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…
Tag: Internal medicine
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Revised Jone’s Criteria – Mnemonic
Remember SPACE LEAF for Revised Jone’s Criteria (2015). Major criteria Mnemonic: SPACE Subcutaneous nodules Pancarditis Arthritis (Polyarthritis; for moderate to high-risk population – monoarthritis also qualifies) Chorea Erythema marginatum Minor criteria Mnemonic: LEAF Long PR interval ESR ≥ 60mm/hr (or ≥ 30mm/hr in moderate to high-risk population) and CRP ≥…
Clinical Skills and Approaches 
Murmurs Made Easy
Mnemonic: SSSS Stenotic lesion of Semilunar valve and Septal defect cause Systolic murmur. From this, you should also be able to remember that regurgitant lesions of semilunar valve causes Diastolic murmur. The stenotic lesions of atrio-ventricular valve causes diastolic murmur and regurgitant lesions cause systolic murmur. Causes of systolic murmur:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Decorticate and Decerebrate Rigidity – Mnemonics
Rubrospinal tract mediates flexor of the upper arm. Here is a way to remember these two postures and never forget again. Decerebrate has more “E” and more “R”. Extended upper limbs Rubrospinal tract transected (Red nucleus is above the level of lesion, i.e. below midbrain level) Decorticate has “COR”. Upper…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Hypertensive Retinopathy Grading – Simplified
Hypertensive retinopathy has been classified by Keith, Wagener & Barker and Scheie (hypertensive and arteriosclerotic features). With this mnemonic, we will have a grading with combination of all these classifications. Mnemonic: SAFEs I – Slight Systemic (generalized) narrowing of arterioles II – AV deflection (at Angle) and focal narrowing of…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Heart Sounds – Abnormal
The basic clinical examination of the Cardiac System is by Auscultation (listening to the sounds made by the heart). As explained in the previous article physiological sounds made in each cardiac cycle viz. S1 and S2 due to the closure of the Atrio-Ventricular Valves and Outlet Valve in synchrony. Please…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Chronic Lead Poisoning : Mnemonic
Mnemonic: ABCDEFGH Anemia: Results from ALA dehydrogenase inhibition Also causes RBC membranes to be permeable to K+ and decrease Na+/K+ ATPase leading to hemolysis Basophilic stippling Burtonian lines: Gum “lead lines” develop in 2-50% Results from subepithelial deposit of lead sulfide granules on gingival margins Colic: Spasmodic pain involving smooth…
Clinical Skills and Approaches 
Koilonychia
Synonyms: Spoon-shaped nails, Concave nails Definition of koilonychia: Loss of longitudinal and lateral convexity of the nail, with thinning and fraying of the distal portions. Conditions associated with koilonychia: Normal variant Soft nails with occupational damage Iron deficiency anemia Hemochromatosis Raynaud’s syndrome Psoriasis (Koilonychia with subungual keratosis) Mechanism of koilonychia in…