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16 intern year mnemonics - a day in the PGY-1 life

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pain, a good history — OLD CARTS — Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatments tried, Severity (on a scale 1 to 10)

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a broad Ddx, etiologic categories — INDICATE Virgo —  Infectious, Neoplastic, Degenerative, Iatrogenic/Intoxication, Congenital, Autoimmune, Trauma, Endocrine/metabolic, Vascular 

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inpatient admission, orders — A DC VANDALISM — Admit to [***], Diagnosis, Condition, Vitals, Activity, Nursing Instructions, Diet, Allergies, Labs, IV Fluids, Specialists/consults, Medications/monitoring

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verbal handoff, a systematic approach — I PASS — Illness severity, Patient summary, Action list, Situation awareness and contingency planning, Synthesis by receiver

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San Francisco Syncope Rule, criteria — CHESS — Congestive heart failure (CHF), Hematocrit < 30%, Abnormalities on ECG, Shortness of breath (SOB), SBP < 90 mm Hg at triage

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altered mental status, causes — MIST — Metabolic, Infectious, Structural, Toxin

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diabetic ketoacidosis, precipitating causes — 8I’s — Initial diagnosis of Type 1 DM, Infection (PNA, UTI, etc.), Insulin (too little/none), Infarction (e.g., CVA or MI), Incision (i.e., surgery), Infant (pregnancy), Iatrogenic (change in insulin by provider), Intoxication (e.g., ETOH or drugs)

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pancreatitis, causes — I GET SMASHED — Idiopathic, Gallstones, Ethanol, Trauma, Steroids, Malignancy (Pancreatic cancer), Autoimmune, Scorpion sting, Hypercalcemia/hypertriglyceridemia, ERCP, Drugs

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new onset atrial fibrillation, causes — PIRATES — Pulmonary, Ischemia/Infarction/CAD, Rheumatic heart disease/Mitral Regurgitation, Alcohol/Anemia, Thyrotoxicosis/Toxins, Electrolytes/Endocarditis, Sepsis/Sick sinus syndrome

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pseudotumor cerebri, risk factors — female TOAD — female sex, Tetracyclines, Obesity, vitamin A excess, Danazol

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multiple myeloma, clinical manifestations — CRAB — Calcium (elevated), Renal failure, Anemia, Bone disease/Back pain

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cytochrome p450, inhibitors — A Cute Gentleman Sipped Iced Grapefruit juice, And Quietly Kept Munching Soft Cinnamon Rolls — Acute EtOH, Gemfibrozil, Ciprofloxacin, Isoniazid, Grapefruit juice, Amiodarone, Quinidine, Ketoconazole, Macrolides, Sulfonamides, Cimetidine, Ritonavir

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cirrhosis, initial management — VIBES — Volume status, Infection (SBP), Bleeding (varices), Encephalopathy, Screening (hepatitis virii, etc.), Surgery (TIPS or liver transplant)

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cystinuria, implicated amino acids — COLA— Cystine, Ornithine, Lysine, Arginine

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picornavirii, examples — PERCH on a peak — Poliovirus, Echovirus, Rhinovirus, Coxsackievirus, HAV

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patent ductus arteriosus, murmur type — PDAs are continuously inspiring! (or annoying?)  — The murmur from a PDA (Patent Ductus Arteriousus) is described as a continuous “machine-like” murmur

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