MNEMONICS: MI: basic management BOOMAR: Bed rest Oxygen Opiate Monitor Anticoagulate Reduce clot size Myocardial

infarctions: treatment INFARCTIONS: IV access Narcotic analgesics (eg morphine, pethidine) Facilities for defibrillation (DF) Aspirin/ Anticoagulant (heparin) Rest Converting enzyme inhibitor Thrombolysis IV beta blocker Oxygen 60% Nitrates Stool Softeners MI: signs and symptoms PULSE: Persistent chest pains Upset stomach Lightheadedness Shortness of breath Excessive sweating MI: therapeutic treatment ROAMBAL: Reassure Oxygen Aspirin Morphine (diamorphine) Beta blocker Arthroplasty Lignocaine MI: therapeutic treatment MONAH: Morphine Oxygen Nitrogen Aspirin Heparin MI: therapeutic treatment "O BATMAN!": Oxygen Beta blocker ASA

Thrombolytics (eg heparin) Morphine Ace prn Nitroglycerin 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. Aortic stenosis characteristics SAD: Syncope Angina Dyspnoea Pericarditis: causes CARDIAC RIND: Collagen vascular disease Aortic aneurysm Radiation Drugs (such as hydralazine) Infections Acute renal failure Cardiac infarction Rheumatic fever Injury Neoplasms Dressler's syndrome Murmurs: right vs. left loudness "RILE": Right sided heart murmurs are louder on Inspiration. Left sided heart murmurs are loudest on Expiration. ST elevation causes in ECG ELEVATION: Electrolytes LBBB Early repolarization Ventricular hypertrophy Aneurysm Treatment (eg pericardiocentesis) Injury (AMI, contusion) Osborne waves (hypothermia) Non-occlusive vasospasm 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) Subendocardial ischemia Subendocardial infarct Encephalon haemorrhage (intracranial haemorrhage)

Dilated cardiomyopathy Shock Toxicity of digitalis, quinidine Beck's triad (cardiac tamponade) 3 D's: Distant heart sounds Distended jugular veins Decreased arterial pressure Peripheral vascular insufficiency: inspection criteria SICVD: Symmetry of leg musculature Integrity of skin Color of toenails Varicose veins Distribution of hair Rheumatic fever: Revised Jones' criteria JONES crITERIA: Major criteria: Joint (arthritis) Obvious (Cardiac) Nodule (Rheumatic) Erythema marginatum Sydenham chorea Minor criteria: Inflammatory cells (leukocytosis) Temperature (fever) ESR/CRP elevated Raised PR interval Itself (previous Hx of Rheumatic fever) Arthralgia Rheumatic fever: Jones criteria Major criteria: CANCER: Carditis Arthritis Nodules Chorea Erythema Rheumatic anamnesis Minor criteria: CAFE PAL: CRP increased Arthralgia Fever Elevated ESR Prolonged PR interval Anamnesis of rheumatism Leucocytosis Rheumatic fever: Revised Jones criteria JONES PEACE: Major criteria: Joints: migratory O (heart shaped) Carditis: new onset murmur

Nodules, subcutaneous: extensor surfaces Erythema marginatum Sydenham's chorea Minor criteria: PR interval, prolonged ESR elevated Arthralgias CRP elevated Elevated temperature (fever) Need 2 major or 1 major and 2 minor criteria, plus evidence of recent GAS infection (throat cx, rapid antigen test, or rising strep antibody titer). CHF: Left-sided systolic failure signs and symptoms "Left Systolic Failure Can Have Dialated Heart Cause Of Pulmpnary Backflow": Loss of hair on legs Skin cold and clammy Fatigue Crackles High heart rate Dyspnea HTN Cyanosis Orthopnea Pink Sputum Stroke risk factors HEADS: Hypertension/ Hyperlipidemia Elderly Atrial fib Diabetes mellitus/ Drugs (cocaine) Smoking/ Sex (male) Head trauma: rapid neuro exam 12 P's: Psychological (mental) status Pupils: size, symmetry, reaction Paired ocular movememts Papilloedema Pressure (BP, increased ICP) Pulse and rate Paralysis, Paresis Pyramidal signs Pin prick sensory response Pee (incontinent) Patellar relex (and others) Ptosis Reevaluate patient every 8 hrs. Status epilepticus: treatment "Thank Goodness All Cerebral Bursts Dissipate": Thiamine Glucose Ativan Cerebyx Barbiturate

Diprivan LEVEL of Conscious change: causes AEIOU TIPS: Alcohol Encephalopathy Infection Opioid Uremia Trauma Insulin Psychosis Syncope Decreased level of consciousness: metabolic causes METABOLIC: Major end organs (liver, kidney) Endocrine/ Electrolytes Toxins Acid Base disorders Oxygenation Lung (PE, pneumonia) Infection/ Inflammatory/ Iatrogenic Calcium Multiple sclerosis: signs and symptoms INSULAR: Intention tremor Nystagmus Slurred speech Uthoff's phenomenon Lhermitte's sign Ataxia Rebound Peripheral nervous examination "Tall People Run-over Small Children": Tone Power Reflexes Sensation Co-ordination/ Clonus Alzheimer's disease: progressive phases ABCD: Amnesic phase (forgetting keys, leaving cooker on) Behavioural problems (antisocial, wandering) Cortical phase (incontinence, falls) Decerebrate phase (return of primitive reflexes) Hydrocephalus: Normal pressure hydrocephalus DDx 3 W's: Wet: urinary incontinence Wobbly: gait abnormality Wacky: dementia, memory problems

Cerebellar signs PINARD'S: Past pointing Intention tremor Nystagmus Ataxia Rebound Dysdiadokinesia Slurred speech Shock: signs and symptoms TV SPARC CUBE: Thirst Vomiting Sweating Pulse weak Anxious Respirations shallow/rapid Cool Cyanotic Unconscious BP low Eyes blank Acute LVF management LMNOP: Lasex (frusemide) Morphine (diamorphine) Nitrates Oxygen (sit patient up) Pulmonary ventilation (if doing badly) Subarachnoid hemorrhage (SAH) causes BATS: Berry aneurysm Arteriovenous malformation/ Adult polycystic kidney disease Trauma (eg being struck with baseball bat) Stroke Ventricular fibrillation: treatment "Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock": Shock= Defibrillate Everybody= Epinephine Little= Lidocaine Big= Bretylium Momma= MgSO4 Poppa= Pocainamide Chest pain treatment, for nurses "MOVE your patient!": Monitor: put patient on cardiac monitor Oxygen: put patient on O2 Venous: gain large bore venous access EKG: 12 lead EKG

Endotrachial tube deliverable drugs O NAVEL: Oxygen Naloxone Atropine Ventolin (albuterol) Epinephrine Lidocaine If you can't get IV access established, and have necessity to administer resuscitative meds, remember you have the airway and can give the above drugs. Drug delivery is enhanced if diluted with 10cc NS and rapid introduced for aeresolization. Alternatively, bare bone version is ALE, as above. Malaria: complications of falciparum malaria CHAPLIN: Cerebral malaria/ Coma Hypoglycemia Anaemia Pulmonary edema Lactic acidosis Infections Necrois of renal tubules (ATN) Carcinomas having tendency to metastasize to bone "Particular Tumours Love Killing Bone": Prostate Thyroid Lung Kidney Breast Rheumatoid arthritis: features RHEUMATOID: Ragocytes/ Rheumatoid factor (anti-IgG) HLA-DR4/ HLA-Dw4 ESR increase/ Extra-articular features (restrictive lung disease, subcutaneous nodules) Ulnar deviation Morning stiffness/ MCP joint Ankylosis/ Atlantoaxial joint subluxation/ Autoimmune/ ANA T-cells (CD4)/ TNF Osteopenia Inflammatory synovial tissue/ Idiopathic/ IL-1 Deformities (swan-neck, boutonniere)