Some mnemonics for mci screening test, FMGE exam
By Live Dr - Thu Oct 30, 12:22 pm
Some mnemonics for mci exam…that might help…..
2.MI: basic management BOOMAR:
Reduce clot size
3.ECG: left vs. right bundle block “WiLLiaM MaRRoW”:
W pattern in V1-V2 and M pattern in V3-V6 is Left bundle block.
M pattern in V1-V2 and W in V3-V6 is Right bundle block.
• Note: consider bundle branch blocks when QRS complex is wide.
4.Pericarditis: causes CARDIAC RIND:
Collagen vascular disease
Drugs (such as hydralazine)
Acute renal failure
5.Murmurs: systolic types SAPS:
• Systolic murmurs include aortic and pulmonary stenosis.
• Similarly, it’s common sense that if it is aortic and pulmonary stenosis it could also be mitral and tricusp regurgitation.
Persistent chest pains
Shortness of breath
7.Heart compensatory mechanisms that ‘save’ organ blood flow during shock “Heart SAVER”:
Atrial natriuretic factor
Endogenous digitalis-like factor
• In all 5, system is activated/factor is released
8.Murmurs: right vs. left loudness “RILE”:
Right sided heart murmurs are louder on Inspiration.
Left sided heart murmurs are loudest on Expiration.
• If get confused about which is which, remember LIRE=liar which will be inherently false.
Treatment (eg pericardiocentesis)
Injury (AMI, contusion)
Osborne waves (hypothermia)
10.Beck’s triad (cardiac tamponade) 3 D’s:
Distant heart sounds
Distended jugular veins
Decreased arterial pressure
11MI: therapeutic treatment ROAMBAL:
12.CHF: causes of exacerbation FAILURE:
Ischemia/ Infarction/ Infection
Lifestyle: taken too much salt
Upregulation of CO: pregnancy, hyperthyroidism
PAID: Pulmonic & Aortic Insufficiency=Diastolic.
14.Murmurs: systolic vs. diastolic Systolic murmurs: MR AS: “MR. ASner”.
Diastolic murmurs: MS AR: “MS. ARden”.
• The famous people with those surnames are Mr. Ed Asner and Ms. Jane Arden.
15.Mitral stenosis (MS) vs. regurgitation (MR): epidemiology MS is a female title (Ms.) and it is female predominant
MR is a male title (Mr.) and it is male predominant.
16.Pericarditis: EKG “PericarditiS”:
PR depression in precordial leads.
Obstruction of venea cava
Lymphatic enlargement – supraclavicular
Intra-Thoracic pressure increase
18.Depressed ST-segment: causes DEPRESSED ST:
Drooping valve (MVP)
Enlargement of LV with strain
Potassium loss (hypokalemia)
Reciprocal ST- depression (in I/W AMI)
Embolism in lungs (pulmonary embolism)
Encephalon haemorrhage (intracranial haemorrhage)
Toxicity of digitalis, quinidine
Sounds (S1 & S2) normal
Special tests normal (X-ray, EKG)
Standing/ Sitting (vary with position)
20.Murmur attributes “IL PQRST” (person has ill PQRST heart waves):
21.Murmurs: locations and descriptions “MRS A$$”:
MRS: Mitral Regurgitation–Systolic
A$$: Aortic Stenosis–Systolic
• The other two murmurs, Mitral stenosis and Aortic regurgitation, are obviously diastolic.
• Cardioselective betablockers are:
23.Apex beat: abnormalities found on palpation, causes of impalpable HILT:
• If it is impalpable, causes are COPD:
Pleural, Pericardial effusion
24.MI: treatment of acute MI COAG:
Depressed ventricular function
Stenosis of the left main stem
Triple vessel disease
26.Peripheral vascular insufficiency: inspection criteria SICVD:
Symmetry of leg musculature
Integrity of skin
Color of toenails
Distribution of hair
27.Heart murmurs “hARD ASS MRS. MSD”:
hARD: Aortic Regurg = Diastolic
ASS: Aortic Stenosis = Systolic
MRS: Mitral Regurg = Systolic
MSD: Mitral Stenosis = Diastolic
29.Sino-atrial node: innervation Sympathetic acts on Sodium channels (SS).
Parasympathetic acts on Potassium channels (PS).
30.Supraventricular tachycardia: treatment ABCDE:
Calcium channel antagonist
Excitation (vagal stimulation)
31.Ventricular tachycardia: treatment LAMB:
32.Pulseless electrical activity: causes PATCH MED:
Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia
Neap thyroid (hypothyroid)
Unconsciousness (vasovagal syncope)
Subnormal temperatures (hypothermia)
Raised CO2 (hypercapnia)
Deficient blood sugar (hypoglycemia)
Imbalance of electrolytes
Cushing’s reflex (raised ICP)
Rx (drugs, such as high-dose atropine)
Ischemic heart disease
• Minor criteria: CAFE PAL:
Prolonged PR interval
Anamnesis of rheumatism
36.JVP: wave form ASK ME:
Systole (ventricular contraction)
Klosure (closure) of tricusps, so atrial filling
Maximal atrial filling
Emptying of atrium
37.Coronary artery bypass graft: indications DUST:
Depressed ventricular function
Stenosis of the left main stem
Triple vessel disease
MI in the last 7 days
39.ECG: T wave inversion causes INVERT:
Normality [esp. young, black]
Ectopic foci [eg calcified plaques]
40.Rheumatic fever: Jones major criteria JONES:
Joints (migrating polyarthritis)
Obvious, the heart (carditis, pancarditis, pericarditis, endocarditis or valvulits)
Nodes (subcutaneous nodules)
Narcotic analgesics (eg morphine, pethidine)
Facilities for defibrillation (DF)
Aspirin/ Anticoagulant (heparin)
Converting enzyme inhibitor
IV beta blocker
42.Atrial fibrillation: causes PIRATES:
Pulmonary: PE, COPD
Rheumatic heart: mirtral regurgitation
Atherosclerotic: MI, CAD
Sick sinus syndrome
43.Atrial fibrillation: management ABCD:
Beta-block to control rate
44.Anti-arrythmics: for AV nodes “Do Block AV”:
46.Apex beat: differential for impalpable apex beat DOPES:
Pericarditis or pericardial tamponade
Sinus inversus/ Student incompetence
Pain in abdomen
Precipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)
BUN:creatinine elevation: causes ABCD:
Diet (high protein parenteral nutrition)
G6PD: oxidant drugs inducing hemolytic anemia AAA: Antibiotic (eg: sufamethoxazole)
Antimalarial (eg: primaquine)
Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)
Vitamin B3 (niacin, nicotinic acid) deficiency: pellagra
The 3 D’s of pellagra: Dermatitis Diarrhea Dementia
• Note vitamin B3 is the 3 D’s.
Tangier’s disease: hallmark
Hallmark is large orange tonsils.
• Important clinical note: there is no increased risk of atherosclerosis, just like eating tangerenes.
Na+/K+ pump: movement of ions and quantity
K+ and in each consist of 2 characters, so so 2 K+ are pumped in. Na+ and out each consist of 3 characters, so 3 Na+ are pumped out
Glycogen storage: Anderson’s (IV) vs. Cori’s (III) enzyme defect
• Otherwise, can’t really distinguish clinically.
Nitric oxide: amino acid precursor
When the dentist works on your teeth, you say, “AAArg! (Arginine)” before he administers Nitric Oxide (NO) to take the pain away.
• Other players necessary for NO synthesis: NO synthase, Ca++, NADPH.
Pompe’s disease: type “Police = Po + lys”:
Pompe’s disease is a lysosomal storage disease (alpha 1,4 glucosidase).
Metabolic acidosis (normal anion-gap): causes
• With hyperkalemia: RAISE K+:
RTA type 4
Aldosterone or mineralocorticord deficiency
Iatrogenic: NH4Cl, HCl
“Stenosis”: obstructive uropathy
• With hypokalemia: ReDUCE K+:
Renal TA type 1 and 2
Urine diversion into gut
Carbonate anhydrase inhibitor
GALIPUT: Galactose 1 Phosphate Uridyl Transferase.
• There is an assay called the Galiput test for this.
Citric acid cycle compounds
“Our City Is Kept Safe And Sound From Malice”:
Oxaloacetate Citrate Isocitrate alpha-Ketoglutarate Succinyl-CoA Succinate Fumarate Malate
Folate deficiency: causes A FOLIC DROP:
Folic acid antagonists
Low dietary intake
Infection with Giardia
Relative folate deficiency
Mitochondrial DNA (mt DNA) properties
mt stands for: Maternal Transfer Mutates Tremendously (high mutation rate)
“The FAT cat is in the ADEK (attic)”:
Fat soluble vitamins are A,D,E,K.
Enzyme kinetics: competitive vs. non-competitive inhibition
With Kompetitive inhibition: Km increases; no change in Vmax. With Non-kompetitive inhibition: No change in Km; Vmax decreases.
Glycogen storage: names of types I through VI
“Viagra Pills Cause A Major Hardon”:
Sickle cell disease pathophysiology
SICKle cell disease is due to a Substitution of the SICKsth amino acid of the B chain.
“Mr. Gluca has Gone to the cAMP to bring out some Glucose”:
• Glucagon elevates glucose by cAMP mechanism.
Van den Bergh reaction (Jaundice test)
“Indirect reacting bilirubin = Unconjugated bilirubin”:
Both start with vowels, so they go together:
Indirect & Unconjugated.
Hemoglobin binding curve: causes of shift to right
“CADET, face right!”:
2,3-DPG (aka 2,3 BPG)
“QISS & QIQ” (Kiss and Kick):
• G-proteins and their respective receptors (alphabetical order):
Q: alpha 1 I: alpha 2 S: beta 1 S: beta 2 &
Q: M1 I: M2 Q: M3
“ABC of Adrenaline”:
Beta receptors–> increases
Citric acid cycle compounds
“Can I Keep Selling Sex For Money, Officer?”:
Citrate Isocitrate alpha Ketogluterate Succinyl CoA Succinate Fumerate Malate Oxaloacetate
Carbon monoxide: electron transport chain target
“CO blocks CO”:
Carbon monoxide (CO) blocks Cytochrome Oxidase (CO)
“Use both arms to HUG”:
Heme synthesis Urea cycle Gluconeogenesis • These reactions occur in both cytoplasm and mitochondria.
Na/K pump: concentrations of Na vs. K on inside/outside of cell, pump action, number of molecules moved
HIKIN’: There is a HIgh K concentration INside the cell. From this can deduce that the Na/K pump pumps K into cell and Na out of cell. Alternatively: When I was learning this pump (circa 1992), a band that was “in” was Kris Kross, and a band that was “out” was “Sha Na Na Na”: So pump moves K K (2 K) in and Na Na Na (3 Na) out. • Sadly, as infectious as their debut album was, Kris Kross can really no longer be classed as “in”.
Strongest bonds are between Cytosine and Guanine, strong like Crazy Glue (3 H-bonds), whereas the A=T only have 2 H-bonds. • This is relevant to DNA replication, as the weaker A=T will be the site where RNA primer makes the initial break.
Dicarboxylic acids (alpha, omega) C2 through C10: common names
“Oh My, Such Good Apple Pie, Sweet As Sugar!”:
Oxalic Malonic Succinic Glutaric Adipic Pimelic Suberic Azelaic Sebacic
Infantile Beriberi symptoms
Restlessness Sleeplessness Breathlessness Soundlessness (aphonia) Eatlessness (anorexia) Great heartedness (dilated heart)
• Alternatively: Get 5 of ’em with BERI: Breathless/ Big hearted, Eatless, Restless, Insomnia.
“A Lighter Lease” (A LyTr LeIs):
A=AcetylCoA or Acetoacetyl CoA
Fasting state: branched-chain amino acids used by skeletal muscles
“Muscles LIVe fast”:
“Goodness Gracious, Father Franklin Did Go By Picking Pumpkins (to) Prepare Pies”:
Phosphoenolpyruvate [PEP] Pyruvate • ‘Did’, ‘By’ and ‘Pies’ tell you the first part of those three: di-, bi-, and py-.
• ‘PrEPare’ tells location of PEP in the process.
Foam cells found in glomeruli and tubules/ Febrile episodes
Alpha galactosidase A deficiency/ Angiokeratomas
Burning pain in extremities/ BUN increased in serum/ Boys
YX genotype (male, X linked recessive)
B vitamin names
“The Rhythm Nearly Proved Contagious”:
• In increasing order: Thiamine (B1) Riboflavin (B2) Niacin (B3) Pyridoxine (B6) Cobalamin (B12)
Rotenone is a site specific inhibitor of complex one.
Citric acid cycle compounds
“Oh! Can I Keep Some Succinate For Myself?”:
Oxaloacetate Citrate Isocitrate Ketoglutarate Succinyl coA Succinate Fumarate Malate
Citric acid cycle compounds
“Oh Citric Acid Is Of (course) A SiLly STupid Funny Molecule”:
Oxaloacetate Citrate Aconitate Isocitrate Oxalosuccinate Alpha-ketoglutarate SuccinyL-CoA SuccinaTe Fumarate Malate
• SilLy and sTupid used to differentiate succinyL and succinaTe
Type 1 glycogen storage disease
Type 1 = one (Von), ie Von Giereke’s disease
Essential amino acids
PVT. TIM HALL: Phe Val Thr Trp Ile Met His Arg Leu Lys
• Pvt. is short for Private in the military.
• Arg and His are considered semiessential.
• Alternatively: “MATT VIL PHLy”.
“Can I Ask Sharon Stone For My Orgasm?”:
Citrate Isocitrate Alpha-Ketoglutarate Succinyl CoA Succinate Fumerate Maleate Oxaloacetate
Golgi complex: functions
“Golgi Distributes A SPAM”:
Distributes proteins and lipids from ER
Add mannose onto specific lysosome proteins
Sulfation of sugars and slected tyrosine
Add O-oligosugars to serine and threnonine
Modify N-ologosugars on asparagine
Pyruvate: products of complete oxidation
“4 Naked Fun 3 Coeds + 1 Guy”:
• Complete oxidation of pyruvate yields:
4 NADH FADH2 3 CO2 1 GTP
Catabolism steps of branched chain amino acids
“Truck hit the Ox to Death”:
Niacin deficiency: signs and symptoms
The famous 4 D’s:
Diarrhoea Dermatitis Dementia Death (if untreated)
Creatine phosphate: amino acid precursors
“Nice GAMs!”: Glycine Arginine Methionine
• Gam is slang for a person’s leg, especiallay an attractive female’s leg: “Nice gams = nice legs!”
• Creatine phosphate is a muscle energy store, and spontaneously converts to creatinine which is excreted in the urine in direct proportion to muscle mass: clinically useful, such as in MS Dx.
“Over The HILL”:
• Enzymes get reaction over the hill.
INsulIN stimulates 2 things to go IN 2 cells: Potassium and Glucose.
Collagen concisely covered
C-terminal propeptide (procollagen)/ Covalent Cross links/ C vitamin/ Connective tissue/ Cartilage/ Chondroblasts/ Copper Cofactor (Covalent Cross linking)
Outside the cell is where collagen normally functions/ Osteoblasts/ Osteogenesis imperfecta
Lysyl hydroxylase/ Lysyl oxidase (oxidatively deaminates lysyl and hydroxylysyl residues to form collagen cross links, last biosynthesis step)
Long triple helical fibers/ Ligaments
Alpha chains/ Attached by H bonds form triple helix/ Ascorbate for hydroxylation of lysyl and prolyl residues of pro-Alpha chains (postranslational modification)
Gly in every third position/ Glycosylation of hydroxyl group of hydroxylysine with Glucose and Galactose; GOlgi allows procollagen to GO outside of cell
Extracellular matrix/ Eye (cornea, sclera)/ Ehlers-Danlos Syndrome
N-terminal propeptide (procollagen)/ Nonhelical terminal extensions
• Note: Procollagen LEAVEs the cell to be cLEAVEd by procollagen peptidases
“Increased Vitamin A makes you HARD”:
Really painful bones
Dry skin/ Drowsiness
Heme synthesis: amino acid precursors to basic unit of porphyrins, heme (pyrrole ring)
“Dracula wants to ^*&^* a Co-ed’s blood [think heme] with his Glystening teeth!”:
Succinyl CoA and Glycine are precursor amino acids to pyrrole rings, which is the basic unit of porphyrins and heme.
Enzymes: competitive inhibitors
“Competition is hard because we have to travel more kilometers (Km) with the same velocity”:
With competitive inhibitors, velocity remains same but Km increases
Phosphorylation cascade: action during low glucose
“In the Phasted State, Phosphorylate”:
The phosphorylation cascade becomes active when blood glucose is low.
Sickle cell anemia: mutation
“HbS isn’t Very Good”:
At Sixth position of HB beta chain, Valine is present instead of Glutamic acid.
tRNA: molecular shape
Fortunately, tRNA (Transfer RNA) is shaped like a capital T.
Malate in. Alpha-ketoglutarate and D (Aspartate) out.
Vitamins: which are fat soluble
KADE: Vitamin K Vitamin A Vitamin D Vitamin E
Phenylketonuria: which enzyme is deficient
PHenylketonuria is caused by a deficiency of: Phenylalanine Hydroxylase
“Guardian Angels are Pure, with two Wings”: G and A are Purines, with two Rings.
“AGUA PURa”: Adenine and GUAnine are PURines.
• “Agua pura” is spanish for “pure water”.
Hurler syndrome features HURLER’S:
Recessive (AR inheritance)
L-iduronidase deficiency (alpha)
Nucleotides: which are purines
• Chemical formula of Pure silver is Ag. Therefore, Purines are Adenine and Guanine.
“My CHILD HAS PROBLEM!”:
Congenital heart disease/ Cataracts
Incure 5th finger/ Increased gap between 1st and 2nd toe
Leukemia risk x2/ Lung problem
Duodenal atresia/ Delayed development
Hirshsprung’s disease/ Hearing loss
Alzheimer’s disease/ Alantoaxial instability
Squint/ Short neck
Protruding tongue/ Palm crease
Round face/ Rolling eye (nystagmus)
Occiput flat/ Oblique eye fissure
Brushfield spot/ Brachycephaly
Low nasal bridge/ Language problem
Epicanthic fold/ Ear folded
Mental retardation/ Myoclonus
Blots: function of Southern vs. Northern vs. Western
• Match up the 1st word letter with 2nd word letter:
• The 0’s in snow drop are zeros, since there is no Eastern blot.
Decreased alpha-fetoprotein and unconjugated estriol (maternal)
One extra chromosome twenty-one
Women of advanced age
Nondisjunction during maternal meiosis
“CUT the PY” (cut the pie):
Cytosine Uracil Thiamine are the PYrimidines
DiGeorge/ Velocardiofacial syndrome: features CATCH 22: Cardiac abnormalities
Marfan syndrome features MARFAN:
Mitral valve prolapse
Negative Nitroprusside test (differentiates from homocystinuria)
Cell cycle stages
“Go Sally Go! Make Children!”:
G1 phase (Growth phase 1)
S phase (DNA Synthesis)
G2 phase (Growth phase 2)
M phase (Mitosis)
C phase (Cytokinesis)
chromosomal deletion causing it is 5p(-)
What’s another name for a cat that’s five letters long and starts with a P? (Answer: AIPGE ).
Why is the cat crying? Missing its P.
ADult Polycystic Kidney Disease is Autosomal Dominant
• Also, “Polycystic kidney” has 16 letters and is due to a defect on chromosome 16.
Tay Sach’s features SACHS:
Spot in macula
Hex A deficiency
• Extra details with TAY:
Autosomal recessive/ Amaurosis
Young death (<4 yrs)
Chromosome 15 diseases
Chromosome 15 has its own MAP:
Bartter syndrome: inheritance
BARtter syndrome is autosomal recessive (AR).
Nucleotides: double vs. triple bonded basepairs
“TU bonds” (two bonds):
T-A and U-A have Two bonds. G-C therefore has the three bonds.
Imprinting diseases: Prader-Willi and Angelman
“Pray to an Angel”:
Prader-Willi and Angelman are the 2 classic imprinting diseases. • Which disease results, depends on whether 15q deletion is maternal or paternal. Keep them straight by: Paternal is Prader-Willi.