You are on page 1of 16

Buzzwords

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
1.
2.
3.
4.

5.
6.
7.

8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.

Third-person auditory hallucinations - Schizophrenia


Mesocortical dopamine hypoactivity negative and cognitive symptoms in schizophrenia
Subcortical dopamine hyperactivity psychosis
Dopamine pathways in the brain: tuberoinfundibular (concerned with prolactin release), nigrostriatal (extra
pyramidal motor movements), subcortical and mesocortical (sometimes known as mesolimbic system)
(motivation and reward). The latter is dysregulated in schizophrenia (see above point).
Mesolimbic - Da blockade - Depression
- Da agonism - psychosis
Remember clozapine does cause agranulocytosis, cardiomyocitis but it also causes a lot of weight gain
(second to olanzapine, which causes the most weight gain of the atypical anti-psychotics)
Clozapine - need to try 2 other anti-psychotics and be a consultant to prescribe. Lots of monitoring once a
week for the first 6/12, then once every 2 weeks for the next 6/12 then every four weeks thereafter and one
month after discontinuation.
Limbic system functions (M2OVE - Motivation, memory, olfaction, visceral afferents and Emotion)
Brain changes in schizophrenia: reduced frontal lobe volume (and grey matter), enlarged lateral ventricles,
reduced grey matter in the temporal cortex.
Pressure of thought: varied ideas in abundance (characteristic of mania but can also be seen in
schizophrenia
Poverty of thought: patient reports lack/absence of thoughts
Thought blocking: abrupt and complete interruption of stream (strongly associated with schizophrenia)
Flight of ideas: quickly moving from one topic to another but there is a link unlike in knights move thinking
where there does not appear to be a link between point A and point B. - seen in bipolar during manic phase
Treat EPSE with procyclidine
Amygdala: involved in normal response to threat
PFC (pre-frontal cortex) : dampen downs amygdala response to threat ( fewer connections less effective)
Management of OCD: 1. SSRI, 2. SSRI, 3. TCA or SSRI, 4. SSRI or TCA - (TCA used is clomipramine) so
essentially an SSRI and if there is a partial response at any of those points, consider CBT as an adjunct
Learning disabilities: borderline 70-80 ish, mild 50-69, moderate 35-49, severe 20-34, profound <20
Becks triad: -ve feelings about self, world and future
NMDA antagonists produce psychotic symptoms
Alcohol withdrawal - use chlordiazepoxide ( 30mg QDS, 25mg QDS, 20 mg QDS, 15mg QDS, 10mg QDS,
10mg TDS, 10mg BD, 10mg OD - nocte).
Alcohol withdrawal seizures within 48 hours
Delirium tremens between 48 and 72 h
Eosinophilic inclusions - Lewy bodies (LBD and PD)
Risk of hypertensive crisis with MAOIs (interactions with tyramine containing foods, ephidrine, nasal
decongestants, TCAs, pethidine) - treat with phentolamine infusion
Avoid TCAs in cardiac problems or patients with suicidal intent

Ophthalmology
1.
2.
3.

Cherry Red Spot at the macula - Central Retinal Artery Occlusion


Tear drop or blood level in sinus - blow-out fracture (cant look up + double vision)
Failure to adduct and nystagmus in abducting eye - Internuclear ophthalmoplegia - issue with medial
longitudinal fasciculus

4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.

Pain on eye movement - optic neuritis, most commonly caused by MS


Painful loss of vision 1-ks - optic neuritis
Curtain coming down <5 mins - Amaurosis Fugax
Curtain coming down (partial) longer than 5 mins - Retinal detachment
Flashes and floaters - retinal detachment
Photophobia, posterior synechiae, cells in AC - Anterior uveitis
Gritty - bacterial conjunctivitis or sub-tarsal foreign body
Watery and pain and pre-auricular lymph nodes - viral conjunctivitis
Silver / copper wiring - HTN eye disease
Loss of red reflex, eye red on ophthalmoscopy - Haemorrhage
New vessels and haemorrhage - ARMD Wet
Follicular conjunctivitis - Chlamydia (unilateral usually)
Pinpoint pupils - Pontine issue
Dilated pupils - trans-calcarine fracture
Different sized pupil - damage to CN3 (or sympathetic chain as in Horners)
Down out dilated - damage to CN3
Down and out not dilated - Diabetes
Roth spots - infective endocarditis
Brushfield spots - Downs syndrome
Scrambled egg/egg yolk appearance of the macula - Best disease
Drusen - dry ARMD

Reproduction
1.
2.
3.

USS Snowstorm appearance, Described as frogspawn when expelled = Hydatidiform Mole


Antepartum haemorrhage in patient with Succenturiate Lobe or Velamentous Insertion - Vasa Praevia
Maternal blood + no Fetal distress - Placenta previa MUST EXCLUDE BEFORE VAGINAL EXAMINATION
in Ante-partum Haemorrhage
4. Fetal blood + sudden fetal distress - vasa previa (need to treat with c-section)
5. Placenta accreta (doughy abdomen) - Insertion into myometrium post endometrial ablation. -> C-section +/hysterectomy. Always give contraception!
6. Fetal distress and loss of engagement, previous C-section or surgery - uterine rupture
7. PPH followed by pituitary failure - Sheehan's Syndrome
8. Strawberry cervix - trichomonas vaginalis (tx: metronidazole)
9. Clue cells, high vaginal pH (>4.5) - bacterial vaginosis (tx: metronidazole)
10. Prolapse + back pain - uterine prolapse
11. Large tense uterus (woody abdomen), bleeding and pain - placental abruption

ENT
1.
2.
3.
4.
5.
6.
7.
8.

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

9. Saddle nose - Wegeners granulomatosis(granulomatosis with polyangiitis)


10. Littles area - branches from external carotid artery (via maxillary and facial) and internal carotid (via
ophthalmic)

Child Health
1.
2.
3.
4.
5.
6.

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
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

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
1.
2.
3.
4.
5.
6.

Stuck-on appearance - Basal cell papilloma (seborhaeic keratoses)


Picket fence pearly border, rodent ulcer- Basal cell carcinoma
Dermatitis Herpetiformis +IgA +ve - Coeliac Disease
Erythema nodosum - Commonly sarcoidosis, also IBD and TB.
Erythematous Bullseye lesion (Erythema migrans) - Lyme disease
Ash Leaf Spots/Shagreen patches + epilepsy + periungum scleroma, adenoma sebacum - Tuberous
Sclerosis
7. Honey coloured crust - Impetigo (caused by staph or group A haemolytic strep)
8. Cafe au lait spots, Lisch spot in eyes, axillary fleckering - Neurofibromatosis Type 1 or 2
9. Silver scales, extensor surfaces - Psoriasis
10. Cauliflower appearance - Plantar warts
11. Kaposi's sarcoma - HIV, immunosuppressed (transplant) - HHV8
12. Intense erythema on cheeks (and proximals limbs) of child - Slapped cheek (caused by [erythrovirus]

13.
14.
15.
16.
17.
18.
19.

Parvovirus B19) - Aplastic anaemia in SCD


Small, umbilicated, translucent papules that look fluid-filled but are solid - molluscum contagiosum
Flaccid blisters than can be burst easily to form erythematous erosions - Pemphigus Vulgaris
Large tense bullae that are itchy and cannot be burst - Bullous Pemphigoid (X involve mouth)
Heliotrope rash and scaly knuckles (Gottorns papule) - Dermatomyositis
Fish scale skin - Ichthyosis
Velvety thickened lesions in axillae - acanthosis nigricans - Addisons (due to increased ACTH)
Target lesion - erythema multiforme

Haematology
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.

Schistocytes - intravascular haemolysis


Pepper pot skull - myeloma
Reed-Sternberg cells/CD30 positive - Hodgkins Lymphoma
Philadelphia Chromosome (9;22 translocation) - Chronic Myeloid Leukemia BCR-ABL gene
Atypical Lymphocytes - EBV (mononucleosis)
Heinz bodies - G6PD deficiency
Auer rods - acute myeloid leukaemia
Bence-Jones Proteins - Multiple Myeloma
Itchy after a hot bath - polycythaemia rubra vera
Translocation (8;14) - Burkitts lymphoma
African kid with history of EBV and tumour is in face/jaw - Burkitts
Alcohol makes it worse - Hodgkins lymphoma
Haemarthrosis - Haemophilia
Bleeding into joint - problem with secondary haemostasis
Reduced levels of factor IX with Christmas Disease - Haemophilia B
Young boy with reduced levels of factor VIII and an increased APTT - Haemophilia A
Priapism - associated with Sickle Cell Disease
Gum infiltration bilobed large mononuclear cells - AML
Smudge cells, peripheral blood lymphocytosis, small mature lymphotcytes - CLL
vWD - behaves like platelet disorder, prolonged bleed time and APTT
IgM paraprotein - Waldenstorms Macroglobulinaemia
Raised ESR and osteoporosis - myeloma until proven otherwise

Cardiology
1.
2.
3.
4.
5.
6.
7.
8.
9.

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

10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.

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
1.
2.
3.
4.
5.
6.
7.

8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.

Stony dull to percuss Pleural Effusion


Right sided pleuritic chest pain most likely pneumonia
Alveolar bats wings, Kerley B lines, cardiomegaly, dilated prominent upper lobe vessels Pleural effusion
Pulmonary oedema
Ground-glass appearance on X-ray Pulmonary fibrosis and Respiratory Distress Syndrome of the
newborn
Ziehl-Neelsen stain positive for acid fast bacilli TB
Caseous necrosis TB
Miliary Tuberculous spread of organism into bloodstream. If organism spread via pulmonary artery,
miliary dissemination into the lung occurs. If organism spread via pulmonary vein, there is systemic
dissemination to the liver, spleen, and kidneys.
Positive anti-glomerular basement membrane antibodies Goodpastures syndrome
Chest infection with a parrot/pigeon as pet caused by chlamydophila psittaci
Dry cough and diarrhoea after holiday abroad, some indication of water spread Legionella pneumophila
(test urine for antigens) - hyponatraemia
Tall, thin young man who indulges in marijuana - or a Mr. Snoop Dogg (I believe hes Mr Snoop Lion now)
probably pneumothorax (Marfans)
Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss
Sarcoidosis
Bronchiole wider than neighbouring arteriole (on CT) (signet ring sign) Bronchiectasis
D sign on X ray Empyema
Steeple sign on X ray laryngotracheobronchitis/croup
Child with barking cough Croup
Pneumocystis pneumonia HIV (treat with Co-trimoxazole [ prednisolone if severe])SS
Asthma + Nasal Polyps + Salicylate sensitivity Samters Triad
Alcoholic (danger of aspiration pneumonia) Klebsiella pneumoniae
Red Jelly sputum Klebsiella Pneumoniae
Mucoid sputum Chlamydia psittaci
Rusty sputum Pneumococcal pneumonia

23.
24.
25.
26.
27.
28.
29.
30.

31.

32.
33.

34.

35.
a.
b.
c.
d.
e.
f.
g.
1.
2.
3.
4.

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

40.
41.
42.
43.
44.

Non-smoker + lung cancer = (peripheral) adenocarcinoma


Squamous + Small-cell Lung cancers = CENTRAL
High d-dimers suspect (but not diagnose) Pulmonary Embolism (send for CTPA or V/Q scan)
Low d-dimers exclude Pulmonary Embolism
Large PE: thrombolysis

45.

Small PE: Low Molecular Weight Heparin

46.

Honeycomb lung: fibrosing alveolitis

Memrise : dundee-buzzwords http://www.memrise.com/course/480297/

Gastrointestinal
1.
2.
3.
4.

5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.

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
13
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

6.
7.

Vibrio Cholerae - India, severe dehydration, watery diarrhoea


Campylobacter jejuni - Unpasteurised/raw milk, Guillain Barre Syndrome

Endocrinology
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.

Catecholamines in the urine, headaches, hypertension and palpitations Phaeochromocytoma


Tanned skin without being on holiday Primary Addisons (no tanning if secondary to hypopituitarism)
Increased shoe size, spade hands, wedding ring too tight Acromegaly
Signs of hyperthyroidism plus any eye changes, gritty eyes, smooth velvety skin Graves disease
Moon face, proximal weakness, stretch marks, buffalo hump, abdo fat Cushings
Ketones on breath (sweet smelling/pear drop breath) DKA
Deep, laboured breathing (Kussmaul breathing) metabolic acidosis (esp DKA)
Orphan Annie Nuclei Papillary thyroid cancer
Bone pain, stones, abdo pain, psychiatric problems (bones, stones, groans, moans) Hypercalcaemia
(hyperparathyroidism)
Psammoma bodies are found in papillary thyroid carcinomas
Butterfly rash SLE
Heat intolerance/palpitations Hyperthyroidism
Cold intolerance/weight gain Hypothyroidism
Anosmia and isolated GnRH deficiency Kallmanns syndrome
Trousseau sign, Chvostek sign and QT prolongation (on ECG) HYPOCALCAEMIA
Acute management of HYPOCALCAEMIA IV calcium gluconate (10 ml of 10% calcium gluconate over 10
minutes in 50% dextrose or saline)
Brachydactyly (short bones) of the 4th metacarpal Pseudohypoparathyroidism

Musculoskeletal
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Pencil-in-cup X-ray appearance, sausage fingers Psoriatic Arthritis


Wrist Drop Radial nerve palsy
Dinner fork or Swans neck deformity in wrist Displaced Colles fracture
Pain/tenderness in the anatomical snuffbox Scaphoid fracture
Feels like walking on pebbles advanced rheumatoid arthritis in the feet - subluxation of the
metatarsophalangeal joints
Arthritis + Uveitis + Urethritis (cant see, cant pee, cant bend the knee) Reiters Syndrome (Reactive
Arthritis, can be post-gonorrhoea)
Foot drop common fibular nerve (peroneal nerve)
Fracture AV necrosis Proximal scaphoid, Intracapsular femoral, femoral condyles, humeral head,
capitellum and proximal talus
Sagging rope sign AVN
Negative birefringent, needle shaped urate crystals (yellow to blue) Gout
Envelope shaped/rhomboid, mildly positive birefringent Ca pyrophosphate crystals Pseudogout
Positive anterior drawer test (tibia can be pulled forward easily on the femur when knee flexed) ACL
tear/rupture
Pain in internal rotation and extension of knee at 90 degree lateral meniscal tear
Painful arc (pain on abducting between about 70-120 degrees) damaged supraspinatus tendon, frozen
shoulder, rotator cuff tendon impingement
Difficulty with external rotation = frozen shoulder

16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.

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

Renal
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.

Cannon balls Renal Mets on CXR


Loin to groin pain Renal colic
Sea anemone transitional cell carcinoma on cystoscopy
UTI + Travel to India Carbapenase-producing Klebsiella (Resistant to all antibiotics)
UTI with foul smelling urine and renal calculi Proteus sp.
Beading of the renal artery Fibromuscular Dysplasia
RBC casts in urine Proves haematuria is glomerular
Muddy brown casts of epithelial cells Acute tubular necrosis
Potato appearance Testicular seminoma
Blue dot sign Torsion of testicular appendix (cremasteric reflex still present)
Saddle nose -> Wegeners
Schistosomiasis/ catheterisation Squamous cell carcinoma
Apple-green birefringence on Congo Red stain Amyloidosis

4 8 15 16 23 42

Miscellaneous
1.
2. Swinging fever Abscess or malaria

Useful mnemonics:
AP x ray A Portable

10

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

11

Megaloblastic anaemia: Cant be fucked (CBF)


- Cytotoxic drugs eg methotrexate
- B12 deficiency
- Folate deficiency
Pruritus causes: ITCH
Iron deficiency anaemia / Internal malignancy
Thyroid / Type 1 Diabetes
CRF / Chronic liver disease
HIV / Hereditary Haemochromatosis
Clubbing
Cyanotic heart disease
Lung disease (hypoxia, cancer and cystic fibrosis, idiopathic pulmonary fibrosis)
UC/Crohns
Biliary cirrhosis
Birth defect
Infective endocarditis
Neoplasm (especially Hodgkins)
GI malabsorption
Clubbing: 8Cs
Cardiac (infective endocarditis)
Chest (suppuration: empyema, abscess, bronchiectasis etc)
Colonic (IBD)
Cirrhosis (liver)
Carcinoma (chest)
Compression (e.g. Pancoasts tumour causing neurovascular compression)
Congenital
Circulation (AV fistula in dialysis patients)
Respiratory Causes of Clubbing
Absess
Bronchiectasis (including CF)
Carcinoma of the lung
Decreased PaO2 (hypoxia)
Empyema
Fibrotic lung diseases
Adrenal cortex layer and secretions: Go Find Rex, Make Good Sex
Glomerulosa
Mineralocorticoids
Fasciculata
Glucocorticoids
Reticularis
Sex hormones
Acromegaly
Arthralgia / Arthritis
BP high
Carpal tunnel syndrome
Diabetes
Enlargement of organs

12

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

13

Causes of Liver Disease:


A - Autoimmune
B - Hepatitis B
C - Hepatitis C
D - Drugs e.g. paracetamol
E - Ethanol
F - Fatty Liver Disease (NASH ~ obesity)
G - Growth (cancer/metastases)
H - Haemodynamic e.g. congestive heart failure
I - Infiltration [iron] (e.g. haemochromatosis, Wilsons Disease) or Infective
to remember AST is increased in alcoholic liver disease: wASTed
- or AST: Alcohol gets you STeaming
ALT is more specific to the Liver than AST
Causes of abdominal distension - 5 (or 6) Fs:
Fat
Foetus
Flatus
Faeces
Fluid
Fucking massive tumour (especially in OSCEs!)
Antibiotics given for different conditions: (thought it might help)
Condition/organism
Antibiotic(s)
Staph aureus
Flucloxacillin
Methicillin resistant Staph (MRSA)
Vancomycin or Teicoplanin
Nosocomial pneumonia (severe)
IV amoxicillin + metronidazole + gentamicin
Nosocomial pneumonia (mild)
Amoxicillin + metronidazole
CAP (CURB 0-2)
Amoxicillin (if penicillin allergic, use doxycycline)
CAP (3 or more)
IV Co-amoxiclav + IV Clarithromycin
Intra-abdominal sepsis
IV amox + metronidazole + gentamicin
Recurrent/relapse C. Difficile
Fidaxomicin C. difficile (mild)
Metronidazole
C. difficile (severe)
ORAL Vancomycin (ONLY TIME YOU EVER USE ORAL VANC - you
want it to stay in the gut)
TB
Rifampicin, Pyrazinamide, Ethambutol, Isoniazid - give all 4 for 2
months then Rifampin and Isoniazid for a further 4 months - KNOW SIDE EFFECTS!!! i.e. orange tears, hepatic and
renal toxicity...
Pneumocystis carinii (HIV patients getting pneumonia) Co-trimoxazole
Acute exacerbation of COPD
1st line - Amox, 2nd line doxycycline
Legionnaires disease
Erythromycin or clarithromycin
Epiglottitis (h. influenzae)
Ceftriaxone
Amoebiasis
Metronidazole
Giardiasis
Metronidazole
Condition

Antibody(s)

14

SLE

ANA, Anti-dsDNA binding, Anti-Sm, Anti-Ro and La

Sjogren's syndrome

Anti Ro, Anti La and Rheumatoid factors

Rheumatoid arthritis

Anti CCP and rheumatoid factor

Systemic sclerosis

Anti- centromere, Anti-scl-70


LIMITED -- Centromere
DIFFUSE -- Anti-scl-70

Autoimmune hepatitis

ANA, ASMA (anti-smooth muscle antibody)

Mixed connective disease

Anti-RNP

Antiphospholipid syndrome

Anticardiolipin antibodies, lupus anticoagulant

Polymyositis

Anti-Jo-1

Dermatomyositis

Anti-Jo-1

Cranial Nerves - Sensory, Motor or Both?


I - Olfactory
Some
II - Optic
Say
III - Occulomotor
Money
IV - Trochlear
Matters
V - Trigeminal
But
VI - Abducent
My
VII - Facial
Brother
VIII - Vestibulocochlear
Says
IX - Glossopharyngeal
Big
X - Vagus
Butts or boobs (depends what floats your boat) ;)
XI - Spinal Accessory
Matter
XII - Hypoglossal
Most
Carlos only smokes spliff since Rastaman offered skunk in indigenous Jamaica. Jamaican joint heaven - order of
cranial nerves cranial foraminae
Parasympathetic = III, VII, IX, X
NONE are sympathetic - sympathetic outflow = T1-L2
Names and order of the cranial nerves
I - Olfactory
Oh
II - Optic
Oh
III - Occulomotor

Oh
IV - Trochlear
To
V - Trigeminal
Touch
VI - Abjucant
And
VII - Facial

Feel
VIII - Vestibulocochlear
Virgin

15

IX - Glossopharyngeal
X - Vagus
XI Spinal Accessory
XII Hypoglossal

Girls
Vagina
And
Hymens

Useful song: https://www.youtube.com/watch?v=dQw4w9WgXcQ

Causes of Pulmonary Fibrosis


Bleomycin
Radiation
Extrinsic allergic alveolitis
Ankylosing Spondylitis
Sarcoidosis
Tuberculosis

Cryptogenic fibrosing alveolitis (idiopathic pulmonary fibrosis)


Asbestosis

RIPc
https://www.youtube.com/watch?v=SmHeP9Sve48

16