The severity of alcoholic hepatitis can be assessed using a number of simple quantitative indices (Maddrey score, Meld score, Combined clinical and laboratory index). Of these, the Maddrey Discriminant Function (MDF) is the simplest. Maddrey score = 4.6 X (prolongation of prothrombin time above control in seconds) + Total bilirubin…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Clinical Criteria for Diagnosis of Enteric Fever
In the Absence of Microbiological Confirmation, these case defintions and criteria may be helpful. Case definitions of Typhoid Fever a. Confirmed enteric fever: A patient with persistent fever (38 °C or more) lasting 3 or more days, with laboratory-confirmed S. typhi organisms (blood, bone marrow, bowel fluid) A clinical compatible…
Emergency Medicine
DKA : Mnemonic Approach and Clinical Aspects
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…
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…
PGMEE, MRCS, USMLE, MBBS, MD/MS
JVP Mnemonics
Jugular venous pulse (JVP) waveforms a – Atrial contraction (RA) c – Closure and Curving of tricuspid valve into RA x – atrial relaXation v – Venous filling of right atrium (RA) y – atrial emptYing Distinguishing JVP from Internal carotid pulsation Mnemonic: POLICE Palpation: Non-palpable Occlussion: Readily occludable Location:…
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) =…