High-Yield Exam Mnemonics
- Dopamine Down in Dark substantia nigra = Parkinson’s Disease.
Recall: Dopamine deficiency in the substantia nigra causes Parkinson’s disease.
- Glutamate Gets neurons Going (excitation).
Recall: Glutamate is the main excitatory neurotransmitter in the CNS, acting on NMDA and AMPA receptors.
- “GPCR = G-protein Coupled = cAMP.” Sedative-Hypnotics: Benzodiazepines & Barbiturates (Q9–Q18)
Recall: GPCRs activate G-proteins that modulate adenylyl cyclase (cAMP) or phospholipase C (IP3/DAG).
- MIDazolam is used in the MIDdle of surgery.
Recall: Midazolam has a short half-life (~2 hours), rapid onset, and causes anterograde amnesia, making it ideal for procedures.
- LOT drugs for Liver patients – Lorazepam, Oxazepam, Temazepam.
Recall: Lorazepam (also oxazepam, temazepam) undergoes glucuronidation only–”LOT” drugs.
- Caffeine for Crying babies with apnoea.
Recall: Caffeine (as caffeine citrate) is preferred for neonatal apnoea due to wider therapeutic index, longer half-life, and less toxicity than theophylline.
- Theophylline affects the heart more – needs Theorapeutic monitoring.
Recall: Theophylline has the most potent cardiac effects (arrhythmias, tachycardia) among methylxanthines.
- Amitriptyline is Arrhythmogenic – avoid in cardiac patients.
Recall: Amitriptyline has the highest anticholinergic and cardiotoxic effects (arrhythmias, QT prolongation) among TCAs.
- Serotonin syndrome = Shaking, Sweating, Stiff muscles.
Recall: Serotonin syndrome triad: mental status changes (agitation/confusion), autonomic instability (hyperthermia, tachycardia), and neuromuscular abnormalities (rigidity, clonus, hyperreflexia).
- John’s Wort Wastes your meds by inducing metabolism.
Recall: John’s Wort induces CYP3A4 (and P-glycoprotein), reducing effectiveness of oral contraceptives, warfarin, cyclosporine, and HIV medications.
- ECT for Extreme depression.
Recall: ECT is highly effective for severe/treatment-resistant depression, especially with psychotic features, catatonia, or suicidality.
- Dopamine Downs prolactin; blocking D2 = prolactin Up.
Recall: Dopamine normally inhibits prolactin release; D2 blockade in tuberoinfundibular pathway removes this inhibition, causing hyperprolactinaemia (galactorrhoea, amenorrhoea).
- Clozapine is the Closer for resistant cases.
Recall: Clozapine is the only antipsychotic proven effective for treatment-resistant schizophrenia (after 2 adequate trials fail).
- Lithium toxicity = Loose movements (ataxia) and Large tremor.
Recall: Lithium toxicity causes coarse tremor (fine tremor is therapeutic side effect), ataxia, confusion, seizures, and arrhythmias.
- Carbamazepine is a Compulsive enzyme inducer – even on itself.
Recall: Carbamazepine induces CYP3A4, increasing its own metabolism (autoinduction), requiring dose adjustments after 2-4 weeks.
- Naloxone Negates Narcotics.
Recall: Naloxone is a competitive opioid receptor antagonist, rapidly reversing respiratory depression.
- Methadone = Maintenance with long Measured half-life.
Recall: Methadone has a long half-life (24-36 hours), good oral bioavailability, and prevents withdrawal without significant euphoria at stable doses, enabling once-daily dosing.
- Cocaine = Craves dopamine.
Recall: Cocaine blocks dopamine reuptake in the mesolimbic pathway, causing euphoria and addiction.
- Lorazepam Leads in status epilepticus.
Recall: IV benzodiazepines (lorazepam preferred, diazepam alternative) are first-line for status epilepticus, followed by phenytoin/fosphenytoin if seizures persist.
- Hypertension = Hemorrhage in deep structures.
Recall: Hypertension causes 50–60% of spontaneous intracerebral hemorrhages, typically in basal ganglia, thalamus, pons, and cerebellum.
- ACA = Affects the Leg (medial surface).
Recall: ACA supplies medial frontal cortex including leg motor area on medial surface.
- Vasospasm = Very dangerous at day 4–14.
Recall: Cerebral vasospasm (days 4–14) is the leading cause of morbidity/mortality after initial SAH, causing delayed ischemic deficits.
- PSEN1 = Primary cause of familial AD.
Recall: PSEN1 mutations cause ~70% of familial early-onset AD.
- Synuclein Surrounds the Lewy body.
Recall: Lewy bodies contain aggregated alpha-synuclein (hence “synucleinopathy”).
- Chorea from CAG.
Recall: Huntington’s is caused by CAG trinucleotide repeat expansion (>40 repeats) in huntingtin gene on chromosome 4, encoding polyglutamine.
- Dominant Doom – one copy causes disease.
Recall: Huntington’s is autosomal dominant with complete penetrance if >40 CAG repeats.
- Werdnig-Hoffmann = Weak Hypotonic infant.
Recall: Werdnig-Hoffmann (SMA type 1) is the most severe spinal muscular atrophy with LMN degeneration presenting in infancy with hypotonia (“floppy baby”).
- Pneumococcus = Primary in adults.
Recall: Streptococcus pneumoniae is the most common cause in adults, followed by N. meningitidis.
- TB Takes glucose like bacteria.
Recall: TB meningitis shows lymphocytic pleocytosis, elevated protein, and characteristically low glucose (similar to bacterial).
- Neighboring infections spread to Neurons.
Recall: Direct extension from sinusitis, otitis media, or mastoiditis is most common (~40–50%), followed by hematogenous spread.
- Toxo = Think AIDS.
Recall: Toxoplasma encephalitis is an AIDS-defining illness, occurring when CD4 <100 cells/μL due to reactivation of latent infection.
- Pseudopalisading = Poor prognosis GBM.
Recall: Pseudopalisading necrosis (tumor cells arranged around necrotic areas) is a histologic hallmark of glioblastoma along with microvascular proliferation.
- Relapsing-Remitting is the Rule.
Recall: Relapsing-remitting MS (RRMS) accounts for ~85% of initial presentations, with discrete attacks followed by recovery.
- Albumin up, Cells down = GBS.
Recall: Albumino-cytologic dissociation (elevated protein >45 mg/dL with <10 cells/μL) is classic CSF finding in GBS due to blood-nerve barrier disruption without inflammation in CSF space.
- NF1 = chromosome 17 (1+7=8, move on).
Recall: NF1 results from NF1 gene mutation on chromosome 17 encoding neurofibromin (tumor suppressor).
- Lisch = Iris nodules in NF1.
Recall: Lisch nodules are pigmented iris hamartomas, present in >90% of adult NF1 patients, useful for diagnosis.
- “Cherry CO-la” – Cherry red color in CO poisoning due to CarboxyHb.
Recall: Carboxyhemoglobin gives the characteristic cherry-red or bright pink color to blood, skin, and viscera in CO poisoning.
- “15-20 is the Widmark clue” – Widmark’s formula uses this elimination rate.
Recall: Ethyl alcohol follows zero-order kinetics and is eliminated at a constant rate of approximately 15-20 mg% (average 15 mg%) per hour, regardless of blood concentration.
- “Methyl Makes you Miss seeing” – causes blindness.
Recall: Blindness is the hallmark of methyl alcohol (methanol) poisoning.
- “Barb Blisters” – Barbiturates cause Bullae.
Recall: Barbiturate blisters (bullous skin lesions) are pathognomonic of barbiturate poisoning, found at pressure points.
- DUMBELS = Drenched Muscarinic Body Expelling Liquids Severely.
Recall: DUMBELS represents muscarinic effects: Diarrhea, Urination, Miosis, Bradycardia/Bronchospasm/Bronchorrhea, Emesis, Lacrimation, Salivation.
- “Kids drink what they see” – accidental ingestion predominates.
Recall: Accidental ingestion is the most common route of kerosene poisoning in children, often due to storage in soft drink bottles and attractive color.
- “No vomiting = No aspiration” – keep kerosene down, not up.
Recall: Induced vomiting dramatically increases aspiration risk.
- Cannabis = Crimson eyes and Cravings.
Recall: Conjunctival injection (red/bloodshot eyes) is a classic sign of cannabis use.
- Meth is Ice cold crystal.
Recall: “Ice” or “Crystal meth” are street names for methamphetamine.
- “Withdrawal = Wide pupils” – mydriasis in withdrawal, miosis in intoxication.
Recall: Miosis (pinpoint pupils) is a sign of opioid INTOXICATION, not withdrawal.
- One Month initial admission – 30 days, then review.
Recall: Initial involuntary admission is for up to 30 days (1 month).
- Use the rhyme – “Dry, Red, Blind, Hot, Mad.”
Recall: Classic anticholinergic toxidrome: “Dry as a bone (anhidrosis), Red as a beet (flushing), Blind as a bat (mydriasis, cycloplegia), Hot as a hare (hyperthermia), Mad as a hatter (delirium).” SLUDGE describes cholinergic excess (opposite). “Fight or flight” is sympathetic activation.
- Contre = Contra = Opposite side.
Recall: Contre-coup injury occurs opposite (contralateral) to the impact site, due to the brain striking the skull on the opposite side during deceleration.
- “Russell Rules the death toll” in South Asia.
Recall: Russell’s viper (Daboia russelii) causes maximum snakebite mortality in Pakistan and the Indian subcontinent.
- Bad cans = Botulism.
Recall: Home-canned, fermented, or improperly preserved foods (low acid content, anaerobic conditions) are classic sources.
- Lidocaine Locks sodium channels.
Recall: Local anaesthetics like lidocaine block voltage-gated sodium channels, preventing action potential generation and propagation.
- Alpha-2 = Autoinhibition of Adrenergic nerves.
Recall: Alpha-2 receptors are presynaptic autoreceptors on sympathetic neurons; their activation inhibits norepinephrine release (negative feedback).
- “Benzo withdrawal = Brain Bounces Back” (hyperexcitability).
Recall: Abrupt benzodiazepine discontinuation after chronic use causes withdrawal syndrome including rebound anxiety, tremors, insomnia, and seizures due to reduced GABAergic inhibition.
- Thiopental = Think fast, protect brain.
Recall: Thiopental is an ultra-short-acting IV barbiturate ideal for rapid anaesthesia induction.
- Doxapram = Drives respiration.
Recall: Doxapram is a respiratory analeptic that stimulates peripheral carotid chemoreceptors and medullary respiratory centers, increasing tidal volume and respiratory rate.
- Theophylline for Thorax (lungs), Caffeine for Cranium (CNS).
Recall: Theophylline has the strongest bronchodilator and significant cardiac effects, making it useful for asthma but risky for arrhythmias.
- SSRIs = Serotonin Stolen from platelets, Slight bleeding risk.
Recall: Serotonin stored in platelets is released during injury, promoting platelet aggregation.
- Paroxetine = Problematic to stop abruptly.
Recall: SSRI discontinuation syndrome occurs with abrupt cessation, especially with short half-life SSRIs like paroxetine.
- Tyramine + MAOIs = Terrible hypertension.
Recall: Tyramine in aged cheese is normally metabolized by MAO-A in the gut.
- Serotonin Syndrome = Shaking, Sweating, hyper-Serotonin.
Recall: Serotonin syndrome results from excessive serotonergic activity, often from combining SSRIs with other serotonergic drugs (tramadol, MAOIs, triptans, linezolid).
- Aripiprazole = Adds partial dopamine for depression.
Recall: Aripiprazole is a partial D2 agonist and 5-HT1A agonist, stabilizing dopamine activity.
- Nigrostriatal = kNeck twisting and movement problems.
Recall: Acute dystonia results from D2 receptor blockade in the nigrostriatal pathway, causing dopamine-acetylcholine imbalance.
- Tardive = Takes Time to appear, Tongue movements.
Recall: Tardive dyskinesia (TD) involves involuntary choreoathetoid movements of orofacial muscles after prolonged antipsychotic use.
- Valproate = Very dangerous in pregnancy.
Recall: Valproate has the highest teratogenic risk (neural tube defects 1-2%, spina bifida).
- Lithium = Low thyroid hormone.
Recall: Lithium inhibits thyroid hormone synthesis and release, causing hypothyroidism in up to 20% of patients.
- Disulfiram = Disgust when Drinking.
Recall: Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation when alcohol is consumed, producing unpleasant symptoms (disulfiram-ethanol reaction).
- Methadone Maintains addicts stable.
Recall: Methadone is a full mu agonist with long half-life (24-36 hours), used for opioid maintenance therapy.
- MDMA = Massive serotonin Dump, Muscle breakdown, overActive.
Recall: MDMA (ecstasy) causes massive serotonin, dopamine, and norepinephrine release.
- EthoSUXimide SUCKS for everything except abSence seizures.
Recall: Ethosuximide specifically blocks T-type (low-threshold) calcium channels in thalamic neurons, which generate the 3-Hz oscillations of absence seizures.
- Lorazepam = Lasting seizure control, first-Line.
Recall: IV benzodiazepines (lorazepam preferred over diazepam due to longer anticonvulsant effect) are first-line for status epilepticus.
- Low solubility = Less absorbed by blood = Lightning-fast onset.
Recall: Low blood-gas partition coefficient means the gas is poorly soluble in blood, so alveolar concentration rises rapidly, equilibrating quickly with brain (rapid induction).
- Remifentanil = Rapidly eliminated, metabolized by esterases.
Recall: Remifentanil is an ultra-short-acting opioid metabolized by plasma esterases (not hepatic CYP), with context-insensitive half-life–no accumulation with prolonged infusion.
- Fentanyl = Fast onset for labor analgesia.
Recall: Fentanyl is commonly added to epidural bupivacaine for labor analgesia.
- Peak-dose = Peaking dopamine causes dyskinesia.
Recall: Peak-dose dyskinesia (chorea, dystonia) occurs at maximum levodopa plasma concentrations due to pulsatile dopamine stimulation. “Wearing-off” is loss of effect before next dose. “On-off” is unpredictable fluctuations.
- Metoclopramide = Moves gut, Mimics parkinsonism.
Recall: Metoclopramide is a D2 antagonist that crosses the BBB, causing extrapyramidal symptoms including drug-induced parkinsonism, especially with prolonged use in elderly women.
- Clusters Clear with high-flow O2.
Recall: High-flow 100% oxygen (12-15 L/min for 15-20 minutes) is first-line abortive treatment for cluster headaches, relieving pain in most patients within 15 minutes.
- “4-5 (400-500) = Farewell to life” – these levels usually mean saying final goodbye.
Recall: Blood alcohol concentrations of 400-500 mg/dL are generally considered fatal in non-tolerant individuals due to respiratory depression and cardiovascular collapse.
- “30-60 mL METHanol = METH-od of Death” – just 30-60 mL can be fatal.
Recall: The minimum lethal dose of methanol is approximately 30-60 mL (1-2 oz) in adults.
- “Barbiturate withdrawal = Bad Seizures” – both start with ‘B’ and seizures are the hallmark danger.
Recall: Barbiturate withdrawal is a medical emergency featuring anxiety, tremors, seizures (potentially fatal), delirium, and hyperthermia.
- “OP = OP-pressed pupils (constricted)” – organophosphates squeeze the pupils small.
Recall: Organophosphate poisoning causes miosis (pinpoint pupils) due to excessive acetylcholine stimulation of the muscarinic receptors in the iris sphincter muscle.
- “LSD = Large Scary Dreams” – it produces intense, often frightening visual experiences.
Recall: LSD is a potent hallucinogen causing vivid visual hallucinations, synesthesia, mydriasis, tachycardia, and hyperthermia.
- “AMPHetamines AMPL-ify catecholamine release” – they amplify neurotransmitter release from storage.
Recall: Amphetamines enter nerve terminals and displace stored catecholamines (dopamine, norepinephrine) causing massive release.
- “Physical dependence = Physically need it or suffer” – body physically adapted to drug presence.
Recall: Physical dependence is a physiological state where the body requires the drug to maintain normal function, and withdrawal symptoms occur upon discontinuation.
- “NO Convenience admissions” – involuntary admission is only for genuine medical emergencies, not family convenience.
Recall: Involuntary admission under MHCA 2017 requires: 1) severe mental illness requiring treatment, 2) lack of capacity to make decisions, and 3) risk of harm to self/others without treatment.
- “Delusions must Directly Damage will Decisions” – only relevant delusions invalidate the will.
Recall: A person with mental illness can make a valid will during a lucid interval (clear period) OR if the illness/delusions don’t affect the specific decisions in the will.
- “Epidural = E-mergency with interval before E-xpiring” – the lucid interval then rapid decline is classic.
Recall: The classic “lucid interval” (talk and die phenomenon) is characteristic of epidural hematoma, typically from rupture of the middle meningeal artery following temporal bone fracture.
- “C4-5 = Can’t move (4) limbs, but Still alive (5)” – quadriplegia but can still breathe.
Recall: C4-C5 injury causes quadriplegia (paralysis of all four limbs) with intact diaphragm function (phrenic nerve C3-5).
- 20 minutes for clotting test = 20 minutes to detect Hemotoxin Havoc.
Recall: Hemotoxic venoms (Russell’s viper, saw-scaled viper) contain procoagulants and anticoagulants that cause consumption coagulopathy (venom-induced consumption coagulopathy – VICC).
- Cross-sectional = takes a Cross-section/snapshot of the population at one moment.
Recall: Cross-sectional studies measure exposure and outcome simultaneously at one point in time, making them useful for prevalence estimation.
- Proportional mortality = Proportion of death pie belonging to that disease.
Recall: Proportional mortality rate represents the proportion of deaths due to a specific cause out of total deaths, not population.
- SeNsitivity = SNout = Sensitive Negative rules OUT disease.
Recall: Sensitivity = True Positives / (True Positives + False Negatives) × 100 = 90/100 × 100 = 90%.
- DALY = Death (YLL) + Disability (YLD).
Recall: DALY = YLL + YLD, measuring total burden of disease as years of healthy life lost.
- Positive skew = Mean Points toward the Positive tail.
Recall: In positive skew, the tail extends toward higher values, pulling the mean rightward.
- SD = Same Dimensions as original data.
Recall: Standard deviation (SD) is the square root of variance, returning the measure to original units (e.g., kg, cm).
- Z = Zero mean, One SD.
Recall: Standard normal distribution (Z-distribution) is a special normal distribution with mean = 0 and SD = 1.
- More Confidence = More Width needed.
Recall: Higher confidence requires a wider interval to be more certain of capturing the true value.
- Lower Alpha = Less false positives but More false negatives.
Recall: Lowering alpha (0.05 → 0.01) reduces Type I error but increases Type II error (inverse relationship).
- Fisher’s = Fix for Few expected Frequencies.
Recall: Chi-square assumptions require expected frequencies ≥5 in at least 80% of cells.
- You can Modify behavior, not birthday.
Recall: Age is a non-modifiable risk factor – it cannot be changed through intervention