Medical reminders - ( P-R-S )

Pancreatitis (Ranson’s poor prognostic factors)

ABG (PO2) < 60

BUN increase > 5

Calcium < 8

Deficit of base > 4

Erythrocyte loss (Htc) > 10%

Fluid accumuliation > 6000cc

Pancreatitis (high risc factors for complication)

Age > 55

Blood sugar > 200

Cell count (WBC) >16,000

Dehydrogenase (LDH) >350

Enzyme (OT) > 250

Pancreatitis (management)

Pain control

Antibiotics

NPO/NG-tube

Coagulopathy (DIC)

Renal function (UOP, S-Gravity)

Electrolyte monitoring

Airway (O2 for hypoxia)

Support with IVF

Parrot fever  (clinical features)

Pneumonitis

Adenopathy

Rashes

Rigid neck (meningismus)

Organomegaly

Throat (pharyngitis)

Pelvic inflammatory disease (diagnostic criteria of at least three)

Discharge, vaginal

Identified GC or Chlamydia

Sed Rate increase

Elevation of temperature

Abdominal tenderness (m)

Sex organ tenderness, bilateral adnexal (m)

Extreme cervix tenderness (m)

Peptic Ulcer Disease (management)

Proton-pump inhibitor (Omeprazole)

Enhance mucose protection (Sucralfate)

Prostoglandin (Misoprostol)

Treating H. Pylori

Inhibitor of H2

CaCO3

Surgery for perforation

Pfeiffer syndrome

Premature closure of cranial sutures

Frontal bossing

Exophthalmos

Imperforate anus

Feet (broad hallux, delta phalanx)

Fused vertebra

Extremity anomaly (broad thumb)

Retarded

Pierre Robin sequence

Retrognathia

Ocular anomalies (Stickler syndrome)

Breathing problem

Incomplete palate (cleft)

Neonatal FTT

Pneumothorax (risk factors)

Tall stature

Thin body mass

Twenties of age

Tobacco smoking

Trauma

Tumors

Poisoning (contraindications for charcoal use)

Cyanide

Hydrocarbon

Acid/alkali

Relative small compounds

Charged (iron, heavy metals)

Organophosphate

Alcohol

Lithium

Poland syndrome

Pectoralis muscle defect

Oblige/syn/brachydactyly

Limb anomaly

Agenesis of kidney

Nipple anomaly

Dextrocardia

Polyarteritis nodosa (clinical featurues)

Abdominal pain

Rashes

Temperature

Extremity (arthralgia)

Renal failure

Intestinal infarction

Tip of fingers (necrosis)

Increased blood pressure

Seizure

Polycystic ovarian syndrome (clinical featurues)

Obesity

Virilization

Anovulationte

Resistance to insulin (diabetes)

Increased hair

Androgen increase

No period

Polymyositis/Dermatomyositis (diagnostic criteria)

Myositis

Unidentification of infectious agent

Symmetric muscle weakness

Cuteneous rashes

Level of enzyme increase (CPK, Aldolase)

EMG shows myopathy

Portal hypertension (emergency management)

Hemostasis (Fluid/RBC/Plt)

Endoscopic sclerotherapy/ligation

Portal-systemic shunting

ADH and Anti-H2 (Zantac)

Tamponade

Insertion of NG-tube (lavage)

Coagulopathy prevention (Vit K, FFP)

Prader-Willi syndrome

Poor tone (hypotonia)

Retarded (MR)

Abnormal genitalia

Dysmorphic face

Eating problem (obesity)

Reduce pigmentation

Preeclampsia (PRE)/eclampsia (E) (clinical features)

Proteinuria

Rise in blood pressure

Edema

Epileptic activity confirm eclampsia

Pregnancy (physiological compensations)

Alkaline phosphatase

Blood volume

Cardiac output

Dilutional anemia

ESR

Factors 7, 8, 9, 10

GFR

Heart rate

Inspiration (tidal volume)

Premenstrual syndrome (management)

Progesterone/pyridoxine/Prozac

Estrogen reduction (GnRH)

Regular aerobic exercise

Inflammatory control (NSAIDs)

OCP. Omega 3 fatty acids (fish oil)

Danazol (reduce mastalgie)

Spironolactone (aldosterone antagonist)

Primary adrenal insufficiency (clinical features)

Amenorrhea

Derma (hairless)

Reduced blood sugar

Electrolyte interference (/K/CabáNa)

Nutrition (weight loss, anorexia)

Arthralgia/myoralgia

Low BP

Skin (hyperpigmentation)

Primary adrenal insufficiency (etiologies)

Addison’s disease

ACTH resistance

Adrenolekodytrophy

Adrenal hypoplasia

Prolong QT syndrome (clinical features--first three are the triad of EKG findings)

Asymmetric T waves

Bradycardia

Corrected QT>0.44 second

Death may ocur

Episodes of presyncope

Proteus syndrome

Pigmentation (café-au-lait spots)

Retarded >20%

Overgrowth with asymmetry

Tumor tendency

Extremity anomalies

Unilateral

Spinal anomaly

Prune-belly syndrome (clinical triad)

Abdominal musculature anomaly

Bladder/urinary tract abnormality

Cryptorchidism

Pruritus (differential diagnosis)

Psychologic

Rashes

Urticaria

Renal/Uremia

Irritants/Allergens

Tumor (Leukemia/Hodgkin)

Infection

Cholestasis (TPN/Pregnancy)

Systemic Medications

Pseudo-tumor cerebri (clinical features)

Papilledema

Severe headache

Emesis

Unsteadiness (ataxia)

Dizziness

Oculomotor paralysis (diplopia)

Pseudo-tumor cerebri (management)

Prednisone

Spinal tap

Eye examination

Uncover underlying causes

Diamox (decrease CSF production)

Operation (shunt, optic nevre sheath fenestration)

Psoriasis (medication triggers)

Steroids

Chloroquine

Aspirin (NSAIDs)

Lithium

Esmolol (beta-blockers)

Psoriasis (clinical features-two phenomena, three triggers and four skin anomalies) include:

Plaque of skin

Scaly skin

Oily skin

Red skin

Isomorpic phenomenon (Koebner)

Auspitz phenomenon

Strep infection as trigger

Injury as trigger

Stres as trigger

Pulmonary embolism (management)

TPA (tissue plasminogen activator)

Heparin

Resection of bolus

Oxygen

Maintaining BP

Bicarbonate for acidosis

Urokinase

Streptokinase

Pulmonary hypertension (etiologies)

Pulmonary vasculitis

Upper airway obstruction

Lung diseases (CF)

Muscular hypoventilation

Occlusion of pulmonary vessel (pulmonary embolism)

Newborn (PPH)

Idiopathic

Cardiac (ASD, VSD, CHF, shunt)

Pyelonephritis (clinical features in newborn)

Poor feeding

Yellow (Jaundice)

Emesis

Lethargy

Odorous urine

Pyloric stenosis (clinical features)

Projectile vomiting

Young male (younger than 6 months)

Loss of fluid/CI (hypochloremic dehydration)

Olive-shaped mass

Reduced weight

Ultrasound with hypertophy

String/Shoulder signs on UGI film

Rabies (clinical data)

RNA rhabdovirus

Animal bite

Black inclusion (nigri bodies)

Involuntary motion

Encephalitis

Serological tool for diagnosis (FA stain)

Rape (management)

Reporting

Antibiotic prophylaxes

Pregnancy prevention

Immunization (HBV or tetanus PRN)

Support (emotional and psychosocial)

Testing for infection or semen

Reiter’s syndrome (reactive inflammation-clinical features)

Rashes

Enteritis

Arthritis

Conjunctivitis

Tract of genitourinary (urethritis)

Renal venous thrombosis (etiologies)

TOF (cyanotic CHD)

H2O deficit (dehydration)

Renal anomalies (congenital)

Overdose of contrast agent (hyperosmolar)

Maternal diabetes

Blood (hemoconcentration)

Oxygen insufficiency (asphyxia)

Shock

Increased muscle tone (hypertonia)

Sepsis

Retropharyngeal abscess (management)

Airway

Breathing

Start antibiotics ASAP

CT scan as gold standard

ENT consultation

Supportive (fluid/pain)

Surgery PRN

Reye’s syndrome (clinical features)

Respiratory distress

Encephalopathy

Yellow liver(fatty degeneration)

Elevation of mitochondrial enzymes

Salicylates as trigger

Rhabdomyolysis (evaluation)

Myoglobinuria

Urinalysis

Serum potassium

Creatinine

Lysis sign on CBC (hemolysis)

Enzyme (CPK) increase

Rheumatic fever [major (M) and/or minor (m) criteria]

Rashes (M)

Heart disease (M)

Extensor skin nodules (M)

Unique chorea(sydenham) (M)

Migrating arthritis (M)

Arthralgia (m)

Temperature (m)

İnflammatory (ESR, CRP) (m)

Cardiac blockage on EKG (m)

Rickets (risk factors)

Rapid growth (premie)

İnadequate intake of D and Ca

Chronic liver disease

Kidney insufficiency (calcitriol)

Enteral loss (IBD)

Tabular dysfunction (loss of Ca or Phos)

Sunlight deficit

Roseola infantum (clinical features)

Rashes

Occipital adenopathy

Seizure

Encephalopathy

Ocular (eyelid) edema

Low platelet

Aseptic meningitis

Rubella (clinical features)

Rash

URI

Birth defects

Eye involvement

Lymphadenopathy

Low grade fever

Artritis

Rubistein -Taybi syndrome

Retarded growth

Unsteady/stiff gait

Broad thumbs/toes

IQ impairment

Narrow palate with hypoplastic maxilla

Speech difficulties

Tone (hypotonia)

Eye (heavy eyebrows and long eyelashes)

Infection in infancy

Nose (beaked and prominent)

Russel-Silver syndrome

Retarded growth

Uniparental disomy 7

Small/Triangular face with normal HC

Short arm-span, limb asymmetry

Extremity anomaly (clinodactyly)

Low birth weight

Low blood sugar at birth

Salmonella infection (complications)

Sepsis

Adenopathy

Loss of fluids/electrolytes

Myocarditis

Osteomyelitis

Neurological

Enteritis

Lung involvement

Liver involvement

Arthritis

Sarcoidosis (clinical features)

Granuloma

Rashes

Adenopathy

Noncaseating

Uveitis

Lung infiltration

Organomegaly

Malaise

Arthritis

Scarlet fever (clinical features)

Strawberry tongue”

Circumoral pallor”

Adenopathy

Rashes (“sandpaper”)

Line of “Pastie”

Enlarged tonsils

Temperature (fever)

Scleroderma (pathogenesis)

Skin as major target

Collagen glycosylation anomaly

Laminin auto-antibodies

Endothelin anomaly

Raynaud phenomenon

Organ involvement

Scleroderma (skin cahanges)

Discoloration

Edema

Raynaud phenomenon

Morning stiffness

Atrophy

Scleroderma (organ involvement)

Skin

Cardiac

Lung

Esophagus/enteral/oral

Renal

Ocular

Skeletal

Intracranial nerves

Sicca syndrome with parotitis

Seckel syndrome

Short stature

Enlarged nose

CNS anomaly (MR)

Knee/hip anomalies

Eleven ribs

Low ears/large eyes

Sepsis (risk factors)

Sickle cell disease

Engrafted (BMT) patients

Polynuclear cell dysfunction

Steroid usage

Indwelling catheter

SCIDS

Serum sickness (clinical features)

Splenomegaly

Extremity (joint effusion)

Regional lymphadenopathy

Urticarial/maculopapular rashes

Mental change (CNS vasculities)

Short stature (evaluation)

Skeletal Age/Sweat

Turner’s (Genetics)

Anemia

TSH.T4.T3

UA (UTI.RTA)

Renal/electrolytes

ESR/Endocrine

SIADH (etiology)

Secretary tumors (pancreatic carcinoma)

Infection of brain (meningitis, encephalitis)

Asthma/lung disease (TB, CF, pneumonia)

Drugs (nicotine, clofibrate)

Head trauma

Slipped capital femoral epiphysis (clinical features)

Chronic-most common

Acute slip superimposed on chronic slip also common

Pain as major symptom

Internal rotation decreased

Thickening palpable

Atrophy of thigh

Limping or waddling gait

Smith-Magenis syndrome

Short stature

Mental retardation

Insertion of foreign bodies (Polyembolokoilamania)

Tendon reflex absence (neuropathy?)

Hypoplastic mid-face

Smoking (risk to kids with parental smoking)

SIDS

Meningitis

Otitis media

Killed by fire or cancers

Embryopathy (IUGR)

Respiratory (RAD, URI)

Speech problems (etiologies)

Autism/Anatomic

Blindness/Brain Injury

Chromosome/CNS

Deafness/DD

Environment Depression/Early Birth (Premature)

Speech delay (evaluation)

Social/family history

Parenting history

Ears (hearing loss)

Autism

Karyotyping/chromosomes

Infection

Neurological imaging

Gestation-related (preemie)

Spider bites (management for black widow)

Benzodazepine and muscle relaxant

Latrodectus antivenom

Analgesic (morphine)

Calcium

Keep wound clean

Splenomegaly (etiologies)

Sickle Cell Anemie

Portal Hypertension

Lupus

Enzyme Deficiencies (Metabolic)

EBV Infection

Neoplastic (Leukemia/Lymphoma)

Stevens-Johnson syndrome (clinical features)

Sensitivity disorders

Temperature high

Erythema multiforme rash and bullae of skin

Ulceration of mucous membranes

Eye (conjunctivitis, uveitis)

Nephritis (hematuria)

Sepsis potential

Stickler syndrome

Spine (spondylo-epiphyseal dysplasia)

Thorax (MVP, disk herniation)

IQ-normal

Cleft palate

Knee/hip anomalies

Loss of hearing

Eye (myopia)

Robin sequence

Stroke (risk factors)

Sickle cell disease

Tobacco

Rise in Cholesterol

Obesity

Ketone (diabetes)

Elevated blood pressure

Sturge-Weber syndrome

Seizure

Trigeminal hemangioma

Unilateral eye involvement

Retarded (MR)

Glaucoma

Ear anomalies

Sudden infant death syndrome (risk factors)

Sleeping position

IUGR/Premature

Defect of airway

Smoking

Supraventricular tachycardia (management)

Adenosine

Beta-blockers

Calcium blockers

Digoxin

Electrocardioversion

Syncope (pathologic etilogies)

Structural Abnormality of  Vessels (AVM)

Youngster’s Breath Holding

Neurological

Cardiac

Orthostatic Hypotension

Prolonged QT syndrome

Endocrine (adrenal insufficiency)

Systemic lupus erythematosus (diagnostic criteria)

Renal involvement

Hematological

Epidermal photosensitivity

Ulceration of mocous membranes (oral/nasal mucosa)

Mallor rashes

ANA (anti-nuclear antibody)

Thorax (pleural/cardial effusion)

Immunological (Anti-dsDNA)

CNS (encephalopathy, seizure etc)

Arthritis

Lupus (discoid lupus)