Escolar Documentos
Profissional Documentos
Cultura Documentos
Neurology
1. Thunderclap headache - subarachnoid haemorrhage (cf. PCKD)
2. Xanthochromic Lumbar Puncture - Subarachnoid Haemorrhage (cf fresh blood - traumatic tap)
3. Lucid period after head trauma (often followed by sudden collapse or deterioration) - extradural
haemorrhage
4. Cogwheel rigidity - Parkinsons (tremor over rigidity)
5. Woody Texture muscle swelling - Duchenne or Becker MD
6. Raised CK - Muscular Dystrophy
7. Toe walker or positive gowers sign - Muscular Dystrophy
8. Mask-like Expression - Parkinsons
9. Fluctuating Cognitive Deficit - Lewy Body Dementia or Delirium
10. REM disturbance (later in night) - Lewy Body Dementia or PD
11. Vivid visual hallucinations normally of children and not threatening - Lewy Body Dementia
12. Acute Onset Cognitive disturbance that fluctuates - Delirium
13. Personality/behaviour changes and then dementia Frontotemporal dementia (Pick's disease)
14. Memory and personality problems in someone with a history of cardiovascular disease Vascular
dementia
15. Stepwise deterioration - vascular dementia
16. Pain on loud noise - Facial nerve palsy
17. Painful third nerve palsy - posterior communicating artery aneurysm
18. Myalgia + myositis + myoglobulinaemia/uria - Rhabdomyolysis (-> DIC and acute Renal failure)
19. Inflammatory myopathy with poor response to steroids - inclusion body myositis\
20. Weakness + frontal balding + cataracts + ptosis -> myotonic dystrophy (onset 30s, +ve FHx)
21. Leg symptoms + midline shift - Falcine herniation
22. Back pain worse on coughing - slipped disk
23. Headache worse on coughing - posterior fossa issue
24. BL sciatica + male sexual dysfunction +/- bowel and bladder symptoms - cauda equina
25. Pleocytosis on CSF -> rule out? bacterial meningitis
26. Migraine prophylaxis 1st line propranolol, topiramate or amitriptyline; 2nd line valproate, pizotifen,
gabapentinhow, pregabalin (if one drug does not work by 4/12, try another)
27. Injury upper brachial plexus - Erbs palsy (waiters tip) - more common, associated with shoulder dystocia
28. Injury lower brachial plexus - Klumpkes palsy (claw hand) - Horners syndrome
29. +ve Simmonds test - Achilles tendon rupture
30. Anti acetylcholine receptor antibody - myaesthenia gravis
31. Purely motor symptoms (UMN and LMN) with ocular sparing = Motor neurone disease
32. Cervical myelopathy = high stepping gait + Rombergs positive
33. Racoon or Panda eyes - fracture of anterior cranial fossa
34. Battle sign behind ears - fracture of middle cranial fossa - mastoid process of temporal bone
35. Diarrhoea + weakness = Guillain Barre
Psychiatry
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Ophthalmology
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Reproduction
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Fluid level behind drum; retracted drum; Dull colour - Otitis Media with Effusion
Difficulty at school + have to shout loud to hear - ? Hearing loss OME?
Feeling of fullness in the ear - Menieres disease
Loss of corneal reflex (+ sensorineural hearing loss, vertigo and tinnitus) - Acoustic neuroma (Vestibular
Schwannoma). Assoc. w/NF-II
Bilateral Vestibular Schwannoma - think NF-II
Vertigo on rotation movement of the head - BPPV
Battle sign - Bruising on the skull, very specific to mastoid process of temporal bone fractures
Pearly white on otoscopy and foul, cheesy discharge - ?cholesteatoma
Child Health
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Edwards chromosome 18
Patau chromosome 13
Downs chromosome 21
ADHD: triad HYPERACTIVE, INATTENTIVE, IMPULSIVE. Rx: methylphenidate or atomoxetine
Autism: social communication, language, repetitive behaviour
Aspergers - Form of autism where there only a problem with social communication
Ageing
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Drug interactions:
Statin + grapefruit juice - BAD!!!
Metronidazole + alcohol - BAD!!!
Warfarin + cranberry - bad
Warfarin+ amiodarone - amiodarone potentiate anticoagulant effect
Statin + clarithromycin - BAD!
Calcium + thyroxine - decreased absorption from GIT
Warfarin + NSAID - BLEED (but not with low dose aspirin)
ACEi + Spironolactone - hyperkalaemia
Digoxin + verapamil - digoxin toxicity
Fluoxetine + phenelzine - serotonin syndrome (hyperthermia, tremor and cardiovascular 6??)
B1 deficiency - Wernickes encephalopathy (usually due to alcohol abuse) - ophthalmoplegia, ataxia and
confusion (can lead to irreversible Korsakoffs syndrome- confabulation) Tx: Pabrinex
13. Delirium - fluctuating mental state + inattention + disorganised thinking and/or altered level of consciousness
(1+2 + either 3 or 4 or both)
14. Triptans contraindicated in IHD, uncontrolled hypertension, concurrent use of lithium, SSRI or ergot
derivative drugs (such as cabergoline in PD)
Dermatology
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Haematology
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Cardiology
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Patient has fever and pleuritic chest pain that is relieved by sitting up and leaning forward - Pericarditis
Irregularly irregular pulse - Atrial Fibrillation
ECG - saw tooth baseline + 150 bpm - Atrial Flutter
Alveolar bats wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels pleural effusion Pulmonary oedema
Raised JVP/hepatojugular - Right-sided heart failure
Sense of impending doom - MI
Saddle shaped ST elevation - Pericarditis
Broad complex tachycardia - Ventricular problem
Mid-diastolic murmur with a tapping, undisplaced apex - Mitral Stenosis
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Broad QRS with slurred upstroke on R wave (delta wave) - Wolff-Parkinson-White syndrome
Tall, tented T waves Hyperkalaemia (and wide QRS complexes)
J wave in ECG - hypothermia
Patient gets pericarditis 4-6 weeks post MI Dresslers syndrome
Blurred yellowing vision headache Digoxin Toxicity
Janeway Lesions/Oslers Nodes Subacute bacterial endocarditis
Continuous Machine like Heart Murmur Patent Ductus Arteriosus
Rib Notching on CXR Coarctation of the aorta
Crescendo decrescendo murmur Aortic Stenosis
Diminished absent lower limb pulses Coarctation of the aorta
radio-femoral delay = coarctation of the aorta
radio-radial delay = coarctation or aortic dissection
MRS ASS (Mitral Regurgitation Systolic, Aortic Stenosis Systolic)
Systolic murmur, radiates to the neck Aortic Stenosis
Sudden tearing/ripping chest pain, radiates to back Aortic Dissection
Respiratory
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Cannonball metastases (also weight loss and haematuria) classically from primary renal cell carcinoma
Morning headache hypercapnia or Side effects of organic nitrates
ACTH secreting lung tumour Small cell carcinoma of the lung
PTH secreting lung tumour Squamous cell ca. of lung
Small-cell carcinoma - neuroendocrine, highly malignant, and may be associated with ectopic endocrine
syndromes.
Increased serum ACE and Ca2+ Sarcoid
Eggshell calcification at hilar region Silicosis
Heart-failure cells seen in alveolar spaces Macrophages that have absorbed haemosiderin - found in
chronic pulmonary oedema, and associated (severe) left-ventricular heart failure. Also, seen in long-standing
pulmonary hypertension.
Ghon Focus An area of infection and caseous necrosis at the periphery of the lung, beneath the pleura found in tuberculosis infection. Note: Ghon Focus rupture (rare) through the visceral pleura into the pleural
cavity will produce tuberculous pleurisy.
Assmann Focus Apical lesion of secondary tuberculous infection
Coin lesion found on chest radiographs a rounded solitary lesion. The common lesions are: Primary
bronchial or lung carcinoma, Metastatic tumour (esp. of kidney), Bronchial hamartoma, Carcinoid tumour,
Granulomatous inflammation, Lung abscess.
Horners Syndrome Can occur when there is a local spread of cancer to the intrathoracic nodes or a
Pancoasts tumour. Signs include: ptosis (drooping of the eyelid), enophthalmos (sunken eye), miosis (small
pupil), and lack of sweating on the ipsilateral (same side as invasion) side of the face. This is due to
invasion, of the cervical sympathetic chain.
Acute management of Asthma: OSHIT MAN:
Oxygen 100% throug a non-rebreather mask
Salbutamol (2.5mg) Nebulised back-to-back.
Hydrocortisone (100mg) IV or Prednisolone(40mg) PO
Ipratropium Bromide (0.5mg) Nebulised hourly
Theophylline IV or aminophylline IV
Magnesium and call an
Anaesthetist
Thumbprint sign on head x ray epiglottitis
Inspiratory whoop/barking cough pertussis
Snow storm appearance on x ray baritosis, silicosis
Management of infective exacerbation of COPD iSOAP
i - ipratropium
S - Salbutamol
O - Oxygen
A - amoxicillin
P - prednisolone
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Gastrointestinal
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Gingival Hypertrophy -> Gingivectomy/Biting on own gums Side effect of Calcium Channel Blockers or
phenytoin
Bird beak appearance (and distended oesophagus) Achalasia; if in lower GI imaging is a sign of bowel
obstruction
Grey Turners (lumbar redness) and Cullens sign (umbilical redness) positive acute Pancreatitis
Mnemonic for causes of acute pancreatitis I GET SMASHED: Idiopathic, Gallstones, Ethanol, Trauma,
Steroids, Mumps, Autoimmune, Scorpion bites/stings, Hyperlipidaemia/hypothermia/hypercalcaemia, ERCP,
Drugs
Murphys sign positive Cholecystitis
Pale stools, jaundice, abdo pain biliary obstruction
Abdo distension, caput medusae, shifting dullness portal hypertension + ascites
Pyoderma gangrenosum, erythema nodosum Crohn's/UC
Tinkling bowel sounds bowel obstruction
Vesicular rash + weight loss Coeliac Disease
Virchows node (left supra-clavicular) gastric cancer
Urea breath test H pylori
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C breath test bacterial overgrowth
Rice-water-like stools vibrio cholera
Primary Biliary Cirrhosis Presence of AMA (Anti mitochondrial antibodies)
Autoimmune hepatitis Presence of ASMA (anti smooth muscle antibodies)
Alpha Feto Protein assay hepatocellular carcinoma (or teratoma)?
Cobblestone mucosa; indicating deep fissuring ulceration of mucosa found in Crohn's Disease
Diuretic for ascites (due to cirrhosis) spironolactone
Corkscrew oesophagus on barium swallow diffuse oesophageal spasm
Severe abdo pain + D after raw milk Campylobacter
Russells sign self induced vomiting
Mallorys hyaline bodies alcoholic liver disease (acute hepatitis) and chronic active hepatitis
Crypt abscess / cryptitis Inflammatory Bowel ULCERATIVE COLITISAC
Onion skinning fibrosis, beading of bile ducts Primary Sclerosing Cholangitis
Signet RIng cells seen on biopsy Linitis plastica - diffuse stomach cancer
Thumb-printing on X-ray commonly at splenic flexure Ischaemic colitis
Charcots triad fever, jaundice and abdominal pain secondary to acute cholangitis.
Causes for abdominal mass: A CHEMICAL: AAA, crohns, hernia, enlarged organ, malignancy,
intussusception, cyst or abcess, appendicitis, lymphadenopathyR
Causes for bowel obstruction: BATH VIPS: bolus, adhesions, tumour, hernia, volvulus, intussusception,
pseudo-obstruction, stricture.tr
Virchows node - lymph node in left supra-clavicular fossa suggestive of gastric malignancy
GI microbiology
1. Klebsiella Pneumoniae - red currant jelly sputum, cavitating lesions in upper zone CXR
2. E. Coli 0157 - Bloody diarrhoea, fragmented RBCs, undercooked hamburgers, metallic green stool cultures;
3. Salmonella Typhi - Red macules on body on examination
4. HSalmonella Enterididis - Playing with turtles, undercooked chicken/ stale chicken
5. Shigella dysenteria - bloody diarrhoea, haemorrhagic mucosa with ulcerations on distal colon
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Endocrinology
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Musculoskeletal
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Dry eyes, mouth, skin, +ve Schirmers test Sjogrens Synd. (with infiltration) (often with RA)
Dry eyes, mouth, vagina, bronchitis Sicca Synd. (no infiltration) (no signs of arthritis)
Locked knee bucket handle meniscal tear
Bamboo spine on X RAY, sacroiliitis and question mark posture Ank Spond
Shortened leg and externally rotated displaced fracture neck of femur
Shortened leg and internally rotated Dislocated femoral head
Onion-peel sign Ewings sarcoma
Sunray spiculation Osteosarcoma
Popcorn calcification on X Ray Chondrosarcoma
Soap bubble appearance on X Ray --> Giant cell tumour (benign)
scalp tenderness and jaw claudication temporal arteritis
Gowers Sign Positive Duchenne MD
Swollen, woody calves Duchenne or Becker MD
Hatchet-like face Myotonic Dystrophy
Rosary Bead sign - polyarteritis nodosa
light-bulb sign - posterior shoulder dislocation
shepherds crook deformity - fibrous dysplasia
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Miscellaneous
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2. Swinging fever Abscess or malaria
Useful mnemonics:
AP x ray A Portable
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TB drugs - 2 RIPE 4 RI - 2 months Rifampicin, Isoniazid, Pyrazinamide, Ethambutol, 4 months Rifampicin, Isoniazid
DRS ABCDE Danger, Response (AV.PU) Shout for help, Airways, Breathing, Circulation, Disability, Exposure
ABCDE (risks for melanoma) Asymmetry, border, colour, diameter, evolving/elevation
BUFALO (sepsis 6 bundle)
B Blood cultures / any other relevant cultures eg stool
U Urine output measurement
F IV Fluids
A Antibiotics
L LDH (lactase dehydrogenase) and FBC
O high flow O2
Hypothyroidism signs: BRADYCARDIC
Bradycardia
Reflexes relax slowly
Ataxia
Dry thin hair and skin
Yawning or drowsy
Cold hands +/- temperature
Ascites +/- non-pitting oedema
Round puffy face = obese
Defeated demeanor
Immobile +/- Ileus
CCF (congestive heart failure)
GET SMASHED for pancreatitis, gallstones, ethanol, trauma, steroids, mumps, autoimmune, scorpion stings,
hyperlipidaemia/hypercalcaemia, ERCP, drugs
For learning bones of the hand: Some Lovers Try Positions That They Cannot Handle (or So Long To Pinky, Here
Comes The Thumb)
Start from thumb (i.e. laterally in anatomical position), bottom line
Scaphoid
Lunate
Triquetrum
Pisiform
Back to thumb, top line
Trapezium
Trapezoid
Capitate
Hamate
Microcytic anaemia: Find The Small Cell
- Fe deficiency
- Thalassaemia
- Sideroblastic anaemia
- Anaemia of Chronic Disease
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Field defects
DKA causes
Infection
Ischaemia
Infarction
Ignorance
Intoxication
PE risk factors
Hereditary eg factor V Leiden
History - previous DVT or PE
Hypomobility eg fracture or long trip
Hypovolaemia eg dehydration
Hypercoagulability eg smoking
Hormones eg oestrogen
Hyperhomocysteinemia
Hyperviscosity states eg malignancy, post-surgery
urolo
4 H's and 4Ts for reversible causes of cardiac arrest
Hypovolaemia
Hypothermia
Hyperkalaemia/hypokalaemia
Hypoxia
Tamponade
Tension pneumothorax
Thromboembolism
Toxin
NO MAPID RASH diagnostic features of SLE (or No Paid Marsh)
Neurological symptoms
Oral ulcers
Malar rash
ANA positive
Photosensitivity
Immunodeficiency
Discoid Rash
Renal problems
Arthritis
Serositis
Haemoglobin low
Keep Grannies Proud, Buy Dentures-layers of the epidermis of the skin
Keratin layer, Granular layer, Prickle cell layer, Basal cell layer, Dermis
Acute limb ischaemia - Pale, Pulseless, Painful, Paralysed, Paraesthetic, Perishingly cold
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Antibody(s)
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SLE
Sjogren's syndrome
Rheumatoid arthritis
Systemic sclerosis
Autoimmune hepatitis
Anti-RNP
Antiphospholipid syndrome
Polymyositis
Anti-Jo-1
Dermatomyositis
Anti-Jo-1
Oh
IV - Trochlear
To
V - Trigeminal
Touch
VI - Abjucant
And
VII - Facial
Feel
VIII - Vestibulocochlear
Virgin
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IX - Glossopharyngeal
X - Vagus
XI Spinal Accessory
XII Hypoglossal
Girls
Vagina
And
Hymens
RIPc
https://www.youtube.com/watch?v=SmHeP9Sve48
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