Diagnostic criteria for DKA a. Plasma glucose (mg/dl): >250 b. Arterial pH: 7.25 to 7.3: mild DKA 7 to 7.24: moderate DKA <7: severe DKA c. Serum bicarbonate (mEq/L): 15 to 18: mild DKA 10 to 15: moderate DKA <10: severe DKA d. Urine and serum ketones (nitroprusside reaction): Positive…
Author: Epomedicine
Clinical Skills and Approaches 
Hyponatremia Correction: Rules and Mnemonics
Corrected sodium level When hyperglycemia is present, the underlying sodium concentration (corrected sodium concentration) can be estimated by adding 1.6-2.4 mEq/L (average of 2 mEq/L) to the reported sodium concentration for every 100 mg/dl increase in plasma glucose above 100 mg/dl. E.g. In a patient with Na+ level, 145 and…
Clinical Skills and Approaches 
Costovertebral or Renal angle tenderness
Synonyms: Murphy’s kidney punch, CVA tenderness (CVAT) Anatomy of Costovertebral angle or Renal angle: Costovertebral angle is formed by the junction of the 12th, or lowermost, rib with the paravertebral muscles, which run parallel to and on both sides of the vertebral column. Eliciting costovertebral angle tenderness: Position of patient:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Somogyi effect and Dawn Phenomenon – Mnemonic
Both Somogyi effect and Dawn phenomenon are the cause of MORNING FASTING HYPERGLYCEMIA. Mnemonic: Somogyi = So Much InsulinDawn = Down Insulin a. Somogyi effect: Excess exogenous insulin → Middle night hypoglycemia → Release of counter-regulatory hormones → Rebound morning hyperglycemia b. Dawn effect: Normal release of morning hormones (growth…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
ORS and ReSoMal – Mnemonic
Oral Rehydration Solution (ORS) Grams per litre: SoDIum C-hloride: 2.6 gm SoDIum Ci-Trate: 2.9 gm Potassium chloride: 1.5 gm Glucose anhydrous: 13.5 gm Mnemonic: DI = 2 and C = 6Ci-Trate = Rotate 6, i.e. 9For Potassium chloride: Deduct 1 from the whole number and decimal both, i.e. (2-1).(6-1) =…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Lines and Angles in Orthopedics
Slipped Capital Femoral Epiphysis (SCFE) Southwick’s angle: Epiphyseal-shaft angle on lateral radiograph <30 degrees: mild 30-60 degrees: moderate >60 degrees: severe Klein’s line: Line drawn along superior border of femoral neck (AP x-ray) In SCFE: will intersect less of the femoral head or not at all Developmental Dysplasia of Hip…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Non-invasive Prenatal Screening
Quick review/Mnemonic: PAPP-A is decreased in all trisomies.Nuchal translucency is increased in all trisomies. Inhibin A is only increased in Down’s syndrome.Beta-HCG is increased in Down’s syndrome. All triple test results decreased in Edward syndrome. Only AFP is increased in NTDs and abdominal wall defects. Acetylcholinesterase level increased in Amniotic…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
List of Osteochondritis of Different Bones
Osteochondritis of the capitulum of humerus (elbow): panner’s disease Osteochondritis of the lunate bone: keinbock’s disease Osteochondritis of the femoral head: perthe’s disease Osteochondritis of lateral part of medial femoral condyle: osteochondritis dissecans Osteochondritis of the tibial tubercle: osgood schlatter’s disease Osteochondritis of lower part of patella: sinding larsen johansson…