Friday, June 3, 2011

Today's Mnemonic

I am beginning to become cross-eyed with mnemonic's right now. Especially some of the dumb ones that are provided in the study guides, like

"Queen Barb Steals Phen-Phen and Refuses Greasy Carbs Chronically" for all the P-450 inducers (Quinidine Barbiturates Phenytoin Rifampin Griseofulvin Carbamazepine, Chronic ETOH, St. John’s wort).

Ok, on second thought, that one isn't the best example because it is (somewhat) reasonable. But I can see myself on the exam, when my brain is flat-lining with stress going, "something to do with queens and grease...?"

Today was cardiac day. I came up with this for remembering EKG* patterns:

TRANSmural infarcts are ST elevation because TRANSvestites like to wear heels.

Subendocardial infarcts are ST depression because SUBs go down.

[Insert slow clap, please.]

*Apologies to those of you that get all scrunched up when people use the "EKG" instead of "ECG" acronym. Yes, yes I know we aren't in Germany anymore but it is my way of making permanent tribute to Einthoven...I mean really, the guy shot melted quartz on the tip of an ARROW to make the first EKG wires ARROW.  When I learned that I decreed, "and from this day forward I shall call it, EKG."

No that is not a chef getting a manicure on his lunch break.


Anonymous said...

No, no, it's totally reasonable to call it an EKG. As long as you call your Kardiologist afterwards to take the patient to the Kath lab.

And I maintain the most badass moment in medicine is still Barry Marshall drinking H Pylori to prove it causes ulcers, then getting hospitalized with a bad bleeding ulcer.

Albinoblackbear said...

Aaaaaannnnnnnnd he takes the bait folks! hahahah :P

Drinking H-pylori is very badass. I'll agree.

And if a crazy industrious German invented the cath lab then YES yes I will call the Kath Lab.


I think I am going to start calling it the "kranken Lab" from now on... :)

Christopher said...

I thought he was Dutch? (this EKG just slinked off into a corner...)

Albinoblackbear said...

Hahahah, oh my GODDDDDDDD!!!!!

He IS Dutch!!!!!!!!!!!!

And my world just spun off its access. Thanks for that.

Ok, if you and IANH lived in Ireland I'd be buying you both a round. Now I have to decide what the HELL I am going to call it now.

I might have to revert to 'heart tracing' in protest.

Anonymous said...

The most famous Mnemonic in my med school, printed on t-shirts and included in year books was "Roses are red, violets are blue, the serratus anterior is innervated by the long thoracic nerve."

Makes no sense, but everyone knew it.

Christopher said...

"Ma'am we're a bit concerned about your heart tracings. We may have to Roto-Root the garden hoses in your heart. Alternatively, we can give your heart Drain-O. I'm going to consult with the heart tracing doctors."

I'm sure lay peoples will enjoy that.

Albinoblackbear said...

About: That. Is. Awesome.

I may have to make myself a mug with that written on it.

Chris: I've had about enough of your guff for one day. :P

PGYx said...

I'll add: PR segment depression is pathognomonic for PeRicarditis (tho' remember you'll likely see diffuse ST-segment elevation, too).

I called pericarditis on an EKG during conference the other day based on PR segment depression. A 2nd year applying for Cardiology fellowship shot me down and patiently explained why it really showed an MI.

She was quiet after the attending lecturer told us the patient had pericarditis. Once in a while, the intern gets it right. :-)

Albinoblackbear said...

PGYX---Awesome and awesome. Thanks for the extra tip!

Did you yell out "BOOM" and do the finger snap motion?? heheh

I know you are much too gracious for that (though it would have happened in my head! hahah)

nursebiteme said...

lol...i remember having to come up with lots of those to memorize before my nursing tests...ugh. glad those days are over.

Anonymous said...

Hopefully this is me in a couple of years.

...figuring out mnemonics that is, not the dude in the picture.

NPO said...

It should be EKG, should we change everything. Okay no more Latin terms because that is a dead language. That does not make sense either.

Albinoblackbear said...

NBM: Sadly my mnemonic days are far from over! hahah :)

MSO: Heh. Either/or, pretty cool. You'll get there!

NPO: I *adore* the Latin and Greek aspects of medical language (surprise!!) I wish that I had actually taken some formal lessons in it.

Christopher said...

If you really want to impress cardiology with your pericarditis pickups:

- Lead aVR shows PR elevation and ST depression
- Leads I and II with elevation together (ridiculously rare in an MI, common in pericarditis)
- Relatively normal QTc in pericarditis

Rogue Medic said...

"TRANSmural infarcts are ST elevation because TRANSvestites like to wear heels."

Maybe TRANSvestites don't really like to wear heels. Maybe TRANSvestites are just perpetuating social stereotypes.

Yeah, that'll cheer your friendly neighborhood TRANSvestite right up. "You're just perpetuating a social stereotype by attacking a social stereotype." :-)