(A)PECCS

• Aschoff/Anitshchow bodies on Path, Polyarthritis, erythema marginatum, chorea, carditis, subq nodules
• Acute Rheumatic Fever, major criteria

(B)ELCH

• EKG: prolonged PR
• Lab: ESR, CRP
• Clinical: fever, arthralgia
• Hx: previous hx of ARF
• Acute rheumatic fever, minor criteria

AEIOU TIPS (tips from the vowels)

• A - Alcohol/drugs
• E - Endocrine
• I - Insulin
• O - Opiates
• U - Uremia
• T - Toxins/trauma
• I - Infections
• P - Psych/porphyria
• S - SAH, shock, stroke, seizure, space occupying lesion
• Altered mental status

JARS

• J - Joints, A - Abdominal pain, R - Renal, S - Skin
• Henoch-Schonlein purpura

4 T's

• Thymoma, Teratoma, Thyroid tumor/goiter, Terrible lymphoma
• Anterior Mediastinal Masses

HABIT5

• H - Hhernia, hematoma, A - Aneurysm, B - Bronchogenic cyst/duplication cyst, I - Inflammation (sarcoid, histo, coccidio, TB), T5 - Tumors (lung, lymphoma, leukemia, leiomyoma, lymph node hyperplasia)
• Middle Mediastinal masses

Please Helen Lick My Popsicle Stick

• P - Primary TB, H - Histoplasmosis, L - Lymphoma, M - Metastases, P - Pneumoconiosis, S - Sarcoidosis
• Bilateral Hilar Lymphadenopathy

SHAMPOO DIRT

• S - Sarcoidosis, H - Hyperparathypoidism, Hyperthyroidism, A - Alkali-milk syndrome, M - Metastases, myeloma, P - Paget disease, O - Osteogenesis imperfecta, O - Osteoporosis, D - Vitamin intoxication, I - Immobility, R - RTA, T - Thiazides
• Hypercalemia

Kinds Of Tumors Leaping Primarily To Bone"

• K - Kidney, O - Ovarian, T - Testicular, L - Lung, P - Prostate, T - Thyroid, B - Breast
• Tumors that metastasize to bone

NAACP

• N - Neoplasm, A - Allergy, A - Addison', C - Cirrhosis, CVD, P - Parasite (visceral larva migrans), Periarteritis nodosa
• Eosinophilia

3 Hypo's &;3 Hyper's"

• Hypoxia, Hypothermia, Hypokalemia,
• hyperkalemia, Hyper H+ (Acidosis), Hyper Rx (Drugs/OD)
• Asystole

Hey, Hey, Hey! THAT's EMD!

• H-hypovolemia, H-hypoxia, H-hypothermia
• T-tamponade (cardiac), H-hyperkalemia, A-acidosis, T-tension pneumothorax
• E-embolism (pulmonary), M-myocardial infarction, D-drug overdose
• Causes of PEA

ReEXPLAIN

• R - renal failure, EX - exogenous/endocrine, P - pituitary. L - liver failure, A - alcohol, I- insulinoma/infection, N - neoplasm
• Hypoglycemia

6Ps

• pulselessness, pain, pallor, parasthesia, poikiolothermia, paralysis
• Compartment syndrome

LANE

• L - lidocaine, A - atropine, N - naloxone, E - epi
• Drugs that go in ET tube

AVPU

• A - alert, V - resonds to verbal stimuli, P - responds to painful stimuli, U - unconscious
• Assessing level of consciousness

TICS

• Thallasemia, Iron deficiency, Chronic disease, Sideroblastic anemia
• Microcytic anemia

BAD SHIT

• Black scorpion bite, Alcohol, Drugs (tetracycline, azothioprin, sulfa) , Stones (gallstones), Hyperlipidemia, Idiopathic, Trauma
• Causes of pancreatitis

ELEVATION

• E - Electrolytes, L - LBBB, E - Early Repolarization, V - Ventricular hypertrophy, A - Aneurysm, T - Treatment - Pericardiocentesis, I - Injury (AMI, contusion), O - Osborne waves (hypothermia), N - Non-occlusive vasospasm
• Causes of ST elevation

MUDPILES

• M - Methanol, U - Uremia, D - DKA/AKA, P - Paraldehyde/phenformin, I - Iron/INH, L - Lactic acidosis, E - Ethylene glycol, S - Salicylates
• Anion Gap acidosis

HARDUP

• H - Hyperalimentation/hyperventilation, A - Acetazolamide (carbonic anydrase inhibitor), aldosterone inhibitor, R - RTA, D - Diarrhea, U - Ureteral diversion, P - Pancreatic fistula/parenteral saline
• Basically, bicarb losses through GI or renal.
• Non-anion gap acidosis

ME DIE

• M - Methanol, E - Ethanol
• D - Diuretics (mannitol, sorbitol, glycerol), I - Isopropanol, E - Ethylene glycol
• Osmolar gaps

SLUDGE

• S - Salivation, L - Lacrimation, U - Urination, D - Diarrhea, G - Gastric upset, E - Emesis
• Cholinergic OD

Anti-cholinergic OD

• Blind as a bat, Dry as a bone, Red as a beet, Mad as a hatter, Hot as a hare
• mydriasis, absent BS, urinary retention

CHIPES

• C - Cocaine condoms/ chloral hydrate/ calcium, H - Heavy metals, I - Iron/ iodides, P - Psychotropics (TCA, phenothiazines), E - Enteric coated/Barium, S - Solvents (CCl4)
• Radio-opaque ingestants

SITS

• S - Supraspinatus, I - Infraspinatus, T - Teres minor, S - Subscapularis
• Rotator cuff muscles

flat face, syndactyly

• Apert syndrome

coronal (suture fusion), can't hear

• Crouzon syndrom

She has a pet tree frog

• Pfeiffer syndrome: broad thumbs and great toes

frowny unibrow baby who can't reach eyebrows with hands and is flaring nostrils with so much effort that she's got her bowels in a knot (at risk for SBO); she's got heart!

• Cornelia de Lange

cat-crying to the moon

• cri-du-chat, moon facies

Can't Give Him/Her Milk/Tit

• Chemo/antimetabolites (certain drugs), Galactosemia, HIV, HTLV, HSV lesions on breasts, Miliary Tb (until 2 weeks post start of abx)

Neutral aa, Niacin deficiency, Nicotinamide

• HartNup's Disease

4 D's: dermatitis, diarrhea, dementia, death (and photosensitivity).

• Pellagra, due to Vit B3 (niacin deficiency)

"ribo flavin"= "bad flavor"

• therefore cheilosis, anorexia, mucositis
• vit B2 (riboflavin) deficiency

Fanconi can't hitchhike

• absent, supernumerary, or bifid thumb
• radius may also be absent
• fanconi's anemia (not fanconi syndrome)

18 year old showing funky gang sign

• Edwards syndrome:  index and pinky fingers overlap the middle two

Gang-sign with 13 fingers

• polydactyly in trisomy 13

MADCAPPING

• Metabolic - hypoglycemia, lytes, hypocalcemia, mitochondrial d/o. Consider genetics w/u: plasma amino acids, urine organic acids, lactate, pyruvate, ammonia
• Anatomic - tonsil hypertrophy, macroglossia, TEF, tracheomalacia: Consider ENT consult, neck xray
• Drugs - toxins, munchausen by proxy: urine/serum tox screen
• Cardiac - arrythmia/CHD: EKG, echo
• Air Holding - (breath-holding spell)
• Prematurity - CNS immaturity (dx of exclusion): theophylline, caffeine, o2, stimulation
• Physiologic - congenital central hypoventilation: sleep study
• Infectious - RSV, pertussis, meningitis, encephalitis: CBC, blood cx, urine cx, LP
• Neurologic - seizures, mass, trauma, nonaccidental trauma, intracerebral hemorrhage: CT, MRI, EEG
• GI: GERD - temporal relation to feeds: scinti scan first, then Barium swallow/UGI. pH probe
• ALTE - Apparent Life Threatening Event

Charcot's Triad: JEF

• Cholangitis
  • Jaundice
  • Epigastric/RUQ pain
  • Fever/Chills
• Reynold's Pentad: Charcot's Triad+
  • Altered Mental Status
  • Shock

• (not crohns=UC, anklyosing..., liver-related, pie-oderma)
• Ulcerative colitis' possible extra-intestinal manifestations:
  • GI related (liver): sclerosing cholangitis, chronic active hepatitis
  • Rheum (HLA-B27): ankylosing spondylitis
  • Derm: pyoderma gangrenosum

Hurler is badness, Hunter in boys only, Sanfillipo seizes, Morquio morphs his skeleton. Hurler is worse (crouched down, hurling a L-id, but can't see where it lands and can't hear when it lands). Hunter (also crouched down, but not as much since He is a Hunter, who grabs a spear with a claw hand and can see and hear his prey.

• MPS 1H (Hurler): organomegaly, coarse features, joint stiffness, developmental regression, death in 1st decade
• MPS 1S (Scheie) 1H/S (Sheie-Hurler):milder disease
• MPS 2 (Hunter): X-linked, no corneal clouding, severe/mild, +/- MR
• MPS 3 (Sanfilippo): less severe somatic stuff, but behavior problems/seizures, survival into 20s
• MPS 4 (Morquio): severe skeletal findings, normal intelligence
• MPS 5 ?
• MPS 6 (Maroteaux-Lamy): like Hurler, but nl intelligence

Think W: Whirly woman: whirly skin, whirly brain, whirly eyes, wacky teeth and bones

• Incontinentia Pigmenti

Moonfaced (obesity) beetle (a lot of legs, polydactyly) scratching at its eyes (retinitis pigmentosa, visual impairment) because it's depressed about its lack of balls (hypogonadism, excuse the impropriety).

• Laurence-moon-biedl

4 F's in Toddler's Diarrhea

• Ask about the 4F's (fiber, fluid, fat, fruit juices).
• Diarrhea of Infancy, Chronic nonspecific
   

Tired bird that got surprised by a tree frog... Rubinstein-tayBEAK

• Rubenstein-Taybi: ptosis, beaked nose, antimongoloid slant, broad thumbs/toes

the Robin makes a nest with Sticks, and pokes you in the eye when you come close

• Pierre-Robin features +  severe myopia/retinal detachment = Stickler syndrome

'ferrous' has an O and can accept and transport O2

• ferrous iron in Hb can accept and transport oxygen
• ferric iron has lost the electron it needs to bond with oxygen = methemoglobinemia

a big St. Bernard against Scott, a small asian dude: Bernard-Soulier syndrome big platelets, Wiscott aldritch - small platelets

PM-AIR

• Etiologies of croup. Viral most common; Viral Etiologies (PM AIR)

  • Parainfluenza(I (60%) >II>II),

  • Measles,

  • Adenovirus,

  • Influenza A has been implicated in children with severe respiratory compromise

  • RSV

• Use the same mnemonic for bronchiolitis!!! RSV is the most commonly isolated agent in 75% of children younger than 2 years and who are hospitalized for bronchiolitis