environment
• Enteropathogenic E.coli or Enteroadhesive E. coli—attaches
intimately to enterocyte membrane, Infants and Children,
Epidemic
Mnemonic: Infant attaches ad for epidemic in Patho.
Enterotoxigenic E.coli: Traveller’s diarrhea
Mnemonic: T for T—Produces enterotoxin (Labile/Stable)
Microbiology 77
Enteroaggregated E.coli: Persistent diarrhea—heat stable
enterotoxin EAST I
Mnemonic: Aggregate persists
Entero
invasive resembles shigellosis
Detected by Sereny tests, penetration of the Hela and Hep2
cells.
Mnemonic: H2 S2 invades
• Leptospira: Three Rs
Rat, Rice, Rainfield.
•Treponema palladium, Syphilis
endemicum: Bejel
Mnemonic: Bend
Pertunae: Yaws (Mnemonic: Ytune)
Caratium: Pinta (Mnemonic: Pintu ki Car)
•Chlamydia trachomatis
Serotype A, B, Ba, C: Endemic blinding trachoma
Serotype D–K: Inclusion conjunctivitis, genital chlamydiasis,
Infant pneumonia
Mnemonic: IGI
Serotype L1, L2, L3: Lymphogranuloma venereum
Mnemonic: L for L
• Immunoglobulin Ig G IgAIgMIgDIgE
Percentage of 75–85% 7–15 5–10 0.3 0.019
total serum Ig
Serum half-life days 23 6 5 3 2.5
Mnemonic:
In decreasing order GAMDE
Classical complement activation: IgM and IgG (Mnemonic:
Mahatma Gandhi Classical)
Alternate complement activation: IgA
Mnemonic: A for A
Ig present in milk: IgA and IgG (Mnemonic: AG in milk)
•Epitope: Antigen
Paratope: Antibody
• Toxin acting by inhibiting protein synthesis
Shiga toxin
Enteroaggregated E.coli: Persistent diarrhea—heat stable
enterotoxin EAST I
Mnemonic: Aggregate persists
Entero
invasive resembles shigellosis
Detected by Sereny tests, penetration of the Hela and Hep2
cells.
Mnemonic: H2 S2 invades
• Leptospira: Three Rs
Rat, Rice, Rainfield.
•Treponema palladium, Syphilis
endemicum: Bejel
Mnemonic: Bend
Pertunae: Yaws (Mnemonic: Ytune)
Caratium: Pinta (Mnemonic: Pintu ki Car)
•Chlamydia trachomatis
Serotype A, B, Ba, C: Endemic blinding trachoma
Serotype D–K: Inclusion conjunctivitis, genital chlamydiasis,
Infant pneumonia
Mnemonic: IGI
Serotype L1, L2, L3: Lymphogranuloma venereum
Mnemonic: L for L
• Immunoglobulin Ig G IgAIgMIgDIgE
Percentage of 75–85% 7–15 5–10 0.3 0.019
total serum Ig
Serum half-life days 23 6 5 3 2.5
Mnemonic:
In decreasing order GAMDE
Classical complement activation: IgM and IgG (Mnemonic:
Mahatma Gandhi Classical)
Alternate complement activation: IgA
Mnemonic: A for A
Ig present in milk: IgA and IgG (Mnemonic: AG in milk)
•Epitope: Antigen
Paratope: Antibody
• Toxin acting by inhibiting protein synthesis
Shiga toxin
Mnemonics78
Pseudomonas toxin
Diphtheria toxin
Mnemonic: Antiprotein ships dip
p-pilli are pyelonephritis associated pilli that are found on
uropathic strains of
E. coli.
Mnemonic:
P for P
•Gram-positive coccobacilli: Listeria
• Gram-negative coccobacilli: Bordetella
Brucella
Campylobacter
Chlamydia
Helicobacter
Haemophilus
Rickettsia
Mnemonic: BCHR
• Bacteria acquiring characteristics
Transformation (free DNA soluble DNA):Pneumococcus
Bacillus
Haemophilus
Mnemonic: BPH/PnBaha
Transduction (bacteriophage): Method of genetic engineering
T/t of inborn errors of metabolism
Mnemonic: DIG
Conjugation (actual physical contact): Episomes and plasmids
for resistance.
Lysogenic conversion (phage DNA itself is new genetic
element)
Corynebacterium diphtheriae
Salmonella typhi
Clostridium botulinum
• Thymus
dependent tissues (collection of T-lymphocytes)
Spleen: Malpighian corpuscle in white pulp (periarterial)
Lymph node: Paracortical area between follicles in cortex and
medullary cords in medulla
Mnemonic: Para Mal dependent
Bursa dependent (collection of B-lymphocytes)
Pseudomonas toxin
Diphtheria toxin
Mnemonic: Antiprotein ships dip
p-pilli are pyelonephritis associated pilli that are found on
uropathic strains of
E. coli.
Mnemonic:
P for P
•Gram-positive coccobacilli: Listeria
• Gram-negative coccobacilli: Bordetella
Brucella
Campylobacter
Chlamydia
Helicobacter
Haemophilus
Rickettsia
Mnemonic: BCHR
• Bacteria acquiring characteristics
Transformation (free DNA soluble DNA):Pneumococcus
Bacillus
Haemophilus
Mnemonic: BPH/PnBaha
Transduction (bacteriophage): Method of genetic engineering
T/t of inborn errors of metabolism
Mnemonic: DIG
Conjugation (actual physical contact): Episomes and plasmids
for resistance.
Lysogenic conversion (phage DNA itself is new genetic
element)
Corynebacterium diphtheriae
Salmonella typhi
Clostridium botulinum
• Thymus
dependent tissues (collection of T-lymphocytes)
Spleen: Malpighian corpuscle in white pulp (periarterial)
Lymph node: Paracortical area between follicles in cortex and
medullary cords in medulla
Mnemonic: Para Mal dependent
Bursa dependent (collection of B-lymphocytes)
Microbiology 79
(Thymus independent)
Spleen: Germinal centre
Mantle layer
Perifollicular region
Mnemonic: German Man around follicle are independent
Lymph nodes: Medullary cords
Cortical follicles
Germinal centres
Mnemonic: Medulla and cortex in Germany are also
independent
• Property S. aureus S. epidermidis
Coagulase Positive Negative
Mannitol Ferments Non-fermenting
Pathogenicity Pathogenic Non-pathogenic
• Susceptibility tests
Shick test: Diphtheria
Dick test: Scarlet fever
Mnemonic: S for D and D for S (opposite)
•Spirochete:Borrelia
Leptospira
Treponema
Mnemonic: BLT (Balti in Hindi)
• Combined immunodeficiency
SCID (severe combined immunodeficiency)—def. of ADA
Wiskott-Aldrich syndrome
Ataxia-telangiectasia
Nezelof syndrome
Mnemonic: SWAN
Defective Phagocytosis
Chronic granulomatous disease (def. of NADPH oxidase)
Chediak-Higashi syndrome
Myeloperoxidase def.
Job’s syndrome
• Two pigments produced by Pseudomonas aeruginosa
Pyo
cyanine: Bluish green pigment
Mnemonic: BC
Pyoverdin (fluorescein): Greenish yellow pigment
(Thymus independent)
Spleen: Germinal centre
Mantle layer
Perifollicular region
Mnemonic: German Man around follicle are independent
Lymph nodes: Medullary cords
Cortical follicles
Germinal centres
Mnemonic: Medulla and cortex in Germany are also
independent
• Property S. aureus S. epidermidis
Coagulase Positive Negative
Mannitol Ferments Non-fermenting
Pathogenicity Pathogenic Non-pathogenic
• Susceptibility tests
Shick test: Diphtheria
Dick test: Scarlet fever
Mnemonic: S for D and D for S (opposite)
•Spirochete:Borrelia
Leptospira
Treponema
Mnemonic: BLT (Balti in Hindi)
• Combined immunodeficiency
SCID (severe combined immunodeficiency)—def. of ADA
Wiskott-Aldrich syndrome
Ataxia-telangiectasia
Nezelof syndrome
Mnemonic: SWAN
Defective Phagocytosis
Chronic granulomatous disease (def. of NADPH oxidase)
Chediak-Higashi syndrome
Myeloperoxidase def.
Job’s syndrome
• Two pigments produced by Pseudomonas aeruginosa
Pyo
cyanine: Bluish green pigment
Mnemonic: BC
Pyoverdin (fluorescein): Greenish yellow pigment
Mnemonics80
• Visceral larva migrains—Toxocara canis
Cutaneous larva migrains—
A—Ancylostoma duodenale
N—Necator americanus
S—Strongyloides stercoralis
• Human is the dead end host for
L—Leptospirosis
T—Tetanus
T—Taenia solinum
E—Endemic typhus
Japan—Japanese encephalitis
L—Legionella
E—Echinococcus, trichinella
H—Human rabies
• Visceral larva migrains—Toxocara canis
Cutaneous larva migrains—
A—Ancylostoma duodenale
N—Necator americanus
S—Strongyloides stercoralis
• Human is the dead end host for
L—Leptospirosis
T—Tetanus
T—Taenia solinum
E—Endemic typhus
Japan—Japanese encephalitis
L—Legionella
E—Echinococcus, trichinella
H—Human rabies
• Characteristic features of Staphylococcus pneumoniae
Pneumatocele (thin walled cystic spaces that may contain air
fluid levels)
Pleural effusion
Pyopneumothorax (bronchopleural fistula)
Abscess formation
Cavitation (single or multiple thick-walled cavities) (may be
bilateral)
Empyema
Mnemonic: 3P and ACE
• Actin: AD FSGS
CD2AP: Adult proteinuria
Steroid sensitive: NPHS I-Nephrin-19q. Finish congenital
nephrotic syndrome
Steroid
resistant: NPHS 2-Podocin-lq: AR acquired FSGS
Mnemonic: 2R-lq-AP
• Type III (pauci immune) RPGN
ANCA small vessel vasculitis
Wegener’s granulomatosis
Microscopic polyangiitis
Churg-Strauss syndrome
Mnemonic: WMC
• Cox 1 Constitutive
Cox 2 Inducible
•Large vessel vasculitis
Giant cell arteritis (temporal arteritis)
Takayasu arteritis
81
Pathology
6
Pneumatocele (thin walled cystic spaces that may contain air
fluid levels)
Pleural effusion
Pyopneumothorax (bronchopleural fistula)
Abscess formation
Cavitation (single or multiple thick-walled cavities) (may be
bilateral)
Empyema
Mnemonic: 3P and ACE
• Actin: AD FSGS
CD2AP: Adult proteinuria
Steroid sensitive: NPHS I-Nephrin-19q. Finish congenital
nephrotic syndrome
Steroid
resistant: NPHS 2-Podocin-lq: AR acquired FSGS
Mnemonic: 2R-lq-AP
• Type III (pauci immune) RPGN
ANCA small vessel vasculitis
Wegener’s granulomatosis
Microscopic polyangiitis
Churg-Strauss syndrome
Mnemonic: WMC
• Cox 1 Constitutive
Cox 2 Inducible
•Large vessel vasculitis
Giant cell arteritis (temporal arteritis)
Takayasu arteritis
81
Pathology
6
Mnemonics82
Cogan syndrome
Mnemonic: Large giant taka of cogan
• Medium vessel vasculitis
PAN
Kawasaki disease
Buerger’s disease
Mnemonic: Pan per kabab aur burger)
• DNA repair defects
HNPCC (mismatch repair): Colon ca.
Bloom syndrome: Developmental defects
Fanconi anaemia: Bone marrow aplasia
Ataxia-telangiectasia: Neural symptoms
Xeroderma pigmentosa (nucleotide excision repair)—skin ca.
Mnemonic: HB FAX
• Bcl-1: Mantle cell lymphoma
Bcl-2: Follicular lymphoma
Bcl-6: Burkitt lymphoma
Mnemonic: My favourite Band is Bcl-126
Diffuse large B cell lymphoma—Bcl-2 and Bcl-6
Mnemonic: D-26
• HLA B27 is associated with
Juvenile rheumatoid arthritis
Psoriatic spondylitis
Ankylosing spondylitis
Inflammatory bowel disease
Reactive arthritis/Reiter’s syndrome
Mnemonic: Juvenile PAIR at 27 yrs of age
• Risk factors for atherosclesosis in decreasing order
Total cholesterol: HDLC
Apoprotein B 100: HDLC
LDL cholesterol: HDLC
Mnemonic:
TBL
ratio
H
• Classification of hyperlipoproteinemias
Lipoproteins elevated
Cogan syndrome
Mnemonic: Large giant taka of cogan
• Medium vessel vasculitis
PAN
Kawasaki disease
Buerger’s disease
Mnemonic: Pan per kabab aur burger)
• DNA repair defects
HNPCC (mismatch repair): Colon ca.
Bloom syndrome: Developmental defects
Fanconi anaemia: Bone marrow aplasia
Ataxia-telangiectasia: Neural symptoms
Xeroderma pigmentosa (nucleotide excision repair)—skin ca.
Mnemonic: HB FAX
• Bcl-1: Mantle cell lymphoma
Bcl-2: Follicular lymphoma
Bcl-6: Burkitt lymphoma
Mnemonic: My favourite Band is Bcl-126
Diffuse large B cell lymphoma—Bcl-2 and Bcl-6
Mnemonic: D-26
• HLA B27 is associated with
Juvenile rheumatoid arthritis
Psoriatic spondylitis
Ankylosing spondylitis
Inflammatory bowel disease
Reactive arthritis/Reiter’s syndrome
Mnemonic: Juvenile PAIR at 27 yrs of age
• Risk factors for atherosclesosis in decreasing order
Total cholesterol: HDLC
Apoprotein B 100: HDLC
LDL cholesterol: HDLC
Mnemonic:
TBL
ratio
H
• Classification of hyperlipoproteinemias
Lipoproteins elevated
Pathology 83
I: chylomicrons
IV: VLDL
V: (1+ 4 = 5)—chylomicron and VLDL
III: (4 – 1 = 3)—chylomicron and VLDL remnant
II: LDL (lla—LDL, IIb—LDL and VLDL)
• Radical scavenging enzymes
–
Glutathion peroxidase
– Catalase
– Superoxide dismutase
Mnemonic: GCS
Note:Superoxide dismutase also generates free radicals
(H
2O
2).
• Amyloid proteins and their clinical settings
Transthyretin (ATTR)
Familial amyloidotic neuropathy
Mnemonic: FAT
Systemic senile amyloidosis
Mnemonic: SST
β2 microglobulin (Aβ2m): Hemodialysis associated amyloidosis
Mnemonic: Dial M for amyloid
β2: amyloid protein (Aβ):Alzheimer’s disease
Senile cerebral disease
Mnemonic: Sc and Ad
•Flexner-Wintersteiner rosettes are characteristic of
retinoblastoma
May also be seen in
Medulloblastoma and pineoblastoma
Mnemonic: Flexible RMP (All are blast)
• Glomerulonephritis without proliferative changes
Minimal change disease
Amyloidosis
Membranous glomerulonephritis
Diabetic nephropathy
± FSGS
Mnemonic: Minimum Amul for membranous Dia
I: chylomicrons
IV: VLDL
V: (1+ 4 = 5)—chylomicron and VLDL
III: (4 – 1 = 3)—chylomicron and VLDL remnant
II: LDL (lla—LDL, IIb—LDL and VLDL)
• Radical scavenging enzymes
–
Glutathion peroxidase
– Catalase
– Superoxide dismutase
Mnemonic: GCS
Note:Superoxide dismutase also generates free radicals
(H
2O
2).
• Amyloid proteins and their clinical settings
Transthyretin (ATTR)
Familial amyloidotic neuropathy
Mnemonic: FAT
Systemic senile amyloidosis
Mnemonic: SST
β2 microglobulin (Aβ2m): Hemodialysis associated amyloidosis
Mnemonic: Dial M for amyloid
β2: amyloid protein (Aβ):Alzheimer’s disease
Senile cerebral disease
Mnemonic: Sc and Ad
•Flexner-Wintersteiner rosettes are characteristic of
retinoblastoma
May also be seen in
Medulloblastoma and pineoblastoma
Mnemonic: Flexible RMP (All are blast)
• Glomerulonephritis without proliferative changes
Minimal change disease
Amyloidosis
Membranous glomerulonephritis
Diabetic nephropathy
± FSGS
Mnemonic: Minimum Amul for membranous Dia
Mnemonics84
• Fibromatosis represent a group of fibrous benign or tumour-
like conditions
Deep fibromatosis: Desmoid tumors
Mnemonic: Deepa ka Des
Superficial fibromatosis
Palmar fibromatoses (Dupuytren’s contracture)
Plantar fibromatoses
Penile fibromatoses (Peyronie’s disease)
•
Prader-Willi syndrome: Clinical features
Mental retardation
Diminished fetal activity
Hypotonia
Obesity
Short stature
Hypogonadotrophic hypogonadism
Mnemonic: Pradip MDHOSH
• Angelman–Willi syndrome
Seizures
Hypotonia
Inappropriate laughter (Happy puppets)
Mental retardation
Ataxia
Mnemonic: Happy puppet SHIMA
•Multiple myeloma
Dutcher bodies—nuclear
Mnemonic: Multiple nuclear Dutch
Russell bodies: Cytoplasmic (Mnemonic: Russell Crowe)
•Mooser’s bodies: Endemic typhus
Mnemonic: Moosa is endemic
Miyagawa bodies: Chlamydia trachomatis
Mnemonic: Miya Kalam
Lafora bodies: Familial myoclonic epilepsy
Mnemonic: Lofar in Family
• Fibromatosis represent a group of fibrous benign or tumour-
like conditions
Deep fibromatosis: Desmoid tumors
Mnemonic: Deepa ka Des
Superficial fibromatosis
Palmar fibromatoses (Dupuytren’s contracture)
Plantar fibromatoses
Penile fibromatoses (Peyronie’s disease)
•
Prader-Willi syndrome: Clinical features
Mental retardation
Diminished fetal activity
Hypotonia
Obesity
Short stature
Hypogonadotrophic hypogonadism
Mnemonic: Pradip MDHOSH
• Angelman–Willi syndrome
Seizures
Hypotonia
Inappropriate laughter (Happy puppets)
Mental retardation
Ataxia
Mnemonic: Happy puppet SHIMA
•Multiple myeloma
Dutcher bodies—nuclear
Mnemonic: Multiple nuclear Dutch
Russell bodies: Cytoplasmic (Mnemonic: Russell Crowe)
•Mooser’s bodies: Endemic typhus
Mnemonic: Moosa is endemic
Miyagawa bodies: Chlamydia trachomatis
Mnemonic: Miya Kalam
Lafora bodies: Familial myoclonic epilepsy
Mnemonic: Lofar in Family
Pathology 85
• Pancytopenia with cellular bone marrow
Myelodysplastic syndrome
Myelofibrosis
Myelophthisis
Bone marrow lymphoma
Aleukemic leukemia
Hairy cell leukemia
Mnemonic: Cellular bone marrow M3 ka BAP hai
•Cold antibody hemolytic anaemia—usually IgM
Mnemonic: CM – Class Mate
• Proteins defective in hereditary spherocytosis
Ankyrin > protein 3 (anion transport channel) > α-spectrin >
protein 4.2 (palladin)
Mnemonic: AP3 ααααα S P4.2
First memorize APSP
Then AP3SP
Then AP3 α SP
Then AP3 α SP4.2
• Prader-Willi syndrome:
(Chromosome 15) Paternal deletion
Maternal imprinting
Maternal disomy
AngeIman syndrome: Maternal deletion
(Chromosome 15) Paternal imprinting
Paternal disomy
• Mechanism of apoptosis
Caspase 9 (N
ine): Intrinsic pathway
Mnemonic: In for In
Caspase 8 (Eight): Extrinsic pathway
Mnemonic: E for E
• Histochemical staining of amyloid with Congo red observed
under ordinary light—pink red colour. Observed under
polarized light: Green birefringence
Mnemonic: PG
• Genes regulating apoptosis
Anti-apoptotic Pro-apoptotic
• Pancytopenia with cellular bone marrow
Myelodysplastic syndrome
Myelofibrosis
Myelophthisis
Bone marrow lymphoma
Aleukemic leukemia
Hairy cell leukemia
Mnemonic: Cellular bone marrow M3 ka BAP hai
•Cold antibody hemolytic anaemia—usually IgM
Mnemonic: CM – Class Mate
• Proteins defective in hereditary spherocytosis
Ankyrin > protein 3 (anion transport channel) > α-spectrin >
protein 4.2 (palladin)
Mnemonic: AP3 ααααα S P4.2
First memorize APSP
Then AP3SP
Then AP3 α SP
Then AP3 α SP4.2
• Prader-Willi syndrome:
(Chromosome 15) Paternal deletion
Maternal imprinting
Maternal disomy
AngeIman syndrome: Maternal deletion
(Chromosome 15) Paternal imprinting
Paternal disomy
• Mechanism of apoptosis
Caspase 9 (N
ine): Intrinsic pathway
Mnemonic: In for In
Caspase 8 (Eight): Extrinsic pathway
Mnemonic: E for E
• Histochemical staining of amyloid with Congo red observed
under ordinary light—pink red colour. Observed under
polarized light: Green birefringence
Mnemonic: PG
• Genes regulating apoptosis
Anti-apoptotic Pro-apoptotic
Mnemonics86
bc l-2 bax
bcl-XL bad bak bim bcl-xs
Mnemonic:
L and LXL are anti-apoptotic
• Chronic manifestations of splenectomy
Anisocytosis
Basophilic stippling
Howell-Jolly bodies (nuclear remnants)
Heinz bodies (denatured Hb)
Nucleated erythrocytes in peripheral blood, occasionally
Poikilocytosis
• Howell-Jolly bodies occur most frequently after
Splenectomy
Megaloblastic anaemia
Severe hemolytic anaemia
Mnemonic: Jolly SMS
• Inactivation of free radical reactions
Enzymes:Glutathione peroxidase
Catalase
Superoxide dismutase
Mnemonic: GCS
Non-enzymatic system: Endogenous/exogenous anti-oxidants
a. Vitamin E, vitamin C
b. Sulfhydryl containing compounds: glutathione, cysteine
c. Serum protein:Albumin
Ceruloplasmin
Transferrin
Mnemonic: EC GC ACT
• Renal lesions in SLE (WHO classifications)
Class I: Normal by light, electron and immunofluorescent
microscopy
Class II:
Mesangial lupus GN
(Mildest clinical variant proteinuria, microscopic hematuria
rare)
bc l-2 bax
bcl-XL bad bak bim bcl-xs
Mnemonic:
L and LXL are anti-apoptotic
• Chronic manifestations of splenectomy
Anisocytosis
Basophilic stippling
Howell-Jolly bodies (nuclear remnants)
Heinz bodies (denatured Hb)
Nucleated erythrocytes in peripheral blood, occasionally
Poikilocytosis
• Howell-Jolly bodies occur most frequently after
Splenectomy
Megaloblastic anaemia
Severe hemolytic anaemia
Mnemonic: Jolly SMS
• Inactivation of free radical reactions
Enzymes:Glutathione peroxidase
Catalase
Superoxide dismutase
Mnemonic: GCS
Non-enzymatic system: Endogenous/exogenous anti-oxidants
a. Vitamin E, vitamin C
b. Sulfhydryl containing compounds: glutathione, cysteine
c. Serum protein:Albumin
Ceruloplasmin
Transferrin
Mnemonic: EC GC ACT
• Renal lesions in SLE (WHO classifications)
Class I: Normal by light, electron and immunofluorescent
microscopy
Class II:
Mesangial lupus GN
(Mildest clinical variant proteinuria, microscopic hematuria
rare)
Pathology 87
Class III: Focal proliferative GN
(Moderate, presents with proteinuria and hematuria)
Class IV:
Diffuse proliferative GN
(Haematuria, nephrotic range proteinuria, mild to severe renal
failures)
Class V:
Membranous GN
(Massive proteinuria and nephrotic syndrome)
Class VI:
End stage of proliferative lupus nephritis
Mnemonic: No Money FD ME
Note:GN—glomerulonephritis
• Location of epitheloid—Testis
Ovary (tunica)
Pancreas (Islet)
Mnemonic: TOP
Pathologically found in granuloma.
• Antigen presenting cells (APC)
Professional (MHC II, GVHD)—Dendritic cells
Langerhans’ cells
Follicular dendritic cells.
Mnemonic: DLF is Very professional
Non-professional (MHC I, graft rejection)—Macrophages
B-lymphocytes
Glial cells
Endothelial cells
Thymic epithelial
cells.
• Autosomal dominant (AD)
H—Hypercholesterolemia (familial)
Hereditary spherocytosis
Huntington’s chorea
E—Ehlers-Danlos syndrome
A—Achondroplasia
V—von Willebrand’s disease (type I and II)
Y—Pseudohypoparathyroidism
D—Dystrophica myotonica
Class III: Focal proliferative GN
(Moderate, presents with proteinuria and hematuria)
Class IV:
Diffuse proliferative GN
(Haematuria, nephrotic range proteinuria, mild to severe renal
failures)
Class V:
Membranous GN
(Massive proteinuria and nephrotic syndrome)
Class VI:
End stage of proliferative lupus nephritis
Mnemonic: No Money FD ME
Note:GN—glomerulonephritis
• Location of epitheloid—Testis
Ovary (tunica)
Pancreas (Islet)
Mnemonic: TOP
Pathologically found in granuloma.
• Antigen presenting cells (APC)
Professional (MHC II, GVHD)—Dendritic cells
Langerhans’ cells
Follicular dendritic cells.
Mnemonic: DLF is Very professional
Non-professional (MHC I, graft rejection)—Macrophages
B-lymphocytes
Glial cells
Endothelial cells
Thymic epithelial
cells.
• Autosomal dominant (AD)
H—Hypercholesterolemia (familial)
Hereditary spherocytosis
Huntington’s chorea
E—Ehlers-Danlos syndrome
A—Achondroplasia
V—von Willebrand’s disease (type I and II)
Y—Pseudohypoparathyroidism
D—Dystrophica myotonica
Mnemonics88
O—Osteogenesis imperfect
M—Marfan’s syndrome
I—Intermittent porphyria
N—Noonan’s syndrome
A—AD PKD
N—NF I and NF II
T—Tuberous sclerosis
• Marfan’s syndrome
M—Mitral valve prolapse
A—Arachnodactyly (long fingers)
R—Retinal detachment
F—Fibrillin I deficiency
Family history
A—Ascending aorta aneurysm
N—Negative nitroprusside test
S—Superotemporal subluxation of lens
• Neurofibromatosis I (17q)
N—Neurofibroma
O—Optic nerve glioma
S—Sphenoid dysplasia (most common skeletal deformity)
P—Plexiform NF
Positive family history
A—Axillary freckling
C—Café-au-lait spots
E—Eye (Lisch nodules on iris)
• Neurofibromatosis II (22q)
M—Multiple
I—Inherited
S—Schwannoma
M—Meningioma
E—Ependymoma
• Autosomal recessive
A— Alkaptonuria
Albinism
B—Beta thalassemia, sickle cell anemia
C—Cystic fibrosis
O—Osteogenesis imperfect
M—Marfan’s syndrome
I—Intermittent porphyria
N—Noonan’s syndrome
A—AD PKD
N—NF I and NF II
T—Tuberous sclerosis
• Marfan’s syndrome
M—Mitral valve prolapse
A—Arachnodactyly (long fingers)
R—Retinal detachment
F—Fibrillin I deficiency
Family history
A—Ascending aorta aneurysm
N—Negative nitroprusside test
S—Superotemporal subluxation of lens
• Neurofibromatosis I (17q)
N—Neurofibroma
O—Optic nerve glioma
S—Sphenoid dysplasia (most common skeletal deformity)
P—Plexiform NF
Positive family history
A—Axillary freckling
C—Café-au-lait spots
E—Eye (Lisch nodules on iris)
• Neurofibromatosis II (22q)
M—Multiple
I—Inherited
S—Schwannoma
M—Meningioma
E—Ependymoma
• Autosomal recessive
A— Alkaptonuria
Albinism
B—Beta thalassemia, sickle cell anemia
C—Cystic fibrosis
Pathology 89
D—Deafness (sensorineural)
E—Emphysema (Panacinar-α
1 antitrypsin deficiency)
F—Friedrick’s ataxia
G—Gaucher’s disease
H—Hurler’s disease
Hemochromatosis
I—Inborn errors of metabolism
Others—Niemann-Pick’s disease
Tay-Sachs disease
Wilson’s disease
• X linked recessive
Less—Lesch-Nyhan syndrome
Chronic—Chronic granulomatous disease
Hunter—Hunter’s disease
Hemophilic—Haemophila A and B
Girls—G6PD deficiency
Don’t—Duchenne muscular dystrophy
Dent’s disease
Color—Color blindness
Fragile—Fragile X syndrome
Fab—Fabry’s disease
Brutun—Brutun’s X linked agammaglobulinemia
Wisely—Wiskott-Aldrich syndrome
• X linked dominant
Rat me—Rett syndrome (only seen in females)
Char—Charcoat Mari tooth disease
Pig—Incontinenta pigmenti (only seen in females)
Airport pe—Alport syndrome
Phosphate kha raha tha—X linked hypophosphatemic rickets
• Mitochondrial inheritance
K—Kearns Sayre syndrome
L—Leber’s hereditary optic neuropathy
M—MERRF (myoclonic epilepsy with ragged red fibres)
MELAS (mitochondrial encephalopathy with lactic acidosis
with stroke like syndrome)
N—NARP (neurologic ataxia with retinitis pigmentosa)
D—Deafness (sensorineural)
E—Emphysema (Panacinar-α
1 antitrypsin deficiency)
F—Friedrick’s ataxia
G—Gaucher’s disease
H—Hurler’s disease
Hemochromatosis
I—Inborn errors of metabolism
Others—Niemann-Pick’s disease
Tay-Sachs disease
Wilson’s disease
• X linked recessive
Less—Lesch-Nyhan syndrome
Chronic—Chronic granulomatous disease
Hunter—Hunter’s disease
Hemophilic—Haemophila A and B
Girls—G6PD deficiency
Don’t—Duchenne muscular dystrophy
Dent’s disease
Color—Color blindness
Fragile—Fragile X syndrome
Fab—Fabry’s disease
Brutun—Brutun’s X linked agammaglobulinemia
Wisely—Wiskott-Aldrich syndrome
• X linked dominant
Rat me—Rett syndrome (only seen in females)
Char—Charcoat Mari tooth disease
Pig—Incontinenta pigmenti (only seen in females)
Airport pe—Alport syndrome
Phosphate kha raha tha—X linked hypophosphatemic rickets
• Mitochondrial inheritance
K—Kearns Sayre syndrome
L—Leber’s hereditary optic neuropathy
M—MERRF (myoclonic epilepsy with ragged red fibres)
MELAS (mitochondrial encephalopathy with lactic acidosis
with stroke like syndrome)
N—NARP (neurologic ataxia with retinitis pigmentosa)
Mnemonics90
O—Ophthalmoplegia (chronic external ophthalmoplegia)
P—Pearson syndrome
• Multiple myeloma
Symptoms
C—Hypercalcemia
R—Renal failure
A—Anemia
B—Bone lytic lesion (on X-ray or bone scan)
• ALL
Testicular infiltration
Mediastinal lymph node involvement
CNS infiltration
Mnemonic: TMC
• Supravital stains—Brilliant cresyl blue
New methylene blue
Crystal violet
Mnemonic: BNC
• Stain
Acidic Basic
Cytoplasm DNA
• Warm antibody—IgG
Cold antibody—IgM
Mnemonic: Classmate
Exception—PCH (Donath Landsteiner antibody)-IgG
• Differential diagnosis of microcytic hypochromic anemia
Sideroblastic anemia
Iron deficiency anemia
Thalassemia
Anemia of chronic disease
Mnemonic: SITA
• Migratory thrombophlebitis (Trousseau syndrome)
S—Stomach
L—Lung
O—Ophthalmoplegia (chronic external ophthalmoplegia)
P—Pearson syndrome
• Multiple myeloma
Symptoms
C—Hypercalcemia
R—Renal failure
A—Anemia
B—Bone lytic lesion (on X-ray or bone scan)
• ALL
Testicular infiltration
Mediastinal lymph node involvement
CNS infiltration
Mnemonic: TMC
• Supravital stains—Brilliant cresyl blue
New methylene blue
Crystal violet
Mnemonic: BNC
• Stain
Acidic Basic
Cytoplasm DNA
• Warm antibody—IgG
Cold antibody—IgM
Mnemonic: Classmate
Exception—PCH (Donath Landsteiner antibody)-IgG
• Differential diagnosis of microcytic hypochromic anemia
Sideroblastic anemia
Iron deficiency anemia
Thalassemia
Anemia of chronic disease
Mnemonic: SITA
• Migratory thrombophlebitis (Trousseau syndrome)
S—Stomach
L—Lung
Pathology 91
A—Adenocarcinoma
P—Pancreas
• Mutation of p53 Li-Fraumeni syndrome.
It is the most common gene mutation causing human cancer.
S—Stomach cancer
B—Breast cancer
B—Brain cancer
A—Adrenal cancer
L—Lung cancer (squamous cell carcinoma)
Mnemonic: SBBAL
• Flea bitten kidney found in
We—Wegener’s granulomatosis
Hate—HSP
P—Polyngitis
S—Subacute endocarditis
M—Malignant hypertension
• Posterior fossa anomalies
Dandy-Walker syndrome—Dilatation of 4th ventricle because
of midline arachnoid cyst. Posterior fossa volume is increased.
Mnemonic: D for D. D is 4th letter
Arnold-Chiari malformation—cerebellar herniation.
• Myelin formation
CNS—Oligodendrocytes
PNS—Schwann’s cells.
Mnemonic: COPS
• Serology in hepatitis B—
s—HbsAg
e—HbeAg
c—anti HBc ab
e—anti HBe ab
s—anti HBs ab
Note:c antigen lacks soluble surface receptor. So, do not
appear in serum.
A—Adenocarcinoma
P—Pancreas
• Mutation of p53 Li-Fraumeni syndrome.
It is the most common gene mutation causing human cancer.
S—Stomach cancer
B—Breast cancer
B—Brain cancer
A—Adrenal cancer
L—Lung cancer (squamous cell carcinoma)
Mnemonic: SBBAL
• Flea bitten kidney found in
We—Wegener’s granulomatosis
Hate—HSP
P—Polyngitis
S—Subacute endocarditis
M—Malignant hypertension
• Posterior fossa anomalies
Dandy-Walker syndrome—Dilatation of 4th ventricle because
of midline arachnoid cyst. Posterior fossa volume is increased.
Mnemonic: D for D. D is 4th letter
Arnold-Chiari malformation—cerebellar herniation.
• Myelin formation
CNS—Oligodendrocytes
PNS—Schwann’s cells.
Mnemonic: COPS
• Serology in hepatitis B—
s—HbsAg
e—HbeAg
c—anti HBc ab
e—anti HBe ab
s—anti HBs ab
Note:c antigen lacks soluble surface receptor. So, do not
appear in serum.
Mnemonics92
• Hepatitis D virus
Delta virus
Defective virus (HDV RNA)
Dependent (on HBV)
• Causes of Mallory-Denk body—
Indian childhood cirrhosis
Wilson’s disease
Hepatocellular carcinoma
Alcoholism
α1 anti-trypsin (AT) deficiency
Primary biliary cirrhosis
Mnemonic:
Indian child wil have alcohol AT primary bill
• Focal nodular hyperplasia
Females more commonly affected (ten times)
OCP use is associated
Asymptomatic
Single
Mnemonic: FOCAl
• Hepatitis D virus
Delta virus
Defective virus (HDV RNA)
Dependent (on HBV)
• Causes of Mallory-Denk body—
Indian childhood cirrhosis
Wilson’s disease
Hepatocellular carcinoma
Alcoholism
α1 anti-trypsin (AT) deficiency
Primary biliary cirrhosis
Mnemonic:
Indian child wil have alcohol AT primary bill
• Focal nodular hyperplasia
Females more commonly affected (ten times)
OCP use is associated
Asymptomatic
Single
Mnemonic: FOCAl
• Mechanism of Injury caused by lightening flash as described
by Cooper and Andrews (1995)
Direct
strike
Side flash
Step voltage
Sledge hammer effect (blunt trauma)
Surface arc discharges and touch voltage
Mnemonic: 5S
Also remember: Four factors of Spencer
Burning by superheated air
Sledge hammer and blow death by compress pushed before
the current
Direct effect of high voltage current
Effect of expanded and repelled air
Mnemonic: BCDE
• Drug used for narcoanalysis (truth serum drugs)
Scopolamine
Sodium pentathal
Sodium amytal
Sodium seconal
Mnemonic: PAS Sodium and Scopolamine
• Exception to general rule of professional secrecy
C Crime
I Infectious disease
V Venereal disease
I Interest (
Self)
C Courts of Law
S Servants and employees
93
Forensic Medicine and
Toxicology (FMT)
7
by Cooper and Andrews (1995)
Direct
strike
Side flash
Step voltage
Sledge hammer effect (blunt trauma)
Surface arc discharges and touch voltage
Mnemonic: 5S
Also remember: Four factors of Spencer
Burning by superheated air
Sledge hammer and blow death by compress pushed before
the current
Direct effect of high voltage current
Effect of expanded and repelled air
Mnemonic: BCDE
• Drug used for narcoanalysis (truth serum drugs)
Scopolamine
Sodium pentathal
Sodium amytal
Sodium seconal
Mnemonic: PAS Sodium and Scopolamine
• Exception to general rule of professional secrecy
C Crime
I Infectious disease
V Venereal disease
I Interest (
Self)
C Courts of Law
S Servants and employees
93
Forensic Medicine and
Toxicology (FMT)
7
Mnemonics94
I Interest ( Patient’s)
N Negligence suits notifiable disease.
CIVIC SIN InP.S .
Interest: Patient’s and self
• Anti-cholinergic (atropine dhatura) poisoning
Dry as a bone (dryness of mouth and skin)
Red as a beet (flushed face)
Blind as a bat (dilated pupil)
Hot as a hare (hyperpyrexia)
Mad as a wet hen (delirium)
Or
Dryness of mouth and anus (i.e. constipation)
Dysphagia
Dilated pupils
Dry hot skin
Drunken gait
Delirium
Drowsiness
Death due to respiratory failure
•
Seminial stain is identified by UV light (physical methods)
Mnemonic: SUV
• Constituents of a typical embalming solution
Formalin
Glycerin
Mnemonic: EFG
• Methods of torture
suspension by the wrist: La bandera (Mnemonic: Wrist band)
Beating with the palm on both ears simultaneously—
telephone
Mnemonic: We pickup telephone to ear
• Hanging versus strangulation
Hanging features:
Stretched neck
Saliva (often runs out of mouth)
Seminal fluid at glands
Carotid artery damage may be seen
I Interest ( Patient’s)
N Negligence suits notifiable disease.
CIVIC SIN InP.S .
Interest: Patient’s and self
• Anti-cholinergic (atropine dhatura) poisoning
Dry as a bone (dryness of mouth and skin)
Red as a beet (flushed face)
Blind as a bat (dilated pupil)
Hot as a hare (hyperpyrexia)
Mad as a wet hen (delirium)
Or
Dryness of mouth and anus (i.e. constipation)
Dysphagia
Dilated pupils
Dry hot skin
Drunken gait
Delirium
Drowsiness
Death due to respiratory failure
•
Seminial stain is identified by UV light (physical methods)
Mnemonic: SUV
• Constituents of a typical embalming solution
Formalin
Glycerin
Mnemonic: EFG
• Methods of torture
suspension by the wrist: La bandera (Mnemonic: Wrist band)
Beating with the palm on both ears simultaneously—
telephone
Mnemonic: We pickup telephone to ear
• Hanging versus strangulation
Hanging features:
Stretched neck
Saliva (often runs out of mouth)
Seminal fluid at glands
Carotid artery damage may be seen
Forensic Medicine and Toxicology (FMT) 95
Oblique ligature mark
Mnemonic: Hang SSS and CO
•Fatty liver is found in
Phosphorus > arsenic > mercury poisoning
Mnemonic: Fatty PAM
•Mercury poisoning: Diphtheritic colitis
Mnemonic: Mercury Dips in Cold
• Clinical feature of chronic lead poisoning—acute mani-
festations
Anemia (with punctate basophilia)
Burtonian line
Colic and constipation: First symptom to arouse suspicion of
lead poisoning
Drop of wrist and foot
Encephalopathy in children
Facial pallor: Earliest symptom
Genitourinary system: Menstrual disorders, abortions still-
births, degenerate off-springs and sterility.
• Forensic tests to detect seminal stain
Acid phosphatase test
Barberio test
Creatine phosphatase test
ELISA test
Fluorescence test
Mnemonic: ABCEF
• Fingerprint patterns
Loops 67%
Whorls 25%
Arches 6–7%
Composite 1–2%
Mnemonic: LWAC
• Cephalic index
70–74.9 Pure aryans
(Dolichocephalic)Aborigins
Oblique ligature mark
Mnemonic: Hang SSS and CO
•Fatty liver is found in
Phosphorus > arsenic > mercury poisoning
Mnemonic: Fatty PAM
•Mercury poisoning: Diphtheritic colitis
Mnemonic: Mercury Dips in Cold
• Clinical feature of chronic lead poisoning—acute mani-
festations
Anemia (with punctate basophilia)
Burtonian line
Colic and constipation: First symptom to arouse suspicion of
lead poisoning
Drop of wrist and foot
Encephalopathy in children
Facial pallor: Earliest symptom
Genitourinary system: Menstrual disorders, abortions still-
births, degenerate off-springs and sterility.
• Forensic tests to detect seminal stain
Acid phosphatase test
Barberio test
Creatine phosphatase test
ELISA test
Fluorescence test
Mnemonic: ABCEF
• Fingerprint patterns
Loops 67%
Whorls 25%
Arches 6–7%
Composite 1–2%
Mnemonic: LWAC
• Cephalic index
70–74.9 Pure aryans
(Dolichocephalic)Aborigins
Mnemonics96
Negroes
Indians
Mnemonic: PANI in Doli
75–79.9 Europeans
(Mesaticephalic)Chinese
Mnemonic: European in Chinese mess
80–84.9 Mongols
(Brachicephalic)Oriental Asians
Native Americans
Mnemonic: MONA
Dolichocephalic Rectangular
Mesaticephalic Triangular
Brachicephalic Rounded
Mnemonic: DMB in increasing order
• Screening tests for blood stains
Benzidine
Orthotoluidine
Leucomalachite green
Phenolphthalein
Note:All these works on the principle of Hb as peroxidase,
which in presence H
2O
2 turns odourless bases into coloured
salts.
• Blood /urine alcohol levels
Alcohol dehydrogenase method (ADH method)
Breath analysis
Cavett method/Kozelka and Hinc method
Gas chromatography—most desirable for medicolegal
purpose
Mnemonic:
ABC-GK
•Snake venoms
VasculotoxicVipers (V for V)
Neurotoxic Cobra (Convulsion) (C for C)
Krait (paralysis)
Coral
Mnemonic: CKC
Myotoxic: Sea snake
Negroes
Indians
Mnemonic: PANI in Doli
75–79.9 Europeans
(Mesaticephalic)Chinese
Mnemonic: European in Chinese mess
80–84.9 Mongols
(Brachicephalic)Oriental Asians
Native Americans
Mnemonic: MONA
Dolichocephalic Rectangular
Mesaticephalic Triangular
Brachicephalic Rounded
Mnemonic: DMB in increasing order
• Screening tests for blood stains
Benzidine
Orthotoluidine
Leucomalachite green
Phenolphthalein
Note:All these works on the principle of Hb as peroxidase,
which in presence H
2O
2 turns odourless bases into coloured
salts.
• Blood /urine alcohol levels
Alcohol dehydrogenase method (ADH method)
Breath analysis
Cavett method/Kozelka and Hinc method
Gas chromatography—most desirable for medicolegal
purpose
Mnemonic:
ABC-GK
•Snake venoms
VasculotoxicVipers (V for V)
Neurotoxic Cobra (Convulsion) (C for C)
Krait (paralysis)
Coral
Mnemonic: CKC
Myotoxic: Sea snake
Forensic Medicine and Toxicology (FMT) 97
• Gustafson method of age determination by inspection of
individual teeth:
Root transparency: Precise measurement
Root resorption
Attrition
Paradentosis
Secondary dentin formation
Cementum opposition
Mnemonic: TRAP SC
• Harrison and Gilroy test: Antimony, barium, lead
Mnemonic: Anbale
Atomic absorption spectroscopy (AAS): Antimony, Copper,
barium
Mnemonic: Ancoba
Neutron activation analysis: Antimony, copper
• Getters test is done for drowning. It estimates chloride content
of blood from both sides of the heart.
A difference of 25% in chloride content is considered.
Significant features seen
Fresh water drowning:Hemodilution
Lysis of RBC with liberation of potas-
sium
Chloride content of left side of heart
decreased
Salt water drowning : Hemoconcentration
RBCs are crenated
Chloride content of left side of heart
increased
• Sign of death from typical drowning
Persistent profuse fine froth from the mouth and nose
Materials (that could be obtained from water only) grasped in
the hand
Fine typical froth from the air passage
Increased volume and edematous condition of the lungs.
Finding of diatoms in the tissues, especially brain and bone
marrow.
• Gustafson method of age determination by inspection of
individual teeth:
Root transparency: Precise measurement
Root resorption
Attrition
Paradentosis
Secondary dentin formation
Cementum opposition
Mnemonic: TRAP SC
• Harrison and Gilroy test: Antimony, barium, lead
Mnemonic: Anbale
Atomic absorption spectroscopy (AAS): Antimony, Copper,
barium
Mnemonic: Ancoba
Neutron activation analysis: Antimony, copper
• Getters test is done for drowning. It estimates chloride content
of blood from both sides of the heart.
A difference of 25% in chloride content is considered.
Significant features seen
Fresh water drowning:Hemodilution
Lysis of RBC with liberation of potas-
sium
Chloride content of left side of heart
decreased
Salt water drowning : Hemoconcentration
RBCs are crenated
Chloride content of left side of heart
increased
• Sign of death from typical drowning
Persistent profuse fine froth from the mouth and nose
Materials (that could be obtained from water only) grasped in
the hand
Fine typical froth from the air passage
Increased volume and edematous condition of the lungs.
Finding of diatoms in the tissues, especially brain and bone
marrow.
Mnemonics98
•Permanent teeth Eruption time
First molar 6–7 years
Central incisor (6–8 years) 7–8 years
Lateral incisor 8–9 years
First premolar 9–11 years
Second premolar 10–12 years
Canines (11–12 years) 11–13 years
Second molars 12–14 years
Third molars 17– 25 years
• Magnan’s symptoms:Feeling as if grains of sago are lying
under skin
Feeling as if small insects (cocaine
bugs) are creeping on the skin.
It is seen in chronic cocaine poisoning.
Macewan sign: An indication of hydrocephalus in which
percussion of the skull generates a cracked pot sound.
• Putrefaction is delayed after death due to poisoning by
Carbolic acid
Arsenic
Antimony
Nux Vomica (strychnine)
Zinc chloride
Mnemonic: CARAN Vomit Zinc to delay putrefaction
•Dactylography (Galton system)—Study of finger prints.
Mnemonic: DaGa
Poroscopy (Locard’s system)—Study of number, sizes and
distribution of pores of sweat glands on ridges (used only
when a part of finger print is available).
Mnemonic:
PoLo
Podogram—Study of foot print.
Cheiloscopy (queiloscopy)—Study of lip prints.
Rugoscopy (palatoprints)—Study of anterior part of palate.
Mnemonic: RuPa
• White vitriol—Zinc sulphate
Blue vitriol—Copper sulphate.
•Permanent teeth Eruption time
First molar 6–7 years
Central incisor (6–8 years) 7–8 years
Lateral incisor 8–9 years
First premolar 9–11 years
Second premolar 10–12 years
Canines (11–12 years) 11–13 years
Second molars 12–14 years
Third molars 17– 25 years
• Magnan’s symptoms:Feeling as if grains of sago are lying
under skin
Feeling as if small insects (cocaine
bugs) are creeping on the skin.
It is seen in chronic cocaine poisoning.
Macewan sign: An indication of hydrocephalus in which
percussion of the skull generates a cracked pot sound.
• Putrefaction is delayed after death due to poisoning by
Carbolic acid
Arsenic
Antimony
Nux Vomica (strychnine)
Zinc chloride
Mnemonic: CARAN Vomit Zinc to delay putrefaction
•Dactylography (Galton system)—Study of finger prints.
Mnemonic: DaGa
Poroscopy (Locard’s system)—Study of number, sizes and
distribution of pores of sweat glands on ridges (used only
when a part of finger print is available).
Mnemonic:
PoLo
Podogram—Study of foot print.
Cheiloscopy (queiloscopy)—Study of lip prints.
Rugoscopy (palatoprints)—Study of anterior part of palate.
Mnemonic: RuPa
• White vitriol—Zinc sulphate
Blue vitriol—Copper sulphate.
• World health report 2008 Primary health care: now more than
ever—the report proposes four sets of reforms
Public policy reforms
Leadership reforms
Universal coverage reforms
Service delivery reforms
Mnemonic: PLUS
• Eight essential components of primary health care (Alma-Ata
declaration)
Education concerning prevailing health problems and
methods of preventing and controlling them.
Prevention and control of
locally endemic diseases
Immunization against major infection diseases
Maternal and child health care including family planning
Essential drugs provisions
Promotion of food supply and proper nutrition
Treatment of common diseases and injuries
Adequate supply of safe water and sanitation.
Mnemonic: ELIMENTS
• Ratio:Prevalence
Standardised mortality ratio
Case fatality ratio
Mnemonic: PSC (Public Service Commission)
• National health policy 2002
2005—Polio, leprosy and yaws
Mnemonic: POLY
2015 (fifteen) – filaria.
Mnemonic: f for f
99
Preventive and Social
Medicine (PSM)
8
ever—the report proposes four sets of reforms
Public policy reforms
Leadership reforms
Universal coverage reforms
Service delivery reforms
Mnemonic: PLUS
• Eight essential components of primary health care (Alma-Ata
declaration)
Education concerning prevailing health problems and
methods of preventing and controlling them.
Prevention and control of
locally endemic diseases
Immunization against major infection diseases
Maternal and child health care including family planning
Essential drugs provisions
Promotion of food supply and proper nutrition
Treatment of common diseases and injuries
Adequate supply of safe water and sanitation.
Mnemonic: ELIMENTS
• Ratio:Prevalence
Standardised mortality ratio
Case fatality ratio
Mnemonic: PSC (Public Service Commission)
• National health policy 2002
2005—Polio, leprosy and yaws
Mnemonic: POLY
2015 (fifteen) – filaria.
Mnemonic: f for f
99
Preventive and Social
Medicine (PSM)
8
Mnemonics100
• lMCI—five major illnesses
Diarrhoea
Respiratory tract infection (including otitis media)
Malaria
Measles
Malnutrition
Mnemonic: DRM3
• Chemoprophylaxis
Plague: Tetracycline
Cholera: Tetracycline
Mnemonic: PCT
Influenza A: Amantadine
Bacterial conjunctivitis
Erythromycin ophthalmic ointment
Diphtheria: Erythromycin
pertussis: Erythromycin
Mnemonic: BCDEP
• National programme for control of blindness 2001:Target
diseases under vision 2020 (India)
Refractive errors and low vision
Cataract
Childhood blindness
Trachoma
Diabetic retinopathy
Corneal blindness
Glaucoma
Mnemonic: Refree Catch Track of DCG of India
Vision 2020—WHO, Geneva, 1999
5 major blinding diseases
Refractive errors and low vision
Cataract
Childhood blindness
Onchocerciasis (River blindness)
Trachoma
Mnemonic: Refree Catch river track of WHO.
• Arthropod Borne diseases
Aedes Dengue haemorrhagic fever, dengue
• lMCI—five major illnesses
Diarrhoea
Respiratory tract infection (including otitis media)
Malaria
Measles
Malnutrition
Mnemonic: DRM3
• Chemoprophylaxis
Plague: Tetracycline
Cholera: Tetracycline
Mnemonic: PCT
Influenza A: Amantadine
Bacterial conjunctivitis
Erythromycin ophthalmic ointment
Diphtheria: Erythromycin
pertussis: Erythromycin
Mnemonic: BCDEP
• National programme for control of blindness 2001:Target
diseases under vision 2020 (India)
Refractive errors and low vision
Cataract
Childhood blindness
Trachoma
Diabetic retinopathy
Corneal blindness
Glaucoma
Mnemonic: Refree Catch Track of DCG of India
Vision 2020—WHO, Geneva, 1999
5 major blinding diseases
Refractive errors and low vision
Cataract
Childhood blindness
Onchocerciasis (River blindness)
Trachoma
Mnemonic: Refree Catch river track of WHO.
• Arthropod Borne diseases
Aedes Dengue haemorrhagic fever, dengue
Preventive and Social Medicine (PSM) 101
Rift valley fever
Chikungunya fever
Yellow fever
Mnemonic: DARCY
CulexJapanese encephalitis
Bancroftian filariasis
West nile fever
Viral arthritis
Mnemonic: Japan Ban West Virus for culex
SandflyKala-azar
Oriental sore
Oraya fever
Sandfly fever
Mnemonic: KOOS
Louse Pediculosis
Epidemic typhus
Relapsing fever
Trench fever
Mnemonic: LEPRT
Rat fleaBubonic plague
Endemic typhus
Chiggerosis
Hymenolepsis diminuta
Mnemonic: Rat on BEnCH
Trombiculid mite Scrub typhus
Rickettsial pox
Mnemonic: SR Mite
• Lepromin test
Early reaction: Fernandez reaction (48 hours reading > 10 mm
area of redness.
Mnemonic:
EF
Late Mitsuda reaction (21 days nodule > 5 mm)
• Breeding habits of mosquitoes
Alphabetically
Aedes: Artificial water
Mnemonic: A for A
Rift valley fever
Chikungunya fever
Yellow fever
Mnemonic: DARCY
CulexJapanese encephalitis
Bancroftian filariasis
West nile fever
Viral arthritis
Mnemonic: Japan Ban West Virus for culex
SandflyKala-azar
Oriental sore
Oraya fever
Sandfly fever
Mnemonic: KOOS
Louse Pediculosis
Epidemic typhus
Relapsing fever
Trench fever
Mnemonic: LEPRT
Rat fleaBubonic plague
Endemic typhus
Chiggerosis
Hymenolepsis diminuta
Mnemonic: Rat on BEnCH
Trombiculid mite Scrub typhus
Rickettsial pox
Mnemonic: SR Mite
• Lepromin test
Early reaction: Fernandez reaction (48 hours reading > 10 mm
area of redness.
Mnemonic:
EF
Late Mitsuda reaction (21 days nodule > 5 mm)
• Breeding habits of mosquitoes
Alphabetically
Aedes: Artificial water
Mnemonic: A for A
Mnemonics102
Anopheles: Clean water
Mnemonic: Clean–Anna
Culex: Dirty water
Mnemonic: CD
Mansonioides: Plant (vegetation) water
Mnemonic: Plant Man
• Biological transmission of arthropod-borne diseases
Propagative: Plague bacilli in rat flea.
Mnemonic: P for P
Cyclopropagative: Malarial parasites in mosquito
Mnemonic: CPM
Cyclodevelopmental: Filarial parasite in culex mosquito and
guinea worm embryo in cyclops.
Mnemonic: CDFG
• Indian reference female: Approximate energy requirement
Light work—1900
Moderate work—2200 (i.e. + 300)
Heavy work—2800 (i.e. + 600)
• SAFE strategy for trachoma
Surgery
Correction of
entropion and trichiasis
Mnemonic: ENT surgery
Chemoprophylaxis is given for
Meningococcal meningitis (rifampicin) My
Diphtheria Dear
Malaria (chloroquine) Mother
Pertussis Prepare
Conjunctivitis Cool
Influenza A (amantadine) Ice
Cholera Cream in
Tetanus (penicillin) Ten
Leprosy (dapsone) Litre
Pneumonic plague Pocket
Anopheles: Clean water
Mnemonic: Clean–Anna
Culex: Dirty water
Mnemonic: CD
Mansonioides: Plant (vegetation) water
Mnemonic: Plant Man
• Biological transmission of arthropod-borne diseases
Propagative: Plague bacilli in rat flea.
Mnemonic: P for P
Cyclopropagative: Malarial parasites in mosquito
Mnemonic: CPM
Cyclodevelopmental: Filarial parasite in culex mosquito and
guinea worm embryo in cyclops.
Mnemonic: CDFG
• Indian reference female: Approximate energy requirement
Light work—1900
Moderate work—2200 (i.e. + 300)
Heavy work—2800 (i.e. + 600)
• SAFE strategy for trachoma
Surgery
Correction of
entropion and trichiasis
Mnemonic: ENT surgery
Chemoprophylaxis is given for
Meningococcal meningitis (rifampicin) My
Diphtheria Dear
Malaria (chloroquine) Mother
Pertussis Prepare
Conjunctivitis Cool
Influenza A (amantadine) Ice
Cholera Cream in
Tetanus (penicillin) Ten
Leprosy (dapsone) Litre
Pneumonic plague Pocket
Preventive and Social Medicine (PSM) 103
•Parathion: Aryl phosphate
Mnemonic: R for R
Malathion: Alkyl phosphate
• HDI
Knowledge
Income
Longevity (life expectancy at birth)
Mnemonic: KILO
•BCG vaccine: Normal saline
Measles vaccine: Distill water
Mnemonic: MD
• Types of data
Nominal data: No implication of order or ratio
Ordinal data: Meaningful order but interval connot be
measured
Interval data: Meaningful order, interval can be measured but
ratio of scores are not meaningful.
Ratio data: Meaningful order, interval can be measured and
ratio of scores are meaningful.
Mnemonic: NOIR
First two are qualitative data and last two are quantitative
data.
• Mosquito control: Anti-adult measures
Residual spray:Malathion
OMS-33
Lindane
DDT
Mnemonic: MOLD
Space spray: Pyrethrum
Residual insecticide: Ultra low volume space spray (feni-
trothion, malathion)
Note:Malathion is not recommended as a larvicidal agent.
• Pertussis component in DPT enhances the potency of
diphtheria toxoid.
•Parathion: Aryl phosphate
Mnemonic: R for R
Malathion: Alkyl phosphate
• HDI
Knowledge
Income
Longevity (life expectancy at birth)
Mnemonic: KILO
•BCG vaccine: Normal saline
Measles vaccine: Distill water
Mnemonic: MD
• Types of data
Nominal data: No implication of order or ratio
Ordinal data: Meaningful order but interval connot be
measured
Interval data: Meaningful order, interval can be measured but
ratio of scores are not meaningful.
Ratio data: Meaningful order, interval can be measured and
ratio of scores are meaningful.
Mnemonic: NOIR
First two are qualitative data and last two are quantitative
data.
• Mosquito control: Anti-adult measures
Residual spray:Malathion
OMS-33
Lindane
DDT
Mnemonic: MOLD
Space spray: Pyrethrum
Residual insecticide: Ultra low volume space spray (feni-
trothion, malathion)
Note:Malathion is not recommended as a larvicidal agent.
• Pertussis component in DPT enhances the potency of
diphtheria toxoid.
Mnemonics104
Diphtheria toxoid increases the immunogenicity of Hib
vaccine.
• Five cleans for control/prevention of neonatal tetanus
Clean blade
Clean cord care
Clean delivery surface
Clean hands
Clean tie for the cord
Mnemonic: BCD-HT
• Factors determining sample size
Design of study
Accuracy of measurements
Precision (degree of) required
Plan of statistical analysis
Prevalence of disease in cohort study or ratio of case to
control in case control study
Mnemonic: DAS3P
• Insect Rickettsial diseaseAgent Mnemonic
Vector
LouseEpidemic typhusR. prowazeki LEPRO
LouseTrench fever Rochalimaea Lottery Queen
quintana
FleaEndemic typhusR. typhi FLENTY
(Murine typhus)
Tick Rocky MountainR. rickettsii TIMORI
spotted fever
TickIndian tick typhusR. conorii TIINCON
MiteRickettsial poxR. akari MIRIAKA
MiteScrub typhus R. tsutsugamushiMISTSU
• HIV screening— ELISA
Rapid test
Simple test
i.e. ERS battery
Confirmatory test—Western blot (protein based)
Diphtheria toxoid increases the immunogenicity of Hib
vaccine.
• Five cleans for control/prevention of neonatal tetanus
Clean blade
Clean cord care
Clean delivery surface
Clean hands
Clean tie for the cord
Mnemonic: BCD-HT
• Factors determining sample size
Design of study
Accuracy of measurements
Precision (degree of) required
Plan of statistical analysis
Prevalence of disease in cohort study or ratio of case to
control in case control study
Mnemonic: DAS3P
• Insect Rickettsial diseaseAgent Mnemonic
Vector
LouseEpidemic typhusR. prowazeki LEPRO
LouseTrench fever Rochalimaea Lottery Queen
quintana
FleaEndemic typhusR. typhi FLENTY
(Murine typhus)
Tick Rocky MountainR. rickettsii TIMORI
spotted fever
TickIndian tick typhusR. conorii TIINCON
MiteRickettsial poxR. akari MIRIAKA
MiteScrub typhus R. tsutsugamushiMISTSU
• HIV screening— ELISA
Rapid test
Simple test
i.e. ERS battery
Confirmatory test—Western blot (protein based)
Preventive and Social Medicine (PSM) 105
• 2 screening tests used in—
Series Parallel
Sensitivity ↓↑
Specificity ↑↓
PPV ↑↓
NPV ↓↑
Mnemonic: P letter words ↓↓↓↓↓ in parallel
• Disease control—reduction of transmission of any disease so
that it stops to be a public health problem.
It implies—↓ complication
↓ duration of disease
↓ financial burden
↓ incidence
Mnemonic: CDFI
•Index case—1st case coming to the notice of investigator.
Mnemonic: I for I
Primary case—First case of a disease in a community.
Secondary case—All cases who develop the disease from the
primary cases.
In India, index cases are usually secondary cases.
• MUFA—Maximum in groundnut (Moongfali).
• RBSK—Rashtriya Bal Swasthya Karyakarm
Target beneficiary—0–18 years of age
Services—Diseases
Deficiency
Disability and developmental delays
Defects
Mnemonic: 4D
• RKSK—Rashtriya Kishore Swasthya Karyakarm
Adolescent—10–19 years
Components—Clinics
Community
Communication
Content
• 2 screening tests used in—
Series Parallel
Sensitivity ↓↑
Specificity ↑↓
PPV ↑↓
NPV ↓↑
Mnemonic: P letter words ↓↓↓↓↓ in parallel
• Disease control—reduction of transmission of any disease so
that it stops to be a public health problem.
It implies—↓ complication
↓ duration of disease
↓ financial burden
↓ incidence
Mnemonic: CDFI
•Index case—1st case coming to the notice of investigator.
Mnemonic: I for I
Primary case—First case of a disease in a community.
Secondary case—All cases who develop the disease from the
primary cases.
In India, index cases are usually secondary cases.
• MUFA—Maximum in groundnut (Moongfali).
• RBSK—Rashtriya Bal Swasthya Karyakarm
Target beneficiary—0–18 years of age
Services—Diseases
Deficiency
Disability and developmental delays
Defects
Mnemonic: 4D
• RKSK—Rashtriya Kishore Swasthya Karyakarm
Adolescent—10–19 years
Components—Clinics
Community
Communication
Content
Mnemonics106
Convergence
Coverage
Counseling
Mnemonic: 7C
• Skewed distribution
Tail on Right side is Positive skewness.
Mean > Median > Mode.
Mnemonic: TRP
• Type I error—Null hypothesis True and Rejected.
Mnemonic: NTR is no. 1
Type II error—Null hypothesis false and accepted.
P value = Probability of doing type I error.
α—maximum permissible limit of type I error (usually 5%)
β—probability of type II error
Note:Confidence level in a study = 1–α
Power of study = 1–β
For significant results, confidence level > 0.95 or 95%.
• Parametric tests are used to compare mean and SD (standard
deviation) in
Paired data (1 group)—Paired test (before and after)
Unpaired data of 2 groups—Unpaired test
Unpaired data of 3 or more groups—ANOVA
Mnemonic: PUA
• Non-parametric tests are used to compare percentage or
fraction in:
Sign test—Paired data (1 group)
Chi-square test—Unpaired data (2 or more groups)
Mnemonic: chai ki quality
• Statistical graphs
Qualitative—
Pictogram
Pie chart
Convergence
Coverage
Counseling
Mnemonic: 7C
• Skewed distribution
Tail on Right side is Positive skewness.
Mean > Median > Mode.
Mnemonic: TRP
• Type I error—Null hypothesis True and Rejected.
Mnemonic: NTR is no. 1
Type II error—Null hypothesis false and accepted.
P value = Probability of doing type I error.
α—maximum permissible limit of type I error (usually 5%)
β—probability of type II error
Note:Confidence level in a study = 1–α
Power of study = 1–β
For significant results, confidence level > 0.95 or 95%.
• Parametric tests are used to compare mean and SD (standard
deviation) in
Paired data (1 group)—Paired test (before and after)
Unpaired data of 2 groups—Unpaired test
Unpaired data of 3 or more groups—ANOVA
Mnemonic: PUA
• Non-parametric tests are used to compare percentage or
fraction in:
Sign test—Paired data (1 group)
Chi-square test—Unpaired data (2 or more groups)
Mnemonic: chai ki quality
• Statistical graphs
Qualitative—
Pictogram
Pie chart
Preventive and Social Medicine (PSM) 107
Bar chart
Map
Mnemonic: Pic pie bar map
Quantitative—
Frequency polygon
Frequency curve
Line diagram
Line chart
Ogive (frequency cumulative curve)
Scatter diagram
Histogram
Mnemonic: (FL)
2OSH
• Hospital waste management
1—Human anatomical waste
2—Animal waste
3—Microbiology and biotechnology
4—Waste sharps
5—Cytotoxic drugs and discarded medicines
6—Solid waste (cotton/cloth)
7—Solid waste (plastic/rubber)
8—Liquid waste
9—Incineration ash
10—Chemical waste
Mnemonic: HAM Share drugs and SoSo LIC
• Obesity
Best indicator—Body mass index = Weight in kg/(height in
meter)
2
.
Other indicators—
Height in cm—Hundred = Broca’s index.
Mnemonic: HHB
Corpulence index = Actual weight/Desired weight
Mnemonic: CAD
Ponderal index = Height/cube root of weight.
Mnemonic: Pin Hai CRoW
Bar chart
Map
Mnemonic: Pic pie bar map
Quantitative—
Frequency polygon
Frequency curve
Line diagram
Line chart
Ogive (frequency cumulative curve)
Scatter diagram
Histogram
Mnemonic: (FL)
2OSH
• Hospital waste management
1—Human anatomical waste
2—Animal waste
3—Microbiology and biotechnology
4—Waste sharps
5—Cytotoxic drugs and discarded medicines
6—Solid waste (cotton/cloth)
7—Solid waste (plastic/rubber)
8—Liquid waste
9—Incineration ash
10—Chemical waste
Mnemonic: HAM Share drugs and SoSo LIC
• Obesity
Best indicator—Body mass index = Weight in kg/(height in
meter)
2
.
Other indicators—
Height in cm—Hundred = Broca’s index.
Mnemonic: HHB
Corpulence index = Actual weight/Desired weight
Mnemonic: CAD
Ponderal index = Height/cube root of weight.
Mnemonic: Pin Hai CRoW
Mnemonics108
• Impact indicators of ASHA—
IMR—major
TB cases
Leprosy cases
PEM rates
Mnemonic: PITL
•Focussed group discussion (FGD)—6–12
Mnemonic: 6 is F
Panel discussion—4–8
• Lecture—ideal audience size < 40
Role play/socio drama < 25
• SPIKES—done for cancer prognosis communication
S—Set up interview
P—Perception is assessed
I—Invitation to explanation
K—Knowledge
E—Emotions
S—Summary and strategy
Note:P- SPIKES—for Ca breast. P stands for protocol.
• GATHER approach is used for contraceptive counseling in
RCH
G—Greet the couple
A—Ask the contraceptive requirement
T—Tell available methods
H—Help choose best methods
E—Explain the usage of contraception
R—Return visit
• Doctor–patient communication
3 levels— Intellectual
Cultural
Emotional
• Impact indicators of ASHA—
IMR—major
TB cases
Leprosy cases
PEM rates
Mnemonic: PITL
•Focussed group discussion (FGD)—6–12
Mnemonic: 6 is F
Panel discussion—4–8
• Lecture—ideal audience size < 40
Role play/socio drama < 25
• SPIKES—done for cancer prognosis communication
S—Set up interview
P—Perception is assessed
I—Invitation to explanation
K—Knowledge
E—Emotions
S—Summary and strategy
Note:P- SPIKES—for Ca breast. P stands for protocol.
• GATHER approach is used for contraceptive counseling in
RCH
G—Greet the couple
A—Ask the contraceptive requirement
T—Tell available methods
H—Help choose best methods
E—Explain the usage of contraception
R—Return visit
• Doctor–patient communication
3 levels— Intellectual
Cultural
Emotional
Preventive and Social Medicine (PSM) 109
4 types— Default
Paternalistic
Consumeristic
Mutualistic
• Kuppuswamy scale is based on—
Education
Income
Occupation
Mnemonic: EIO. All 3 are vowels
• International health regulation 2005 guidelines of WHO
Diseases notifiable to WHO—
Smallpox
SARS
Wild polio
Yellow fever
Plague
Human influenza
Cholera
Mnemonic: SSP Wild yellow PHC
• NPCB—supported by World bank
Mnemonic: Blindness-Bank
RNTCP—supported by WHO
RCH (family planning)—UN fund for population activity
Mnemonic: family-Fund
• UNICEF
HQ—New York.
Mnemonic: New Chef
GOBI—For reduction of under 5 mortality rate
Growth monitoring
ORS
Breast feeding
Immunization
4 types— Default
Paternalistic
Consumeristic
Mutualistic
• Kuppuswamy scale is based on—
Education
Income
Occupation
Mnemonic: EIO. All 3 are vowels
• International health regulation 2005 guidelines of WHO
Diseases notifiable to WHO—
Smallpox
SARS
Wild polio
Yellow fever
Plague
Human influenza
Cholera
Mnemonic: SSP Wild yellow PHC
• NPCB—supported by World bank
Mnemonic: Blindness-Bank
RNTCP—supported by WHO
RCH (family planning)—UN fund for population activity
Mnemonic: family-Fund
• UNICEF
HQ—New York.
Mnemonic: New Chef
GOBI—For reduction of under 5 mortality rate
Growth monitoring
ORS
Breast feeding
Immunization
Mnemonics110
New additions— Female education
Family planning
Food supplementation
• WHO low osmolarity ORS
Sodium—75 mmol/L
Glucose—75 mmol/L
Chloride—65 mmol/L
Potassium—20 mmol/L
Citrate—10 mmol/L
Total osmolality—245
Mnemonic: SGCl PCi-75/75/65/20/10
Glucose—13.5 gm
Trisodium citrate—2.9 gm
NaCl—2.6 gm
KCl—1.5 gm
Total—20.5 gm
• Essential healthcare—4A
Available
Acceptable
Accessible
Affordable
New additions— Female education
Family planning
Food supplementation
• WHO low osmolarity ORS
Sodium—75 mmol/L
Glucose—75 mmol/L
Chloride—65 mmol/L
Potassium—20 mmol/L
Citrate—10 mmol/L
Total osmolality—245
Mnemonic: SGCl PCi-75/75/65/20/10
Glucose—13.5 gm
Trisodium citrate—2.9 gm
NaCl—2.6 gm
KCl—1.5 gm
Total—20.5 gm
• Essential healthcare—4A
Available
Acceptable
Accessible
Affordable
• Function of extraocular muscle
Superior oblique
Lateral (abduction)
Intorsion
Depression
Mnemonic: SOLID
• Argyll Robertson pupil (ARP) (also called light near
dissociation)
Accommodation reaction present (ARP)
Pupillary reaction absent (ARP-PRA) (both direct and
consensual)
Seen in several conditions affecting midbrain (pretectal
nucleus)
•
RAPD (Marcus Gunn pupil) is most characteristic of lesion in
optic nerve
Mnemonic: Rapid Nervous Gun
• Anterior surface of cornea has highest refractive power (2/3rd
of eye’s refractive power)
Centre of lens has highest refractive index.
Mnemonic: COP (Cornea-Power)
• Visual pathway and site of lesion
Optic nerve: Ipsilateral blindness
Proximal part of optic nerve: Ipsilateral blindness with
contralateral hemianopia or superior quadrantanopia
Central level of chiasma: Bitemporal hemianopia
Mnemonic: Hum Bite central Cheese
111
Eye
9
Superior oblique
Lateral (abduction)
Intorsion
Depression
Mnemonic: SOLID
• Argyll Robertson pupil (ARP) (also called light near
dissociation)
Accommodation reaction present (ARP)
Pupillary reaction absent (ARP-PRA) (both direct and
consensual)
Seen in several conditions affecting midbrain (pretectal
nucleus)
•
RAPD (Marcus Gunn pupil) is most characteristic of lesion in
optic nerve
Mnemonic: Rapid Nervous Gun
• Anterior surface of cornea has highest refractive power (2/3rd
of eye’s refractive power)
Centre of lens has highest refractive index.
Mnemonic: COP (Cornea-Power)
• Visual pathway and site of lesion
Optic nerve: Ipsilateral blindness
Proximal part of optic nerve: Ipsilateral blindness with
contralateral hemianopia or superior quadrantanopia
Central level of chiasma: Bitemporal hemianopia
Mnemonic: Hum Bite central Cheese
111
Eye
9
Mnemonics112
Optic tract: Homonymous hemianopia.
Temporal lobe: Quadrantopic homonymous defect
Mnemonic: Tample queen
Optic radiation: Homonymous hemianopia
Anteriorly in occipital cortex: Contralateral temporal
crescentic field defect
Occipital lobe: Homonymous hemianopia (usually sparing
the macula)
Mnemonic:
HRT—Homonymous hemianopia in optic
radiation and optic tract
• Primordial tissue and derivatives
Surface ectoderm: Conjunctival epithelium
Corneal epithelium
Lacrimal glands
Tarsal glands
Lens
• Various grades of visual defects
Low vision—< 6/18 to 6/60—Cat 1
Economic blindness—< 6/60 to 3/60—Cat 2
Social blindness—< 3/60 to 1/60—Cat 3
Manifest blindness—< 160 to only light perception—Cat 4
Absolute blindness—No light perception—Cat 5
Mnemonic: LESMA-631 LN
Note:WHO grade: Low vision—Cat 1 and 2
Blindness—Cat 3, 4 and 5
• Causes of persistent hyperplastic primary vitreous (PHPV)
Patau syndrome (Trisomy 13)
Norries disease
Walker Warburg syndrome
Mnemonic: Norries persistently walks to pataya
• Visual pathway from retina to visual cortex
Ganglion cells: M (Magno cells)
lateral geniculate body: Magnocellular lamina—
(lamina 1, 2)
Optic tract: Homonymous hemianopia.
Temporal lobe: Quadrantopic homonymous defect
Mnemonic: Tample queen
Optic radiation: Homonymous hemianopia
Anteriorly in occipital cortex: Contralateral temporal
crescentic field defect
Occipital lobe: Homonymous hemianopia (usually sparing
the macula)
Mnemonic:
HRT—Homonymous hemianopia in optic
radiation and optic tract
• Primordial tissue and derivatives
Surface ectoderm: Conjunctival epithelium
Corneal epithelium
Lacrimal glands
Tarsal glands
Lens
• Various grades of visual defects
Low vision—< 6/18 to 6/60—Cat 1
Economic blindness—< 6/60 to 3/60—Cat 2
Social blindness—< 3/60 to 1/60—Cat 3
Manifest blindness—< 160 to only light perception—Cat 4
Absolute blindness—No light perception—Cat 5
Mnemonic: LESMA-631 LN
Note:WHO grade: Low vision—Cat 1 and 2
Blindness—Cat 3, 4 and 5
• Causes of persistent hyperplastic primary vitreous (PHPV)
Patau syndrome (Trisomy 13)
Norries disease
Walker Warburg syndrome
Mnemonic: Norries persistently walks to pataya
• Visual pathway from retina to visual cortex
Ganglion cells: M (Magno cells)
lateral geniculate body: Magnocellular lamina—
(lamina 1, 2)
Eye 113
Visual cortex:Superficial layer 4C
Function: Movement, depth, location and flicker
Mnemonic: MSM
• Vogt triad: Tuberous sclerosis and congenital glaucoma
Islet of Vogt—pterygium
• CMV retinitis occurs in HIV patients with < 50 CD4 T cells
• Ophthalmoscopy
Indirect: Inverted, real, 5 times magnification, ora serrata is
seen
Mnemonic:
I for I
Direct: Erect, virtual, 15 times magnification.
• Medication for treatment of open angle glaucoma
Decrease in aqueous secretion:Beta blocker (timolol)
Clonidine congeners
(Brimonidine, Apraclonidine)
Carbonic anhydrase inhibitors
(Acetazolamide, Dorzolamide)
Mnemonic: ABCD
Increase in trabecular outflow: Pilocarpine (miotics)
Mnemonic: Tray Se Pilo
Increase in uveoscleral outflow: Prostaglandins (latanoprost)
Note:Only acetazolamide is oral, others mentioned are
topical.
Atropine is C/I in all types of glaucoma. Pilocarpine is also C/I
in uveitis
• Bilateral subluxation of lens
Marfan’s syndrome: Downward and temporally (Harrison,
17th edition)
Homocysteinuria: Downward and nasally.
• Most common ocular infection in AIDS patients—CMV
MC cause of chorioretinitis in AIDS patients—CMV
MC ocular lesion in AIDS—HIV microvasculopathy
(involving conjunctiva and retina)
MC ocular neoplasm in AIDS—Kaposi sarcoma
Visual cortex:Superficial layer 4C
Function: Movement, depth, location and flicker
Mnemonic: MSM
• Vogt triad: Tuberous sclerosis and congenital glaucoma
Islet of Vogt—pterygium
• CMV retinitis occurs in HIV patients with < 50 CD4 T cells
• Ophthalmoscopy
Indirect: Inverted, real, 5 times magnification, ora serrata is
seen
Mnemonic:
I for I
Direct: Erect, virtual, 15 times magnification.
• Medication for treatment of open angle glaucoma
Decrease in aqueous secretion:Beta blocker (timolol)
Clonidine congeners
(Brimonidine, Apraclonidine)
Carbonic anhydrase inhibitors
(Acetazolamide, Dorzolamide)
Mnemonic: ABCD
Increase in trabecular outflow: Pilocarpine (miotics)
Mnemonic: Tray Se Pilo
Increase in uveoscleral outflow: Prostaglandins (latanoprost)
Note:Only acetazolamide is oral, others mentioned are
topical.
Atropine is C/I in all types of glaucoma. Pilocarpine is also C/I
in uveitis
• Bilateral subluxation of lens
Marfan’s syndrome: Downward and temporally (Harrison,
17th edition)
Homocysteinuria: Downward and nasally.
• Most common ocular infection in AIDS patients—CMV
MC cause of chorioretinitis in AIDS patients—CMV
MC ocular lesion in AIDS—HIV microvasculopathy
(involving conjunctiva and retina)
MC ocular neoplasm in AIDS—Kaposi sarcoma
Mnemonics114
Earliest and most consistent finding in HIV retinopathy—
cotton wool spots.
CMV retinitis occurs in HIV patients with < 50 CD4 T cells
• Predisposing factors for sympathetic ophthalmitis
Injury
Incarceration of iris
Infection is absent
Mnemonic: 3I
• Indication of LASIK surgery—criteria
Cornea should not be excessive flat or steep.
Central corneal thickness > 500 micron
Refraction must be stable for 18 months
Age > 18 years
Myopia – 1 to – 20 diopters
Mnemonic: CT RAM
Contraindication of LASIK
Diabetic retinopathy
Autoimmune disease
Dry eye
Monocular patient
Infections, e.g. conjunctivitis, keratitis
Glaucoma
Keratoconus
Poor endothelial cell count <1500
Thin cornea <450 micron
Mnemonic: DAD MIG KPT
• Management of senile entropion
Bick’s operation
Wobin, Jones and Rech operation (plication of inferior lid
retractors)
Modified
Wheeler’s operation.
Weiss operation
Mnemonic: Bick’s 3W
• The extent of normal visual field with a 5 mm white color
object is
Earliest and most consistent finding in HIV retinopathy—
cotton wool spots.
CMV retinitis occurs in HIV patients with < 50 CD4 T cells
• Predisposing factors for sympathetic ophthalmitis
Injury
Incarceration of iris
Infection is absent
Mnemonic: 3I
• Indication of LASIK surgery—criteria
Cornea should not be excessive flat or steep.
Central corneal thickness > 500 micron
Refraction must be stable for 18 months
Age > 18 years
Myopia – 1 to – 20 diopters
Mnemonic: CT RAM
Contraindication of LASIK
Diabetic retinopathy
Autoimmune disease
Dry eye
Monocular patient
Infections, e.g. conjunctivitis, keratitis
Glaucoma
Keratoconus
Poor endothelial cell count <1500
Thin cornea <450 micron
Mnemonic: DAD MIG KPT
• Management of senile entropion
Bick’s operation
Wobin, Jones and Rech operation (plication of inferior lid
retractors)
Modified
Wheeler’s operation.
Weiss operation
Mnemonic: Bick’s 3W
• The extent of normal visual field with a 5 mm white color
object is
Eye 115
Superiorly 50°
Nasally 60°
Inferiorly 70°
Temporally 90°
Mnemonic: SNIT (in increasing order)
• Tonography is a non-invasive technique for determining the
facility of aqueous outflow.
Tonometry is measurement of intraocular pressure by an
instrument called tonometer, this process is called tonometry.
• Protanomalous—defective
red color perception
Deuteranomalous—defective green color perception
Tritanomalous—defective blue color perception
Mnemonic: RGB
•Superior oblique: IVth cranial nerve
Mnemonic: SO
4
Lateral rectus: VIth cranial nerve
Mnemonic: LR6
Rest extraocular muscles—IIIrd cranial nerve
• Pupil in different conditions.
Acute conjunctivitis —normal
Acute uveitis—constricted/irregular
Acute congestive glaucoma—dilated vertically oval
Retrobulbar neuritis—normal
• Open angle glaucoma is characterised by the triad of
Typical
visual field defects (earliest visual field defects in
glaucoma are small isolated paracentral scotomas between
2° and 10°)
Raised
intraocular pressure
Optic disc changes/cupping of disc (vertical cup/disc ratio
becomes greater than horizontal)
Mnemonic: VIC
• Wernicke’s hemianopic pupillary reaction—optic tract
lesion.
Marcus Gunn pupil—optic nerve lesion
Argyll Robertson pupil—Pretectal neucleus involved
Superiorly 50°
Nasally 60°
Inferiorly 70°
Temporally 90°
Mnemonic: SNIT (in increasing order)
• Tonography is a non-invasive technique for determining the
facility of aqueous outflow.
Tonometry is measurement of intraocular pressure by an
instrument called tonometer, this process is called tonometry.
• Protanomalous—defective
red color perception
Deuteranomalous—defective green color perception
Tritanomalous—defective blue color perception
Mnemonic: RGB
•Superior oblique: IVth cranial nerve
Mnemonic: SO
4
Lateral rectus: VIth cranial nerve
Mnemonic: LR6
Rest extraocular muscles—IIIrd cranial nerve
• Pupil in different conditions.
Acute conjunctivitis —normal
Acute uveitis—constricted/irregular
Acute congestive glaucoma—dilated vertically oval
Retrobulbar neuritis—normal
• Open angle glaucoma is characterised by the triad of
Typical
visual field defects (earliest visual field defects in
glaucoma are small isolated paracentral scotomas between
2° and 10°)
Raised
intraocular pressure
Optic disc changes/cupping of disc (vertical cup/disc ratio
becomes greater than horizontal)
Mnemonic: VIC
• Wernicke’s hemianopic pupillary reaction—optic tract
lesion.
Marcus Gunn pupil—optic nerve lesion
Argyll Robertson pupil—Pretectal neucleus involved
Mnemonics116
Mnemonic: ARP-Pre
Holmes Adie—ciliary muscle involvement.
• Congenital glaucoma (buphthalmos)—characteristic triad of
symptoms
Blepharospasm
Photophobia
Lacrimation
Mnemonic: BPL
Signs: Mild proptosis
Enlarged cornea
Haab’s stria (opacity due to rupture in Descemet’s
membrane)
Deep anterior chamber
Lens subluxation
Note:In megalocornea, eye is absolutely normal except for
the large cornea.
•Fast or saccadic horizontal eye movements—abducens
nucleus
(ipsilateral)—PPRF (ipsilateral)—contralateral frontal lobe
Mnemonic: F for F
Smooth/persuit eye movement—Parietal lobe
Mnemonic: P for P
Note:Cerebral structures determine when and where eye
move, while brainstem determine how they move.
• Primary optic atrophy: It is caused by lesions affecting the
visual pathways from retrolaminar portion of the optic nerve
to the lateral geniculate body.
Causes
Hereditary optic neuropathy
Toxic and nutritional optic neuropathies
Traumatic optic atrophy
Retrobulbar neuritis
Compressive lesions (Tumors and aneurysms)
Mnemonic: HTN TRAT
Mnemonic: ARP-Pre
Holmes Adie—ciliary muscle involvement.
• Congenital glaucoma (buphthalmos)—characteristic triad of
symptoms
Blepharospasm
Photophobia
Lacrimation
Mnemonic: BPL
Signs: Mild proptosis
Enlarged cornea
Haab’s stria (opacity due to rupture in Descemet’s
membrane)
Deep anterior chamber
Lens subluxation
Note:In megalocornea, eye is absolutely normal except for
the large cornea.
•Fast or saccadic horizontal eye movements—abducens
nucleus
(ipsilateral)—PPRF (ipsilateral)—contralateral frontal lobe
Mnemonic: F for F
Smooth/persuit eye movement—Parietal lobe
Mnemonic: P for P
Note:Cerebral structures determine when and where eye
move, while brainstem determine how they move.
• Primary optic atrophy: It is caused by lesions affecting the
visual pathways from retrolaminar portion of the optic nerve
to the lateral geniculate body.
Causes
Hereditary optic neuropathy
Toxic and nutritional optic neuropathies
Traumatic optic atrophy
Retrobulbar neuritis
Compressive lesions (Tumors and aneurysms)
Mnemonic: HTN TRAT
• Trotter’s triad
Mnemonic: CD 105
CD: Conductive deafness
10: Palatal paralysis due to involvement of CNX
5: Temporoparietal neuralgia due to ipsilateral involvement of CN
V
• Endoscopic cordectomy: Classification by European laryngeal
society
Type I Subepithelial cordectomy
Type II Subligamental cordectomy
Type III Transmuscular cordectomy
Type IVTotal Cordectomy
Mnemonic:ELMT (like element)
Extended cordectomy encompassing
Type IVa—Contralateral fold
Type IVb—arytenoids
Type IVc—ventricular fold
Type IVd—subglottis
Mnemonic: CAVES
• Structures fully developed at birth
–Mastoid antrum
–Auditory ossicles
–Tympanic cavity
–Internal ear structures
Mnemonic: MATI
117
Ear, Nose and Throat (ENT)
10
Mnemonic: CD 105
CD: Conductive deafness
10: Palatal paralysis due to involvement of CNX
5: Temporoparietal neuralgia due to ipsilateral involvement of CN
V
• Endoscopic cordectomy: Classification by European laryngeal
society
Type I Subepithelial cordectomy
Type II Subligamental cordectomy
Type III Transmuscular cordectomy
Type IVTotal Cordectomy
Mnemonic:ELMT (like element)
Extended cordectomy encompassing
Type IVa—Contralateral fold
Type IVb—arytenoids
Type IVc—ventricular fold
Type IVd—subglottis
Mnemonic: CAVES
• Structures fully developed at birth
–Mastoid antrum
–Auditory ossicles
–Tympanic cavity
–Internal ear structures
Mnemonic: MATI
117
Ear, Nose and Throat (ENT)
10
Mnemonics118
• Pathophysiology of Romberg test
Equilibrium (central postural control) is dependent on input
from three peripheral modalities:
Proprioception (joint position sense) carried in posterior
column of spinal cord.
Vision
Vestibular apparatus
Mnemonic: PVR Vision
• Vestibular schwannoma/acoustic neuroma can arise from any
cranial nerve except optic and olfactory nerve because they
are myelinated by oligodendroglia rather than Schwann cells.
• Syndromes associated with sensorineural deafness
Bartter’s syndrome
Alport’s syndrome
Distal renal tubular acidosis
Mnemonic: BAD
• Siegel’s pneumatic speculum: Uses
To test mobility of tympanic membrane
To see magnified view of small perforation
To introduce medicine into middle ear
Fistula test for vestibular function.
Mnemonic: 3MF
• Isshiki’s categorization of thyroplasty
Type 1Medial displacement
Type 2Lateral displacement
Type 3Shortening (relaxation)—female to male
Type 4Lengthening (tensioning)—male to female
(low to high pitch)
Mnemonic: Mela ka Shole
• Weber test
Conductive deafness—lateralised to diseased ear
Sensorineural deafness—lateralised to better ear
Mnemonic: LCD—Lateralised in conductive deafness to
diseased ear
• Pathophysiology of Romberg test
Equilibrium (central postural control) is dependent on input
from three peripheral modalities:
Proprioception (joint position sense) carried in posterior
column of spinal cord.
Vision
Vestibular apparatus
Mnemonic: PVR Vision
• Vestibular schwannoma/acoustic neuroma can arise from any
cranial nerve except optic and olfactory nerve because they
are myelinated by oligodendroglia rather than Schwann cells.
• Syndromes associated with sensorineural deafness
Bartter’s syndrome
Alport’s syndrome
Distal renal tubular acidosis
Mnemonic: BAD
• Siegel’s pneumatic speculum: Uses
To test mobility of tympanic membrane
To see magnified view of small perforation
To introduce medicine into middle ear
Fistula test for vestibular function.
Mnemonic: 3MF
• Isshiki’s categorization of thyroplasty
Type 1Medial displacement
Type 2Lateral displacement
Type 3Shortening (relaxation)—female to male
Type 4Lengthening (tensioning)—male to female
(low to high pitch)
Mnemonic: Mela ka Shole
• Weber test
Conductive deafness—lateralised to diseased ear
Sensorineural deafness—lateralised to better ear
Mnemonic: LCD—Lateralised in conductive deafness to
diseased ear
Ear, Nose and Throat (ENT)119
• Rinnie’s test:
Positive Rinnie AC > BC—Normal person and
sensorineural deafness
Mnemonic: PoRi AB Normally Sensed
• Meniere’s disease
Tinnitus (fluctuating)
Vertigo
Sensorineural hearing loss
Mnemonic: TVS
• Fistula test: Induction of nystagmus (vertigo) by producing
pressure changes in the external canal, which are then
transmitted to the labyrinth.
Normal condition—negative (as pressure cannot be
transmitted)
Positive in
Cholesteatoma
Surgically created window in the horizontal canal
(fenestration operation)
In abnormal opening:
In oval window (post stapedectomy fistula)
In round window (rupture of round window membrane)
False positive: Congenital syphilis
Meniere’s disease (Hennebert’s sign)
False negative: Cholesteatoma fills the site of fistula
Note:It is absent when labyrinth is dead.
• Etiology
Malignant otitis externaPseudomonas
Otitis externa Staphylococcus aureus
Otomycosis Aspergillus niger, A. fumigatus,
Candida albicans
Otitis externa hemorrhagica—viral
Acute otitis media in paediatric age group
Streptococcus pneumoniae > H. influenzae > M.catarrhalis.
• Water’s (occipito mental)—maxillary sinus (best seen)
Caldwell’s (occipito frontal)—frontal sinus (best seen)
Mnemonic:
Front OF Well
• Rinnie’s test:
Positive Rinnie AC > BC—Normal person and
sensorineural deafness
Mnemonic: PoRi AB Normally Sensed
• Meniere’s disease
Tinnitus (fluctuating)
Vertigo
Sensorineural hearing loss
Mnemonic: TVS
• Fistula test: Induction of nystagmus (vertigo) by producing
pressure changes in the external canal, which are then
transmitted to the labyrinth.
Normal condition—negative (as pressure cannot be
transmitted)
Positive in
Cholesteatoma
Surgically created window in the horizontal canal
(fenestration operation)
In abnormal opening:
In oval window (post stapedectomy fistula)
In round window (rupture of round window membrane)
False positive: Congenital syphilis
Meniere’s disease (Hennebert’s sign)
False negative: Cholesteatoma fills the site of fistula
Note:It is absent when labyrinth is dead.
• Etiology
Malignant otitis externaPseudomonas
Otitis externa Staphylococcus aureus
Otomycosis Aspergillus niger, A. fumigatus,
Candida albicans
Otitis externa hemorrhagica—viral
Acute otitis media in paediatric age group
Streptococcus pneumoniae > H. influenzae > M.catarrhalis.
• Water’s (occipito mental)—maxillary sinus (best seen)
Caldwell’s (occipito frontal)—frontal sinus (best seen)
Mnemonic:
Front OF Well
Mnemonics120
• Neoplasm showing calcification:
Craniopharyngioma (75%)
Oligodendroglioma—glioma (50%)
Choroid plexus papilloma (25%)
Astrocytoma (posterior fossa tumor) (20%)
Meningioma (20%)
Ependymoma (unusual but if seen dense)
Mnemonic: CO CAME
Note:Most common cause of intracranial calcification is
pineal calcification.
• Acute pancreatitis—X-ray abdomen
Gasless abdomen
Colon cut off sign
Sentinel loop
Renal halo sign
Mnemonic: Halo GCS
•Chronic pancreatitis—ERCP
Beaded appearance
String of pearls appearance
Chain of lake appearance
Rat tail stricture of CBD
Mnemonic: Be strong chained rat
•Rasmussen aneurysm—pulmonary artery
Mnemonic: PR
Physical quantity SI unit Non-SI unit
Radioactivity Becquerel (Bq) Curie
Absorbed dose Gray (Gy) Rad
Dose equivalent Sievert (Sv) Rem
Radiation exposure Colum ns/kg Roentegen
Mnemonic:
ABC
Ab gray is red
Shiv and Ram are equivalent
Ex colonel Rungta
• Neoplasm showing calcification:
Craniopharyngioma (75%)
Oligodendroglioma—glioma (50%)
Choroid plexus papilloma (25%)
Astrocytoma (posterior fossa tumor) (20%)
Meningioma (20%)
Ependymoma (unusual but if seen dense)
Mnemonic: CO CAME
Note:Most common cause of intracranial calcification is
pineal calcification.
• Acute pancreatitis—X-ray abdomen
Gasless abdomen
Colon cut off sign
Sentinel loop
Renal halo sign
Mnemonic: Halo GCS
•Chronic pancreatitis—ERCP
Beaded appearance
String of pearls appearance
Chain of lake appearance
Rat tail stricture of CBD
Mnemonic: Be strong chained rat
•Rasmussen aneurysm—pulmonary artery
Mnemonic: PR
Physical quantity SI unit Non-SI unit
Radioactivity Becquerel (Bq) Curie
Absorbed dose Gray (Gy) Rad
Dose equivalent Sievert (Sv) Rem
Radiation exposure Colum ns/kg Roentegen
Mnemonic:
ABC
Ab gray is red
Shiv and Ram are equivalent
Ex colonel Rungta
Ear, Nose and Throat (ENT)121
• Malampatti grading—inspection of oral cavity (for assessment
of difficult airway)
I—Faucial pillars, soft palate, uvula
II—Faucial pillars, soft palate, uvula masked by base of tongue
III—Only soft palate
IV—Hard palate
Mnemonic:
UMSH. Like Umesh
• ASA physical status scale
(American Society of Anesthesiologist)
1—Healthy patient
2—Mild to moderate systemic disease
3—Severe systemic disease
4—Severe systemic disease that is Constant threat to life
5—Moribund patient not expected to survive without surgery
6—Declared brain dead patient whose organ is being
removed for donor purpose.
Mnemonic: HMS CMD
• Facial artery—
From cervical part:Submental
Tonsillar
Ascending palatine
Glandular (to lymph nodes and sub-
mandibular gland)
Mnemonic: STAG
From facial part:Superior labial
Inferior labial
Unnamed posterior branches
Lateral nasal
Mnemonic: SILa ko UP me LaNa
• Developmental dysplasia of hip
DAD—Adduction to dislocate—Barlow maneuver
RAB—Abduction to reduce—Ortolani maneuver
Mnemonic: O rab
• Malampatti grading—inspection of oral cavity (for assessment
of difficult airway)
I—Faucial pillars, soft palate, uvula
II—Faucial pillars, soft palate, uvula masked by base of tongue
III—Only soft palate
IV—Hard palate
Mnemonic:
UMSH. Like Umesh
• ASA physical status scale
(American Society of Anesthesiologist)
1—Healthy patient
2—Mild to moderate systemic disease
3—Severe systemic disease
4—Severe systemic disease that is Constant threat to life
5—Moribund patient not expected to survive without surgery
6—Declared brain dead patient whose organ is being
removed for donor purpose.
Mnemonic: HMS CMD
• Facial artery—
From cervical part:Submental
Tonsillar
Ascending palatine
Glandular (to lymph nodes and sub-
mandibular gland)
Mnemonic: STAG
From facial part:Superior labial
Inferior labial
Unnamed posterior branches
Lateral nasal
Mnemonic: SILa ko UP me LaNa
• Developmental dysplasia of hip
DAD—Adduction to dislocate—Barlow maneuver
RAB—Abduction to reduce—Ortolani maneuver
Mnemonic: O rab
• Bacterial pneumonias associated with cavitation
Staphylococcus
Klebsiella
Pseudomonas
Anaerobic bacteria
Mnemonic: Staph Klub main Pseudo Anna ka Cave
• Bronchogenic carcinoma
Cavitatory variant :Squamous cell (most common)
Large cell
Mnemonic: Squat in Large Cavity
Central location:Squamous cell
Small cell
Mnemonic: SSC
Peripheral location:Adenocarcinoma
Large cell
Mnemonic: PAL
• ARF: Prerenal versus intrinsic
Mnemonic: FRU Na
+
is less in Pre-renal ARF
Fractional excretion of Na
+
(%) <1.
Renal failure index
Na Na
cr cr
++UP
<1
UPUrinary sodium concentration <10 mmol/L or < 20 mEq/L.
• Coagulation factor def.—treatment
II, V, X, VII and XI—FFP
VIII—F VIII concentrate
122
Medicine
11
Staphylococcus
Klebsiella
Pseudomonas
Anaerobic bacteria
Mnemonic: Staph Klub main Pseudo Anna ka Cave
• Bronchogenic carcinoma
Cavitatory variant :Squamous cell (most common)
Large cell
Mnemonic: Squat in Large Cavity
Central location:Squamous cell
Small cell
Mnemonic: SSC
Peripheral location:Adenocarcinoma
Large cell
Mnemonic: PAL
• ARF: Prerenal versus intrinsic
Mnemonic: FRU Na
+
is less in Pre-renal ARF
Fractional excretion of Na
+
(%) <1.
Renal failure index
Na Na
cr cr
++UP
<1
UPUrinary sodium concentration <10 mmol/L or < 20 mEq/L.
• Coagulation factor def.—treatment
II, V, X, VII and XI—FFP
VIII—F VIII concentrate
122
Medicine
11
Medicine 123
IX—F IX concentrate
Fibrinogen, XIII—Cryoprecipitate
Mnemonic: Cry in First and thirteenth
• Paraneoplastic syndrome
Small cell (lung) Ca :Calcitonin
ACTH
ANF
AVP (vasopressin)
Gastrin releasing peptide
Mnemonic: Small CAG
Squamous cell CA—PTH
Mnemonic: Squat Pith
• Restless leg syndrome
Drugs causing it:Alcohol
Antipsychotics
Barbiturates
Benzodiazepines
Caffeine
Mnemonic: ABC
Also remember: Common causes:Idiopathic/familial
Iron def. anaemia
Chronic renal failure
• Bacteria associated with invasive diarrhoea
Plesiomonas Listeria monocytogenes
Aeromonas Yersinia pestis
Shigella Salmonella
Entero invasive E. coli
Mnemonic: PLAY SIS
• Type of LKM antibodies
Anti-LKM 1Chronic hepatitis C
Autoimmune hepatitis 2
Anti-LKM 2Drug induced hepatitis
Anti-LKM 3Chronic hepatitis D
Mnemonic: A1 C1 Dr2 D3
IX—F IX concentrate
Fibrinogen, XIII—Cryoprecipitate
Mnemonic: Cry in First and thirteenth
• Paraneoplastic syndrome
Small cell (lung) Ca :Calcitonin
ACTH
ANF
AVP (vasopressin)
Gastrin releasing peptide
Mnemonic: Small CAG
Squamous cell CA—PTH
Mnemonic: Squat Pith
• Restless leg syndrome
Drugs causing it:Alcohol
Antipsychotics
Barbiturates
Benzodiazepines
Caffeine
Mnemonic: ABC
Also remember: Common causes:Idiopathic/familial
Iron def. anaemia
Chronic renal failure
• Bacteria associated with invasive diarrhoea
Plesiomonas Listeria monocytogenes
Aeromonas Yersinia pestis
Shigella Salmonella
Entero invasive E. coli
Mnemonic: PLAY SIS
• Type of LKM antibodies
Anti-LKM 1Chronic hepatitis C
Autoimmune hepatitis 2
Anti-LKM 2Drug induced hepatitis
Anti-LKM 3Chronic hepatitis D
Mnemonic: A1 C1 Dr2 D3
Mnemonics124
• Reiter’s syndrome characteristic triad (found in one-third of
patients)
Reactive arthritis
Conjunctivitis
Urethritis
Mnemonic: RCU
• Strawberry gingivitis—Wegener’s granulomatosis
Strawberry tongue—Kawasaki disease
Strawberry vagina—Trichomonas
•Temporal arteritis worsens on exposure to cold
Multiple sclerosis worsens on exposure to heat (Uthoff’s)
Mnemonic:
CT
• Zona glomerulosa—mineralocorticoid
Zona fasciculata—glucocorticoid
Zona reticularis—Sex steroid
Mnemonic: GFR-MGS
•Normal peressure hydrocephalus triad
Dementia (mild to moderate)
Urinary incontinence
Ataxic or apractic gait
Mnemonic: NPH has DUA
• Motor neuron disease
UMN and LMN: Amylotropic lateral sclerosis
UMN only: Primary lateral sclerosis
Mnemonic: Upper Primary or UPri
LMN only: Progressive spinal muscular atrophy (progressive
London or lower progressive)
• Treatment of visceral leishmaniasis
First line
Pentavalent antimony
Sodium stibogluconate
Meglumine antimonate
Amphotericin B
• Reiter’s syndrome characteristic triad (found in one-third of
patients)
Reactive arthritis
Conjunctivitis
Urethritis
Mnemonic: RCU
• Strawberry gingivitis—Wegener’s granulomatosis
Strawberry tongue—Kawasaki disease
Strawberry vagina—Trichomonas
•Temporal arteritis worsens on exposure to cold
Multiple sclerosis worsens on exposure to heat (Uthoff’s)
Mnemonic:
CT
• Zona glomerulosa—mineralocorticoid
Zona fasciculata—glucocorticoid
Zona reticularis—Sex steroid
Mnemonic: GFR-MGS
•Normal peressure hydrocephalus triad
Dementia (mild to moderate)
Urinary incontinence
Ataxic or apractic gait
Mnemonic: NPH has DUA
• Motor neuron disease
UMN and LMN: Amylotropic lateral sclerosis
UMN only: Primary lateral sclerosis
Mnemonic: Upper Primary or UPri
LMN only: Progressive spinal muscular atrophy (progressive
London or lower progressive)
• Treatment of visceral leishmaniasis
First line
Pentavalent antimony
Sodium stibogluconate
Meglumine antimonate
Amphotericin B
Medicine 125
Paromomycin
Pentamidine
Miltefosine
Mnemonic: SPAM
Cutaneous leishmaniasis
First line
Pentavalent antimony
Parenteral alternative
Amphotericin B
Pentamidine
Mucosal leishmaniasis
First line
Pentavalent antimony
Amphotericin B
Alternative
Pentamidine
•
Omphalocele
Chromosomal abnormalities
Congenital abnormalities (including cardiac and CNS)
Carnell’s pentalogy
Beckwith-Wiedemann syndrome
Mnemonic: 3 COMB
• Hypoxic ischemia
Preterm infants—Periventricular leucomalacia—spastic
diplegia
Mnemonic: Pre Peri dip
Term infants—Subcortical white matter and basal ganglia—
status marmoratus—Spastic quadriplegia
(Basal ganglia and thalamus)
Mnemonic: Term = 3 SQ
Modified Jones’ criteria for rheumatic fever
Major criteraCarditis
Arthritis (migratory polyarthritis)
Sydenham’s chorea
Subcutaneous nodules
Erythema marginatum
Mnemonic: CASSEt
Paromomycin
Pentamidine
Miltefosine
Mnemonic: SPAM
Cutaneous leishmaniasis
First line
Pentavalent antimony
Parenteral alternative
Amphotericin B
Pentamidine
Mucosal leishmaniasis
First line
Pentavalent antimony
Amphotericin B
Alternative
Pentamidine
•
Omphalocele
Chromosomal abnormalities
Congenital abnormalities (including cardiac and CNS)
Carnell’s pentalogy
Beckwith-Wiedemann syndrome
Mnemonic: 3 COMB
• Hypoxic ischemia
Preterm infants—Periventricular leucomalacia—spastic
diplegia
Mnemonic: Pre Peri dip
Term infants—Subcortical white matter and basal ganglia—
status marmoratus—Spastic quadriplegia
(Basal ganglia and thalamus)
Mnemonic: Term = 3 SQ
Modified Jones’ criteria for rheumatic fever
Major criteraCarditis
Arthritis (migratory polyarthritis)
Sydenham’s chorea
Subcutaneous nodules
Erythema marginatum
Mnemonic: CASSEt
Mnemonics126
• HSP is characterized by a tetrad of
Purpura
Arthritis
Glomerulonephritis
Abdominal pain
Mnemonic: PAGlA
•Renal papillary necrosis: Associated conditions
(underlying mechanism is ischaemia)
Diabetes mellitus
Obstruction of urinary tract with infection
Sickle cell disease
Analgesic abuse (aspirin)
Mnemonic: DOSA
Note:Alcohol also ca uses RPN.
• Virchow’s triad for venous thrombosis
Hypercoagulability of blood
Injury to endothelium
Stasis of blood
Mnemonic: HIS
•Nitroblue tetrazolium test is used for phagocytosis
Mnemonic: Phani
• Framingham major criteria for congestive heart failure
PND
Neck vein distension
Rales
Positive hepatojugular reflux
Increased venous pressure (> 16 cm H
2O)
Cardiomegaly
Acute pulmonary oedema, and
S3 gallop
Mnemonic: PNR PICASo
•Burn-curling ulcer-duodenum
Mnemonic: BCD
• HSP is characterized by a tetrad of
Purpura
Arthritis
Glomerulonephritis
Abdominal pain
Mnemonic: PAGlA
•Renal papillary necrosis: Associated conditions
(underlying mechanism is ischaemia)
Diabetes mellitus
Obstruction of urinary tract with infection
Sickle cell disease
Analgesic abuse (aspirin)
Mnemonic: DOSA
Note:Alcohol also ca uses RPN.
• Virchow’s triad for venous thrombosis
Hypercoagulability of blood
Injury to endothelium
Stasis of blood
Mnemonic: HIS
•Nitroblue tetrazolium test is used for phagocytosis
Mnemonic: Phani
• Framingham major criteria for congestive heart failure
PND
Neck vein distension
Rales
Positive hepatojugular reflux
Increased venous pressure (> 16 cm H
2O)
Cardiomegaly
Acute pulmonary oedema, and
S3 gallop
Mnemonic: PNR PICASo
•Burn-curling ulcer-duodenum
Mnemonic: BCD
Medicine 127
Cushing’s ulcer—Stress ulcer
Mnemonic: S for S
Peripheral aneurysm—Popliteal artery (70%)
Mnemonic: P for P
Central dot sign—Carolis disease
Mnemonic: C for C
•Achalasia cardia—Bird’s beak appearance
Diffuse esophageal spasm—Corkscrew esophagus
Mnemonic: AB-CD
Ca esophagus—Rat tail appearance (Mn: Carat)
• Antiviral therapy in chronic hepatitis B is indicated in
HBsAg (+), HBeAg (±), and HBV DNA high levels and ALT
elevated
Note:In above case, if HBeAg is – ve, it is called precore-
mutant.
Viral hepatitis—ALT
Alcoholic hepatitis—AST (S for Sharab)
• Hypocellular bone marrow ± cytopenia
Starvation
Q fever
Legionnaire’s disease
Anorexia nervosa
Mycobacteria
Mnemonic:Starving QLAM is Hypo
•C-ANCA—Cytoplasmic proteinase 3 is the target antigen.
P-ANCA—Perinuclear myeloperoxidase is the major target
antigen.
Mnemonic: CP-MP
• Pontine syndromes
Ventral pontine syndrome—Millard-Gubler syndrome
Mnemonic: VM
Lower dorsal pontine syndnome—Fovilles syndrome
Mnemonic: FOLD
Cushing’s ulcer—Stress ulcer
Mnemonic: S for S
Peripheral aneurysm—Popliteal artery (70%)
Mnemonic: P for P
Central dot sign—Carolis disease
Mnemonic: C for C
•Achalasia cardia—Bird’s beak appearance
Diffuse esophageal spasm—Corkscrew esophagus
Mnemonic: AB-CD
Ca esophagus—Rat tail appearance (Mn: Carat)
• Antiviral therapy in chronic hepatitis B is indicated in
HBsAg (+), HBeAg (±), and HBV DNA high levels and ALT
elevated
Note:In above case, if HBeAg is – ve, it is called precore-
mutant.
Viral hepatitis—ALT
Alcoholic hepatitis—AST (S for Sharab)
• Hypocellular bone marrow ± cytopenia
Starvation
Q fever
Legionnaire’s disease
Anorexia nervosa
Mycobacteria
Mnemonic:Starving QLAM is Hypo
•C-ANCA—Cytoplasmic proteinase 3 is the target antigen.
P-ANCA—Perinuclear myeloperoxidase is the major target
antigen.
Mnemonic: CP-MP
• Pontine syndromes
Ventral pontine syndrome—Millard-Gubler syndrome
Mnemonic: VM
Lower dorsal pontine syndnome—Fovilles syndrome
Mnemonic: FOLD
Mnemonics128
Upper dorsal pontine syndrome—Raymond-Cestan syndrome
Mnemonic: Ray UDP
•Features of pontine stroke
Hyperpyrexia
Hyperhydrosis
Hyperventilation/Hyperapnoea (severe)
Quadriplegia and coma
Pin point pupil, occulocephalic manoeuvre/doll’s head,
ocular blobbing
Decerebrate rigidity
Mnemonic: 4H + Quadriplegia + Ocular features +
Decerebrate rigidity
• Damage to red nucleus causes contralateral involuntary
movements
Chorea
Athetosis
Tremor
Mnemonic: Red CAT
• Benedikt’s syndrome—Ipsilateral oculomotor palsy +
contralateral involuntary movement—chorea, athetosis,
tremor
Nothnagel’s syndrome—Ipsilateral oculomotor palsy +
contralateral cerebellar ataxia
Claude’s syndrome = Benedikt + Nothnagel
• Laurence–Moon–Biedl syndrome
Autosomal recessive
Mental retardation
Obesity
Retinitis pigmentosa
Polydactyly
Hypogonadism
Mnemonic: MORPH
• CNS tumours
Intra-axialNeuronal tumor
Astrocytoma (glioma)
Lymphoma
Upper dorsal pontine syndrome—Raymond-Cestan syndrome
Mnemonic: Ray UDP
•Features of pontine stroke
Hyperpyrexia
Hyperhydrosis
Hyperventilation/Hyperapnoea (severe)
Quadriplegia and coma
Pin point pupil, occulocephalic manoeuvre/doll’s head,
ocular blobbing
Decerebrate rigidity
Mnemonic: 4H + Quadriplegia + Ocular features +
Decerebrate rigidity
• Damage to red nucleus causes contralateral involuntary
movements
Chorea
Athetosis
Tremor
Mnemonic: Red CAT
• Benedikt’s syndrome—Ipsilateral oculomotor palsy +
contralateral involuntary movement—chorea, athetosis,
tremor
Nothnagel’s syndrome—Ipsilateral oculomotor palsy +
contralateral cerebellar ataxia
Claude’s syndrome = Benedikt + Nothnagel
• Laurence–Moon–Biedl syndrome
Autosomal recessive
Mental retardation
Obesity
Retinitis pigmentosa
Polydactyly
Hypogonadism
Mnemonic: MORPH
• CNS tumours
Intra-axialNeuronal tumor
Astrocytoma (glioma)
Lymphoma
Medicine 129
Mnemonic: NALy
Extra-axialPituitary tumor
Schwannoma
Meningioma (dura based)
Mnemonic: PSM. Also, dura matter is a Meninge. (PSM is
extra-axial)
• Contrast nephropathy is more common in individuals with
pre-existing
Metformin
Multiple myeloma
CRF (chronic renal failure)
CCF (congestive cardiac failure)
Diabetes mellitus
Dehydration (hypovolemia)
Mnemonic: (MCD)2
• Obstructive lung disease versus restrictive lung diseases
In obstructive lung disease, vital capacity and FEVI/FVC
decrease, others remain normal (diffusion capacity), increases
(residual volumes) or normal to increases (total lung capactiy).
– In restrictive lung disease, VC, RV,TLC, DLCO, all dec-
reases except FEVI/FVC which is normal to increase.
• Obstructive lung disease
Asthma
Bronchiectasis
Bronchiolitis
Cystic fibrosis
COPD (chronic bronchitis and emphysema)
Mnemonic: ABC
• Lower motor neuron (LMN) palsy
Flaccidity (hypotonia)
Fasciculation
Flexor plantar
Individual muscle paralysis
Degeneration reaction
Atrophy (wasting) is marked (cardinal feature)
Mnemonic: 3FIDA
Mnemonic: NALy
Extra-axialPituitary tumor
Schwannoma
Meningioma (dura based)
Mnemonic: PSM. Also, dura matter is a Meninge. (PSM is
extra-axial)
• Contrast nephropathy is more common in individuals with
pre-existing
Metformin
Multiple myeloma
CRF (chronic renal failure)
CCF (congestive cardiac failure)
Diabetes mellitus
Dehydration (hypovolemia)
Mnemonic: (MCD)2
• Obstructive lung disease versus restrictive lung diseases
In obstructive lung disease, vital capacity and FEVI/FVC
decrease, others remain normal (diffusion capacity), increases
(residual volumes) or normal to increases (total lung capactiy).
– In restrictive lung disease, VC, RV,TLC, DLCO, all dec-
reases except FEVI/FVC which is normal to increase.
• Obstructive lung disease
Asthma
Bronchiectasis
Bronchiolitis
Cystic fibrosis
COPD (chronic bronchitis and emphysema)
Mnemonic: ABC
• Lower motor neuron (LMN) palsy
Flaccidity (hypotonia)
Fasciculation
Flexor plantar
Individual muscle paralysis
Degeneration reaction
Atrophy (wasting) is marked (cardinal feature)
Mnemonic: 3FIDA
Mnemonics130
Upper motor neuron (UMN) palsy
Extensor plantar
Clonus
Clasp knife spasticity (hypertonia)
Group of muscles affected
Mnemonic: ECG
Note:Loss of superficial reflexes are found in both UMN
and LMN.
• Wernicke’s encephalopathy
Triad of:Global confusion
Ophthalmoplegia (due to LR palsy)
Ataxia
Mnemonic: GOA
• Seven adverse prognostic factors for Hodgkin’s disease
Leukocytosis with WBC > 15,000
Serum albumin level < 4 g/dl
Lymphocytopenia with either one
Absolute lymphocyte count < 6000/ml
Stage IV disease
Hb < 10.5 g/dl
Age > 45 years
Male
Lymphocytes < 8% of WBC
Mnemonic: LAL SHAMA
Thrombotic thrombocytopenic purpura (TTP)
Decreased renal function
Disturbed neurological function
Thrombocytopenia
Fever M
icroangiopathic hemolytic anaemia
Pathognomonic of TTP—pentad + normal coagulation tests
Mnemonic: RNT Fever in MAHA, TTP
• Jodbasedow disease—iodine induced hyperthyroidism
Caused by: Diet
Radiographic contrast material
Iodine containing drug like amiodarone
Upper motor neuron (UMN) palsy
Extensor plantar
Clonus
Clasp knife spasticity (hypertonia)
Group of muscles affected
Mnemonic: ECG
Note:Loss of superficial reflexes are found in both UMN
and LMN.
• Wernicke’s encephalopathy
Triad of:Global confusion
Ophthalmoplegia (due to LR palsy)
Ataxia
Mnemonic: GOA
• Seven adverse prognostic factors for Hodgkin’s disease
Leukocytosis with WBC > 15,000
Serum albumin level < 4 g/dl
Lymphocytopenia with either one
Absolute lymphocyte count < 6000/ml
Stage IV disease
Hb < 10.5 g/dl
Age > 45 years
Male
Lymphocytes < 8% of WBC
Mnemonic: LAL SHAMA
Thrombotic thrombocytopenic purpura (TTP)
Decreased renal function
Disturbed neurological function
Thrombocytopenia
Fever M
icroangiopathic hemolytic anaemia
Pathognomonic of TTP—pentad + normal coagulation tests
Mnemonic: RNT Fever in MAHA, TTP
• Jodbasedow disease—iodine induced hyperthyroidism
Caused by: Diet
Radiographic contrast material
Iodine containing drug like amiodarone
Medicine 131
Wolff-Chaikoff effect—iodine dependent transient sup-
pression of thyroid. Prevents iodide organification.
Mnemonic: Wolf are decreasing
• Wegener’s granulomatosis
Characteristic triad of
Upper respiratory tract infection
Lower respiratory tract infection
Renal involvement
Mnemonic: ULR
• ATP 7B—Chromosome 13—Wilms’ disease
ATP 7A disease—kinky hair disease.
• Pure motor neuropathies
Hereditary spinal muscular atrophy
Lower motor neuron form of amylotropic lateral sclerosis
Lambert-Eaton myaesthenic syndrome
Poliomyelitis
Lead intoxication
Dapsone intoxication
Adult variant of hexosaminidase deficiency
Acute intermittent porphyria (occasionally)
Tick bite paralysis
Mnemonic: Here, a lamba and lower pole is leading dapsone
to adult variant of porphyria by the tick bite
• Malignant melanoma—Clark level.
I Restricted to epidermis
II Invading papillary dermis
III Impinging reticular dermis
IV Invading reticular dermis
V Invading subcutaneous tissue
Mnemonic: EPRRS
Impinges before invasion
• MEN2A (Sipple)
MTC
Wolff-Chaikoff effect—iodine dependent transient sup-
pression of thyroid. Prevents iodide organification.
Mnemonic: Wolf are decreasing
• Wegener’s granulomatosis
Characteristic triad of
Upper respiratory tract infection
Lower respiratory tract infection
Renal involvement
Mnemonic: ULR
• ATP 7B—Chromosome 13—Wilms’ disease
ATP 7A disease—kinky hair disease.
• Pure motor neuropathies
Hereditary spinal muscular atrophy
Lower motor neuron form of amylotropic lateral sclerosis
Lambert-Eaton myaesthenic syndrome
Poliomyelitis
Lead intoxication
Dapsone intoxication
Adult variant of hexosaminidase deficiency
Acute intermittent porphyria (occasionally)
Tick bite paralysis
Mnemonic: Here, a lamba and lower pole is leading dapsone
to adult variant of porphyria by the tick bite
• Malignant melanoma—Clark level.
I Restricted to epidermis
II Invading papillary dermis
III Impinging reticular dermis
IV Invading reticular dermis
V Invading subcutaneous tissue
Mnemonic: EPRRS
Impinges before invasion
• MEN2A (Sipple)
MTC
Mnemonics132
Pheochromocytoma
Parathyroid hyperplasia or adenoma
Cutaneous lichen amyloidosis
Hirschsprung’s disease
FMTC
Mnemonic: MP ke Para main FM se Clah
• MEN2B
MTC
Mucosal and gastrointestinal neuromas
Marfanoid features
Pheochromocytoma
Mnemonic: 2MP
• Noonan’s syndrome versus Turner’s syndrome
Noonan’s syndrome
Autosomal dominant (seen in both sexes)
Pectus carinatum/pectus excavatum
Cardiac defect—pulmonary stenosis, HOCM, ASD
Mental retardation.
Mnemonic: Ad PCM at Noon
•Turner syndrome
Phenotypically females only
Broad chest with widely spread nipples.
Coarctation of aorta
Bicuspid aortic valve
Short fourth metacarpal
Mnemonic: Turn broad, CoBi to short.
• Metabolic acidosis
Normal anion gap
Fistula
Cholera
Mineralocorticoid deficiency
Ureterosigmoidostomy
Diarrhoea
Renal tubular acidosis
Pheochromocytoma
Parathyroid hyperplasia or adenoma
Cutaneous lichen amyloidosis
Hirschsprung’s disease
FMTC
Mnemonic: MP ke Para main FM se Clah
• MEN2B
MTC
Mucosal and gastrointestinal neuromas
Marfanoid features
Pheochromocytoma
Mnemonic: 2MP
• Noonan’s syndrome versus Turner’s syndrome
Noonan’s syndrome
Autosomal dominant (seen in both sexes)
Pectus carinatum/pectus excavatum
Cardiac defect—pulmonary stenosis, HOCM, ASD
Mental retardation.
Mnemonic: Ad PCM at Noon
•Turner syndrome
Phenotypically females only
Broad chest with widely spread nipples.
Coarctation of aorta
Bicuspid aortic valve
Short fourth metacarpal
Mnemonic: Turn broad, CoBi to short.
• Metabolic acidosis
Normal anion gap
Fistula
Cholera
Mineralocorticoid deficiency
Ureterosigmoidostomy
Diarrhoea
Renal tubular acidosis
Medicine 133
Ammonium chloride ingestion
Mnemonic: FC MUDRA
Increased anion gap
Ketoacidosis
Exogenous substance
Renal failure
Lactic acidosis
Mnemonic: KERL
Lactic acidosis (shock, cardiopulmonary arrest, severe
anaemia, carbon monoxide or cyanide poisoning)
Ketoacidosis (
Diabetics, alcoholics, starvation)
Mnemonic: DAS
Exogenous substances (Ethylene glycol, methanol, salicylates)
Mnemonic: EMS
• Amount of sodium bicarbonate given in metabolic acidosis is
= 1/2 × body weight
(kg) × [Desired HCO
3
– measured HCO
3]
Half of this quantity should be administered within first ½ hr.
Desired HCO
3
= 25 mEq/L.
• Acute pericarditis—after several days T waves become
inverted but this occurs only when ST segments return to
baseline.
Acute myocardial infarction—T wave inversion occurs within
hours before ST segment returns to baseline.
•
Osborne wave/J wave/Late delta wave/Camel hump sign is an
ECG finding usually seen in hypothermia
Mnemonic: CaJOL
• Shortly before S1–S4
Mnemonic: 41
Shortly after S1—ejection click (high pitched)
Between S1 and S2—midsystolic click
Shrotly after S2–S3
Tumor plop, opening snap, pericardial knock
Mnemonic:
S3TOP
Ammonium chloride ingestion
Mnemonic: FC MUDRA
Increased anion gap
Ketoacidosis
Exogenous substance
Renal failure
Lactic acidosis
Mnemonic: KERL
Lactic acidosis (shock, cardiopulmonary arrest, severe
anaemia, carbon monoxide or cyanide poisoning)
Ketoacidosis (
Diabetics, alcoholics, starvation)
Mnemonic: DAS
Exogenous substances (Ethylene glycol, methanol, salicylates)
Mnemonic: EMS
• Amount of sodium bicarbonate given in metabolic acidosis is
= 1/2 × body weight
(kg) × [Desired HCO
3
– measured HCO
3]
Half of this quantity should be administered within first ½ hr.
Desired HCO
3
= 25 mEq/L.
• Acute pericarditis—after several days T waves become
inverted but this occurs only when ST segments return to
baseline.
Acute myocardial infarction—T wave inversion occurs within
hours before ST segment returns to baseline.
•
Osborne wave/J wave/Late delta wave/Camel hump sign is an
ECG finding usually seen in hypothermia
Mnemonic: CaJOL
• Shortly before S1–S4
Mnemonic: 41
Shortly after S1—ejection click (high pitched)
Between S1 and S2—midsystolic click
Shrotly after S2–S3
Tumor plop, opening snap, pericardial knock
Mnemonic:
S3TOP
Mnemonics134
• Ejection click
Semilunar valves (AS, PS, HTN)
Opening snap—AV Valves (MS > TS)
Pericardial knock—constrictive pericarditis tumor plop—
atrial myxoma
• Pansystolic murmur—
VSD, MR, TR and aortopulmonary
shunts.
Mnemonic: MTV
Midsystolic murmur—aortic (AS, COA, aneurysm, PDA
Pulmonary (PS, P.hypertension, P.artery dilatation)
Early systolic murmur TR (in absence of Pul. HTN), MR (in a
noncompliant left atrium), VSD (V.small muscular VSD, large
VSD with Pul. HTN)
• Allergic bronchopulmonary aspergillosis
Main diagnostic criteria
Clinical history of
asthma
Pulmonary infiltrates (transient/fixed)
Precipitating antibodies to Aspergillus fumigatus
Immediate skin reactivity to Aspergillus antigen (wheal and
flare response)
Peripheral
eosinophilia
Elevated serum IgE levels
Central/proximal bronchiectasis.
Mnemonic: All India Exam 2 times, i.e.
(AIE) 2 + Bronchiectasis
• Causes of transudative pleural effusion
Cirrhosis of liver
Nephrotic syndrome
Myxoedema
CHF
SVC obstruction
Mnemonic: CNMC in SVC is transudative
• Exudative pleural fluid
Light criteria: Pleural fluid protein /serum protein > 0.5
Pleural fluid LDH/serum LDH > 0.6
Pleural fluid LDH > 2/3 upper limit of serum LDH
• Ejection click
Semilunar valves (AS, PS, HTN)
Opening snap—AV Valves (MS > TS)
Pericardial knock—constrictive pericarditis tumor plop—
atrial myxoma
• Pansystolic murmur—
VSD, MR, TR and aortopulmonary
shunts.
Mnemonic: MTV
Midsystolic murmur—aortic (AS, COA, aneurysm, PDA
Pulmonary (PS, P.hypertension, P.artery dilatation)
Early systolic murmur TR (in absence of Pul. HTN), MR (in a
noncompliant left atrium), VSD (V.small muscular VSD, large
VSD with Pul. HTN)
• Allergic bronchopulmonary aspergillosis
Main diagnostic criteria
Clinical history of
asthma
Pulmonary infiltrates (transient/fixed)
Precipitating antibodies to Aspergillus fumigatus
Immediate skin reactivity to Aspergillus antigen (wheal and
flare response)
Peripheral
eosinophilia
Elevated serum IgE levels
Central/proximal bronchiectasis.
Mnemonic: All India Exam 2 times, i.e.
(AIE) 2 + Bronchiectasis
• Causes of transudative pleural effusion
Cirrhosis of liver
Nephrotic syndrome
Myxoedema
CHF
SVC obstruction
Mnemonic: CNMC in SVC is transudative
• Exudative pleural fluid
Light criteria: Pleural fluid protein /serum protein > 0.5
Pleural fluid LDH/serum LDH > 0.6
Pleural fluid LDH > 2/3 upper limit of serum LDH
Medicine 135
With increased amylase:Pancreatic pleural effusion
Esophageal rupture
Malignancy
Mnemonic: Amylase increases in PEM
With decreased glucose:Bacterial infection
Malignancy
Rheumatoid pleuritis
Mnemonic: Glucose decreases in BMR
• The MC cause of sporadic viral encephalitis—HSV-1
The MC cause of epidemic viral encephalitis—arbovirus (JE
virus)
The MC cause of viral meningitis—enterovirus
• Charcot’s joint /neuropathic joints
Joints involved
Syringomyelia Glenohumeral joint, elbow and wrist
Tabes dorsalis Knee, hip and ankle
Diabetes mellitus Tarsal and metatarsal joints
Mnemonic: STD from above downwards—position of joints
• Disorders associated with Charcot’s joint
Syringomyelia
Tabes dorsalis
Diabetes mellitus
Peroneal muscular atrophy
Amyloidosis
Leprosy
Meningomyelocele
Congenital insensitivity to pain
Mnemonic: STD PALM CO
• Down’s syndrome: Transient myeloproliferative syndrome
AML (FAB M7—acute magakaryocytic
subtype)
• Extraintestinal manifestation occurs more commonly with
Crohn’s disease than with ulcerative colitis. Those specially
associated with Crohn’s disease include:
Digital clubbing
Oral aphthous ulcers
With increased amylase:Pancreatic pleural effusion
Esophageal rupture
Malignancy
Mnemonic: Amylase increases in PEM
With decreased glucose:Bacterial infection
Malignancy
Rheumatoid pleuritis
Mnemonic: Glucose decreases in BMR
• The MC cause of sporadic viral encephalitis—HSV-1
The MC cause of epidemic viral encephalitis—arbovirus (JE
virus)
The MC cause of viral meningitis—enterovirus
• Charcot’s joint /neuropathic joints
Joints involved
Syringomyelia Glenohumeral joint, elbow and wrist
Tabes dorsalis Knee, hip and ankle
Diabetes mellitus Tarsal and metatarsal joints
Mnemonic: STD from above downwards—position of joints
• Disorders associated with Charcot’s joint
Syringomyelia
Tabes dorsalis
Diabetes mellitus
Peroneal muscular atrophy
Amyloidosis
Leprosy
Meningomyelocele
Congenital insensitivity to pain
Mnemonic: STD PALM CO
• Down’s syndrome: Transient myeloproliferative syndrome
AML (FAB M7—acute magakaryocytic
subtype)
• Extraintestinal manifestation occurs more commonly with
Crohn’s disease than with ulcerative colitis. Those specially
associated with Crohn’s disease include:
Digital clubbing
Oral aphthous ulcers
Mnemonics136
Peripheral arthritis
Erythema nodosum
Episcleritis
Renal stones (uric acid oxalate)
Gallstones
Mnemonic: DOPE ERG in Crohn’s
• Approach to diagnosis of arthritis in a single joint
Associated with fever Septic arthritis
Not associated with feverAcute: Trauma
Hemarthrosis
Hemophilia
Chronic:
JRA
Trauma
Tuberculosis
Legg-Perthes disease
Mnemonic: JTTL (like Jatil in hindi)
• Tubulopathy/tubulitis
PCT—RTA2, Fanconi syndrome
Mnemonic: 2 Fan for PC
Thick ascending—Bartter syndrome
Mnemonic: BaTA
DCT—Gitelman syndrome
Collecting duct : RTA1
Liddle’s syndrome
D(Nephrogenic)
Renal papilla—Renal papillary necrosis
Major calyx/pelvis—hydronephrosis, pyonephrosis, reflux
nephropathy
Any/all—acute tubular necrosis
Mnemonic: 1 Little DIN in CD-Collecting Duct
• Syndrome Most likely congenital cardiac lesion
Down’s syndrome ASD of end ocardial cushion type
(ostium primum type)
Turner’s syndrome Coarctation of aorta, bicuspid aortic
valve
Peripheral arthritis
Erythema nodosum
Episcleritis
Renal stones (uric acid oxalate)
Gallstones
Mnemonic: DOPE ERG in Crohn’s
• Approach to diagnosis of arthritis in a single joint
Associated with fever Septic arthritis
Not associated with feverAcute: Trauma
Hemarthrosis
Hemophilia
Chronic:
JRA
Trauma
Tuberculosis
Legg-Perthes disease
Mnemonic: JTTL (like Jatil in hindi)
• Tubulopathy/tubulitis
PCT—RTA2, Fanconi syndrome
Mnemonic: 2 Fan for PC
Thick ascending—Bartter syndrome
Mnemonic: BaTA
DCT—Gitelman syndrome
Collecting duct : RTA1
Liddle’s syndrome
D(Nephrogenic)
Renal papilla—Renal papillary necrosis
Major calyx/pelvis—hydronephrosis, pyonephrosis, reflux
nephropathy
Any/all—acute tubular necrosis
Mnemonic: 1 Little DIN in CD-Collecting Duct
• Syndrome Most likely congenital cardiac lesion
Down’s syndrome ASD of end ocardial cushion type
(ostium primum type)
Turner’s syndrome Coarctation of aorta, bicuspid aortic
valve
Medicine 137
Noonan’s syndrome Pulmonic stenosis
Holt-Oram syndrome (ASD with bony abnormalities)
Familial ASD
(Strongest association)
Marfan’s syndrome Aortic or pulmonary artery dilatation,
mitral or aortic regurgitation
Ellis-van Creveld syndrome ASD + single atrium
Rubella PDA > PS > VSD
• X-linked recessive X-linked dominant
Hemophilia A Hypophosphatemic rickets
G6PD deficiency
Duchenne-Becker muscular dystrophy
Fragile X syndrome
Fabry’s disease
• LAP scores are decreased in PNH and CML
LAP scores are increased in
Infection
Polycythemia
Leukemoid reaction
Mnemonic: IPL
• Myeloproliferative syndrome
Polycythemia vera
Idiopathic myelofibrosis
Essential thrombocytosis
CML
• a wave: Right atrial contraction
c wave: Bulging of tricuspid valve into right atrium
a-x descent: Atrial relaxation and downward displacement
of tricuspid valve
v wave: Increasing volume of blood in the right atrium
v-y descent:Opening of tricuspid valve and subsequent
rapid in flow of blood into right ventricle.
• a waves: Due to distension produced by right atrial
contraction
Large a waves Tricuspid stenosis
Noonan’s syndrome Pulmonic stenosis
Holt-Oram syndrome (ASD with bony abnormalities)
Familial ASD
(Strongest association)
Marfan’s syndrome Aortic or pulmonary artery dilatation,
mitral or aortic regurgitation
Ellis-van Creveld syndrome ASD + single atrium
Rubella PDA > PS > VSD
• X-linked recessive X-linked dominant
Hemophilia A Hypophosphatemic rickets
G6PD deficiency
Duchenne-Becker muscular dystrophy
Fragile X syndrome
Fabry’s disease
• LAP scores are decreased in PNH and CML
LAP scores are increased in
Infection
Polycythemia
Leukemoid reaction
Mnemonic: IPL
• Myeloproliferative syndrome
Polycythemia vera
Idiopathic myelofibrosis
Essential thrombocytosis
CML
• a wave: Right atrial contraction
c wave: Bulging of tricuspid valve into right atrium
a-x descent: Atrial relaxation and downward displacement
of tricuspid valve
v wave: Increasing volume of blood in the right atrium
v-y descent:Opening of tricuspid valve and subsequent
rapid in flow of blood into right ventricle.
• a waves: Due to distension produced by right atrial
contraction
Large a waves Tricuspid stenosis
Mnemonics138
(atria is contracting Pulmonic stenosis
against increased resistance)
Pulmonary hypertension
Cannon a waves Regularly—during junctional rhythm
Irregularly—AV dissociation with ventricular tachycardia,
complete heart block
Absent a waves—atrial fibrillation
• a-x descent—due to both atrial relaxation and the downward
displacement of the tricusupid valve during ventricular
systole. Accentuated in: Constrictive
pericarditis
Restrictive cardiomyopathy
Cardiac tamponade
Mnemonic: PRT
Reduced with Right ventricular dilatation
Reversed with Tricuspid regurgitation
• v-y descent—by the opening of the tricuspid valve and
subsequent rapid flow of blood into the right ventricle
Accentuated in:Tricuspid regurgitation
Constrictive pericarditis
Reduced with: Tricuspid stenosis
Right atrial myxoma
(suggest obstruction to right ventricular
filling)
• Tricuspid regurgitation causes the v waves to be prominent.
When TR becomes severe, the combination of a prominent
v waves and obliteration of x-descent results in a single large
positive systolic wave.
• Pheochromocytoma has been called the 10% tumor. 10% of
tumor are:
Bilateral Malignant
Occur in childrenMultiple
Extra adrenal
Familial
Mnemonic: BCEF MM
(atria is contracting Pulmonic stenosis
against increased resistance)
Pulmonary hypertension
Cannon a waves Regularly—during junctional rhythm
Irregularly—AV dissociation with ventricular tachycardia,
complete heart block
Absent a waves—atrial fibrillation
• a-x descent—due to both atrial relaxation and the downward
displacement of the tricusupid valve during ventricular
systole. Accentuated in: Constrictive
pericarditis
Restrictive cardiomyopathy
Cardiac tamponade
Mnemonic: PRT
Reduced with Right ventricular dilatation
Reversed with Tricuspid regurgitation
• v-y descent—by the opening of the tricuspid valve and
subsequent rapid flow of blood into the right ventricle
Accentuated in:Tricuspid regurgitation
Constrictive pericarditis
Reduced with: Tricuspid stenosis
Right atrial myxoma
(suggest obstruction to right ventricular
filling)
• Tricuspid regurgitation causes the v waves to be prominent.
When TR becomes severe, the combination of a prominent
v waves and obliteration of x-descent results in a single large
positive systolic wave.
• Pheochromocytoma has been called the 10% tumor. 10% of
tumor are:
Bilateral Malignant
Occur in childrenMultiple
Extra adrenal
Familial
Mnemonic: BCEF MM
Medicine 139
• Type 1 respiratory failure
PaO
2—low (< 60 mmHg)
PaCO
2—normal/low (≤ 49 mmHg)
PA-aO
2—increased
Oxygenation affected:
Parenchymal disease (V/Q mismatch)
Diseases of vasculature/shunts
Interstitial lung diseases
ExamplesRight to left shunts
ARDS
Pneumonia
Emphysema
Mnemonic: RAPE
Type 2 respiratory failure
PaO
2—decreased (< 60 mmHg)
PaCO
2—increased (> 49 mmHg)
PA-aO
2—normal
Ventilation affected:
Obstructive lung disease—COPD, foreign body
Decreased central respiratory drive
Brain injury, meningitis
Weakness of respiratory muscle
Myasthenia gravis
Interstitial lung disease
Polymyositis
Kyphoscoliosis
• Tumors associated with polycythemia vera
Hypernephroma
Uterine fibromyoma
Meningioma
Pheochromocytoma
Adrenal adenoma
Cerebellar hemangioblastoma
Hepatoma
Mnemonic: HUM PACH
• Type 1 respiratory failure
PaO
2—low (< 60 mmHg)
PaCO
2—normal/low (≤ 49 mmHg)
PA-aO
2—increased
Oxygenation affected:
Parenchymal disease (V/Q mismatch)
Diseases of vasculature/shunts
Interstitial lung diseases
ExamplesRight to left shunts
ARDS
Pneumonia
Emphysema
Mnemonic: RAPE
Type 2 respiratory failure
PaO
2—decreased (< 60 mmHg)
PaCO
2—increased (> 49 mmHg)
PA-aO
2—normal
Ventilation affected:
Obstructive lung disease—COPD, foreign body
Decreased central respiratory drive
Brain injury, meningitis
Weakness of respiratory muscle
Myasthenia gravis
Interstitial lung disease
Polymyositis
Kyphoscoliosis
• Tumors associated with polycythemia vera
Hypernephroma
Uterine fibromyoma
Meningioma
Pheochromocytoma
Adrenal adenoma
Cerebellar hemangioblastoma
Hepatoma
Mnemonic: HUM PACH
Mnemonics140
• Normal total bilirubin is 0.3 to 1.0 mg/dl
Conjugated—0.1 to 0.3 mg/dl
Unconjugated—0.2 to 0.7 mg/dl
Normal alkaline phosphatase
3 to 13 KA/U (30 to 120 lU/L)
• Clinical significance of different casts (urinary casts)
Hyaline casts—normal constituent of urine and no attached
significance. Tomm-Horsfall protein is the protein secreted by
epithelial cells of loop of Henle. This protein may be excreted
as hyaline casts
RBC cast—glomerular injury
White cell cast—interstitial injury seen in interstitial nephritis
or pyelonephritis
Broad granular cast—interstitial fibrosis and dilatation of
tubules, seen in CRF
Pigmented muddy brown granular casts—ischaemic or
nephrotoxic injury, i.e. tubular necrosis
• Parkinsonism is characteristically associated with a triad of
Bradykinesia
Tremor at rest
Rigidity
Mnemonic: BTR (like Butter in hindi)
• The clinical hallmarks of ‘Huntigton’s disease
Behavioural disturbance
Chorea
Dementia (late onset)
Mnemonic: BCD
• Migraine
Frontotemporal usually (lateralised)
Females
Family history
Focal neurological symptoms like clumsiness and weakness
Pain preceded by aura
Photophobia
Photopsia and fortification spectra
Paresthesia with tingling and numbness
Mnemonic: 4F4P
• Normal total bilirubin is 0.3 to 1.0 mg/dl
Conjugated—0.1 to 0.3 mg/dl
Unconjugated—0.2 to 0.7 mg/dl
Normal alkaline phosphatase
3 to 13 KA/U (30 to 120 lU/L)
• Clinical significance of different casts (urinary casts)
Hyaline casts—normal constituent of urine and no attached
significance. Tomm-Horsfall protein is the protein secreted by
epithelial cells of loop of Henle. This protein may be excreted
as hyaline casts
RBC cast—glomerular injury
White cell cast—interstitial injury seen in interstitial nephritis
or pyelonephritis
Broad granular cast—interstitial fibrosis and dilatation of
tubules, seen in CRF
Pigmented muddy brown granular casts—ischaemic or
nephrotoxic injury, i.e. tubular necrosis
• Parkinsonism is characteristically associated with a triad of
Bradykinesia
Tremor at rest
Rigidity
Mnemonic: BTR (like Butter in hindi)
• The clinical hallmarks of ‘Huntigton’s disease
Behavioural disturbance
Chorea
Dementia (late onset)
Mnemonic: BCD
• Migraine
Frontotemporal usually (lateralised)
Females
Family history
Focal neurological symptoms like clumsiness and weakness
Pain preceded by aura
Photophobia
Photopsia and fortification spectra
Paresthesia with tingling and numbness
Mnemonic: 4F4P
Medicine 141
Other—all age group affected
Pain builds up
• Cluster headache
Periorbital or less commonly temporal
All ages above 10 years with peak at 30–50 years
Male preponderance (90%)
No hereditary factor
Pain (periodic attacks 1–21 days)
Begins without warning
Reaches crescendo within 5 minutes
Lasts for 45 minutes
Excoriating, deep, explosive pain but only rarely pulsatile
Awakens the patients from sleep
Homolateral lacrimation
Reddening of eye
Nasal stuffiness
Ptosis
Nausea
• Gastrointestinal lymphoma—modified Ann Arbor classification
IE Tumor confined to
small intestine
IIE Spread to regional lymph nodes
IIIE Spread to non-resectable nodes beyond regional nodes
IVE Spread to other organs
Mnemonic: SRNO
• Basal ganglia and lesions
Chorea—Caudate nucleus and putamen (striatum)
Mnemonic: C for C
Athetosis — Lantiform nucleus (globus pallidus)
Mnemonic: Lathi
Hemi ballismus — Subthalamic nucleus
Mnemonic: Hemi-Sub
Parkinsonism —substantia nigra
• All porphyrias except congenital erythropoietic porphyria
(which is autosomal recessive) are autosomal dominant.
Other—all age group affected
Pain builds up
• Cluster headache
Periorbital or less commonly temporal
All ages above 10 years with peak at 30–50 years
Male preponderance (90%)
No hereditary factor
Pain (periodic attacks 1–21 days)
Begins without warning
Reaches crescendo within 5 minutes
Lasts for 45 minutes
Excoriating, deep, explosive pain but only rarely pulsatile
Awakens the patients from sleep
Homolateral lacrimation
Reddening of eye
Nasal stuffiness
Ptosis
Nausea
• Gastrointestinal lymphoma—modified Ann Arbor classification
IE Tumor confined to
small intestine
IIE Spread to regional lymph nodes
IIIE Spread to non-resectable nodes beyond regional nodes
IVE Spread to other organs
Mnemonic: SRNO
• Basal ganglia and lesions
Chorea—Caudate nucleus and putamen (striatum)
Mnemonic: C for C
Athetosis — Lantiform nucleus (globus pallidus)
Mnemonic: Lathi
Hemi ballismus — Subthalamic nucleus
Mnemonic: Hemi-Sub
Parkinsonism —substantia nigra
• All porphyrias except congenital erythropoietic porphyria
(which is autosomal recessive) are autosomal dominant.
Mnemonics142
• P24 antigen assay is the earliest marker for HIV infection. It is
most useful as a screening test for HIV infection in patient
presents prior to development of antibodies.
Antibodies to HIV (detected by ELISA or Western blot)
generally appear in circulation 4 to 8 weeks after circulation.
The MC screening test used for HIV—ELISA
The MC confirmatory test—Western blot
Screening test in window period of acute HIV infection is P24
antigen
The gold standard for diagnosis is PCR
(in a patient with positive or indeterminate ELISA test and an
indeterminate Western blot or in patients in whom serological
testing is unreliable (patients with hypogammaglobulinemia)
• Progression to chronicity in various types of hepatitis
Hepatitis A—none
Hepatitis B—occasional (1–10%), 90% in neonates
Hepatitis C—common, 50–70% chronic hepatitis; 80–90%
chronic infection.
Hepatitis D—relatively common: In coinfection with HBV, it
is same as that for HBV
In superinfection it is variable
Hepatitis E—none
Note:Hepatitis B, C, D Parenteral spread Hepatitis A, E Non-parenteral spread.
• Anti-HbSAg positive alone indicates
Immunization with HBsAg
Remote past infection
False positive
• Chronic arsenic exposure is associated with greatly elevated
risk of skin cancer (both basal cell and squamous cell
carcinoma)
Lung cancer
Ca liver (angiosarcoma)
Bladder Ca
Kidney Ca
Colon Ca
• P24 antigen assay is the earliest marker for HIV infection. It is
most useful as a screening test for HIV infection in patient
presents prior to development of antibodies.
Antibodies to HIV (detected by ELISA or Western blot)
generally appear in circulation 4 to 8 weeks after circulation.
The MC screening test used for HIV—ELISA
The MC confirmatory test—Western blot
Screening test in window period of acute HIV infection is P24
antigen
The gold standard for diagnosis is PCR
(in a patient with positive or indeterminate ELISA test and an
indeterminate Western blot or in patients in whom serological
testing is unreliable (patients with hypogammaglobulinemia)
• Progression to chronicity in various types of hepatitis
Hepatitis A—none
Hepatitis B—occasional (1–10%), 90% in neonates
Hepatitis C—common, 50–70% chronic hepatitis; 80–90%
chronic infection.
Hepatitis D—relatively common: In coinfection with HBV, it
is same as that for HBV
In superinfection it is variable
Hepatitis E—none
Note:Hepatitis B, C, D Parenteral spread Hepatitis A, E Non-parenteral spread.
• Anti-HbSAg positive alone indicates
Immunization with HBsAg
Remote past infection
False positive
• Chronic arsenic exposure is associated with greatly elevated
risk of skin cancer (both basal cell and squamous cell
carcinoma)
Lung cancer
Ca liver (angiosarcoma)
Bladder Ca
Kidney Ca
Colon Ca
Medicine 143
• Portal HTN in absence of cirrhosis may result from alteration
in hepatic architecture produced by
Vitamin A
Exposure to vinyl chloride
Arsenic intoxication
Administration of thorium dioxide
Mnemonic: VAVA-thorium
• Descending motor paralysis
3 important causes
Diphtheria
Botulinum
Polio
Mnemonic: Descending Bottle Paralysis
• Subdural empyema: The major pathogen
Aerobic and anaerobic streptococci (about 50%)
Staph (about 12–16%)
Aerobic gram-negative bacilli (3–10%)
Other anaerobes (5%)
Note:H. influenzae is the most common causative
organism in children only.
• Order of involvement of adrenals from various primaries in
decreasing order: Melanoma > lung and bladder > breast,
cervix and colorectal Ca > ovary and kidney > prostate.
• Particle size and respiratory tract
Particle with size 10–15 mm in diameter—do not penetrate
beyond the upper airways.
Particle of size 2.5–10 mm—deposit relatively high in
tracheobronchial tree
Particle of size <2.5 mm can be carried to lower airways.
• Low serum iron with increased TIBC—iron deficiency
anaemia
Low serum iron with decreased TIBC—anaemia of chronic
disease
• Condition giving false positive reaction with the modern RPR
and VDRL tests include:
• Portal HTN in absence of cirrhosis may result from alteration
in hepatic architecture produced by
Vitamin A
Exposure to vinyl chloride
Arsenic intoxication
Administration of thorium dioxide
Mnemonic: VAVA-thorium
• Descending motor paralysis
3 important causes
Diphtheria
Botulinum
Polio
Mnemonic: Descending Bottle Paralysis
• Subdural empyema: The major pathogen
Aerobic and anaerobic streptococci (about 50%)
Staph (about 12–16%)
Aerobic gram-negative bacilli (3–10%)
Other anaerobes (5%)
Note:H. influenzae is the most common causative
organism in children only.
• Order of involvement of adrenals from various primaries in
decreasing order: Melanoma > lung and bladder > breast,
cervix and colorectal Ca > ovary and kidney > prostate.
• Particle size and respiratory tract
Particle with size 10–15 mm in diameter—do not penetrate
beyond the upper airways.
Particle of size 2.5–10 mm—deposit relatively high in
tracheobronchial tree
Particle of size <2.5 mm can be carried to lower airways.
• Low serum iron with increased TIBC—iron deficiency
anaemia
Low serum iron with decreased TIBC—anaemia of chronic
disease
• Condition giving false positive reaction with the modern RPR
and VDRL tests include:
Mnemonics144
Acute false positive reactions (<6 months)
Recent viral illness or immunization Genital Herpes
HIV
Mycoplasma pneumonia
Malaria
Parenteral drug use
Chronic false positive reactions (> 6 months)
Aging
Autoimmune disorders (SLE, RA)
Parenteral drug use
Mnemonic: AAP
• Non-specific tests for syphilis which use cardiolipin antigen
(Reagin antibody)
Wassermann
Kahn’s flocculation test
VDRL
RPR (rapid plasma reagin)
Advantage:Become negative after effective treatment of
syphilis and hence can be used in
Detecting
reinfection
Indicating stage of disease
Monitoring treatment response
Mnemonic: RST
Disadvantage
Lack of specificity
False positive cases
• Low pitched sound—S3, S4 and tumor plop. (heard by bell)
• Mitral valve prolapsed—most common cause is Myxomatous
degeneration—mid-systolic click on examination.
• Orthopnea:
Acute CHF
Bilateral diaphragmatic palsy
(GB syndrome/myesthenic crisis/transverse myelitis)
Platypnea:
ARDS
Hepatopulmonary syndrome
Atrial myxoma
Mnemonic: AHA
Acute false positive reactions (<6 months)
Recent viral illness or immunization Genital Herpes
HIV
Mycoplasma pneumonia
Malaria
Parenteral drug use
Chronic false positive reactions (> 6 months)
Aging
Autoimmune disorders (SLE, RA)
Parenteral drug use
Mnemonic: AAP
• Non-specific tests for syphilis which use cardiolipin antigen
(Reagin antibody)
Wassermann
Kahn’s flocculation test
VDRL
RPR (rapid plasma reagin)
Advantage:Become negative after effective treatment of
syphilis and hence can be used in
Detecting
reinfection
Indicating stage of disease
Monitoring treatment response
Mnemonic: RST
Disadvantage
Lack of specificity
False positive cases
• Low pitched sound—S3, S4 and tumor plop. (heard by bell)
• Mitral valve prolapsed—most common cause is Myxomatous
degeneration—mid-systolic click on examination.
• Orthopnea:
Acute CHF
Bilateral diaphragmatic palsy
(GB syndrome/myesthenic crisis/transverse myelitis)
Platypnea:
ARDS
Hepatopulmonary syndrome
Atrial myxoma
Mnemonic: AHA
Medicine 145
• RCM—most common cause—amyloidosis
DCM—most common cause—alcohol
Mnemonic: DCM-Daru
•S
3—Ventricle gallop
S
4—Atrial gallop
Mnemonic: V3S
• Atrial fibrillation—treatment:
R—Rate control (Esmolol)
A—Anticoagulation (Warfarin, debigatran, rivoraxaban)
C—Chemical cardioversion/rhythm control (IV ibutilide/
amiodarone)
E—Electrical-DC shock.
• Stroke identification:
S—Smile—asymmetry
T—Talk—aphasia
R—Raise arm—inability to raise arm
• Most common blood vessels involved in atherosclerosis—
Abdominal aorta > Coronary artery > Carotid artery >
Popliteal artery.
Mnemonic: AA CoCa Pi
• Infective endocarditis
ABE (< 2 weeks)—Staph. aureus.
IV drug abuse—Right-sided endocarditis—Staph. aureus
Mnemonic: acute, abuse-aureus
SABE (> 2 weeks): Streptococcus viridens > Enterococcus
Prosthetic valve endocarditis: CONS (Coagulase negative
Staphylococcus)
Mnemonic: Pros and cons
Streptococcus viridian: SABE (> 2 weeks)
Prosthetic valve endocarditis (> 12
months)
Mnemonic: viridians for more
Left-sided endocarditis (R to L shunt)—Patent fossa ovalis—
Enterococcus.
• RCM—most common cause—amyloidosis
DCM—most common cause—alcohol
Mnemonic: DCM-Daru
•S
3—Ventricle gallop
S
4—Atrial gallop
Mnemonic: V3S
• Atrial fibrillation—treatment:
R—Rate control (Esmolol)
A—Anticoagulation (Warfarin, debigatran, rivoraxaban)
C—Chemical cardioversion/rhythm control (IV ibutilide/
amiodarone)
E—Electrical-DC shock.
• Stroke identification:
S—Smile—asymmetry
T—Talk—aphasia
R—Raise arm—inability to raise arm
• Most common blood vessels involved in atherosclerosis—
Abdominal aorta > Coronary artery > Carotid artery >
Popliteal artery.
Mnemonic: AA CoCa Pi
• Infective endocarditis
ABE (< 2 weeks)—Staph. aureus.
IV drug abuse—Right-sided endocarditis—Staph. aureus
Mnemonic: acute, abuse-aureus
SABE (> 2 weeks): Streptococcus viridens > Enterococcus
Prosthetic valve endocarditis: CONS (Coagulase negative
Staphylococcus)
Mnemonic: Pros and cons
Streptococcus viridian: SABE (> 2 weeks)
Prosthetic valve endocarditis (> 12
months)
Mnemonic: viridians for more
Left-sided endocarditis (R to L shunt)—Patent fossa ovalis—
Enterococcus.
Mnemonics146
• Modified Duke’s criteria for infective endocarditis
Major:
1. Echocardiography—Vegetations on the heart valves
Oscilating mass in the atria
Valve ring abscess
2. Blood culture positive
3. New onset murmur due to valve perforation
Minor:
1. Predisposition to IV drug abuse
2. Fever > 101°F
3. Immunological manifestations:
R—Roth spot
O—Osler’s node
G—Glomerulonephritis (post-infectious)
4. Vascular phenomenon—Janeway lesion, mycotic aneurysm
5. Echocardiography—small vegetations (0.5 mm)
Mnemonic:
P-FIVE
Diagnosis—2 major or 1 major + 3 minor or 5 minor
•Carey Coombs murmur: Delayed diastolic murmur—Charac-
teristic murmur of rheumatic myocarditis
Mnemonic: cc is dd
• Early diastolic murmur
G—Graham Steell’s murmur
A—AR (mild)
P—PR (mild)
Mnemonic: GAP is ED
• Mid-diastolic murmur
Austin Flint murmur (severe AR)
MS (with secondary spike)
Flow murmur of ASD
Mnemonic: MDM is Flea flow MS
• Framingham heart risk score
Age
Total cholesterol
• Modified Duke’s criteria for infective endocarditis
Major:
1. Echocardiography—Vegetations on the heart valves
Oscilating mass in the atria
Valve ring abscess
2. Blood culture positive
3. New onset murmur due to valve perforation
Minor:
1. Predisposition to IV drug abuse
2. Fever > 101°F
3. Immunological manifestations:
R—Roth spot
O—Osler’s node
G—Glomerulonephritis (post-infectious)
4. Vascular phenomenon—Janeway lesion, mycotic aneurysm
5. Echocardiography—small vegetations (0.5 mm)
Mnemonic:
P-FIVE
Diagnosis—2 major or 1 major + 3 minor or 5 minor
•Carey Coombs murmur: Delayed diastolic murmur—Charac-
teristic murmur of rheumatic myocarditis
Mnemonic: cc is dd
• Early diastolic murmur
G—Graham Steell’s murmur
A—AR (mild)
P—PR (mild)
Mnemonic: GAP is ED
• Mid-diastolic murmur
Austin Flint murmur (severe AR)
MS (with secondary spike)
Flow murmur of ASD
Mnemonic: MDM is Flea flow MS
• Framingham heart risk score
Age
Total cholesterol
Medicine 147
Gender
Cigarette smoking
SBP
Mnemonic: AT GCS
• Sheehan’s syndrome—order of loss of hormone—
G—GH
F—FSH
L—LH
T—TSH
A—ACTH
Mnemonic: GFLTA
• Migraine
Pulsating headache
One day illness
Unilateral headache
Nausea
Disabling.
Mnemonic: POUND
• Sturge-Weber syndrome
S—Seizure
T—Trigeminal nerve distribution—Hemangioma/Portwine stain
U—unilateral weakness
R—mental Retardation
G—Glaucoma
E—Eye problems—Buphthalmos.
• Anencephaly—
Polyhydramnios
Post-dated delivery
Pituitary hypoplasia
Mnemonic: 3P
• Diagnostic criteria of SLE
M—Malar rash
D—Discoid rash
S—Serositis
Gender
Cigarette smoking
SBP
Mnemonic: AT GCS
• Sheehan’s syndrome—order of loss of hormone—
G—GH
F—FSH
L—LH
T—TSH
A—ACTH
Mnemonic: GFLTA
• Migraine
Pulsating headache
One day illness
Unilateral headache
Nausea
Disabling.
Mnemonic: POUND
• Sturge-Weber syndrome
S—Seizure
T—Trigeminal nerve distribution—Hemangioma/Portwine stain
U—unilateral weakness
R—mental Retardation
G—Glaucoma
E—Eye problems—Buphthalmos.
• Anencephaly—
Polyhydramnios
Post-dated delivery
Pituitary hypoplasia
Mnemonic: 3P
• Diagnostic criteria of SLE
M—Malar rash
D—Discoid rash
S—Serositis
Mnemonics148
O—Oral ulcer
A—Antinuclear antibody (ANA)
P—Photosensitivity
B—Brain (lupus cerebritis)
R—Renal (lupus nephritis)
A—AIHA (Auto-immune hemolytic anemia)
I—Immunological criteria (dsDNA/anti-cardiolipin antibody/
anti-β
2 glycoprotein)
N—Non-erosive arthritis
Diagnosis—4 out of 11 (immunological criteria is must)
•
PAN—Poly arteritis nodosa
It is necrotizing vasculitis of small to medium vessels.
Mnemonic: PAN: Pulmonary Artery Never involved
Note:PAN can never lead to renal artery stenosis.
• Wegener’s granulomatosis is now known as granulomatosis
with angitis. It is a granulomatous vasculitis.
Blood vessels of upper respiratory tract—Epistaxis
Lower respiratory tract—Hemoptysis
Kidney—Hematuria
CT scan chest—multiple Cavities in lung
IOC-C-ANCA
Treatment—cyclophosphamide.
Mnemonic:
3C
• Atypical pneumonia is caused by:
Mycoplasma
Coxiella burnetti
Viral
Legionella
Chlamydia
Mnemonic: My cox vi leg se chalte hain
• Child Pugh criteria of cirrhosis of liver:
Bilirubin ↑
Albumin ↓
O—Oral ulcer
A—Antinuclear antibody (ANA)
P—Photosensitivity
B—Brain (lupus cerebritis)
R—Renal (lupus nephritis)
A—AIHA (Auto-immune hemolytic anemia)
I—Immunological criteria (dsDNA/anti-cardiolipin antibody/
anti-β
2 glycoprotein)
N—Non-erosive arthritis
Diagnosis—4 out of 11 (immunological criteria is must)
•
PAN—Poly arteritis nodosa
It is necrotizing vasculitis of small to medium vessels.
Mnemonic: PAN: Pulmonary Artery Never involved
Note:PAN can never lead to renal artery stenosis.
• Wegener’s granulomatosis is now known as granulomatosis
with angitis. It is a granulomatous vasculitis.
Blood vessels of upper respiratory tract—Epistaxis
Lower respiratory tract—Hemoptysis
Kidney—Hematuria
CT scan chest—multiple Cavities in lung
IOC-C-ANCA
Treatment—cyclophosphamide.
Mnemonic:
3C
• Atypical pneumonia is caused by:
Mycoplasma
Coxiella burnetti
Viral
Legionella
Chlamydia
Mnemonic: My cox vi leg se chalte hain
• Child Pugh criteria of cirrhosis of liver:
Bilirubin ↑
Albumin ↓
Medicine 149
Ascites +/↑
Asterixis +/↑
PT with INR ↑
Note:BAAAP
• Pautrier’s microabscess—Mycosis fungoides
Munro microabscess—Psoriasis
Mnemonic: P for M and M for P
• Psoriasis
Auspitz sign
Bulkely membrane
Candle grease sign
DIP joint in psoriatic arthropathy
Extensor surface of knee, elbow and scalp
Face uncommon
Grattage sign
Guttate psoriasis (Eruptive psoriasis)
Histopathology—parakeratosis
Inverse psoriasis (flexor surface involved)
Itching uncommon
Koebner phenomenon (isomorphic phenomenon)
Never involved—Mucosa, CNS, alopecia
Onycholysis, thimble pitting of nail plate
Papules and plaques
Rupoid psoriasis
Silvery mica scales
T cell mediated chronic inflammatory disease
von Zombusch disease (generalized pustular psoriasis)
Wornoff ring (white halo around lesion).
• Hand-Schüller-Christian disease triad:
Calvarial defect in scalp
Diabetes insipidus
Exophthalmos
Mnemonic: CDE
Ascites +/↑
Asterixis +/↑
PT with INR ↑
Note:BAAAP
• Pautrier’s microabscess—Mycosis fungoides
Munro microabscess—Psoriasis
Mnemonic: P for M and M for P
• Psoriasis
Auspitz sign
Bulkely membrane
Candle grease sign
DIP joint in psoriatic arthropathy
Extensor surface of knee, elbow and scalp
Face uncommon
Grattage sign
Guttate psoriasis (Eruptive psoriasis)
Histopathology—parakeratosis
Inverse psoriasis (flexor surface involved)
Itching uncommon
Koebner phenomenon (isomorphic phenomenon)
Never involved—Mucosa, CNS, alopecia
Onycholysis, thimble pitting of nail plate
Papules and plaques
Rupoid psoriasis
Silvery mica scales
T cell mediated chronic inflammatory disease
von Zombusch disease (generalized pustular psoriasis)
Wornoff ring (white halo around lesion).
• Hand-Schüller-Christian disease triad:
Calvarial defect in scalp
Diabetes insipidus
Exophthalmos
Mnemonic: CDE
Mnemonics150
• Congenital syphilis: Hutchinson’s triad:
Hutchinson’s teeth
Interstitial keratitis
8th nerve deafness.
Mnemonic: HI8
• Solid raised area
Papule < 1 cm
Nodule 1–5 cm
Tumor > 5 cm.
Mnemonic: PNT
• Pemphigus vulgaris:
Nikolosky sign
Intraepidermal bullae
Mucosal involvement
Acantholysis
Poor prognosis
Upper part of body (Trunk > limbs)
Row of tombstone
40–60 years age group
Mnemonic: NIMAPUR
• Pemphigoid:
Subepidermal and tense bulla
Lower part of body (limbs > trunk)
Good prognosis
60–80 years old
• Inclusion body myositis
Familial
Fine motor involvement—early
Facial muscle involvement
Falling
Chronic course (years)
Mnemonic: 4F
• Congenital syphilis: Hutchinson’s triad:
Hutchinson’s teeth
Interstitial keratitis
8th nerve deafness.
Mnemonic: HI8
• Solid raised area
Papule < 1 cm
Nodule 1–5 cm
Tumor > 5 cm.
Mnemonic: PNT
• Pemphigus vulgaris:
Nikolosky sign
Intraepidermal bullae
Mucosal involvement
Acantholysis
Poor prognosis
Upper part of body (Trunk > limbs)
Row of tombstone
40–60 years age group
Mnemonic: NIMAPUR
• Pemphigoid:
Subepidermal and tense bulla
Lower part of body (limbs > trunk)
Good prognosis
60–80 years old
• Inclusion body myositis
Familial
Fine motor involvement—early
Facial muscle involvement
Falling
Chronic course (years)
Mnemonic: 4F
Medicine 151
• Microsporum does not infect nails.
Mnemonic: MN
Epidermophyton does not infect hair.
Mnemonic: EH
• Gonococcus involves epididymis, infection spreading
through urethrae
Syphilis involves testis, infection spreading blood.
Mnemonic: ST
• Kawasaki disease—presents with
NC—Non-purulent conjunctivitis
C—Children
S—Strawberry tongue
U—Unilateral cervical lymphadenopathy
R—Rash (polymorphic)
E—Edema in hands and feet
• Microsporum does not infect nails.
Mnemonic: MN
Epidermophyton does not infect hair.
Mnemonic: EH
• Gonococcus involves epididymis, infection spreading
through urethrae
Syphilis involves testis, infection spreading blood.
Mnemonic: ST
• Kawasaki disease—presents with
NC—Non-purulent conjunctivitis
C—Children
S—Strawberry tongue
U—Unilateral cervical lymphadenopathy
R—Rash (polymorphic)
E—Edema in hands and feet
• Esophageal dysphagia
Solid and liquidProgressive systemic sclerosis—progressive
(motility) Achalasia—progressive
Diffuse esophageal spasm—non-progressive
Mnemonic: PaDi Motile
Solid onlyCancer—progressive
(mechanical)Stricture (peptic)—progressive
Ring (lower esophageal)—non-progressive
Mnemonic: CaSRi is Mechanical
• MBC fail ESWL test—stones that are not broken by ESWL are
Calcium oxalate monohydrate
Brushite
Cysteine
Mnemonic: MBC
• Whole liver orthotopic transplantation require five sequential
anastomoses.
Suprahepatic lVC
lnfrahepatic lVC
Portal vein
Hepatic artery
Bile ducts
Mnemonic: SIPoHe Bill
• Factors indicating possibility of malignancy in gallbladder
polyps
Single polyp
Size of polyp > 1.0 cm
152
Surgery
12
Solid and liquidProgressive systemic sclerosis—progressive
(motility) Achalasia—progressive
Diffuse esophageal spasm—non-progressive
Mnemonic: PaDi Motile
Solid onlyCancer—progressive
(mechanical)Stricture (peptic)—progressive
Ring (lower esophageal)—non-progressive
Mnemonic: CaSRi is Mechanical
• MBC fail ESWL test—stones that are not broken by ESWL are
Calcium oxalate monohydrate
Brushite
Cysteine
Mnemonic: MBC
• Whole liver orthotopic transplantation require five sequential
anastomoses.
Suprahepatic lVC
lnfrahepatic lVC
Portal vein
Hepatic artery
Bile ducts
Mnemonic: SIPoHe Bill
• Factors indicating possibility of malignancy in gallbladder
polyps
Single polyp
Size of polyp > 1.0 cm
152
Surgery
12
Surgery153
Size of polyp change rapidly
Sessile polyp
Stones (gall) associated
50 yrs or more age
Mnemonic: S/50
• Radiolucent ureteric stones are
Uric acid stones
Triamterene stone
Indinavir stone
Xanthine stones
Mnemonic: UTI-X
• Risk factors for cholangiocarcinoma
Primary sclerosing cholangitis
Choledochal cyst
Ulcerative colitis
Clonorchis sinensis
Chronic typhoid carriers
Mnemonic: 5c
•Revised trauma score
Respiratory rate
Glasgow Coma Scale
Systolic BP
Mnemonic: RTS-RGS
Trauma and injury severity score (TRlSS)
Mechanism of injury—blunt or penetrating
Injury severity score (ISS)
Revised trauma score (RTS)
Age
Mnemonic: MIRA
• The structures injured by the primary blast wave in order to
prevalence are the
Middle ear
Lungs
Bowel
Mnemonic: MLB
Size of polyp change rapidly
Sessile polyp
Stones (gall) associated
50 yrs or more age
Mnemonic: S/50
• Radiolucent ureteric stones are
Uric acid stones
Triamterene stone
Indinavir stone
Xanthine stones
Mnemonic: UTI-X
• Risk factors for cholangiocarcinoma
Primary sclerosing cholangitis
Choledochal cyst
Ulcerative colitis
Clonorchis sinensis
Chronic typhoid carriers
Mnemonic: 5c
•Revised trauma score
Respiratory rate
Glasgow Coma Scale
Systolic BP
Mnemonic: RTS-RGS
Trauma and injury severity score (TRlSS)
Mechanism of injury—blunt or penetrating
Injury severity score (ISS)
Revised trauma score (RTS)
Age
Mnemonic: MIRA
• The structures injured by the primary blast wave in order to
prevalence are the
Middle ear
Lungs
Bowel
Mnemonic: MLB
Mnemonics154
• Glasgow Coma Scale
E Eye opening 4
V Verbal response 5
M Motor response 6
Mnemonic: EVM (Electronic voting machine)
Eye opening Spontaneous
To voice
To pain
None
Mnemonic: SVP
Verbal responseOriented
Confused
Inappropriate words
In Comprehensible sound
None
Mnemonic: OrC InAC
Motor response Obeys commands
Localises pain
Withdraws
Flexion (abnormal)
Extension (abnormal)
None
Mnemonic: OLWFEN (Just remember)
• Psammoma bodies
Papillary Ca of thyroid
Papillary type of renal cell Ca
Prolactinoma (pituitary adenoma)
Serous cystadenoma of ovary
Meningioma
Appendical carcinoid (rarely)
Mnemonic: 3PSMA
• Sister Mary Joseph nodule
Most common tumours to present with this sign
Stomach (20%)
Colon (14%)
Ovary (14%)
• Glasgow Coma Scale
E Eye opening 4
V Verbal response 5
M Motor response 6
Mnemonic: EVM (Electronic voting machine)
Eye opening Spontaneous
To voice
To pain
None
Mnemonic: SVP
Verbal responseOriented
Confused
Inappropriate words
In Comprehensible sound
None
Mnemonic: OrC InAC
Motor response Obeys commands
Localises pain
Withdraws
Flexion (abnormal)
Extension (abnormal)
None
Mnemonic: OLWFEN (Just remember)
• Psammoma bodies
Papillary Ca of thyroid
Papillary type of renal cell Ca
Prolactinoma (pituitary adenoma)
Serous cystadenoma of ovary
Meningioma
Appendical carcinoid (rarely)
Mnemonic: 3PSMA
• Sister Mary Joseph nodule
Most common tumours to present with this sign
Stomach (20%)
Colon (14%)
Ovary (14%)
Surgery155
Pancreas (11%)
Mnemonic: SCOP
• Phosphate or struvite stones are infection stones associated
with urea splitting organisms
Proteus
Pseudomonas
Providencia
Klebsiella
Staphylococci
Mycoplasma
Mnemonic: P3KSM
• Syndrome associated with Wilms’ tumour
Denys-Drash syndrome
Male pseudohermaphrodite
Mesangial sclerosis
Missense mutation in WT1 gene
Mnemonic: Denys ki MaMMi
Beckwith-Wiedemann syndrome
Hemihypertrophy
Macroglossia
Visceromegaly
Omphalocele
Wilms’ tumour
Mnemonic: BHMV of Wilms’
•Papillary Ca thyroid
Calcification
Radiation induced
Orphan-Annie eye nuclei
Mnemonic: CROP
•Hashimoto’s thyroiditis
Hürthle cells are virtually pathognomonic
Mnemonic: H for H
•Posterior urethra (membranous urethra) is injured in pelvic
trauma and fracture
Mnemonic: P for P
Pancreas (11%)
Mnemonic: SCOP
• Phosphate or struvite stones are infection stones associated
with urea splitting organisms
Proteus
Pseudomonas
Providencia
Klebsiella
Staphylococci
Mycoplasma
Mnemonic: P3KSM
• Syndrome associated with Wilms’ tumour
Denys-Drash syndrome
Male pseudohermaphrodite
Mesangial sclerosis
Missense mutation in WT1 gene
Mnemonic: Denys ki MaMMi
Beckwith-Wiedemann syndrome
Hemihypertrophy
Macroglossia
Visceromegaly
Omphalocele
Wilms’ tumour
Mnemonic: BHMV of Wilms’
•Papillary Ca thyroid
Calcification
Radiation induced
Orphan-Annie eye nuclei
Mnemonic: CROP
•Hashimoto’s thyroiditis
Hürthle cells are virtually pathognomonic
Mnemonic: H for H
•Posterior urethra (membranous urethra) is injured in pelvic
trauma and fracture
Mnemonic: P for P
Mnemonics156
Anterior urethra (bulbar urethra is injured in fall astride injury)
Mnemonic: A for A
• Lynch syndrome
Colon Ca
Endometrial Ca
Ovarian Ca
Mnemonic: CEO
• Choledochal cyst—classification
Type 1 Fusiform dilatation of bile duct
Type 2 Diverticulum protruding from the wall of the
CBD
Type 3 Dilatation of the bile duct within the duodenum
(choledochocele)
Type 4A Multiple dilatations of intrahepatic and extra-
hepatic bile ducts (both)
Type 4B Multiple dilatations involving only the extra-
hepatic bile ducts
Type 5 Multiple dilatations of intrahepatic bile ducts
also called Caroli’s disease
Mnemonic: Fausi dives due 2 extra care
• MEN 1 syndrome
Parathyroid tumours > Pancreatic endocrine tumours >
Pituitary tumours.
Mnemonic: Para No.1, Pan-2nd, Pitu-3rd
Among pancreatic tumours: In order to decreasing frequency
in MEN 1:
Pancreatic polypeptide tumour
Zollinger-Ellison syndrome (gastrin)
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
Mnemonic: PZI GVS
• MEN I: Chromosome 11
MEN II: Chromosome 10
Anterior urethra (bulbar urethra is injured in fall astride injury)
Mnemonic: A for A
• Lynch syndrome
Colon Ca
Endometrial Ca
Ovarian Ca
Mnemonic: CEO
• Choledochal cyst—classification
Type 1 Fusiform dilatation of bile duct
Type 2 Diverticulum protruding from the wall of the
CBD
Type 3 Dilatation of the bile duct within the duodenum
(choledochocele)
Type 4A Multiple dilatations of intrahepatic and extra-
hepatic bile ducts (both)
Type 4B Multiple dilatations involving only the extra-
hepatic bile ducts
Type 5 Multiple dilatations of intrahepatic bile ducts
also called Caroli’s disease
Mnemonic: Fausi dives due 2 extra care
• MEN 1 syndrome
Parathyroid tumours > Pancreatic endocrine tumours >
Pituitary tumours.
Mnemonic: Para No.1, Pan-2nd, Pitu-3rd
Among pancreatic tumours: In order to decreasing frequency
in MEN 1:
Pancreatic polypeptide tumour
Zollinger-Ellison syndrome (gastrin)
Insulinoma
Glucagonoma
VIPoma
Somatostatinoma
Mnemonic: PZI GVS
• MEN I: Chromosome 11
MEN II: Chromosome 10
Surgery157
•Absorbable suture materials
Natural-Catgut-chromic/plain
Collagen
Synthetic—polydiaxonone
Polyglactin (Vicryl)
Polyglycaprone
Polyglyconate
Polyglycolic acid
Mnemonic: Cat Call Vicky DAGA
• Hereditary gastrointestinal polyposis syndromes
Gardner’s syndrome
Osteoma
Desmoid tumour
Lipomas
Epidermal cyst
Ampullary Ca
Fibroma
Mnemonic: GOD LEAF
Turcot’s syndrome—Brain tumors
Mnemonic: Rain Coat
• Nigro regimen for anal canal tumors
Chemotherapy—5-FU + Mitomycin
Or
Bleomycin, Cisplatin
• Types of hiatus hernia
Type 1Sliding hernia: 70–80% (i.e. hernia en glissade)
Type 2 Paraoesophageal rolling hernia: 8–10%
Type 3Mixed: 10%
Mnemonic: SRM
• Lateral swellings of the neck
Ranula
Bronchogenic cyst
Cystic hygroma
Mnemonic: RBC
•Absorbable suture materials
Natural-Catgut-chromic/plain
Collagen
Synthetic—polydiaxonone
Polyglactin (Vicryl)
Polyglycaprone
Polyglyconate
Polyglycolic acid
Mnemonic: Cat Call Vicky DAGA
• Hereditary gastrointestinal polyposis syndromes
Gardner’s syndrome
Osteoma
Desmoid tumour
Lipomas
Epidermal cyst
Ampullary Ca
Fibroma
Mnemonic: GOD LEAF
Turcot’s syndrome—Brain tumors
Mnemonic: Rain Coat
• Nigro regimen for anal canal tumors
Chemotherapy—5-FU + Mitomycin
Or
Bleomycin, Cisplatin
• Types of hiatus hernia
Type 1Sliding hernia: 70–80% (i.e. hernia en glissade)
Type 2 Paraoesophageal rolling hernia: 8–10%
Type 3Mixed: 10%
Mnemonic: SRM
• Lateral swellings of the neck
Ranula
Bronchogenic cyst
Cystic hygroma
Mnemonic: RBC
Mnemonics158
• Tumors of urothelium, i.e. pelvis, ureter and bladder are most
commonly transitional cell carcinoma. But tumours of urethra
are most commonly squamous cell carcinoma.
• Cardinal manifestations of bowel obstruction
– Pain is most pronounced in small bowel obstruction
– Vomiting is most pronounced in high small bowel
obstruction
– Distension is most pronounced in large bowel obstruction
• Pain of ureteric colic from different regions of ureter
Site Pain referred to
Upper ureter
Testis
Middle ureter McBurney’s point
Simulates appendicitis on right side
Simulates diverticulitis on left side
Lower ureter Inner side of
thigh
Labia majora in females.
Intramural part of ureterStranguary
Mnemonic: From above downwards Test McBurger with the
stranger
• Ligation in arterial aneurysm
Ligation applied just proximal to sacAnel’s method.
Ligature applied just proximal to Bractor’s method
branch of an artery
Double ligature applied just distal Anlylus method
to the branch
Ligature proximal to first collateral Hunter’s operation
of aneurysm
Mnemonic:Anal Sac
Proximal Brac
Double ‘L’
Collateral hunting
• Early gastric cancer—cancer limited to the mucosa,
submucosa with or without lymph node involvement
Late gastric cancer—it involves the muscularis
• Acute intussusception
Idiopathic (peak incidence 3–9 months)
• Tumors of urothelium, i.e. pelvis, ureter and bladder are most
commonly transitional cell carcinoma. But tumours of urethra
are most commonly squamous cell carcinoma.
• Cardinal manifestations of bowel obstruction
– Pain is most pronounced in small bowel obstruction
– Vomiting is most pronounced in high small bowel
obstruction
– Distension is most pronounced in large bowel obstruction
• Pain of ureteric colic from different regions of ureter
Site Pain referred to
Upper ureter
Testis
Middle ureter McBurney’s point
Simulates appendicitis on right side
Simulates diverticulitis on left side
Lower ureter Inner side of
thigh
Labia majora in females.
Intramural part of ureterStranguary
Mnemonic: From above downwards Test McBurger with the
stranger
• Ligation in arterial aneurysm
Ligation applied just proximal to sacAnel’s method.
Ligature applied just proximal to Bractor’s method
branch of an artery
Double ligature applied just distal Anlylus method
to the branch
Ligature proximal to first collateral Hunter’s operation
of aneurysm
Mnemonic:Anal Sac
Proximal Brac
Double ‘L’
Collateral hunting
• Early gastric cancer—cancer limited to the mucosa,
submucosa with or without lymph node involvement
Late gastric cancer—it involves the muscularis
• Acute intussusception
Idiopathic (peak incidence 3–9 months)
Surgery159
Hyperplasia of Peyer’s patches in the terminal ileum is usually
the initiating event.
Known cause/lead point (older children)
Duplication
Meckel’s diverticulum
Polyp
Mnemonic: DMP
• Cushing syndrome
– Petrous sinus sampling for ACTH is the best method of
differentiating a pituitary adenoma from an ectopic ACTH
producing tumor.
– Adrenal CT scan reliably differentiates cortical hyperplasia
from tumor.
–T
2-weighted MRI is more specific, reliably distinguishing
adrenal adenoma from carcinoma.
• Esophageal carcinoma
MC type in India Squamous cell carcinoma
MC type in west Adenocarcinoma
Mc site of squamous Middle 1/3rd
MC site of adenocarcinoma lower 1/3rd
MC type of upper 2/3rd Squamous
• Hyperplastic TB
Radiology/barium swallow shows
–Long narrow filling defect in terminal ileum
–Fleshner sign: Thickening of the ileocaecal valve, a wide
open valve accompanied by narrowing of
terminal ileum
–
Sterling sign:Fibrotic terminal ileum opening into a
contracted caecum.
Mnemonic: SFL (Safal in Hindi)
• Marjolin’s ulcer squamous cell carcinoma which arises in
amino acid
Chronic benign ulcer, e.g. a venous ulcer, or
A scar, e.g. scar of an old burn
Characteristics
– Grows slowly (relatively avascular)
– Painless (no nerves)
Hyperplasia of Peyer’s patches in the terminal ileum is usually
the initiating event.
Known cause/lead point (older children)
Duplication
Meckel’s diverticulum
Polyp
Mnemonic: DMP
• Cushing syndrome
– Petrous sinus sampling for ACTH is the best method of
differentiating a pituitary adenoma from an ectopic ACTH
producing tumor.
– Adrenal CT scan reliably differentiates cortical hyperplasia
from tumor.
–T
2-weighted MRI is more specific, reliably distinguishing
adrenal adenoma from carcinoma.
• Esophageal carcinoma
MC type in India Squamous cell carcinoma
MC type in west Adenocarcinoma
Mc site of squamous Middle 1/3rd
MC site of adenocarcinoma lower 1/3rd
MC type of upper 2/3rd Squamous
• Hyperplastic TB
Radiology/barium swallow shows
–Long narrow filling defect in terminal ileum
–Fleshner sign: Thickening of the ileocaecal valve, a wide
open valve accompanied by narrowing of
terminal ileum
–
Sterling sign:Fibrotic terminal ileum opening into a
contracted caecum.
Mnemonic: SFL (Safal in Hindi)
• Marjolin’s ulcer squamous cell carcinoma which arises in
amino acid
Chronic benign ulcer, e.g. a venous ulcer, or
A scar, e.g. scar of an old burn
Characteristics
– Grows slowly (relatively avascular)
– Painless (no nerves)
Mnemonics160
Does not spread to regional lymph nodes as lymphatic vessels
have been destroyed
• Triple assessment of breast lump suggestive of carcinoma:
Clinical assesment
Radiological imaging
Tissue sampling for either cytological or histological
examination
Mnemonic: CRT
• Radical neck dissection Structure preserved
Carotid arteries
Cranial nerve
Phrenic nerve
Radical neck dissection Structures removed
Omohyoid
Sternomastoid
Internal jugular vein
Submandibular gland
Accessory nerve
Mnemonic: O-SISA
Structures preserved in modified radical neck dissection
Internal jugular vein
Sternomastoid
Accessory nerve
Mnemonic: ISA
• Common causes of acute lower gastrtointestinal bleeding over
55 years of age (in decreasing order)
Anorectal disease (haemorrhoids and fissures)
Diverticulosis
Angiodysplasia
Polyps and cancer
Enterocolitis
Mnemonic: ADAPE
• MC site of colonic diverticulaSigmoid colon (left colon)
MC site of bleeding diverticulaAscending colon (right colon)
Mnemonic: CDS and AB
Does not spread to regional lymph nodes as lymphatic vessels
have been destroyed
• Triple assessment of breast lump suggestive of carcinoma:
Clinical assesment
Radiological imaging
Tissue sampling for either cytological or histological
examination
Mnemonic: CRT
• Radical neck dissection Structure preserved
Carotid arteries
Cranial nerve
Phrenic nerve
Radical neck dissection Structures removed
Omohyoid
Sternomastoid
Internal jugular vein
Submandibular gland
Accessory nerve
Mnemonic: O-SISA
Structures preserved in modified radical neck dissection
Internal jugular vein
Sternomastoid
Accessory nerve
Mnemonic: ISA
• Common causes of acute lower gastrtointestinal bleeding over
55 years of age (in decreasing order)
Anorectal disease (haemorrhoids and fissures)
Diverticulosis
Angiodysplasia
Polyps and cancer
Enterocolitis
Mnemonic: ADAPE
• MC site of colonic diverticulaSigmoid colon (left colon)
MC site of bleeding diverticulaAscending colon (right colon)
Mnemonic: CDS and AB
Surgery161
• Wilkie’s syndrome (superior mesenteric syndrome)
Compression of third part of duodenum, by mesenteric
artery.
• Hemobilia—classic triad
Obstructive jaundice
Abdominal pain (biliary colic)
Malena or occult blood in stool
Mnemonic: JAM
• MC benign tumor of spleen—hemangioma
MC cause of neoplastic enlargement of spleen—lymphoma
• Spleen phagocytose encapsulated bacteria. Splenectomized
patients are at increased risk of septicemia due to pneumococcus
(MC), meningococcus, H. influenzae, Babesia microti
Note:MC complication of splenectomy is pulmonary
complications (left basal atelectasis).
•Penetrating neck injury—breach of platysma
Mnemonic: P for P
• Wilkie’s syndrome (superior mesenteric syndrome)
Compression of third part of duodenum, by mesenteric
artery.
• Hemobilia—classic triad
Obstructive jaundice
Abdominal pain (biliary colic)
Malena or occult blood in stool
Mnemonic: JAM
• MC benign tumor of spleen—hemangioma
MC cause of neoplastic enlargement of spleen—lymphoma
• Spleen phagocytose encapsulated bacteria. Splenectomized
patients are at increased risk of septicemia due to pneumococcus
(MC), meningococcus, H. influenzae, Babesia microti
Note:MC complication of splenectomy is pulmonary
complications (left basal atelectasis).
•Penetrating neck injury—breach of platysma
Mnemonic: P for P
• Congenital rubella syndrome
Eye defectsCataract and congenital (CC) glaucoma
Heart defectPDA and Pulmonic (PP) stenosis
CNS—Microcephaly, milestone delay (developmental)
meningoencephalitis (MMM) pigmentary retinopathy,
purpura (PP)
Mnemonic:
CMP
• Pain pathways during labour
Prelabour pains are mediated through T11–T12
Mnemonic: Prelabour-Pre L1
It eventually involves T10– L1 dermatomes during labour.
• Genital Ridge—Ovary, testis
Mnemonic: ROT
Tubercle—clitoris, glans
Mnemonic: Clitoris and glans like tube
Swelling—Labia majora, scrotum
Fold—Labia minora, ventral part of penile urethra
Mnemonic: Major Scrotal swelling
Minor ventral fold
• Puberty sequential changes
Thelarche
Pubarche
Peak height velocity
Menarche
Mnemonic: The Pub Peaks for Men
162
Gynecology and Obstetrics
(G and O)
13
Eye defectsCataract and congenital (CC) glaucoma
Heart defectPDA and Pulmonic (PP) stenosis
CNS—Microcephaly, milestone delay (developmental)
meningoencephalitis (MMM) pigmentary retinopathy,
purpura (PP)
Mnemonic:
CMP
• Pain pathways during labour
Prelabour pains are mediated through T11–T12
Mnemonic: Prelabour-Pre L1
It eventually involves T10– L1 dermatomes during labour.
• Genital Ridge—Ovary, testis
Mnemonic: ROT
Tubercle—clitoris, glans
Mnemonic: Clitoris and glans like tube
Swelling—Labia majora, scrotum
Fold—Labia minora, ventral part of penile urethra
Mnemonic: Major Scrotal swelling
Minor ventral fold
• Puberty sequential changes
Thelarche
Pubarche
Peak height velocity
Menarche
Mnemonic: The Pub Peaks for Men
162
Gynecology and Obstetrics
(G and O)
13
Gynecology and Obstetrics (G and O) 163
• HPV 16 is the most prevalent HPV type in squamous cell
cancer cervix
HPV 18 is the most prevalent HPV type in adenocarcinorma
cervix
Mnemonic: Sweet 16
•Head compression—Early deceleration
Cord compression—Mid deceleration (Mn: CM)
Placental compression—Late deceleration (Mn: PL)
• The drug of choice for acute control of hypertension in severe
pre-eclampsia is Hydralazine > labetalol > nifedipine
Mnemonic: HelaN
• OCP is a risk factor for
Breast Ca
Cervical Ca
Hepatocellular Ca
Pituitary adenoma
Mnemonic: Bihar PHC
• Indication of antenatal steroids
To reduce incidence of respiratory distress syndrome—when
pregnancy is less than 34-betamethasone is preferred.
To prevent virilization of female fetus in case of previous baby
with
congenital adrenal hyperplasia—as soon as pregnancy
is confirmed
–
Dexamethasone is prefered.
Mnemonic: CD
• Bishop’s score
Cervix-Consistency (soft/medium)
Dilatation (1–2 cm/3–4 cm/5–6 cm)
Effacement (40–50%/60–70%/80%)
Position (middle/anterior)
+ Station of presenting part (–1, –2/0/+1, +2)
Mnemonic: Cx-CDEP + Station
• Fetal hydantoin syndrome
– Cardiac defects
• HPV 16 is the most prevalent HPV type in squamous cell
cancer cervix
HPV 18 is the most prevalent HPV type in adenocarcinorma
cervix
Mnemonic: Sweet 16
•Head compression—Early deceleration
Cord compression—Mid deceleration (Mn: CM)
Placental compression—Late deceleration (Mn: PL)
• The drug of choice for acute control of hypertension in severe
pre-eclampsia is Hydralazine > labetalol > nifedipine
Mnemonic: HelaN
• OCP is a risk factor for
Breast Ca
Cervical Ca
Hepatocellular Ca
Pituitary adenoma
Mnemonic: Bihar PHC
• Indication of antenatal steroids
To reduce incidence of respiratory distress syndrome—when
pregnancy is less than 34-betamethasone is preferred.
To prevent virilization of female fetus in case of previous baby
with
congenital adrenal hyperplasia—as soon as pregnancy
is confirmed
–
Dexamethasone is prefered.
Mnemonic: CD
• Bishop’s score
Cervix-Consistency (soft/medium)
Dilatation (1–2 cm/3–4 cm/5–6 cm)
Effacement (40–50%/60–70%/80%)
Position (middle/anterior)
+ Station of presenting part (–1, –2/0/+1, +2)
Mnemonic: Cx-CDEP + Station
• Fetal hydantoin syndrome
– Cardiac defects
Mnemonics164
– Hypoplastic phalanges
– Nail dysplasia
– Facial dysmorphism
– Cleft lip and palate
– Microcephaly
Mnemonic:
Heart, Hand, Head
• Neonatal complications of diabetic mothers
– Hypoglycemia
– Hypocalcemia
– Hypomagnesemia
– Hypothermia
– Hyperbilirubinemia
– Polycythemia
– RDS
– Cardiomyopathy.
Mnemonic: Only these two increases—bilirubin and blood
• MC ovarian neoplasm during pregnancy
Benign cystic teratoma (dermoid) (21%) > Serous cyst
adenoma (21%) > Cystic corpus luteum (18%)
Mnemonic: BSC
• Bacterial vaginosis
– Few leucocytes
– No/few lactobacilli
– Clue cells
– Gram variable micro-organism including
Gardnerella vaginalis (Gram-negative)
Haemophilus vaginalis (Gram-negative)
Moblincus (Gram-positive)
Mnemonic:
Lactobacilli and leukocytes are low in number
• Neural tube defect Ventral wall defect
↑ Acetylcholinesterase↓ Acetylcholinesterase
↓ Pseudocholinesterase↑ Pseudocholinesterase
Mnemonic: PV
– Hypoplastic phalanges
– Nail dysplasia
– Facial dysmorphism
– Cleft lip and palate
– Microcephaly
Mnemonic:
Heart, Hand, Head
• Neonatal complications of diabetic mothers
– Hypoglycemia
– Hypocalcemia
– Hypomagnesemia
– Hypothermia
– Hyperbilirubinemia
– Polycythemia
– RDS
– Cardiomyopathy.
Mnemonic: Only these two increases—bilirubin and blood
• MC ovarian neoplasm during pregnancy
Benign cystic teratoma (dermoid) (21%) > Serous cyst
adenoma (21%) > Cystic corpus luteum (18%)
Mnemonic: BSC
• Bacterial vaginosis
– Few leucocytes
– No/few lactobacilli
– Clue cells
– Gram variable micro-organism including
Gardnerella vaginalis (Gram-negative)
Haemophilus vaginalis (Gram-negative)
Moblincus (Gram-positive)
Mnemonic:
Lactobacilli and leukocytes are low in number
• Neural tube defect Ventral wall defect
↑ Acetylcholinesterase↓ Acetylcholinesterase
↓ Pseudocholinesterase↑ Pseudocholinesterase
Mnemonic: PV
Gynecology and Obstetrics (G and O) 165
Note:AFP is raised in both.
• Conjugate diameters of pelvic inlet
Diagonal conjugate can be measured directly
Mnemonic: D for D
True conjugate diameter Midpoint of sacral promontory
to inner margin of upper bor-
der of symphysis pubis (11cm)
Obstetric conjugate diameter Midpoint of sacral promontory
to prominent bony projection
on inner surface of pubic sym-
physis
Diagonal conjugate diameter Midpoint of sacral promontory
to inner margin of lower
border of symphysis pubis
(12 cm)
Mnemonic:
On inner margin of symphysis pubis, from above
downward order is TOD
• Gestational trophoblastic neoplasia is classified as a high risk
tumour if it has any of the following factors:
Antecedent term pregnancy
Brain or liver metastasis
Prior chemotherapy failure
Duration > 4 months
Pretherapy HCG level > 40,000 mIU/ml
Mnemonic: ABCD and H
• Criteria for medical management of ectopic pregnancy:
– Hemodynamically stable patient
– Size of ectopic mass < 4 cm
– Gestation preferably < 6 weeks
– Fetus preferably dead (no fetal cardiac activity on USG)
– Serum beta-hCG levels preferably < 1500 mIU
Note:Active intra-abdominal hemorrhage is a contraindi-
cation to chemotherapy.
• Pure gonadal dysgenesis: It is a disorder in which phenotypic
females have
Note:AFP is raised in both.
• Conjugate diameters of pelvic inlet
Diagonal conjugate can be measured directly
Mnemonic: D for D
True conjugate diameter Midpoint of sacral promontory
to inner margin of upper bor-
der of symphysis pubis (11cm)
Obstetric conjugate diameter Midpoint of sacral promontory
to prominent bony projection
on inner surface of pubic sym-
physis
Diagonal conjugate diameter Midpoint of sacral promontory
to inner margin of lower
border of symphysis pubis
(12 cm)
Mnemonic:
On inner margin of symphysis pubis, from above
downward order is TOD
• Gestational trophoblastic neoplasia is classified as a high risk
tumour if it has any of the following factors:
Antecedent term pregnancy
Brain or liver metastasis
Prior chemotherapy failure
Duration > 4 months
Pretherapy HCG level > 40,000 mIU/ml
Mnemonic: ABCD and H
• Criteria for medical management of ectopic pregnancy:
– Hemodynamically stable patient
– Size of ectopic mass < 4 cm
– Gestation preferably < 6 weeks
– Fetus preferably dead (no fetal cardiac activity on USG)
– Serum beta-hCG levels preferably < 1500 mIU
Note:Active intra-abdominal hemorrhage is a contraindi-
cation to chemotherapy.
• Pure gonadal dysgenesis: It is a disorder in which phenotypic
females have
Mnemonics166
– Gonads and genitalia characteristic of gonadal dysgenesis
– Bilateral streak gonads
– Infentile uterus and fallopian tubes
– Sexual infantilism
– Normal height
– Normal somatic development
– Normal 46, XX or a 46, XY karyotype
Note:Swyer syndrome is pure gonadal dysgenesis 46, XY.
• All the elements of Virchow’s triad is circulatory stasis,
vascular damage and hypercoagulability of the blood are
present during pregnancy. Vascular stasis is due to increase
in the calibre of capacitance vessels and blood. Hyper-
coagulability is due to increased amounts of factors VII, VIII
and X.
• Cephalhematoma Caput succedaneum
– Collection of blood between Swelling due to stagnation
the pericranium and flat of fluid in between layers of
bone of skull scalp beneath the girdle of
contact
– Usually unilateral May be bilateral
– Limited by suture line Not limited by suture line
– Develops after 12–24 hrs Present at birth
(never present at birth)
– Swelling disappears in Swelling disappears in
6–8 wks 24 hrs
– Good prognosis Good prognosis
– No impulse on crying No impulse on crying
Note:Meningocele always lies over a suture line or
fontanelle and variation in tension of swelling with crying (cry
impulse) is suggestive of a meningocele.
• Contraindication of ergometrine
– Suspected multiple pregnancies
– Gonads and genitalia characteristic of gonadal dysgenesis
– Bilateral streak gonads
– Infentile uterus and fallopian tubes
– Sexual infantilism
– Normal height
– Normal somatic development
– Normal 46, XX or a 46, XY karyotype
Note:Swyer syndrome is pure gonadal dysgenesis 46, XY.
• All the elements of Virchow’s triad is circulatory stasis,
vascular damage and hypercoagulability of the blood are
present during pregnancy. Vascular stasis is due to increase
in the calibre of capacitance vessels and blood. Hyper-
coagulability is due to increased amounts of factors VII, VIII
and X.
• Cephalhematoma Caput succedaneum
– Collection of blood between Swelling due to stagnation
the pericranium and flat of fluid in between layers of
bone of skull scalp beneath the girdle of
contact
– Usually unilateral May be bilateral
– Limited by suture line Not limited by suture line
– Develops after 12–24 hrs Present at birth
(never present at birth)
– Swelling disappears in Swelling disappears in
6–8 wks 24 hrs
– Good prognosis Good prognosis
– No impulse on crying No impulse on crying
Note:Meningocele always lies over a suture line or
fontanelle and variation in tension of swelling with crying (cry
impulse) is suggestive of a meningocele.
• Contraindication of ergometrine
– Suspected multiple pregnancies
Gynecology and Obstetrics (G and O) 167
– Organic cardiac diseases
– Severe pre-eclampsia and eclampsia (there may be sudden
rise in BP)
– Rh negative mothers –More chances of fetomater-
nal microtransfusion
• Risk of abnormal off-spring for carriers of a balanced trans-
location: Risk percentage
Translocation Carrier father Carrier mother
Centric fusion 13 : 14 1 1
Centric fusion 14 : 21 1 15
Centrtic fusion 21 : 22 5 10
Centric fusion 21 : 21 100 100
Reciprocal (Any) 10 10
• Oligospermia: Mild—when the count is 10–20 million/ml
Moderate—when the count is 5–10 million/ml
Severe—when the count is <5 million/ml
• WHO criteria
Volume > 2 ml
Sperm count > 20 million/ml
Total sperm count > 40 million/ejaculate
Percent mobility
> 50% with forward progression
> 25% with rapid linear progression
Forward progression > 2 (Scale 0–4)
Normal morphology > 50% normal
Round cells < 5 million/ml
Sperm agglutination < 2 (Scale 0–3)
WBC fewer than 1 million.
• Mother with glycosylated HbA1c before 14 weeks of
gestational values less than or equal to 8.5% have got least
chance of severe malformation of the fetus.
9.5% or more have greater chance of major congenital
malformation.
– Organic cardiac diseases
– Severe pre-eclampsia and eclampsia (there may be sudden
rise in BP)
– Rh negative mothers –More chances of fetomater-
nal microtransfusion
• Risk of abnormal off-spring for carriers of a balanced trans-
location: Risk percentage
Translocation Carrier father Carrier mother
Centric fusion 13 : 14 1 1
Centric fusion 14 : 21 1 15
Centrtic fusion 21 : 22 5 10
Centric fusion 21 : 21 100 100
Reciprocal (Any) 10 10
• Oligospermia: Mild—when the count is 10–20 million/ml
Moderate—when the count is 5–10 million/ml
Severe—when the count is <5 million/ml
• WHO criteria
Volume > 2 ml
Sperm count > 20 million/ml
Total sperm count > 40 million/ejaculate
Percent mobility
> 50% with forward progression
> 25% with rapid linear progression
Forward progression > 2 (Scale 0–4)
Normal morphology > 50% normal
Round cells < 5 million/ml
Sperm agglutination < 2 (Scale 0–3)
WBC fewer than 1 million.
• Mother with glycosylated HbA1c before 14 weeks of
gestational values less than or equal to 8.5% have got least
chance of severe malformation of the fetus.
9.5% or more have greater chance of major congenital
malformation.
Mnemonics168
• Types of pelvis
Naegele’s pelvis Ala on one side is absent
Mnemonic: N for N
Robert’s pelvis Ala on both sides is absent
Mnemonic: B for B
Rachitic pelvis
Increased interspinous diameter of the false pelvis
Reniform shape of inlet with shortened AP diameter
Widened transverse diameter of the outlet and pubic arch
inlet is typically triradiate
Osteomalacic pelvis
• Side effects of OCP—
Mild—continue the OCP
N—Nausea
O—Oedema
R—Recurrent headache
M—Mastalgia
A—Abnormal bleeding (breakthrough bleeding)
L—Loss of bleeding (withdrawal bleeding)
Moderate—Acne
Weight gain
Chloasma
If patient is worried, stop the OCP.
Severe—stop the OCP.
Cholestasis
Cardiovascular—thromboembolism
CNS—depression
Cancer—increased risk of breast carcinoma and cervical
carcinoma
• Non-contraceptive benefits of OCP—Decreases risk of
Other—Ovarian cyst and carcinoma
B—Benign breast disease (like fibroadenoma)
E—Endometriosis
N—Neoplasia like ovarian and endometrial carcinoma
• Types of pelvis
Naegele’s pelvis Ala on one side is absent
Mnemonic: N for N
Robert’s pelvis Ala on both sides is absent
Mnemonic: B for B
Rachitic pelvis
Increased interspinous diameter of the false pelvis
Reniform shape of inlet with shortened AP diameter
Widened transverse diameter of the outlet and pubic arch
inlet is typically triradiate
Osteomalacic pelvis
• Side effects of OCP—
Mild—continue the OCP
N—Nausea
O—Oedema
R—Recurrent headache
M—Mastalgia
A—Abnormal bleeding (breakthrough bleeding)
L—Loss of bleeding (withdrawal bleeding)
Moderate—Acne
Weight gain
Chloasma
If patient is worried, stop the OCP.
Severe—stop the OCP.
Cholestasis
Cardiovascular—thromboembolism
CNS—depression
Cancer—increased risk of breast carcinoma and cervical
carcinoma
• Non-contraceptive benefits of OCP—Decreases risk of
Other—Ovarian cyst and carcinoma
B—Benign breast disease (like fibroadenoma)
E—Endometriosis
N—Neoplasia like ovarian and endometrial carcinoma
Gynecology and Obstetrics (G and O) 169
E—Ectopic pregnancy
F—Fibroid
I—Iron deficiency anemia
T—Tension—pre-menstrual tension
S—Skeletal—osteoporosis and rheumatoid arthritis.
E—Ectopic pregnancy
F—Fibroid
I—Iron deficiency anemia
T—Tension—pre-menstrual tension
S—Skeletal—osteoporosis and rheumatoid arthritis.
• Hereditary hyperbilirubinemias
UGC—Unconjugated
Gilbert’s syndrome
Crigler-Najjar syndrome I and II
• Downe’s score
–Cyanosis
–Air entry
–Respiratory rate
–Grunting
–Retraction
Mnemonic: CARGR
• Silverman-Anderson index
–Grunting
– Nasal flaring
–Retraction—Upper chest
–Retraction—Lower chest
–Retraction—Xiphoid
Mnemonic: GFR 3–LUX–Silver
• Fallot’s triadRVH
ASD
Pulmonic stenosis
Mnemonic: RAP
Fallot’s tetralogyPulmonic stenosis
RVH
Overriding of aorta
Ventricular septal defect
Mnemonic: PROVe
170
Pediatrics
14
UGC—Unconjugated
Gilbert’s syndrome
Crigler-Najjar syndrome I and II
• Downe’s score
–Cyanosis
–Air entry
–Respiratory rate
–Grunting
–Retraction
Mnemonic: CARGR
• Silverman-Anderson index
–Grunting
– Nasal flaring
–Retraction—Upper chest
–Retraction—Lower chest
–Retraction—Xiphoid
Mnemonic: GFR 3–LUX–Silver
• Fallot’s triadRVH
ASD
Pulmonic stenosis
Mnemonic: RAP
Fallot’s tetralogyPulmonic stenosis
RVH
Overriding of aorta
Ventricular septal defect
Mnemonic: PROVe
170
Pediatrics
14
Pediatrics171
• A newborn is classified as vigorous if he has all the following:
Heart rate > 100 / min
Respiratory effort (strong)
Tone of muscles (good)
Mnemonic: HRT
• Classification systems for PEM based on weight-for-age
Gomez classification
Indian academy of pediatrics (IAP) classification
Wellcome trust classification (also considers presence or
absence of edema)
Mnemonic: India Welcome Weight of Gomez
• Glycogen storage disease
Anderson disease—Branching enzyme defect (Type IV)
Cori Forbe or limit dextrinosis)—Debranching enzyme defect
(Type III)
Mnemonic: 4 AB and CD3
• Muscle glycogenases
Type II (Pompe’s)—Lysosomal acid α-glucosidase
Type V (McArdle)—Muscle phosphorylase (M for M)
Type VII (Tarui)—Phosphofructokinase
Mnemonic: 257–PMT–LMP
• Timing of selected primitive reflexes
Reflex present at birth (in bracket age at appearance in
intrauterine life)
– Palmar grasp (23)
– Crossed extensor reflex (28)
– Moro’s reflex (32)
– Asymmetric tonic neck reflex (35) (ATNR)
– Rooting/suckling reflex
Mnemonic: PCMARt
Reflexer developing after birth
– Parachute reflex
– Symmetric tonic neck reflex (STNR)
• A newborn is classified as vigorous if he has all the following:
Heart rate > 100 / min
Respiratory effort (strong)
Tone of muscles (good)
Mnemonic: HRT
• Classification systems for PEM based on weight-for-age
Gomez classification
Indian academy of pediatrics (IAP) classification
Wellcome trust classification (also considers presence or
absence of edema)
Mnemonic: India Welcome Weight of Gomez
• Glycogen storage disease
Anderson disease—Branching enzyme defect (Type IV)
Cori Forbe or limit dextrinosis)—Debranching enzyme defect
(Type III)
Mnemonic: 4 AB and CD3
• Muscle glycogenases
Type II (Pompe’s)—Lysosomal acid α-glucosidase
Type V (McArdle)—Muscle phosphorylase (M for M)
Type VII (Tarui)—Phosphofructokinase
Mnemonic: 257–PMT–LMP
• Timing of selected primitive reflexes
Reflex present at birth (in bracket age at appearance in
intrauterine life)
– Palmar grasp (23)
– Crossed extensor reflex (28)
– Moro’s reflex (32)
– Asymmetric tonic neck reflex (35) (ATNR)
– Rooting/suckling reflex
Mnemonic: PCMARt
Reflexer developing after birth
– Parachute reflex
– Symmetric tonic neck reflex (STNR)
Mnemonics172
– Neck righting reflex
– Landau reflex
Mnemonic: PSNL
Note:ATNR—fencing reflex, STNR—Cat’s reflex.
• Hereditary associations with acute myeloid leukemia (AML)
– Fanconi’s anaemia
– Ataxia-telangiectasia
– Bloom syndrome
– Down’s syndrome
– Patau syndrome
– Klinefelter’s syndrome
– Kostmann syndrome
Mnemonic: FAB DiPika Ko AML
• Autosomal recessive disorders that have occurred due to
uniparental disomy (UPD)
– Alpha thalassemia
– Spinal muscular atrophy
– Beta thalassemia
– Bloom syndrome
– Cystic fibrosis
– Cartilage hair hypoplasia
Mnemonic: A2B2C2
• Autism Triad of impaired
Imagination
Communication
Social interaction
Mnemonic: ICS
• Standard ORS versus ReSoMal (rehydration solution for
severely malnourished child)
Standard ORS ReSoMal New WHO–ORS
111 Glucose 125 75 (Anhydrous)
90 Sodium 45 75
20 Potassium 40 20
– Neck righting reflex
– Landau reflex
Mnemonic: PSNL
Note:ATNR—fencing reflex, STNR—Cat’s reflex.
• Hereditary associations with acute myeloid leukemia (AML)
– Fanconi’s anaemia
– Ataxia-telangiectasia
– Bloom syndrome
– Down’s syndrome
– Patau syndrome
– Klinefelter’s syndrome
– Kostmann syndrome
Mnemonic: FAB DiPika Ko AML
• Autosomal recessive disorders that have occurred due to
uniparental disomy (UPD)
– Alpha thalassemia
– Spinal muscular atrophy
– Beta thalassemia
– Bloom syndrome
– Cystic fibrosis
– Cartilage hair hypoplasia
Mnemonic: A2B2C2
• Autism Triad of impaired
Imagination
Communication
Social interaction
Mnemonic: ICS
• Standard ORS versus ReSoMal (rehydration solution for
severely malnourished child)
Standard ORS ReSoMal New WHO–ORS
111 Glucose 125 75 (Anhydrous)
90 Sodium 45 75
20 Potassium 40 20
Pediatrics173
80 Chloride 70 65
10 Citrate 7 10
Magnesium 3
Zinc 0.3
Copper 0.045
311 300
Mnemonic: Mazic in ReSoMal
• Agents responsible for bronchiolitis
MC agent Respiratory syncytial virus (RSV)
Other Parainfluenza virus 3,1
Adenovirus
Influenza virus
Mycoplasma pneumonia
Mnemonic: MYC PAIR in bronchiolitis
• Surgical management of tetralogy of Fallot
Waterson shunt—Ascending Aorta to Pulmonary artery
Blalock-Taussig shunt—Subclavian artery to pulmonary artery
Pott’s shunt—Descending aorta to pulmonary artery
Mnemonic: Water’s Black Pot–ASD
• Target cells are seen in
Haemoglobin C, S, etc.
Thalassemia
Liver diseases
Mnemonic: HaThali Target
• Total anomalous pulmonary venous connection (TAPVC)
Type 1 (45%)Supracardiac
Type 2 (25%)Cardiac
Type 3 (25%)Infracardiac
Type 4 (5%) Multiple levels
Mnemonic: SCIM
• Assessment of dehydration in patients with diarrhoea and
PLAN
No sign of dehydrationTreatment plan A (home avai-
lable food, ORS)
Some sign of dehydration Treatment plan B
80 Chloride 70 65
10 Citrate 7 10
Magnesium 3
Zinc 0.3
Copper 0.045
311 300
Mnemonic: Mazic in ReSoMal
• Agents responsible for bronchiolitis
MC agent Respiratory syncytial virus (RSV)
Other Parainfluenza virus 3,1
Adenovirus
Influenza virus
Mycoplasma pneumonia
Mnemonic: MYC PAIR in bronchiolitis
• Surgical management of tetralogy of Fallot
Waterson shunt—Ascending Aorta to Pulmonary artery
Blalock-Taussig shunt—Subclavian artery to pulmonary artery
Pott’s shunt—Descending aorta to pulmonary artery
Mnemonic: Water’s Black Pot–ASD
• Target cells are seen in
Haemoglobin C, S, etc.
Thalassemia
Liver diseases
Mnemonic: HaThali Target
• Total anomalous pulmonary venous connection (TAPVC)
Type 1 (45%)Supracardiac
Type 2 (25%)Cardiac
Type 3 (25%)Infracardiac
Type 4 (5%) Multiple levels
Mnemonic: SCIM
• Assessment of dehydration in patients with diarrhoea and
PLAN
No sign of dehydrationTreatment plan A (home avai-
lable food, ORS)
Some sign of dehydration Treatment plan B
Mnemonics174
Rehydration therapy
75 ml/kg ORS in first 4 hrs
Maintenance therapy
10–20 ml/kg ORS for each liquid
stool
Severe dehydration Treament plan C
IV fluid (RL best, NS can be given)
< 12 months 30 ml/kg in 70 mI/kg in
1 hr 5 hr
> 12 months 30 ml/kg in 70 ml/kg in
to 5 yrs 30 minutes 2½ hrs
• Congenital rubella syndrome
The common manifestations are:
Growth retardation
Cardiac anomalies PDA > PS > VSD
Sensorineural deafness
Ocular Microphthalmia, cataract, glaucoma,
retinitis
Cerebral Chronic encephalitis
Hematological Thrombocytopenia
Lymphopenia
Bluberry muffin rash, i.e. dermal nests of
extramedullary hematopoiesis or purpura.
•β-thalassemia or Cooley’s anaemia
Peripheral blood picture shows
Microcytic hypochromic
anaemia
Anisocytosis (marked)
Target cells
Reticulocytosis
Nucleated red cells
Mnemonic: MATRN
• Endemic cretinism includes two different overlapping
syndromes
Neurological syndrome—Goitre, severe mental retardation,
deaf mutism, cerebral diplegia, squint
Mnemonic: CDS GS
Myxedematous syndrome: Hypothyroid (T4, TSH) severe
growth retardation, physical signs—coarse dry skin, husky
Rehydration therapy
75 ml/kg ORS in first 4 hrs
Maintenance therapy
10–20 ml/kg ORS for each liquid
stool
Severe dehydration Treament plan C
IV fluid (RL best, NS can be given)
< 12 months 30 ml/kg in 70 mI/kg in
1 hr 5 hr
> 12 months 30 ml/kg in 70 ml/kg in
to 5 yrs 30 minutes 2½ hrs
• Congenital rubella syndrome
The common manifestations are:
Growth retardation
Cardiac anomalies PDA > PS > VSD
Sensorineural deafness
Ocular Microphthalmia, cataract, glaucoma,
retinitis
Cerebral Chronic encephalitis
Hematological Thrombocytopenia
Lymphopenia
Bluberry muffin rash, i.e. dermal nests of
extramedullary hematopoiesis or purpura.
•β-thalassemia or Cooley’s anaemia
Peripheral blood picture shows
Microcytic hypochromic
anaemia
Anisocytosis (marked)
Target cells
Reticulocytosis
Nucleated red cells
Mnemonic: MATRN
• Endemic cretinism includes two different overlapping
syndromes
Neurological syndrome—Goitre, severe mental retardation,
deaf mutism, cerebral diplegia, squint
Mnemonic: CDS GS
Myxedematous syndrome: Hypothyroid (T4, TSH) severe
growth retardation, physical signs—coarse dry skin, husky
Pediatrics175
voice reflex (delayed relaxation), ECG—small voltage QRS,
epiphyseal dysgenesis
• Hemangioma (vascular malformations) : Classification
Capillary hemangiomaSalmon patch
Strawberry angioma
Portwine stain
Venous or cavernous hemangioma
Arterial or plexiform hemangioma
Spontaneous regressionSalmon patch (regresses by 1
year of age)
Strawberry angioma (regresses
by 7–8 yrs of age)
Mnemonic: S for S
• Down’s syndrome
P—Protruding tongue
R—Round face
O—Open wide fontanelle/occiput flat
B—Brachycephaly/Brachydactyly
L—Low set ear/Low (depressed) nasal bridge
M—Mangolian slant/Mental retardation
A—Acute leukemia (AML M7 > ALL)/Alzheimer’s disease/
Atresia of duodenum
T—Trisomy 21/Thyroid problem (hypothyroidism)
I—Iris-Brushfield’s spot
C—Congenital heart disease
• Noonan syndrome
Autosomal dominant
Normal karyotype
Fertile
Short stature
Webbed neck
Cubitus valgus
Clinodactyly
Cryptoorchidism
Mnemonic: 3C
voice reflex (delayed relaxation), ECG—small voltage QRS,
epiphyseal dysgenesis
• Hemangioma (vascular malformations) : Classification
Capillary hemangiomaSalmon patch
Strawberry angioma
Portwine stain
Venous or cavernous hemangioma
Arterial or plexiform hemangioma
Spontaneous regressionSalmon patch (regresses by 1
year of age)
Strawberry angioma (regresses
by 7–8 yrs of age)
Mnemonic: S for S
• Down’s syndrome
P—Protruding tongue
R—Round face
O—Open wide fontanelle/occiput flat
B—Brachycephaly/Brachydactyly
L—Low set ear/Low (depressed) nasal bridge
M—Mangolian slant/Mental retardation
A—Acute leukemia (AML M7 > ALL)/Alzheimer’s disease/
Atresia of duodenum
T—Trisomy 21/Thyroid problem (hypothyroidism)
I—Iris-Brushfield’s spot
C—Congenital heart disease
• Noonan syndrome
Autosomal dominant
Normal karyotype
Fertile
Short stature
Webbed neck
Cubitus valgus
Clinodactyly
Cryptoorchidism
Mnemonic: 3C
Mnemonics176
• Principle of phototherapy—
SI > PI > PO
Structural isomerisation > Photoisomerisation > Photo
oxidation.
• T-series are cyanotic—
TAPVC
Truncus arteriosus
Tetralogy of Fallot
Tricuspid atresia
TGA with VSD
TGA with VSD with PS.
• Principle of phototherapy—
SI > PI > PO
Structural isomerisation > Photoisomerisation > Photo
oxidation.
• T-series are cyanotic—
TAPVC
Truncus arteriosus
Tetralogy of Fallot
Tricuspid atresia
TGA with VSD
TGA with VSD with PS.
• Causes of non-cicatricial alopecia
Primary cutaneous disorders
Telogen effluvium
Anagen effluvium
Traumatic alopecia
Androgenic alopecia
Alopecia areata
Tinea capitis
Mnemonic: 3T and 3A
• Epidermolysis bullosa and targeted protein
Epidermolysis bullosa simplex—Keratin 4 and 14
Junctional epidermolysis bullosa—Laminin 5
Dystrophic epidermolysis bullosa—Collagen VII
Mnemonic: SK Jha LDC Clerk
SK4
JL5
DC 7
• Tinea
capitis Caused by:
Trichophyton
Microsporum
Mnemonic: TMC
•Salmon’s patch is seen in Still’s disease
Mnemonic: S for S
•Dannie’s fold—AD (atopic dermatitis)
Mnemonic: DA–AD
177
Skin
15
Primary cutaneous disorders
Telogen effluvium
Anagen effluvium
Traumatic alopecia
Androgenic alopecia
Alopecia areata
Tinea capitis
Mnemonic: 3T and 3A
• Epidermolysis bullosa and targeted protein
Epidermolysis bullosa simplex—Keratin 4 and 14
Junctional epidermolysis bullosa—Laminin 5
Dystrophic epidermolysis bullosa—Collagen VII
Mnemonic: SK Jha LDC Clerk
SK4
JL5
DC 7
• Tinea
capitis Caused by:
Trichophyton
Microsporum
Mnemonic: TMC
•Salmon’s patch is seen in Still’s disease
Mnemonic: S for S
•Dannie’s fold—AD (atopic dermatitis)
Mnemonic: DA–AD
177
Skin
15
Mnemonics178
• Darrier sign—Urticaria pigmentosa
Mnemonic: Dirty pig
• Lymphogranuloma venereum
Asymptomatic
Bubo (usually unilateral)
Chlamydia trachomatis (L
1L
2L
3)
Doxycycline (DOC)
Estheiomine—vaginal and rectal stricture and elephantiasis of
vulva
Fries test—intradermal test for hypersensitivity to chlamydial
antigens
Groove’s sign—enlarged LN on both sides of inguinal
ligament.
Mnemonic: ABCDEFG
• Lepra reaction
Type I: Reverse lepra reaction, is Type IV hypersensitivity
Type II: ENL, is Type III hypersensitivity
Mnemonic:I + IV = V
II + III = V
• Pityriasis rosea = Characteristic features
Herpesvirus (suspected etiology)
Trunk
Cigarette paper scales
Herald patch
Fir tree pattern
Mnemonic: HT + CHF (Rose ko HT and CHF)
• Cutaneous tuberculosis (non-tuberculides)
Lupus vulgaris
Scrofuloderma
Metastatic tuberculosis
Tuberculosis cutis verrucosus
Tuberculosis cutis orificialis
Miliary tuberculosis
Mnemonic: Vulgar derma met cute Mili
• Darrier sign—Urticaria pigmentosa
Mnemonic: Dirty pig
• Lymphogranuloma venereum
Asymptomatic
Bubo (usually unilateral)
Chlamydia trachomatis (L
1L
2L
3)
Doxycycline (DOC)
Estheiomine—vaginal and rectal stricture and elephantiasis of
vulva
Fries test—intradermal test for hypersensitivity to chlamydial
antigens
Groove’s sign—enlarged LN on both sides of inguinal
ligament.
Mnemonic: ABCDEFG
• Lepra reaction
Type I: Reverse lepra reaction, is Type IV hypersensitivity
Type II: ENL, is Type III hypersensitivity
Mnemonic:I + IV = V
II + III = V
• Pityriasis rosea = Characteristic features
Herpesvirus (suspected etiology)
Trunk
Cigarette paper scales
Herald patch
Fir tree pattern
Mnemonic: HT + CHF (Rose ko HT and CHF)
• Cutaneous tuberculosis (non-tuberculides)
Lupus vulgaris
Scrofuloderma
Metastatic tuberculosis
Tuberculosis cutis verrucosus
Tuberculosis cutis orificialis
Miliary tuberculosis
Mnemonic: Vulgar derma met cute Mili
Skin179
Tuberculides:
Papulonecrotic tuberculides
(Acne scrofulosorum)
Lichen scrofulosorum
Rosaceous tuberculide
Erythema induratum
Lupus miliaris disseminatus faccei
Mnemonic: ALi Rose Indure Lupus Miliaris
Pityriasis Classification
Trunk involvementP. versicolor
P. rosea—erythematous (rose red)
Mnemonic: VeROT
Face involvementP.alba
P.rubra—erythematous (rubra red)
• Fordyce’s spots Ectopic sebacious glands (if on head of
penis—Tyson glands)
Fox-Fordyce (apocrine miliaria)—blockage of sweat glands
Forcheimer’s spots—German measles (rubella)
Infectious mononucleosis
Scarlet fever
• Gluten restriction in diet Celiac sprue
Dermatitis herpetiformis
Note:Gluten is found in Barley: Rye, oat and wheat, i.e. Brow.
• All pemphigus cases are characterized by the formation of an
intraepidermal acantholytic split, located at the following
levels:
Stratum granulosum—P.foliaceous and P.erythematosus
Mnemonic: EFG
Between Str. basale and prickle cell layer—P.vulgaris and
P.vegetans
Mnemonic: V2
• Non-anesthetic hypopigmented, non-scaly macule on face
– Indeterminate leprosy
Note:Omitting non-scaly, diagnosis becomes Pityriasis
alba.
Tuberculides:
Papulonecrotic tuberculides
(Acne scrofulosorum)
Lichen scrofulosorum
Rosaceous tuberculide
Erythema induratum
Lupus miliaris disseminatus faccei
Mnemonic: ALi Rose Indure Lupus Miliaris
Pityriasis Classification
Trunk involvementP. versicolor
P. rosea—erythematous (rose red)
Mnemonic: VeROT
Face involvementP.alba
P.rubra—erythematous (rubra red)
• Fordyce’s spots Ectopic sebacious glands (if on head of
penis—Tyson glands)
Fox-Fordyce (apocrine miliaria)—blockage of sweat glands
Forcheimer’s spots—German measles (rubella)
Infectious mononucleosis
Scarlet fever
• Gluten restriction in diet Celiac sprue
Dermatitis herpetiformis
Note:Gluten is found in Barley: Rye, oat and wheat, i.e. Brow.
• All pemphigus cases are characterized by the formation of an
intraepidermal acantholytic split, located at the following
levels:
Stratum granulosum—P.foliaceous and P.erythematosus
Mnemonic: EFG
Between Str. basale and prickle cell layer—P.vulgaris and
P.vegetans
Mnemonic: V2
• Non-anesthetic hypopigmented, non-scaly macule on face
– Indeterminate leprosy
Note:Omitting non-scaly, diagnosis becomes Pityriasis
alba.
• Anatomical dead space is decreased in
Hyperventilation
Intubation
Tracheostomy
Bronchoconstriction
Flexion of neck
Mnemonic: HITCornflex decreases dead space
• Sites of absorption of local anesthetics in decreasing order
Intrapleural
Intercostal
Pudendal
Caudal
Epidural
Brachial plexus
Infiltration
Mnemonic: Pleco Puca Epi Brain
• Relative potency of inhalational agents
Nitrous oxide
Cyclopropane
Desflurane
Sevoflurane
Ether Potency increases
Enflurane
Isoflurane
Chloroform
Halothane
180
Anesthesia
16
Hyperventilation
Intubation
Tracheostomy
Bronchoconstriction
Flexion of neck
Mnemonic: HITCornflex decreases dead space
• Sites of absorption of local anesthetics in decreasing order
Intrapleural
Intercostal
Pudendal
Caudal
Epidural
Brachial plexus
Infiltration
Mnemonic: Pleco Puca Epi Brain
• Relative potency of inhalational agents
Nitrous oxide
Cyclopropane
Desflurane
Sevoflurane
Ether Potency increases
Enflurane
Isoflurane
Chloroform
Halothane
180
Anesthesia
16
Anesthesia 181
Trielene
Methoxyflurane
Mnemonic: NCD SEE ICH of TM–In increasing order of
potency.
Note:Ether is between sevoflurane and enflurane, chloro-
form is between isoflurane and halothane
• Blood gas partition coefficient
Desflurane
Cyclopropane
Nitrous oxide
Sevoflurane
Isoflurane B/G partition coefficient
Enflurane Increases
Halothane
Chloroform
Trielene
Ether
Methoxyflurane
Mnemonic: DCNS IEN HCTEM (Recall 10 times in mind)
• Amide linked local anesthetics
Lidocaine/Lignocaine
Bupivacaine
Dibucaine
Prilocaine
Ropivacaine
Mnemonic:
I In Amide, I in Amide linked LA (besides in
Caine)
Ester-linked LA Cocaine Procaine Chlorprocaine Tetracaine Benzocaine
• Monitoring of respiration
Intubated patientCapnography
Infrared end tidal CO
2 measurement
Trielene
Methoxyflurane
Mnemonic: NCD SEE ICH of TM–In increasing order of
potency.
Note:Ether is between sevoflurane and enflurane, chloro-
form is between isoflurane and halothane
• Blood gas partition coefficient
Desflurane
Cyclopropane
Nitrous oxide
Sevoflurane
Isoflurane B/G partition coefficient
Enflurane Increases
Halothane
Chloroform
Trielene
Ether
Methoxyflurane
Mnemonic: DCNS IEN HCTEM (Recall 10 times in mind)
• Amide linked local anesthetics
Lidocaine/Lignocaine
Bupivacaine
Dibucaine
Prilocaine
Ropivacaine
Mnemonic:
I In Amide, I in Amide linked LA (besides in
Caine)
Ester-linked LA Cocaine Procaine Chlorprocaine Tetracaine Benzocaine
• Monitoring of respiration
Intubated patientCapnography
Infrared end tidal CO
2 measurement
Mnemonics182
Mnemonic: Cap into infra
Non-intubated patient Impedance pulmonometry
Pulse oximetry
Transcutaneous gas analysis (infants)
• Faster, pleasant and smooth induction with no significant
systemic toxicity makes sevoflurane the agent of choice for
induction especially in children.
Mnemonic:
Smooth, Sweet Sevoflurane for seven year old
(i.e. child)
• Anesthetic agents
Bronchospasmodics
(contraindicated in asthmatics)
Ether
N
2O
Thiopentone
Mnemonic: ENT
• Gas Colour of cylinder
Oxygen Black body, White shoulder
Mnemonic: Black and White OX
Air Gray body, black and white shoulder
N
2O Blue
Mnemonic: Blue nitrous
Entonox Blue body, white and blue quartered
shoulder
CyclopropaneOrange
Mnemonic: Cycle per oranges
Carbon dioxideGray
Mnemonic: Grey Carbon
Thiopentone Yellow
Mnemonic: Yellow Pant
HalothaneAmber (purple red)
Mnemonic: Hello Amber
• Agents used in day care anesthesia
Seroflurane, Isoflurane and Desflurane
Mnemonic: Cap into infra
Non-intubated patient Impedance pulmonometry
Pulse oximetry
Transcutaneous gas analysis (infants)
• Faster, pleasant and smooth induction with no significant
systemic toxicity makes sevoflurane the agent of choice for
induction especially in children.
Mnemonic:
Smooth, Sweet Sevoflurane for seven year old
(i.e. child)
• Anesthetic agents
Bronchospasmodics
(contraindicated in asthmatics)
Ether
N
2O
Thiopentone
Mnemonic: ENT
• Gas Colour of cylinder
Oxygen Black body, White shoulder
Mnemonic: Black and White OX
Air Gray body, black and white shoulder
N
2O Blue
Mnemonic: Blue nitrous
Entonox Blue body, white and blue quartered
shoulder
CyclopropaneOrange
Mnemonic: Cycle per oranges
Carbon dioxideGray
Mnemonic: Grey Carbon
Thiopentone Yellow
Mnemonic: Yellow Pant
HalothaneAmber (purple red)
Mnemonic: Hello Amber
• Agents used in day care anesthesia
Seroflurane, Isoflurane and Desflurane
Anesthesia 183
Alfentanyl, Remifentanyl
Etomidate
Methohexitone
Propofol
Thiopentone
Mnemonic: SID ARe EMPTy
• Rapid sequence anesthesia (crash induction)
Preoxygenation
Induction agent
Suxamethonium
Sellick’s maneuver (cricoid pressure)
Mnemonic: PISS
• Concept of balanced anesthesia (Lundy)
Thiopental for Induction
N
2O for Amnesia
Mepridine (or other opioid) for Analgesia
Curare for Muscle relaxation
Mnemonic: TNMC
• Drugs sensitizing the heart to arrhythmogenic action of
adrenaline include:
Halothane
Methoxyflurane
Trichlorethylene
Cyclopropane
Chloroform
Mnemonic: Halo Metri, Cycle se Chalo
Alfentanyl, Remifentanyl
Etomidate
Methohexitone
Propofol
Thiopentone
Mnemonic: SID ARe EMPTy
• Rapid sequence anesthesia (crash induction)
Preoxygenation
Induction agent
Suxamethonium
Sellick’s maneuver (cricoid pressure)
Mnemonic: PISS
• Concept of balanced anesthesia (Lundy)
Thiopental for Induction
N
2O for Amnesia
Mepridine (or other opioid) for Analgesia
Curare for Muscle relaxation
Mnemonic: TNMC
• Drugs sensitizing the heart to arrhythmogenic action of
adrenaline include:
Halothane
Methoxyflurane
Trichlorethylene
Cyclopropane
Chloroform
Mnemonic: Halo Metri, Cycle se Chalo
• CSF spreading tumours
Germ cell tumour
Medulloblastoma
Ependymoma
Primary CNS lymphoma
High grade astrocytoma
Choriocarcinoma
Mnemonic: German MELA Chor
• HRCT-ILD, bronchiectasis and CSF leak
• Radiation effects
Deterministic effects—Severity of effect is dependent upon
dose
These effects have a
threshold
Mnemonic: DTS
Stochastic effects—probability of effect is dependent upon
dose
Note:S is not S
• Pure beta emittersP 32
Sr 90
Y 90
H 3
Mnemonic: HSPY
• 1–125 60 days
1–131 8 days
1–123 13 hrs
1–132 2.3 hrs
184
Radiology
17
Germ cell tumour
Medulloblastoma
Ependymoma
Primary CNS lymphoma
High grade astrocytoma
Choriocarcinoma
Mnemonic: German MELA Chor
• HRCT-ILD, bronchiectasis and CSF leak
• Radiation effects
Deterministic effects—Severity of effect is dependent upon
dose
These effects have a
threshold
Mnemonic: DTS
Stochastic effects—probability of effect is dependent upon
dose
Note:S is not S
• Pure beta emittersP 32
Sr 90
Y 90
H 3
Mnemonic: HSPY
• 1–125 60 days
1–131 8 days
1–123 13 hrs
1–132 2.3 hrs
184
Radiology
17
Radiology 185
• Superior rib notching
Hyperparathyroidism
Connective tissue diseasesRA, SLE, Scleroderma
Sjögren syndrome
Mnemonic: RS3
Poliomyelitis
Osteogenesis imperfecta
Restrictive lung disease
Marfan’s syndrome
Neurofibromatosis
Mnemonic: Parathyroid connect, Post and restrict Marfan to
neuro
• Inferior rib notching
Coarctation of aorta
Pulmonary oligemia
Aortic thrombosis
Subclavian obstruction
Blalock-Taussig operation
Mnemonic: CAPAST
• Prophylactic craniospinal irradiation is useful in CNS
malignancy which shows dissemination via CSF or any
malignancy with high risk of CNS spread.
Medulloblastoma
Glioblastoma
Germinoma
Small cell Ca of lung
ALL
Non-Hodgkin’s lymphoma
• Groundglass appearance of the lung—differential diagnosis
TAPVC (obstructive)
Persistent pulmonary hypertension
Respiratory distress syndrome
Pneumonia (bacterial and meconium aspiration)
Pulmonary lymphangiectasia
• Superior rib notching
Hyperparathyroidism
Connective tissue diseasesRA, SLE, Scleroderma
Sjögren syndrome
Mnemonic: RS3
Poliomyelitis
Osteogenesis imperfecta
Restrictive lung disease
Marfan’s syndrome
Neurofibromatosis
Mnemonic: Parathyroid connect, Post and restrict Marfan to
neuro
• Inferior rib notching
Coarctation of aorta
Pulmonary oligemia
Aortic thrombosis
Subclavian obstruction
Blalock-Taussig operation
Mnemonic: CAPAST
• Prophylactic craniospinal irradiation is useful in CNS
malignancy which shows dissemination via CSF or any
malignancy with high risk of CNS spread.
Medulloblastoma
Glioblastoma
Germinoma
Small cell Ca of lung
ALL
Non-Hodgkin’s lymphoma
• Groundglass appearance of the lung—differential diagnosis
TAPVC (obstructive)
Persistent pulmonary hypertension
Respiratory distress syndrome
Pneumonia (bacterial and meconium aspiration)
Pulmonary lymphangiectasia
• Level of intelligence Mental age
Idiot 0–24 < 3 yrs life support
Imbecile 25–49 3–7 yrs trainable
Moron 50–69 7–10 yrs educable
Border line 70–79
Mnemonic: IIM Bangalore
• Intelligence quotient
Profound <20
Severe 20–35
Moderate 35–50
Mild 50–70
• Disorganized schizophrenia
Attention deficits and cognition defects
Disorganized behaviour
Disorganized speech
Mnemonic: ABCDS
• Disorder Most common type of delusion
Mania Delusion of grandeur
DepressionNihilistic delusion
Delirium Transient delusion
SchizophreniaDelusion of persecution/reference/control/
infidelity/passivity
• Patients with multiple somatic complaints that cannot be
explained may have
Hypochondriasis
Somatization disorder
Malingering
Factitious illness
186
Psychiatry
18
Idiot 0–24 < 3 yrs life support
Imbecile 25–49 3–7 yrs trainable
Moron 50–69 7–10 yrs educable
Border line 70–79
Mnemonic: IIM Bangalore
• Intelligence quotient
Profound <20
Severe 20–35
Moderate 35–50
Mild 50–70
• Disorganized schizophrenia
Attention deficits and cognition defects
Disorganized behaviour
Disorganized speech
Mnemonic: ABCDS
• Disorder Most common type of delusion
Mania Delusion of grandeur
DepressionNihilistic delusion
Delirium Transient delusion
SchizophreniaDelusion of persecution/reference/control/
infidelity/passivity
• Patients with multiple somatic complaints that cannot be
explained may have
Hypochondriasis
Somatization disorder
Malingering
Factitious illness
186
Psychiatry
18
Psychiatry187
• Difference between anorexia nervosa and bulimia nervosa
Anorexia nervosa Bulimia nervosa
Feature Refusal to maintain Irresistible craving for
body weight above food with episodes of
a minimum normal overeating in less time
(binge eating)
Method Very less eating Attempts to counteract
of weight the effects of overeating
control byself-ind uced vomi-
tings purgative abuse
periods of starvation
appetite suppressants
Ritualized Common Rare
exercise
Amenorrhea 100% 50%
Decreased Common Uncommon
vitals
BP, pulse
Hypothermia Common Rare
Skin changed Common Rare
(hirsutism)
Medical Hypokalemia Hypokalemia
complicationsCardiac arrhythmias Cardiac arrhythmias
Note:In bulimia, Dental caries are frequent because of high
carbohydrate content in the diet.
Antisocial behaviour, e.g. stealing, alcohol, drug abuse is
common
Prognosis is
worse.
Mnemonic: DAW
• Difference between delirium and dementia
Delirium Dementia
Onset Acute Insidious
Consciousness Clouded Normal
Orientation Grossly disturbed Disturbed only, in late
stages
Memory Immediate and Immediate is normal
• Difference between anorexia nervosa and bulimia nervosa
Anorexia nervosa Bulimia nervosa
Feature Refusal to maintain Irresistible craving for
body weight above food with episodes of
a minimum normal overeating in less time
(binge eating)
Method Very less eating Attempts to counteract
of weight the effects of overeating
control byself-ind uced vomi-
tings purgative abuse
periods of starvation
appetite suppressants
Ritualized Common Rare
exercise
Amenorrhea 100% 50%
Decreased Common Uncommon
vitals
BP, pulse
Hypothermia Common Rare
Skin changed Common Rare
(hirsutism)
Medical Hypokalemia Hypokalemia
complicationsCardiac arrhythmias Cardiac arrhythmias
Note:In bulimia, Dental caries are frequent because of high
carbohydrate content in the diet.
Antisocial behaviour, e.g. stealing, alcohol, drug abuse is
common
Prognosis is
worse.
Mnemonic: DAW
• Difference between delirium and dementia
Delirium Dementia
Onset Acute Insidious
Consciousness Clouded Normal
Orientation Grossly disturbed Disturbed only, in late
stages
Memory Immediate and Immediate is normal
Mnemonics188
recent disturbed recent and remote
disturbed
Perception Visual illusion and Hallucination may
hallucination is occur
common
Diurnal Marked Absent
variation (Sundowning)
• Dissociative fugue
Sudden onset of complete amnesia for his earlier life
Patient usually wander away from home
Adopts a new purposeful identity
Absence of awareness of amnesia
• Catatonic signs
Mutism Absence of speech
Rigidity Maintenance of rigid posture against efforts to
be moved
PosturismVoluntary assumption of bizarre, inappropriate
posture for long period of time
NegativismResistance to all commands and attempts to be
moved
EcholaliaRepetition, mimicking of actions observed
Waxy Parts of body can be placed in positions that
flexibilitywill be maintained for long periods of time
even if very uncomfortable flexible like wax
Mannerism
Automatic Commands are followed automatically,
obedienceirrespective of their nature.
• Mechanism of depression—Deficiency of monoamines—
Serotonin (5 HT) > Noradrenaline > Dopamine
Mnemonic: SeND
recent disturbed recent and remote
disturbed
Perception Visual illusion and Hallucination may
hallucination is occur
common
Diurnal Marked Absent
variation (Sundowning)
• Dissociative fugue
Sudden onset of complete amnesia for his earlier life
Patient usually wander away from home
Adopts a new purposeful identity
Absence of awareness of amnesia
• Catatonic signs
Mutism Absence of speech
Rigidity Maintenance of rigid posture against efforts to
be moved
PosturismVoluntary assumption of bizarre, inappropriate
posture for long period of time
NegativismResistance to all commands and attempts to be
moved
EcholaliaRepetition, mimicking of actions observed
Waxy Parts of body can be placed in positions that
flexibilitywill be maintained for long periods of time
even if very uncomfortable flexible like wax
Mannerism
Automatic Commands are followed automatically,
obedienceirrespective of their nature.
• Mechanism of depression—Deficiency of monoamines—
Serotonin (5 HT) > Noradrenaline > Dopamine
Mnemonic: SeND
• Klippel-Feil syndrome
Triad—Short (web) neck
Low hair line
Restriction of neck motion
Mnemonic: SLR
• Risk of progression of vertebral anomalies in decreasing order
Unsegmented bar
Hemivertebra
Wedge vertebra
Block vertebra
Mnemonic: Unique History of West Bengal (UH of WB)
• Reconstruction of an amputated limb: Order of repair
Bone
Extensor tendons
Flexor tendons
Arteries
Nerves
Vein
Mnemonic: BE FAN Vein
• Test for anterior shoulder instability
Anterior shoulder instability
Apprehension test (Crank test)
Relocation test
Fulcrum test
Mnemonic: FRANK–CRANK
189
Orthopedics
19
Triad—Short (web) neck
Low hair line
Restriction of neck motion
Mnemonic: SLR
• Risk of progression of vertebral anomalies in decreasing order
Unsegmented bar
Hemivertebra
Wedge vertebra
Block vertebra
Mnemonic: Unique History of West Bengal (UH of WB)
• Reconstruction of an amputated limb: Order of repair
Bone
Extensor tendons
Flexor tendons
Arteries
Nerves
Vein
Mnemonic: BE FAN Vein
• Test for anterior shoulder instability
Anterior shoulder instability
Apprehension test (Crank test)
Relocation test
Fulcrum test
Mnemonic: FRANK–CRANK
189
Orthopedics
19
Mnemonics190
• Tests for posterior shoulder instability
Jahnke test
Jerk test
Posterior drawer test
Posterior apprehension test
Push-pull test
Circumduction test
Mnemonic: JPC
Also remember: Test for inferior shoulder instability—sulcus
test
• Albright-McCune syndrome
Polyostotic fibrous dysplasia
Pseudo precocious puberty
Pigmentation
Mnemonic: 3P
• Mazabraud syndrome
Myxoma of soft tissues
Polyostotic fibrous dysplasia
Sulcus test
• Tarsal
tunnel syndrome may be caused by rheumatoid
arthritis
Mnemonic: Tunnel in room
• Metastasis distal to knee and elbow is rare and usually arises
from a primary tumours of the
Bladder
Bronchus
Colon
Mnemonic: BBC: One from thorax, abdomen and pelvis each
• Casts and splints
Minerva cast—Cervical spine fracture
Mnemonic: Mice
Scoliosis—Risser’s localiser cast, Turn buckle cast
Milwaukee brace
Boston brace
Mnemonic: Ritu Mili Boss
• Tests for posterior shoulder instability
Jahnke test
Jerk test
Posterior drawer test
Posterior apprehension test
Push-pull test
Circumduction test
Mnemonic: JPC
Also remember: Test for inferior shoulder instability—sulcus
test
• Albright-McCune syndrome
Polyostotic fibrous dysplasia
Pseudo precocious puberty
Pigmentation
Mnemonic: 3P
• Mazabraud syndrome
Myxoma of soft tissues
Polyostotic fibrous dysplasia
Sulcus test
• Tarsal
tunnel syndrome may be caused by rheumatoid
arthritis
Mnemonic: Tunnel in room
• Metastasis distal to knee and elbow is rare and usually arises
from a primary tumours of the
Bladder
Bronchus
Colon
Mnemonic: BBC: One from thorax, abdomen and pelvis each
• Casts and splints
Minerva cast—Cervical spine fracture
Mnemonic: Mice
Scoliosis—Risser’s localiser cast, Turn buckle cast
Milwaukee brace
Boston brace
Mnemonic: Ritu Mili Boss
Orthopedics 191
• Risk factors associated with shoulder dystocia
Diabetes
Obesity
Post-term
Excess weight gain during pregnancy
Mnemonic: DOPE
•Non-odontogenic cysts
Nasolabial cysts
Nasopalatine cysts
Mnemonic: N for N
Pseudocysts
Static bone cysts
Traumatic bone cysts
Aneurysmal bone cyst
Ganglion cysts
Mnemonic: STAN GAN
• Ossicular joints
Incudo-Malleolar joint—Saddle type of synovial joint
Incudo-Stapedial joint—Ball and socket type of synovial joint
Mnemonic: Ball IS MISS
• Ligament of Humphrey—Anterior menisco-femoral ligament
Ligament of Wrisberg—Posterior menisco-femoral ligament
Mnemonic: Humpy Antie
• Knee joint
Unlocking is brought about by popliteus muscle
Mnemonic: UP
Locking—Quadriceps femoris
Mnemonic: Q-locked
• Myositis ossificans progressiva
Muscles that are characteristically spared
Smooth muscles
Cardiac muscles
Diaphragm
• Risk factors associated with shoulder dystocia
Diabetes
Obesity
Post-term
Excess weight gain during pregnancy
Mnemonic: DOPE
•Non-odontogenic cysts
Nasolabial cysts
Nasopalatine cysts
Mnemonic: N for N
Pseudocysts
Static bone cysts
Traumatic bone cysts
Aneurysmal bone cyst
Ganglion cysts
Mnemonic: STAN GAN
• Ossicular joints
Incudo-Malleolar joint—Saddle type of synovial joint
Incudo-Stapedial joint—Ball and socket type of synovial joint
Mnemonic: Ball IS MISS
• Ligament of Humphrey—Anterior menisco-femoral ligament
Ligament of Wrisberg—Posterior menisco-femoral ligament
Mnemonic: Humpy Antie
• Knee joint
Unlocking is brought about by popliteus muscle
Mnemonic: UP
Locking—Quadriceps femoris
Mnemonic: Q-locked
• Myositis ossificans progressiva
Muscles that are characteristically spared
Smooth muscles
Cardiac muscles
Diaphragm
Mnemonics192
Extraocular muscles
Mnemonic: Smooth CDE
• O’Donogues triad (unhappy triad)
Anterior cruciate ligament AC
Medial collateral ligament MC
Medial meniscus MM
Mnemonic: AC MC MM
• Plaster casts and their uses
Humerus fracture—Hanging cast and U slab.
Mnemonic: Hu-Hu
A spica is a cast where a limb and a part of the trunk are
included, e.g. hip spica (fracture femur)
Shoulder spica (shoulder immobilization)
Patellar tendon bearing cast—fracture of tibia
Cylinder cast (tube cast)—fracture patella (fracture around
knees)
• Common sites for bone tumors
Epiphysis—Chondroblastoma
Giant cell tumor
Mnemonic: ECG (GC–CB)
DiaphysisAdamantinoma
Multiple myeloma
Ewing’s sarcoma
Eosinophilic granuloma (Langerhans’ cell
histiocytosis)
Osteoid osteoma
Mnemonic: Dia add multiple wing to Eosinophil of osteoma
• Markers of bone formation
– Serum bone specific alkaline phosphatase
– Serum propeptide or type I procollagen
– Serum osteocalcin
Mnemonic: Alka Type Osteocalcin for bone formation
• Management of idiopathic clubfoot
So Soft tissue release <3 yrs
Extraocular muscles
Mnemonic: Smooth CDE
• O’Donogues triad (unhappy triad)
Anterior cruciate ligament AC
Medial collateral ligament MC
Medial meniscus MM
Mnemonic: AC MC MM
• Plaster casts and their uses
Humerus fracture—Hanging cast and U slab.
Mnemonic: Hu-Hu
A spica is a cast where a limb and a part of the trunk are
included, e.g. hip spica (fracture femur)
Shoulder spica (shoulder immobilization)
Patellar tendon bearing cast—fracture of tibia
Cylinder cast (tube cast)—fracture patella (fracture around
knees)
• Common sites for bone tumors
Epiphysis—Chondroblastoma
Giant cell tumor
Mnemonic: ECG (GC–CB)
DiaphysisAdamantinoma
Multiple myeloma
Ewing’s sarcoma
Eosinophilic granuloma (Langerhans’ cell
histiocytosis)
Osteoid osteoma
Mnemonic: Dia add multiple wing to Eosinophil of osteoma
• Markers of bone formation
– Serum bone specific alkaline phosphatase
– Serum propeptide or type I procollagen
– Serum osteocalcin
Mnemonic: Alka Type Osteocalcin for bone formation
• Management of idiopathic clubfoot
So Soft tissue release <3 yrs
Orthopedics 193
EvansEvans 4–8 yrs
Was Wedge resection 8–11yrs
Treated Triple arthrodesis > 12 yrs
IntelligentlyIlizarov Old/neglected
club foot
• Erb’s palsy K lumpke’s palsy
Upper obstetric palsyLower obstetric palsy
Mnemonic: L for L
C5–C6 roots affected C8–Tl, roots affected
Waiter’s tip deformity Generalized wasting of all intrinsic
muscles and claw hand deformity
Ipsilateral Horner syndrome (due to TI)
• Pyogenic arthritis—bony ankylosis
(B for bacteria, B for bony)
Tubercular arthritis—fibrous ankylosis
(Exception—tubercle spine has bony ankylosis)
• Idiopathic osteoarthritis
Herbeden’s nodes—bony enlargement of DIP joint
Mnemonic: HerDip (herdip)
It is also MC form of idiopathic osteoarthritis.
Bouchard’s nodes—bony enlargement of PIP joint
• Common sites of avascular necrosis
Head of femur Fracture through neck of femur, post-
dislocation of hip
Proximal pole of scaphoid—fracture through waist of
scaphoid
Body of talus—fracture through neck of talus
Lunate—dislocation
Common sites of non-union of fracture
Scaphoid
Neck of femur
Talus
Lateral condyles of humerus
Lower third of Ulna
Lower third of tibia
Mnemonic: SNT LUT
EvansEvans 4–8 yrs
Was Wedge resection 8–11yrs
Treated Triple arthrodesis > 12 yrs
IntelligentlyIlizarov Old/neglected
club foot
• Erb’s palsy K lumpke’s palsy
Upper obstetric palsyLower obstetric palsy
Mnemonic: L for L
C5–C6 roots affected C8–Tl, roots affected
Waiter’s tip deformity Generalized wasting of all intrinsic
muscles and claw hand deformity
Ipsilateral Horner syndrome (due to TI)
• Pyogenic arthritis—bony ankylosis
(B for bacteria, B for bony)
Tubercular arthritis—fibrous ankylosis
(Exception—tubercle spine has bony ankylosis)
• Idiopathic osteoarthritis
Herbeden’s nodes—bony enlargement of DIP joint
Mnemonic: HerDip (herdip)
It is also MC form of idiopathic osteoarthritis.
Bouchard’s nodes—bony enlargement of PIP joint
• Common sites of avascular necrosis
Head of femur Fracture through neck of femur, post-
dislocation of hip
Proximal pole of scaphoid—fracture through waist of
scaphoid
Body of talus—fracture through neck of talus
Lunate—dislocation
Common sites of non-union of fracture
Scaphoid
Neck of femur
Talus
Lateral condyles of humerus
Lower third of Ulna
Lower third of tibia
Mnemonic: SNT LUT
Mnemonics194
Common sites of malunion of fracture
Supracondylar fracture
Colles’ fracture
Intertrochanteric fracture
Mnemonic: SCIT
• Osteochondritis: A group of miscellaneous affection of the
growing epiphysis, which cause them to be temporarily
softened and liable to be deformed by pressure.
Common osteochondritis
Crushing osteochondritis (due to avascular necrosis)
Perthes disease Femoral head (commonest)
Pannr’s disease Capitulum
Mnemonic: Pan in Cap
Keinbock’s disease Lunate
Mnemonic: Luna Keino
Kohler’s disease Navicular bone
Mnemonic: Navi Kohli
Freiberg’s disease Head of metatarsal
Mnemonic: HMT Free
Scheumann’s disease Ring epiphysis of vertebrae
Mnemonic: Man in Ring
Calves’ disease Central bony nucleus of vertebral
body
Mnemonic: Central cave
Traction osteochondritis (due to chronic strain or apophysitis)
Osgood-Shlatter disesase—Tibial tubercle
Mnemonic: tt = tt
Sever’s disease Calcaneal tuberosity
Mnemonic: Severe Calca
Larsen-Johansson disease—lower pole of patella
Mnemonic: Patel Son Sen
Splitting osteochondritis (trauma plays major role)
Osteochondritis dessican MC site is femoral condyle
Common sites of malunion of fracture
Supracondylar fracture
Colles’ fracture
Intertrochanteric fracture
Mnemonic: SCIT
• Osteochondritis: A group of miscellaneous affection of the
growing epiphysis, which cause them to be temporarily
softened and liable to be deformed by pressure.
Common osteochondritis
Crushing osteochondritis (due to avascular necrosis)
Perthes disease Femoral head (commonest)
Pannr’s disease Capitulum
Mnemonic: Pan in Cap
Keinbock’s disease Lunate
Mnemonic: Luna Keino
Kohler’s disease Navicular bone
Mnemonic: Navi Kohli
Freiberg’s disease Head of metatarsal
Mnemonic: HMT Free
Scheumann’s disease Ring epiphysis of vertebrae
Mnemonic: Man in Ring
Calves’ disease Central bony nucleus of vertebral
body
Mnemonic: Central cave
Traction osteochondritis (due to chronic strain or apophysitis)
Osgood-Shlatter disesase—Tibial tubercle
Mnemonic: tt = tt
Sever’s disease Calcaneal tuberosity
Mnemonic: Severe Calca
Larsen-Johansson disease—lower pole of patella
Mnemonic: Patel Son Sen
Splitting osteochondritis (trauma plays major role)
Osteochondritis dessican MC site is femoral condyle
Orthopedics 195
• Hip deformity following a history of severe trauma
Posterior dislocation of hip—Flexion + Adduction + Internal
Rotation + Shortening (FADIR)
Fracture neck of femur—Flexion + Adduction + External
Rotation + Shortening (FADER)
Fracture intertrochanteric femur—FADER (exaggerated)
Anterior dislocation of lip—Flexion + Abduction + External
Rotation + Shortening (FABER)
Tuberculosis hip
Stage of synovitis FABER (apparent lengthening)
Stage of arthritis FADIR (apparent shortening)
Stage of erosion FADIR (true shortening)
• Rheumatoid arthritis
Swan-neck deformityHyperextension at PIP joint
Hyperflexion at DIP joint.
Mnemonic: HEPIP of Swan
Boutonniere deformity Hyperflexion at PIP joint
Hyperextexnsion at DIP joint
Mnemonic: BDE-PF
• Impacted fractures are commonly seen in
Surgical neck of humerus
Neck of femur
Lower end of radius
Mnemonic: Impacted SuNiL
• Triple arthrodesis Fusion of three joints of foot
Talonavicular joint
Subtalar joint
Calcaneocuboid joint
Mnemonic: TN ST CaCu
• Common sites of origin of osteosarcoma in decreasing order
of frequency:
Lower end of femur
Upper end of tibia
Upper end of humerus
• Involvement of joints in different types of arthritis
• Hip deformity following a history of severe trauma
Posterior dislocation of hip—Flexion + Adduction + Internal
Rotation + Shortening (FADIR)
Fracture neck of femur—Flexion + Adduction + External
Rotation + Shortening (FADER)
Fracture intertrochanteric femur—FADER (exaggerated)
Anterior dislocation of lip—Flexion + Abduction + External
Rotation + Shortening (FABER)
Tuberculosis hip
Stage of synovitis FABER (apparent lengthening)
Stage of arthritis FADIR (apparent shortening)
Stage of erosion FADIR (true shortening)
• Rheumatoid arthritis
Swan-neck deformityHyperextension at PIP joint
Hyperflexion at DIP joint.
Mnemonic: HEPIP of Swan
Boutonniere deformity Hyperflexion at PIP joint
Hyperextexnsion at DIP joint
Mnemonic: BDE-PF
• Impacted fractures are commonly seen in
Surgical neck of humerus
Neck of femur
Lower end of radius
Mnemonic: Impacted SuNiL
• Triple arthrodesis Fusion of three joints of foot
Talonavicular joint
Subtalar joint
Calcaneocuboid joint
Mnemonic: TN ST CaCu
• Common sites of origin of osteosarcoma in decreasing order
of frequency:
Lower end of femur
Upper end of tibia
Upper end of humerus
• Involvement of joints in different types of arthritis
Mnemonics196
OsteoarthritisSparing of wrist and metacarpophal-
angeal joints (MCP joint) with involvement
of base of thumb is characteristic feature
Mnemonic: Sparing of WM in OA
Joints involvedDIP: Heberden’s nodes MC form of idio-
pathic osteoarthritis
Mnemonic: Her DIP
– PIP: Bouchard’s nodes
– Thumb base (carpometacarpal joint)
(second MC joint)
– Knee
– Spine
• Rheumatoid arthritis: DIP is not involved.
Axial involvement is limited to upper cervical
spine, usualy lumbar spine is not involved.
14 possible joint areas involved (left and right)
Wrist
Ankle
Knee
Elbow
Metatarsophalangeal
MCP
PIP
Mnemonic:
DIP joint is not involved in RA–DNR
Wake MMP
• Psoriatic arthritis: Any joint may be involved
Disease limited to involvement of a single/few small joints
(70%)
Seronegative, RA like symmetrical arthritis
Involvement of DIP
Severe destructive arthritis with development of arthritis
mutilans
Disease limited to the spine.
• Pivot shift test is used in cases of anterolateral instability
where injured structure include:
Anterior cruciate ligament
Lateral capsule
Lateral–collateral ligament
OsteoarthritisSparing of wrist and metacarpophal-
angeal joints (MCP joint) with involvement
of base of thumb is characteristic feature
Mnemonic: Sparing of WM in OA
Joints involvedDIP: Heberden’s nodes MC form of idio-
pathic osteoarthritis
Mnemonic: Her DIP
– PIP: Bouchard’s nodes
– Thumb base (carpometacarpal joint)
(second MC joint)
– Knee
– Spine
• Rheumatoid arthritis: DIP is not involved.
Axial involvement is limited to upper cervical
spine, usualy lumbar spine is not involved.
14 possible joint areas involved (left and right)
Wrist
Ankle
Knee
Elbow
Metatarsophalangeal
MCP
PIP
Mnemonic:
DIP joint is not involved in RA–DNR
Wake MMP
• Psoriatic arthritis: Any joint may be involved
Disease limited to involvement of a single/few small joints
(70%)
Seronegative, RA like symmetrical arthritis
Involvement of DIP
Severe destructive arthritis with development of arthritis
mutilans
Disease limited to the spine.
• Pivot shift test is used in cases of anterolateral instability
where injured structure include:
Anterior cruciate ligament
Lateral capsule
Lateral–collateral ligament
Orthopedics 197
• Swelling of joint—
X-ray
MRI
Aspiration (for culture)
Swelling of joint
Mnemonic: X MAS
• Epithelial tumors of bone
Adamantinoma—Tibia
Mnemonic: Ad on Tb
Ameloblastoma—Mandible
Mnemonic: Mandi ka mela
• Bone metastasis
BPL—Breast carcinoma, Prostate carcinoma, Lung carcinoma
Pure osteoblastic—Prostate carcinoma
Carcinoid tumor
Medulloblastoma
Mnemonic: PCM
Breast carcinoma—Mixed
Osteolytic (2/3rd) > osteolytic (1/3rd)
•Ollier’s syndrome—Only enchondroma
Mnemonic: O for O
Maffucci syndrome—Multiple enchondroma and cavernous
hemangioma
Mnemonic: M for M
• Coast of Maine—McCune-Albright syndrome (margins are
irregular)
Mnemonic: M for M
Coast of California—Neurofibromatosis (margins are regular)
• Poor factors of rheumatoid arthritis:
RF
Acute phase reactants/advanced age
One year
• Swelling of joint—
X-ray
MRI
Aspiration (for culture)
Swelling of joint
Mnemonic: X MAS
• Epithelial tumors of bone
Adamantinoma—Tibia
Mnemonic: Ad on Tb
Ameloblastoma—Mandible
Mnemonic: Mandi ka mela
• Bone metastasis
BPL—Breast carcinoma, Prostate carcinoma, Lung carcinoma
Pure osteoblastic—Prostate carcinoma
Carcinoid tumor
Medulloblastoma
Mnemonic: PCM
Breast carcinoma—Mixed
Osteolytic (2/3rd) > osteolytic (1/3rd)
•Ollier’s syndrome—Only enchondroma
Mnemonic: O for O
Maffucci syndrome—Multiple enchondroma and cavernous
hemangioma
Mnemonic: M for M
• Coast of Maine—McCune-Albright syndrome (margins are
irregular)
Mnemonic: M for M
Coast of California—Neurofibromatosis (margins are regular)
• Poor factors of rheumatoid arthritis:
RF
Acute phase reactants/advanced age
One year
Mnemonics198
Nodules
Erosion/ESR
Mnemonic: RA—ONE
• MESS—Mangled extremity severity score. It tells about the
survival of a limb after crushing injury.
V—Velocity of trauma
I—Ischemia
S—Shock
A—Age.
• Housemaid knee—Prepatellar bursitis
Clergyman knee—Infrapatellar bursitis
Mnemonic: Pre-maid, i.e. Pramod
• Nerve injury in supracondylar humerus fracture—Anterior
interosseous > Median > Radial > Ulnar nerve.
Mnemonic: AMRU
• Colles’ fracture—Extra-articular fracture of distal end of radius
with
S—Supination of distal fragment
L—Lateral displacement (tilt, shift)
I—Impaction
P—Posterior displacement (tilt, shift)
Treatment—Hand shaking cast.
• Trendelenberg test
Normal hip—Negative
Hip abductors—Gluteus medius > Gluteus minimus
Superior gluteal nerve
Drop of pelvis on opposite side—Positive
Mnemonic: DROP
If bilateral drop—Waddling gait
• Kocher’s maneuver is the most common maneuver used to
reduce shoulder dislocation. It involves—
Traction
Nodules
Erosion/ESR
Mnemonic: RA—ONE
• MESS—Mangled extremity severity score. It tells about the
survival of a limb after crushing injury.
V—Velocity of trauma
I—Ischemia
S—Shock
A—Age.
• Housemaid knee—Prepatellar bursitis
Clergyman knee—Infrapatellar bursitis
Mnemonic: Pre-maid, i.e. Pramod
• Nerve injury in supracondylar humerus fracture—Anterior
interosseous > Median > Radial > Ulnar nerve.
Mnemonic: AMRU
• Colles’ fracture—Extra-articular fracture of distal end of radius
with
S—Supination of distal fragment
L—Lateral displacement (tilt, shift)
I—Impaction
P—Posterior displacement (tilt, shift)
Treatment—Hand shaking cast.
• Trendelenberg test
Normal hip—Negative
Hip abductors—Gluteus medius > Gluteus minimus
Superior gluteal nerve
Drop of pelvis on opposite side—Positive
Mnemonic: DROP
If bilateral drop—Waddling gait
• Kocher’s maneuver is the most common maneuver used to
reduce shoulder dislocation. It involves—
Traction
Orthopedics 199
External rotation
Adduction
Internal rotation
Mnemonic: TEDI
• Vertebra plana—Coin like vertebra. Seen in
M—Metastasis
E—Eosinophilic granuloma
L—Lymphoma
T—Trauma and very rarely TB
External rotation
Adduction
Internal rotation
Mnemonic: TEDI
• Vertebra plana—Coin like vertebra. Seen in
M—Metastasis
E—Eosinophilic granuloma
L—Lymphoma
T—Trauma and very rarely TB
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