Synonyms: Hot potato speech, Potato in mouth It is a term for a defect of resonance in which the speech has muffled quality, fancifully likened to a person speaking with a (very) hot potato in their mouth. Mechanism of Hot Potato Voice: Hot potato voice is the result of an…
Author: Epomedicine
Emergency Medicine 
Manual detorsion of testis in Testicular Torsion
Indications of Manual Detorsion It can serve as a temporizing measure to attempt to reperfuse the testis while the patient is awaiting definite surgical management. Contraindications of Manual Detorsion Manual detorsion is not recommended for torsion of duration >6-8 hours (prolonged ischemia leads to marked swelling and edema after which…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Wilm’s Tumor (Nephroblastoma) : Quick review
Wilm’s tumor is the most common primary renal tumor of childhood. Origin: Embryonic nephrogenic (mesodermal) cells Mechanism: Deletion of WT-1 gene on chromosome 11 Pathology: a. Macroscopic (Gross): large, solitary tan to grey color mass; pale on cut section with areas of hemorrhage; 10% are bilateral or multicentric; grossly difficult…
Emergency Medicine 
C-spine Clearance
C-spine clearance refers to a clinical decision suggesting the absence of acute bone related, ligamentous and neurologic abnormalities of the cervical spine based on history, physical exam and/or negative radiologic studies. NEXUS criteria for C-spine Clearance NEXUS (National Emergency X-Radiography Utilization Study) is a set of validated criteria used to decide…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Dizziness : History and Examination
HISTORY Mnemonic: 4D-3E-2Fg-2H 1. Define “Dizziness”: Room is spinning/rocking/somersaulting – Vertigo Feel like “going to faint” – Near-syncope “Going to fall” or “Unsteady on feet” – Disequilibrium Feel like they’ve or are “left their body” or “floating/swimming” – Psychophysiologic dizziness 2. Duration of each episode: Seconds: BPPV Minutes: TIA or…
Emergency Medicine 
Pulmonary Embolism : Chest X-ray Signs
1. Classic presentation is normal X-ray in patient with dyspnea and hypoxia 2. Atelectasis or parenchymal abnormality (68%) 3. Elevated hemidiaphragm 4. Pleural effusion (Felson’s sign – pleural effusion on left > right) 5. Hampton’s hump: peripheral pleural based wedge-shaped density above the diaphragm due to pulmonary infarct 6. Westermark’s…
Emergency Medicine 
Well’s and PERC Criteria for Pulmonary Embolism : Mnemonic
Well’s Criteria (Modified and Simplified) Mnemonic: CHADS (Remember, this is not the CHADS2 score for Atrial Fibrillation) Clinical features of DVT Cancer Heart rate > 100/min Hemoptysis Alternative diagnosis less likely DVT/PE in past Surgery in past 4 weeks or Immobilization for 3 days Well’s criteria Original score Simplified score…
Clinical Skills and Approaches 
Folstein Mini-Mental State Examination (MMSE): Mnemonic
ORARL, 5-3-5-3-9 1. Orientation: Time (5 points – 1 for each correct): What is the: (year) (season) (date) (day) (month)? Place (5 points – 1 for each correct): Where are we: (state) (county) (town) (hospital) (floor)? 2. Registration: Name three objects, ask patient to repeat (3 points – 1 for each on first…