picmonic style Flashcards

Question

antenatal testing

Answer 1

Here’s a high-yield, exam-focused way to understand and memorise antenatal (quadruple + combined) testing, keeping it simple, pattern-based, and fast to recall. --- 1️⃣ Big picture (exam framing) Timeline 11–13+6 weeks → Combined test 15–20 weeks → Quadruple test High-risk result → NIPT (then invasive if needed) 👉 Exams love which test, when, and the hormone pattern. --- 2️⃣ Combined test (early pregnancy) What’s in it? Nuchal translucency HCG PAPP-A Down’s syndrome pattern > “Thick neck, High HCG, Poor PAPP-A” ↑ β-hCG ↓ PAPP-A ↑ Nuchal translucency 📌 Edward’s / Patau Similar pattern BUT hCG is LOW, not high --- 3️⃣ Quadruple test (later booking) Markers AFP Unconjugated oestriol HCG Inhibin A 🔑 The golden mnemonic “Down = LOW LOW HIGH HIGH” Condition AFP Oestriol hCG Inhibin A Down’s (T21) ↓ ↓ ↑ ↑ Edward’s (T18) ↓ ↓ ↓ ↔ Neural tube defect ↑ ↔ ↔ ↔ 📌 This table is extremely high yield. --- 4️⃣ One-line memory hooks Down’s = “Sad placenta, shouting baby” Placenta underperforms → ↓ AFP, ↓ oestriol Placenta shouts → ↑ hCG, ↑ inhibin A Edward’s = “Everything is low” All ↓ except inhibin (normal) Neural tube defect = “AFP leaks out” Only AFP ↑ --- 5️⃣ Interpreting results (exam wording) Low chance = ≥ 1 in 150 (e.g. 1 in 300) High chance = < 1 in 150 (e.g. 1 in 100) 👉 High chance ≠ diagnosis → offer NIPT or invasive testing --- 6️⃣ NIPT (modern exam favourite) What it is Blood test analysing cell-free fetal DNA Placental in origin (≈ fetal DNA) Key facts From 10 weeks >99% sensitivity & specificity for Down’s Screening, not diagnostic 👉 If positive → CVS or amniocentesis --- 7️⃣ Ultra-short exam summary (perfect for last-day revision) Combined (11–13+6): ↑ hCG, ↓ PAPP-A, ↑ NT = Down’s Quadruple (15–20): Down’s = ↓ ↓ ↑ ↑ Edward’s = ↓ ↓ ↓ ↔ NTD = AFP ↑ only High risk → NIPT → invasive if needed If you want next, I can: Turn this into 5 Brainscape cards Build a single visual mnemonic diagram Give you exam-style one-liners that map straight to marks

Answer 2

Here’s a high-yield, exam-ready summary of palliative care nausea & vomiting, with a simple memorisation system that actually works on the ward and in exams. --- 🔑 The BIG picture (this is the key examiner idea) > Palliative N&V is multi-factorial → treat the dominant mechanism, not just symptoms. There are 6 syndromes. Two are most common: 👉 Gastric stasis and Chemical causes --- 🧠 The 6 syndromes — memorise as: “G C V R V C” → Good Care Very Rarely Vomits Calmly Syndrome Think of… First-line drugs Gastric stasis Opioids, slow gut Metoclopramide, domperidone Chemical HyperCa²⁺, opioids, chemo Haloperidol, ondansetron, levomepromazine Visceral/serosal Constipation, thrush Cyclizine, levomepromazine Raised ICP Brain mets Cyclizine, ± dexamethasone Vestibular Motion, skull base Cyclizine Cortical Anxiety, anticipatory Lorazepam, cyclizine --- ⭐ Ultra–high-yield drug matching (this is what exams love) Cyclizine = brain + balance Use it for: Raised ICP Vestibular causes Visceral/serosal Cortical (if benzos unsuitable) 🧠 Cyclizine covers anything involving the brain or movement --- Metoclopramide = moving stomach Best for gastric stasis ❌ Avoid if bowel obstruction, perforation, post-GI surgery 🧠 “Metoclopramide makes the gut move” --- Haloperidol = chemicals Opioids Hypercalcaemia Chemo-related nausea 🧠 “Halo clears toxins” --- Benzos (lorazepam) = anticipation Anxiety-driven nausea Anticipatory vomiting 🧠 “Anxiety → benzo” --- 🚨 Safety pearl (very high yield) ❌ Do NOT use metoclopramide in: Complete bowel obstruction GI perforation Immediately post-gastric surgery --- 💉 Route of administration (easy marks) Oral preferred Use parenteral (SC/IV) if: Active vomiting Malabsorption Severe gastric stasis IV only if access already present --- 🧠 One-line memory hook (gold) > “Cyclizine for the brain, metoclopramide for the gut, haloperidol for chemicals.” If you want next: A 1-page ward cheat sheet Brainscape cards Or exam-style vignettes (“Which anti-emetic?”) Just say 👍

Answer 3

Here’s an ultra–high-yield, exam-focused summary with a very simple memory hook. --- Addison’s disease – management (ULTRA HIGH YIELD) 1️⃣ Core replacement (think “2 hormones lost → 2 hormones replaced”) Hydrocortisone = glucocorticoid replacement 20–30 mg/day, split into 2–3 doses Most in the morning (mimics normal cortisol rhythm) Fludrocortisone = mineralocorticoid replacement 👉 Mnemonic: “HYDRO + FLUDRO” (HYDRO-cortisone, FLUDRO-cortisone) --- 2️⃣ Sick-day rules (VERY EXAMINABLE) Intercurrent illness → DOUBLE the hydrocortisone Do NOT change fludrocortisone 👉 Mnemonic: “Double the STEROID, leave the SALT” (STEROID = hydrocortisone, SALT = fludrocortisone) --- 3️⃣ Patient safety essentials (classic OSCE/exam points) Never miss steroids Steroid card / MedicAlert bracelet Emergency IM hydrocortisone kit (for adrenal crisis) Education on when and how to inject 👉 Mnemonic: “CARD – KIT – NEVER SKIP” --- One-line memory summary > Addison’s = HYDRO + FLUDRO, double HYDRO when sick, FLUDRO stays fixed, always carry CARD + KIT. If you want, I can: Turn this into Brainscape cards Create a Picmonic-style mental image Give a 1-minute OSCE answer version

Answer 4

Here’s the high-yield recap for neck lumps, plus the simple memory framework we discussed — kept tight and exam-focused. --- 🔑 High-yield neck lump causes (exam essentials) 1️⃣ Reactive lymphadenopathy Most common cause Tender nodes Recent local infection or viral illness Usually settles 📌 If it’s tender + recent infection → think reactive --- 2️⃣ Lymphoma Rubbery, painless lymph nodes B symptoms: night sweats, weight loss, fever ± splenomegaly Alcohol-related pain is rare (don’t rely on it) 📌 Painless + rubbery + sweats = lymphoma --- 3️⃣ Thyroid swelling Moves up on swallowing May be hypo-, eu- or hyperthyroid Usually midline or paramedian 📌 Swallow = thyroid --- 4️⃣ Thyroglossal cyst Young patients (<20) Midline Moves up with tongue protrusion Can get infected → painful 📌 Tongue movement = thyroglossal --- 5️⃣ Pharyngeal pouch (Zenker’s) Older men Dysphagia, regurgitation, aspiration, chronic cough Gurgles on palpation if large 📌 Elderly + regurgitation = pouch --- 6️⃣ Cystic hygroma (lymphangioma) Congenital Soft, transilluminates Often left side of neck Presents at birth or <2 years 📌 Baby + glowing cyst = hygroma --- 7️⃣ Branchial cyst Young adults Lateral neck Along anterior border of SCM Embryological remnant 📌 Young adult + lateral neck cyst = branchial --- 8️⃣ Cervical rib More common in adult females ± thoracic outlet syndrome Neurovascular symptoms in arm 📌 Neck lump + arm symptoms = cervical rib --- 9️⃣ Carotid aneurysm Pulsatile Lateral neck Does NOT move on swallowing 📌 Pulsatile + fixed = carotid --- 🧠 Ultra-simple memory framework (this is the key) Step 1: MIDLINE or LATERAL? Midline → Thyroid, Thyroglossal, Pharyngeal pouch Lateral → Lymph nodes, Branchial cyst, Carotid, Cervical rib --- Step 2: MOVES with what? Swallowing → Thyroid Tongue protrusion → Thyroglossal cyst Neither → Lymphoma, branchial, carotid --- Step 3: AGE clue Baby / <2 yrs → Cystic hygroma Child / teen → Thyroglossal cyst Young adult → Branchial cyst Older adult → Pharyngeal pouch, malignancy --- Step 4: SPECIAL FEATURES Tender → Reactive Rubbery, painless → Lymphoma Pulsatile → Carotid Gurgling + regurgitation → Pharyngeal pouch Transilluminates → Cystic hygroma --- 🧠 One-line exam mantra > “Midline moves with swallow or tongue, lateral rubbery sweats = lymphoma, pulsatile fixed = carotid, baby glow = hygroma.” If you want next: a 1-page exam table Brainscape cards or a single Picmonic explanation walkthrough just say the word.

Answer 5

Toxin Antidote N NAC (Paracetamol) A Alkaline urine (Salicylates) B Bicarb (TCAs) B Beta-blocker → Glucagon O Opioids → Naloxone L Lithium → Dialysis D Digoxin → Fab F Fomepizole (Ethylene glycol / Methanol) A Atropine (Organophosphate) T Transfusion factors (Warfarin) P Protamine (Heparin) H Hyperbaric O₂ (CO) D Desferrioxamine (Iron) C Cobalamin (Cyanide) O Oxygen (CO) 🔑 Core principle (exam mindset) > Most toxins = supportive care A few have “signature antidotes” → these are what exams test So we memorise only the signature pairs. --- 🧠 The “POISON → ONE ANTIDOTE” memory map 🔥 Paracetamol Antidote: N-acetylcysteine (NAC) Hook: Paracetamol destroys glutathione → NAC replaces it 🧠 “Paracetamol Needs NAC” --- 🧂 Salicylates (aspirin) Antidote: Urinary alkalinisation (IV bicarbonate) ± dialysis Hook: Alkaline urine traps acid drugs 🧠 “Aspirin likes Acid → Alkaline pee” --- 💉 Opioids Antidote: Naloxone Hook: Nalox-one knocks opioids off receptors 🧠 “No breathing? Naloxone.” --- 😴 Benzodiazepines Antidote: Supportive care (NOT flumazenil usually) Hook: Flumazenil causes seizures 🧠 “Benzo = hands off” --- 💔 Tricyclic antidepressants Antidote: IV sodium bicarbonate Hook: TCAs cause acidosis + arrhythmias → bicarb fixes both 🧠 “TCA = Bicarb” ❌ Dialysis does NOT work --- 🔋 Lithium Antidote: Fluids first → dialysis if severe Hook: Lithium is a salt → wash it out 🧠 “Lithium LOVES dialysis” --- 🩸 Warfarin Antidote: Vitamin K ± PCC Hook: Replace clotting factors 🧠 “WAR = Vitamin K” --- 🧬 Heparin Antidote: Protamine sulphate Hook: Protamine binds heparin 🧠 “HePARIN → PROTA-mine” --- 💊 Beta-blockers Antidote: Glucagon Hook: Bypasses beta-receptor 🧠 “Beta-blocker? Give sugar hormone” --- 🧪 Ethylene glycol Antidote: Fomepizole (± ethanol, ± dialysis) Hook: Blocks alcohol dehydrogenase 🧠 “Anti-freeze → FOME” --- 🧴 Methanol Antidote: Fomepizole or ethanol Hook: Same enzyme as ethylene glycol 🧠 “Methanol = same as antifreeze” --- 🐛 Organophosphates Antidote: Atropine Hook: Blocks muscarinic overload 🧠 “Organophosphate = atropine” (Pralidoxime = controversial → ignore for exams) --- ❤️ Digoxin Antidote: Digoxin-specific antibody fragments (Fab) Hook: Bind and neutralise digoxin 🧠 “Digoxin → Fab fragments” --- 🔩 Iron Antidote: Desferrioxamine Hook: Chelates iron 🧠 “IRON → DESFER” --- 🎨 Lead Antidote: Dimercaprol + calcium edetate Hook: Chelation 🧠 “LEAD → EDTA” --- 🫁 Carbon monoxide Antidote: 100% oxygen ± hyperbaric O₂ Hook: Kick CO off haemoglobin 🧠 “CO → O₂” --- ☠️ Cyanide Antidote: Hydroxocobalamin Hook: Turns cyanide into vitamin B12 🧠 “CYANIDE → COBALAMIN” --- 🧠 Ultra-compressed exam mnemonic “NAB BOLD FAT PHD CO CO” --- 🎯 Exam takeaway > If the question says “specific antidote”, they want ONE word. If you hesitate → dialysis or supportive care is often wrong. If you want next: Brainscape cards One-page PDF Picmonic-style mental image walkthrough just tell me 👌 I'm thinking of doing a PICmonic for this to remember. I'll go through various characters or scenes to remember each thing.For Aspen, I want a donkey, aka an ass, who is peeing, urinating.I'm urinating on something like bread, a carbohydrate, with the symbol for bisexuality over it.The thing is a chasipants, I want a big bend, and I want it to have wings and be flying to represent the flumesino.To try a select antidepressants, I want someone on a tricycle, and I want them to be holding a carbohydrate such as bread with the bisexuality symbol over it. For lithium, I want a lithium battery, and I want it to be hooked up and powering a dialysis machine.For waterin, I want a fairy that looks like it's going to war, armour, and they are holding a box of Special K cereal with the letters PCC below.For Heckerin, I want a parrot who looks like they're in a protest and they're holding a sign that has a picture of a mine on it with a tick because they're pro-mines.The beta block is a big block with no letter without the symbol for beta on it.And I want it covered in a sugary syrup like caramel to represent Greek yogurt.For ethylene glycol, I want a picture of a bottle of antifreeze, and I want lots of foam coming out of it. For methanol, I want a bottle of red alcohol, again with foam coming out of it. So Digioxin, I wanted a Digimon monster which is facing another Digimon monster that has been broken up into fragments.For iron, I want a iron to be holding a spray and to be spraying a fox to represent deferoxamine.For lads, I wanted a big block of lads above and about to crush a bone and a dime coin wearing a cap.carbon monoxide, I want a fire with blacksmith coming off, going into a hyperbaric chamber.For cyanide, I want an apple with a poison symbol on it, opposite a bee with a 12 on it.Please can you generate this Picmonic image for me?

Answer 6

One-Glance Memory Framework 🧠 “X-US-CT → PPLCM → 30 → Light → pH 7.2 → R-PIP-D” Image smartly Sample properly Protein first Light’s for borderline Drain if pH <7.2 Plan for recurrence Pleural Effusion – Ultra High-Yield Facts 1️⃣ Imaging: X → US → CT Think “X-US-CT” CXR (PA) → all patients Ultrasound → before aspiration (↑ success, ↓ complications, detects septations) Contrast CT → especially for exudates / malignancy work-up --- 2️⃣ Pleural aspiration: Always US-guided Needle + samples = exam gold 21G needle, 50 mL syringe Send fluid for PPLCM: PH Protein LDH Cytology Microbiology 👉 pH is critical for infection decisions. --- 3️⃣ Transudate vs Exudate: Protein first, then Light’s Rule of 30 Protein >30 g/L → exudate Protein <30 g/L → transudate Protein 25–35 g/L → apply Light’s criteria Light’s criteria (need ≥1): Pleural/serum protein > 0.5 Pleural/serum LDH > 0.6 Pleural LDH > ⅔ ULN serum LDH 👉 Light = Exudate finder --- 4️⃣ Classic pleural fluid associations (VERY examinable) Think “GLOW CHAMP” Glucose ↓ → RA, TB LDH ↑ (relative) → exudate Oesophageal rupture → amylase ↑ Weird enzymes → pancreatitis (amylase ↑) Complement ↓ → SLE Haemorrhagic → mesothelioma, PE, TB Amylase ↑ → pancreatitis, oesophageal perforation Malignancy → cytology positive PH ↓ → infection → drain --- 5️⃣ Pleural infection = Drain early Absolute exam rule: Any effusion + sepsis/pneumonia → aspirate Drain if: Fluid is purulent/cloudy OR pH < 7.2 (even if fluid looks clear) 👉 pH < 7.2 = chest tube --- 6️⃣ Recurrent pleural effusion: R-PIP-D Repeat aspiration Pleurodesis Indwelling pleural catheter Palliative drugs (e.g. opioids for dyspnoea) --- One-Glance Memory Framework 🧠 “X-US-CT → PPLCM → 30 → Light → pH 7.2 → R-PIP-D” Image smartly Sample properly Protein first Light’s for borderline Drain if pH <7.2 Plan for recurrence --- Absolute Exam Pearls 🚨 Ultrasound before aspiration is mandatory pH <7.2 = chest tube, regardless of appearance Protein first, Light’s only if borderline Amylase ↑ = think pancreas or oesophagus Bloody effusion = mesothelioma / PE / TB If you want, I can: Turn this into Brainscape cards Create a Picmonic-style visual Make a single A4 exam cheat sheet

Answer 7

Here’s a very high-yield, exam-focused summary of PAD management, with a simple memory framework you can recall in seconds. --- 🧠 Peripheral Arterial Disease – Ultra-High Yield Facts 1️⃣ Every PAD patient gets “best medical therapy” Think S–C–E–D Smoking cessation 🚬 (MOST important modifiable risk) Clopidogrel (first-line antiplatelet – NOT aspirin) Exercise (supervised programme before any procedure) Dose-high statin → atorvastatin 80 mg 👉 Also aggressively manage: Hypertension Diabetes Obesity --- 2️⃣ Exercise before intervention Supervised exercise therapy improves walking distance and symptoms Must be offered before revascularisation (unless critical limb ischaemia) --- 3️⃣ Revascularisation: short vs long lesions Think “Short = Stent, Long = Scalpel” Endovascular (angioplasty ± stent) Short lesions (<10 cm) Aorto-iliac disease High-risk surgical patients Surgical Long lesions (>10 cm) Multifocal disease Common femoral artery Infrapopliteal disease --- 4️⃣ Amputation Last resort only Reserved for critical limb ischaemia when revascularisation isn’t possible --- 5️⃣ PAD-specific drugs Naftidrofuryl oxalate → improves symptoms/QoL Cilostazol → antiplatelet + vasodilator ❌ Not recommended by NICE --- 🧠 One-line exam memory hook PAD = “STOP & WALK, then WIRE or CUT” STOP smoking WALK (supervised exercise) WIRE (angioplasty) if short lesion CUT (surgery) if long lesion --- ⚠️ Common exam traps ❌ Aspirin first-line → Wrong (clopidogrel) ❌ Jumping straight to surgery → Wrong (exercise first) ❌ Low-dose statin → Wrong (atorvastatin 80 mg) --- If you want, I can: Turn this into Brainscape cards Create a Picmonic-style visual Give you a one-page PAD exam checklist

Answer 8

psychiatric drugs: lithium, benzodiazepines aspirin carbimazole methotrexate sulfonylureas cytotoxic drugs amiodarone The following are a list of things that should be avoided in breastfeeding. For antibiotics, I want a character represented by a character who is a syringe. They're holding a sippy cup. They're riding a quad cycle. And they are next to a fondue machine filled with sulfur, and they're covered in, or no, they're surrounded by chlorine gas. And then I want for psychiatric drugs a character in a straitjacket next to a lithium battery and Big Ben. To represent aspirin, I want a donkey, aka an ass. The donkey has smelly armpits represented by yellow smelliest, or no, green smelliest coming from their armpits. I then want them next to a toilet, because they're peeing out sulfonylureas.I want methotrexate, no, I want carbimazole, represented by bread, which is a carbohydrate, with a maize pattern on the bread.Methadryx, I want to have a racing driver on a track who has got a meth pipe armour.I want them to be traced by a cyclops character who is riding a truck with toxic chemicals in it. Please generate this Picmonic image for me. The following drugs should be avoided: antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides

Answer 9

TME = total mesorectal excision 🔥 Ultra high-yield facts (what examiners love) 1️⃣ Staging (DO THIS FOR EVERY CRC) “CEA + CT + COLON + MRI (if rectal)” CEA baseline CT chest/abdomen/pelvis Full colon evaluation (colonoscopy or CT colonography) MRI pelvis if tumour is below the peritoneal reflection (rectal cancer) All cases → colorectal MDT --- 2️⃣ Surgery = mainstay of cure (colon cancer) Resection is the only curative treatment Segmental resections based on blood supply + lymphatic drainage Anastomosis requires: good blood supply no tension good mucosal apposition --- 3️⃣ Location → operation → anastomosis (VERY high yield) Tumour site Operation Anastomosis Caecum / Ascending / Proximal transverse Right hemicolectomy Ileo-colic Distal transverse / Descending Left hemicolectomy Colo-colic Sigmoid High anterior resection Colo-rectal Upper rectum Anterior resection (TME) Colo-rectal Low rectum Low anterior resection (TME) Colo-rectal ± defunctioning stoma Anal verge APER No anastomosis --- 4️⃣ Rectal cancer = different rules Chemotherapy + radiotherapy commonly neoadjuvant Surgery includes TME Higher likelihood of defunctioning stoma --- 5️⃣ Obstruction & emergencies (EXAM GOLD) Colon obstruction → stent or resect Perforation / emergency surgery: Colon-colon anastomosis = high risk Often safer to form end colostomy Hartmann’s procedure = sigmoid resection + end colostomy Ileo-colic anastomosis is relatively safe, even in emergencies --- 6️⃣ Adjuvant / metastatic disease Chemotherapy: FOLFOX, FOLFIRI Radiotherapy: mainly rectal cancers Targeted therapy (metastatic): Bevacizumab (anti-VEGF) Cetuximab (anti-EGFR) --- 🧠 Easy way to memorise 🔑 “RIGHT = ILEO, LEFT = COLO, RECTUM = TME” Right side colon → Right hemi → Ileo-colic Left side colon → Left hemi → Colo-colic Rectum → Anterior resection + TME Anal verge → APER = no anastomosis --- 🚨 Emergency mnemonic: “PERF = HART” PERForated sigmoid → HARTmann’s Colon-colon anastomosis risky Ileo-colic safer --- 🎯 One-line killer summary > Colon cancer = surgery first. Rectal cancer = MRI + neoadjuvant therapy. Emergency perforation = Hartmann’s. If you want, I can now: Turn this into 3 killer Brainscape cards Create a single anatomy → operation flow diagram Build a Picmonic-style visual for resections

Answer 10

🧠 FINAL ONE-PAGE MEMORY MAP Stroke Reperfusion Ladder CT → No bleed? ↓ <4.5h → Thrombolyse ↓ >4.5h → Mismatch? → Thrombolyse ↓ Large vessel → Thrombectomy Secondary Prevention Clopidogrel + Statin + CEA if >50% carotid stenosis 🚨 Acute Ischaemic Stroke: Reperfusion — HIGH-YIELD ONLY 1️⃣ Thrombolysis (alteplase / tenecteplase) ✅ Core rules (must know) Time: within 4.5 hours Imaging: haemorrhage excluded BP must be < 185/110 mmHg before giving thrombolysis 💡 If in doubt → image → don’t delay antibiotics/antithrombotics --- ⏱️ Extended window (2023 guideline update – VERY EXAMMY) Thrombolysis can be given up to 9 hours or wake-up stroke IF: Evidence of salvageable brain tissue on imaging: CT/MR perfusion → core–perfusion mismatch MRI → DWI–FLAIR mismatch ✔️ Age and stroke severity do NOT exclude thrombolysis anymore --- 🚫 ABSOLUTE CONTRAINDICATIONS (memorise as a block) Think “BLEED IN THE BRAIN OR BLEEDING NOW” Previous intracranial haemorrhage Suspected SAH Intracranial neoplasm Stroke or head injury < 3 months Active bleeding GI bleed < 3 weeks Lumbar puncture < 7 days Oesophageal varices Uncontrolled BP > 200/120 --- ⚠️ RELATIVE CONTRAINDICATIONS Think “BLEEDING RISK BUT NOT BRAIN” Pregnancy Anticoagulation (INR > 1.7) Haemorrhagic diathesis Recent major surgery/trauma (<2 weeks) Active diabetic haemorrhagic retinopathy Suspected intracardiac thrombus --- 🧠 EASY MEMORY HOOK (Thrombolysis) “4.5 – BLEED – BP – BRAIN SAVED” 4.5h No bleed BP <185/110 Extended window needs mismatch --- 2️⃣ Mechanical Thrombectomy ✅ Who benefits most Large vessel occlusion Functionally independent pre-stroke (mRS < 3) NIHSS > 5 --- ⏱️ Time windows 0–6 hours Proximal anterior circulation occlusion Give with IV thrombolysis if eligible 6–24 hours (including wake-up strokes) Proximal anterior circulation occlusion Salvageable tissue on CT/MR perfusion ⚠️ Posterior circulation (basilar / PCA) Consider thrombectomy up to 24h if salvageable tissue --- 🧠 EASY MEMORY HOOK (Thrombectomy) “BIG CLOT → BIG GAIN” Big vessel (proximal) Big deficit (NIHSS >5) Big tissue to save (perfusion mismatch) --- 3️⃣ Secondary Prevention (NICE-FAVOURITES) 💊 Antiplatelets Clopidogrel = FIRST LINE Aspirin ONLY if clopidogrel not tolerated --- 🩺 Carotid endarterectomy Symptomatic carotid territory stroke/TIA Stenosis > 50% (NASCET) Perform within 7 days Only if not severely disabled ⚠️ Remember: NASCET ≥50% ≈ ECST ≥70% --- --- If you want next: 3 killer Brainscape cards One Picmonic scene for thrombolysis vs thrombectomy Absolute vs relative contraindications condensed into ONE card Just say the word 🔥

Answer 11

🧠 One ultra-high-yield memory system “Jaundice? Pain? Fever?” rule Ask three questions: 1️⃣ Is there jaundice? Painless → Pancreatic cancer With fever → Ascending cholangitis Progressive + weight loss → Cholangiocarcinoma --- 2️⃣ Is there severe pain? Epigastric → back + vomiting → Acute pancreatitis RUQ, persistent + fever → Acute cholecystitis RUQ, intermittent, post-meal → Biliary colic --- 3️⃣ Is it systemic / obstructive? Viral symptoms → Viral hepatitis Bowel obstruction signs → Gallstone ileus Heart failure signs → Congestive hepatomegaly Ill but no jaundice → Amoebic abscess --- 🔥 High-yield comparison table (what actually distinguishes them) 🟨 Pancreatic cancer Classical: Painless jaundice Also common: epigastric pain, weight loss, anorexia Pain may radiate to the back Think head of pancreas → bile duct obstruction 👉 Key discriminator: painless jaundice + weight loss --- 🟤 Amoebic liver abscess Systemic symptoms: malaise, anorexia, weight loss RUQ pain: usually mild Jaundice uncommon 👉 Key discriminator: ill-looking + RUQ pain but no jaundice --- 🟥 Ascending cholangitis Charcot triad: Fever (often rigors) RUQ pain Jaundice Usually due to gallstones 👉 Key discriminator: sepsis + jaundice --- 🟦 Gallstone ileus Small bowel obstruction symptoms: Abdominal pain Distension Vomiting Due to gallstone fistula into bowel 👉 Key discriminator: bowel obstruction + gallstone history --- 🟪 Cholangiocarcinoma Persistent jaundice Weight loss, anorexia Palpable gallbladder (Courvoisier sign) Metastatic signs: Sister Mary Joseph node Virchow node 👉 Key discriminator: progressive jaundice + cancer nodes --- 🟧 Acute pancreatitis Severe epigastric pain Radiates to back Vomiting common Causes: alcohol or gallstones Rare signs: Cullen (periumbilical) Grey-Turner (flanks) 👉 Key discriminator: severe pain + vomiting --- 🟩 Viral hepatitis Systemic viral symptoms: Nausea, vomiting Myalgia Lethargy RUQ pain Risk factors: travel, IVDU 👉 Key discriminator: viral prodrome --- 🟫 Congestive hepatomegaly Liver pain only when stretched Cause: right-sided heart failure Chronic → cardiac cirrhosis 👉 Key discriminator: heart failure signs --- 🟨 Biliary colic Intermittent RUQ pain Abrupt onset, gradual resolution Often post-prandial No fever 👉 Key discriminator: colicky pain, well between attacks --- 🟥 Acute cholecystitis Pain similar to biliary colic but: More severe Persistent Fever Murphy’s sign positive Pain may radiate to right shoulder 👉 Key discriminator: persistent pain + fever + Murphy’s --- 🧠 One ultra-high-yield memory system “Jaundice? Pain? Fever?” rule Ask three questions: 1️⃣ Is there jaundice? Painless → Pancreatic cancer With fever → Ascending cholangitis Progressive + weight loss → Cholangiocarcinoma --- 2️⃣ Is there severe pain? Epigastric → back + vomiting → Acute pancreatitis RUQ, persistent + fever → Acute cholecystitis RUQ, intermittent, post-meal → Biliary colic --- 3️⃣ Is it systemic / obstructive? Viral symptoms → Viral hepatitis Bowel obstruction signs → Gallstone ileus Heart failure signs → Congestive hepatomegaly Ill but no jaundice → Amoebic abscess --- 🏆 MSRA one-liner memory hook > “Jaundice sorts cancers and infection. Pain sorts gallbladder vs pancreas. Fever makes it surgical.” --- If you want, I can: Turn this into 3 killer Brainscape cards Create a single Picmonic scene covering all of these Give you a 10-second ED decision algorithm Just say the word.

picmonic style Flashcards

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