Types of facies:

1.Moon face(Cushingoid facies)
*2.Mouse facies - CRF
*3.Ashen Grey facies - Myocardial infarction
*4.Potter facies-Oligohydromnia

5.Mask like-parkinsonism
6.Leonine-leprosy
7.frog like facies-ethmoidal polyps,NP angiofibroma..
8.gargoyle facies - hurler's syndro
9.meflat facies - down's syndrome
10.Hippocratic face (also known as "Hippocratic facies"; eyes are sunken, temples collapsed, nose is pinched with crusts on the lips and the forehead is clammy) 11.snarling facies - myasthenia gravis
12.torpid facies - myxoedema

13.chipmunk facies- untreated thalassemia major, bullimia nervosa.
14.bird facies..(typically small mandible)- Pierre Robin symdrome
15.ashen gray facies- MI
16.adenoid facies-adenoids,other causes of b/l nasl obs.
17.facies mitrale-MS

PATHOGNOMONIC SIGNS of diseases:-

Pathognomonic signs
1. COPD - Barrel-Chested
2. Pneumonia - Greenish Rusty Sputum
3. Pernicious Anemia - Beefy Red Tongue (Schilling’s Test)

4. Kawasaki Dieases - Strawberry Tongue
5. Typhoid - Rose Spot
6. Tetany - Chvostek Sign (Muscle Twitching Face)
- Trosseau’s Sign (Jerky Mov’ts)
7. Pancreatitis - Cullen Sign (Bluish discoloration preumbilical area)
8. Appendicitis - McBurney’s Point (rebound tenderness)
- Rovsing Sign (RLQ pain w/ palpation in LLQ)
- Psoas Sign(pain on lying down putting pressure on MB pt)
9. Thrombophlebitis - Homan’s Sign
10. Hepatitis - Icteric Sclera (yellowish discoloration of sclera)

11. Meningitis - Burdzinski Sign (Pain on nape)
- Karnig Sign (pain on leg/ knee area)
12. Pyloric Stenosis - Olive-Shaped Mass
13. Hyperthyroidism - Exopthalmus
14. Addison’s Disease. - Bronze-like skin
15. Cushing Syndrome- Boffalo Hump
16. Cholera - Rice Watery Stool
17. SLE - Butterfly Rashes
18. Leprosy - Leoning Face (contracted face)
19. Bulimia Nervosa - Chipmunk Face
20. Liver Cirrhosis - Spider Angioma
21. Asthma - Wheezing Inspiration
22. Hyperpituitarism - CAROTENEMIA (Discoloration of skin)
- XANTHAMIA
23. Down Syndrome- Single Crease on Palm
24.TOF - Clubbing of Fingernails
Ventricular Septal Defect
Pulmonary Stenosis
Overriding of Aorta
Right Ventricular Hypertrophy
25.Cataract - Blurry Vision / Hizzy Vision
26.Glucoma - Tunnel-like Vision
27. PTB - Low grade fever in a ternoon
28. Cholecystitis- Murphy’s Sign (pain RUQ)
29. Myasthemia Gravis (MG) – Ptosis (inability to open upper eyelids)
30. Dengue - Petechiae
31. Parkinson’s Diease. - Pill Rolling Tremors
32. Measles - Koplick’s Spot

PATHOGNOMONIC SIGNS of diseases:-

Pathognomonic signs
1. COPD - Barrel-Chested
2. Pneumonia - Greenish Rusty Sputum
3. Pernicious Anemia - Beefy Red Tongue (Schilling’s Test)

4. Kawasaki Dieases - Strawberry Tongue
5. Typhoid - Rose Spot
6. Tetany - Chvostek Sign (Muscle Twitching Face)
- Trosseau’s Sign (Jerky Mov’ts)
7. Pancreatitis - Cullen Sign (Bluish discoloration preumbilical area)
8. Appendicitis - McBurney’s Point (rebound tenderness)
- Rovsing Sign (RLQ pain w/ palpation in LLQ)
- Psoas Sign(pain on lying down putting pressure on MB pt)
9. Thrombophlebitis - Homan’s Sign
10. Hepatitis - Icteric Sclera (yellowish discoloration of sclera)

11. Meningitis - Burdzinski Sign (Pain on nape)
- Karnig Sign (pain on leg/ knee area)
12. Pyloric Stenosis - Olive-Shaped Mass
13. Hyperthyroidism - Exopthalmus
14. Addison’s Disease. - Bronze-like skin
15. Cushing Syndrome- Boffalo Hump
16. Cholera - Rice Watery Stool
17. SLE - Butterfly Rashes
18. Leprosy - Leoning Face (contracted face)
19. Bulimia Nervosa - Chipmunk Face
20. Liver Cirrhosis - Spider Angioma
21. Asthma - Wheezing Inspiration
22. Hyperpituitarism - CAROTENEMIA (Discoloration of skin)
- XANTHAMIA
23. Down Syndrome- Single Crease on Palm
24.TOF - Clubbing of Fingernails
Ventricular Septal Defect
Pulmonary Stenosis
Overriding of Aorta
Right Ventricular Hypertrophy
25.Cataract - Blurry Vision / Hizzy Vision
26.Glucoma - Tunnel-like Vision
27. PTB - Low grade fever in a ternoon
28. Cholecystitis- Murphy’s Sign (pain RUQ)
29. Myasthemia Gravis (MG) – Ptosis (inability to open upper eyelids)
30. Dengue - Petechiae
31. Parkinson’s Diease. - Pill Rolling Tremors
32. Measles - Koplick’s Spot

Pain questions

SOCRATES (Greek philosopher)

• Site – central?
• Onset – sudden?
• Character – burning, heavy, crushing, tight?
• Radiation – e.g. jaw, neck, arms
• Associations – e.g. sweating, dyspnoea, nausea, vomiting
• Timing – duration?
• Exacerbating and alleviating factors – e.g. by glyceryl trinitrate
• Severity out of 10

Describing an ulcer

BBEDDS

• Basics – site, size, shape
• Base – colour (red, pink, white, black)
• Edge:
• Flat, sloping (venous)
• Punched-out (arterial/neuropathic); arterial = pain, neuropathic = no pain
• Undermined (pressure sores)
• Rolled edge (basal cell carcinoma)
• Everted edge (squamous cell carcinoma)
• Depth – measure height (mm)
• Discharge – serous (clear), blood, purulent
• Surroundings – skin changes, colour, scars

Parkinson’s disease examination

TRAMESS

• Tremor
• Rigidity
• Akinesia
• Micrographic
• Eye movements (Glabellar tap and impaired upward gaze in supranuclear palsy)
• Speech slow and monotonous
• Shuffling gait (stooped posture, reduced arm swing)

Lump examination

She Cuts The Fish PERfectly!

• Site, Size, Surface (skin)
• Colour, Contour (border), Consistency (firm/soft)
• Temperature, Tenderness, Trans-illuminable
• Fluctuance (fluid-filled), Fixity
• Pulsatile (aneurysm)
• Expansile
• Reducible (hernia)

Pupils:

Small HAPPY
Horners, Argyll-Robertson, Pontine haemorrhage, Pilocarpine, Happy (morphine)

Argyll Robertson SADE (accommodates but doesn’t react – c.f. prostitute)
Syphilis, Alcohol, DM, Encephalitis

Small muscle wasting MARS BAR
MND / Myopathies, Apical tumours, RA, Syringomyelia
Brachial Plexus injuries, Ageing, cervical Rib

Syncope HEAD, HEART & VESS’LS
Hypoglycaemia / hypoxia, epilepsy, anxiety, drop attack (brain stem Dysfunction - TIA)
Heart attack, embolism, aortic obstruction (stenosis, myxoma, IHSS), rhythm, tachy - VT
Vasovagal, ectopic preg, situational (on the crapper), subclavian steal, low SVR (anaphylaxis,
shock, DIC), Sick sinus syndrome

Wernickes and Korsakoffs CANON
Confusion, Ataxia, Nystagmus, Ocular palsy, Neuritis

Pes Cavus Disease Can Shorten The Foot
DM
Charcot Marie Tooth
Syringomyelia
Tabes dorsalis
Fredreich’s Ataxia

Basic Signs & Symptoms

Chills & Rigors
 CAMP
Cholangitis, Abscess, Malaria / Meningitis, Pylonephritis / Pneumonia

Itch, Non-dermatological causes of
 DULL JAM
DM, Uraemia, Lymphoma, Leukaemia
Jaundice, Anaemia, Myxoedema

Non-pitting lower limb oedema
 MI CHAM
Milroys, infection (filariasis), Congenital, Hypothyroid, Allergy, Malignancy

Shock
 HEN SCAM
Hypovolaemia, Endocrine (adrenal, thyroid), Neuropathic (autonomic)
Spinal cord injury/ Sepsis, Cardiac, anapyhlaxis/ anaesthesia, anti HPT, Massive PE

APGAR Score:

A-P-G-A-R:

A - appearance (color)
P - pulse (heart rate)
G - grimmace (reflex, irritability)
A - activity (muscle tone)
R - respiratory effort

ACUTE ABDOMINAL PAIN Causes

 

"BAD GUT PAINS" and "ECTOPIC"

B - Bowel obstruction
A - Appendicitis, Adenitis (mesenteric)
D - Diverticulitis
Diabetic Ketoacidosis
Dysentary/Diarrhea Drug withdrawal
G - Gastroenteritis
Gall bladder disease/stones/
obstruction/infection
U - Urinary tract obstruction (stone)
infection (pyelo/cystitis)
T - Testicular Torsion
Toxin - Lead, black widow spider bite
P - Pneumonia/Pleurisy
Pancreatitis
Perforated bowel/ulcer
Porphyuria
A - Abdominal aneurysm
IN - Infarcted bowel
Infarcted myocardium (AMI)
Incarcerated hernia
Inflammatory bowel disease
S - Splenic rupture/infarction
Sickle cell pain crisis
sequestration crisis

For FEMALES with acute PELVIC pain, think "ECTOPIC" as well as the above causes
E - Ectopic (This is your priority rule out always)
Endometriosis
C - Cyst rupture (corpus leutium cyst rupture)
T - Torsion of ovary or cyst
O - Ovulation: Mittelschmerz
P - Pelvic Inflammatory Disease,
salpingitis, tubo - ovarian abscess
I - Incomplete abortion
C - Cystitis/pyelonephritis

Causes of asterixis (flapping tremor)

[[ DRUGS (ABC) FAILED Helping Him ]]

DRUGS (ABC) :
- Alcohol

- Barbiturate
- carbamazepine

FAILED :
- respiratory failure
- liver failure
- renal failure

Helping : [[[ H = HYPO ]]]
- hypoglycemia
- hypokalemia
- hypomagnesemia

Him : [[[ H = HEMORRHAGE ]]]
- intracerebral hemorrhage
- subarachinoid hemorrhage
- subdural hematoma

H/o of Pain

Site - Where is the pain?
Onset - When did the pain start, and was it sudden or gradual?
Character - What is the pain like? An dull? Stabbing?

Radiation - Does the pain radiate anywhere? visceral pain radiates to back
Associations - Any other signs or symptoms associated with the pain?
Time course - Does the pain follow any pattern?pain frm duodenal ulcer at night.
Exacerbating/Relieving factors - Does anything change the pain?
Severity - How bad is the pain?








MNEMONICS IS
SOCRATES