Rule of 150 and 4 a. Begin treatment if: Paracetamol is ingested at a dose >150 mg/kg Threshold to begin treatment is half the dose (75 mg/kg) in high risk cases: 1. Regular ethanol consumption: >21 Units/week in male and >14 Units/week in female 2. Regular use of enzyme inducing…
Tag: Pediatrics
Section Editor: Dr. Sujit Kumar Shrestha, MD Pediatrics, Fellowship Neonatology
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Dengue Classification : Mnemonic
Probable Dengue Mnemonic: FEVeR TLC (Send Total Leukocyte Count in Fever) a. Feverb. Endemic area (living or travel)and 2 of –c. Vomiting and nausead. Rashe. Tourniquet test positivef. Leukopenia (EARLIEST sign)g. Cramps and cries (Aches and pains) Tourniquet test: Inflate the BP cuff between SBP and DBP and keep it…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Hyponatremia : SIADH vs Cerebral Salt Wasting Syndrome
SIADH causes Mnemonic: SIADH Surgery Intracranial – Infection, Head injury, CVA Alveolar – Carcinoma, Pus Drugs – Opiates, Antiepileptics, Cytotoxics, Anti-psychotics Hormonal – Hypothyroid, Low corticosteroid level SIADH diagnostic criteria Mnemonic: SOD-IUM/S Serum Osmollity Decreased (<275 mOsm/kg) Increased Urine Molality/osmolality (>100 mOsm/kg) Increased Urine Sodium/Na+ (>40 Meq/L) Others: Euvolemic (Normal…
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…
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) =…