Anatomy
- SCALP layers — S = Skin, C = Connective tissue (dense), A = Aponeurosis (galea aponeurotica), L = Loose areolar tissue, P = Pericranium. The dangerous layer is L where infection spreads easily.
- Carpal bones (lateral to medial) — "Some Lovers Try Positions That They Can't Handle" = Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate (proximal row first, then distal).
- Rotator cuff muscles — "SITS" = Supraspinatus, Infraspinatus, Teres minor, Subscapularis. These four muscles stabilize the glenohumeral joint.
- Cranial nerves — "On Old Olympus Towering Tops A Finn And German Viewed Some Hops" = Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Spinal accessory, Hypoglossal.
- Branches of facial nerve — "To Zanzibar By Motor Car" = Temporal, Zygomatic, Buccal, Mandibular, Cervical (from superior to inferior emerging from parotid gland).
Physiology
- Insulin vs Glucagon effects — Insulin does the 4 G's: Glycogenesis, Glucose uptake, lipogenesis (Grease), Growth. Glucagon reverses these—glycogenolysis, gluconeogenesis, lipolysis.
- Oxygen-hemoglobin curve right shift — "CADET face Right" = CO₂↑, Acid↑ (pH↓), 2,3-DPG↑, Exercise, Temperature↑. Right shift = decreased affinity = more O₂ release to tissues.
- Vitamin K-dependent factors — "1972" = Factors II, VII, IX, X (and proteins C, S). Warfarin inhibits these factors.
- Obligate anaerobes — "ABC" = RBCs have Anaerobic glycolysis only, Brain and Cornea prefer glucose (though brain uses oxygen, RBCs are strict anaerobes due to no mitochondria).
Biochemistry
- Essential amino acids — "PVT TIM HALL" = Phenylalanine, Valine, Threonine, Tryptophan, Isoleucine, Methionine, Histidine, Arginine, Leucine, Lysine. (Arginine semi-essential in children.)
- Glucogenic vs Ketogenic amino acids — Only Leucine and Lysine are purely ketogenic ("LL"). Isoleucine, Phenylalanine, Tryptophan, Tyrosine are both. Rest are glucogenic.
- Glycolysis irreversible steps — "Phosphorylation Pays Forward" or remember enzymes: Hexokinase (step 1), Phosphofructokinase (step 3), Pyruvate kinase (step 10)—the three rate-limiting/committed steps.
- Fat-soluble vitamins — "ADEK" = Vitamins A, D, E, K are fat-soluble; require bile for absorption; stored in liver/adipose; toxicity possible with excess.
Pharmacology
- Cytochrome P450 inducers — "PC BRAS" = Phenytoin, Carbamazepine, Barbiturates, Rifampicin, Alcohol (chronic), Sulphonylureas. These reduce efficacy of other drugs metabolized by CYP450.
- Cytochrome P450 inhibitors — "SICKFACES.COM" = Sodium valproate, Isoniazid, Cimetidine, Ketoconazole, Fluconazole, Alcohol (acute), Chloramphenicol, Erythromycin, Sulfonamides, Ciprofloxacin, Omeprazole, Metronidazole.
- Selective β1 blockers — "BEAM" = Bisoprolol, Esmolol, Atenolol, Metoprolol. Cardioselective; safer in asthma/COPD than non-selective blockers.
- Muscarinic antagonist effects — "Blind as a bat, Red as a beet, Hot as a hare, Dry as a bone, Mad as a hatter" = mydriasis, flushing, hyperthermia, anhidrosis, delirium from atropine/scopolamine.
Pathology
- Granulomatous diseases — "TB CALLS" = Tuberculosis, Berylliosis, Cat-scratch disease, Aspergillosis, Leprosy, Listeriosis, Sarcoidosis, Syphilis. Remember caseating (TB, fungal) vs non-caseating (sarcoid).
- Conditions with skip lesions — Think Crohn's disease (classic), also Takayasu arteritis, Buerger's disease. Continuous involvement = Ulcerative colitis.
- Rb gene (13q14) associations — "ROB" = Retinoblastoma, Osteosarcoma, Bladder carcinoma. Loss of tumor suppressor causing these malignancies.
Microbiology
- Encapsulated bacteria — "SHiNE SKiS" = Streptococcus pneumoniae, Haemophilus influenzae type b, Neisseria meningitidis, E. coli (some), Salmonella, Klebsiella, Group B Streptococcus. High risk in asplenic patients.
- Urease-positive organisms — "PUNCH" = Proteus, Ureaplasma, Nocardia, Cryptococcus, H. pylori, Klebsiella. Proteus causes staghorn calculi via urease.
- Catalase-positive cocci — "Cats Need PLACESS" = Staphylococcus (vs Streptococcus which is catalase-negative). Quick test to differentiate at bench.
Medicine
- Cushing vs Conn syndrome — Cushing has high cortisol (hypertension, hyperglycemia, central obesity); Conn has high aldosterone (hypertension, hypokalemia, metabolic alkalosis). Conn = "K+gone."
- MUDPILES for metabolic acidosis — Methanol, Uremia, DKA, Propylene glycol/Paraldehyde, Iron/INH, Lactic acidosis, Ethylene glycol, Salicylates. High anion-gap causes.
- Duke criteria major for endocarditis — 2 positive blood cultures with typical organism OR persistent bacteremia OR new valvular regurgitation OR positive echo (vegetation/abscess). Need 2 major or 1 major + 3 minor.
Surgery
- Glasgow Coma Scale — Eyes: 4-3-2-1 (spontaneous-to voice-to pain-none), Verbal: 5-4-3-2-1 (oriented-confused-words-sounds-none), Motor: 6-5-4-3-2-1 (obeys-localizes-withdraws-flexion-extension-none). Max=15, Min=3.
- Courvoisier's law — Painless jaundice + palpable gallbladder = unlikely to be stones (likely periampullary malignancy). Stone-related GB is usually fibrosed, non-distensible.
- Charcot's triad — RUQ pain, Jaundice, Fever = ascending cholangitis. Add hypotension +