High-Yield Exam Mnemonics

Medexamium Dr.Myo
  1. GTN = Goes To Nitric oxide.

Recall: Glyceryl trinitrate (GTN) is metabolized to nitric oxide, which activates guanylyl cyclase, increasing cGMP and causing venodilation.

  1. Nitrates are “BOTH-way” dilators.

Recall: Nitrates cause venodilation (reducing preload) at low doses and arteriolar dilation (reducing afterload) at higher doses.

  1. “NICOrandil = NItr-O + K channel opener.” Lipid Lowering Drugs

Recall: Nicorandil opens ATP-sensitive potassium channels (causing arterial dilation) and has a nitrate moiety (causing venodilation).

  1. FIBrates FIX Fats (triglycerides).

Recall: Fibrates like fenofibrate activate PPAR-alpha, increasing lipoprotein lipase activity and reducing triglycerides by 30–50%.

  1. Heparin HELPS Antithrombin.

Recall: Heparin binds to antithrombin III, accelerating its inhibition of thrombin (Factor IIa) and Factor Xa 1000-fold.

  1. IN-R = IN-ternal warfarin Report.

Recall: INR (International Normalized Ratio) standardizes prothrombin time for warfarin monitoring.

  1. Fonda-PARIN-ux = PENTA-saccharide blocking Xa.

Recall: Fondaparinux is a synthetic pentasaccharide that selectively inhibits Factor Xa via antithrombin.

  1. AbciXimab = Anti-Xib/IIIa.

Recall: Abciximab is a monoclonal antibody blocking GP IIb/IIIa receptor, the final common pathway of platelet aggregation.

  1. TicagRELOR = REversibLy binds receptor.

Recall: Ticagrelor is a direct-acting, reversible P2Y12 inhibitor with faster onset and offset than clopidogrel.

  1. LoSARTAN = Sartan class = ARB.

Recall: Losartan blocks AT1 receptors, preventing angiotensin II effects without affecting bradykinin (no cough).

  1. ACE/ARB = Protect Against diabetic KIDney disease.

Recall: ACE inhibitors/ARBs reduce intraglomerular pressure and proteinuria, providing renal protection beyond BP control.

  1. ACE + Beta = Best survival combo.

Recall: ACE inhibitors reduce mortality by blocking neurohormonal activation.

  1. DOBUTamine = DO give in acute HF for Beta-1 stimUlaTion.

Recall: Dobutamine primarily stimulates cardiac beta-1 receptors, providing positive inotropy with some beta-2 vasodilation.

  1. AMIOdarone = ALL class properties, Mainly III.

Recall: Amiodarone is primarily Class III (potassium channel blocker), prolonging action potential duration.

  1. SOTalol = prolongs QT SOO much.

Recall: Sotalol (Class III + beta blocker) prolongs QT interval by blocking potassium channels.

  1. Codeine Controls Central Cough.

Recall: Codeine (opioid) directly depresses the cough center in the medulla.

  1. Brain liquefies, body coagulates.

Recall: Brain undergoes liquefactive necrosis due to high lipid content and lack of substantial extracellular matrix.

  1. High pressure tears the aorta.

Recall: Hypertension is the major risk factor for aortic dissection, causing hemodynamic stress that tears the intima.

  1. Left failure drags the right along.

Recall: Left heart failure increases pulmonary pressures, leading to right ventricular strain and eventual failure.

  1. VSD = Very common Septal Defect.

Recall: VSD accounts for ~25–30% of all CHDs, making it the most common.

  1. Virchow’s SEH – Stasis, Endothelial injury, Hypercoagulability.

Recall: Virchow’s triad (endothelial injury, stasis, hypercoagulability) describes factors predisposing to thrombosis.

  1. Ghon = First (primary) encounter.

Recall: Ghon focus is the initial parenchymal lesion (usually mid-lung zone) in primary TB.

  1. Obstruction = air resorption.

Recall: Resorption (obstructive) atelectasis occurs when airway obstruction (mucus plug, tumor, foreign body) prevents air entry; trapped air is absorbed.

  1. Panacinar = PiZZ phenotype (α1-AT deficiency).

Recall: Α1-antitrypsin deficiency allows unopposed elastase activity, destroying entire acini predominantly in lower lobes (panacinar pattern).

  1. Sick lungs + embolus = Infarction.

Recall: Dual blood supply (bronchial + pulmonary arteries) usually prevents infarction.

  1. Exudate = Extra protein and LDH.

Recall: Light’s criteria define exudate: pleural/serum protein >0.5, pleural/serum LDH >0.6, or pleural LDH >⅔ upper normal serum LDH.

  1. Silver for Legionella (both are metals).

Recall: Legionella stains poorly with Gram stain (gram-negative but faint).

  1. Mycoplasma = Mild, Walking around.

Recall: Mycoplasma causes “walking pneumonia”–mild atypical pneumonia where patients remain ambulatory despite respiratory symptoms.

  1. Pertussis = Paroxysmal Whoop.

Recall: Pertussis has paroxysmal coughing episodes followed by inspiratory “whoop” due to forceful inspiration against closed glottis.

  1. TB is slow–15+ hours to double.

Recall: M. tuberculosis divides slowly (15–20 hours), explaining prolonged culture time (weeks) and need for extended treatment.

  1. Haemophilus = Heme-loving gram-negative.

Recall: H. influenzae is a small, pleomorphic gram-negative coccobacillus.

  1. FLAIL = FREE-floating segment = 2+ ribs × 2+ fractures.

Recall: Two or more adjacent ribs are fractured at two or more points Flail chest requires at least two adjacent ribs fractured at two or more sites, creating a free-floating segment that moves paradoxically during respiration.

  1. “Queen Aconite rules with Quick death” – fastest-acting plant poison.

Recall: Aconite Aconite is called “Queen of Poisons” due to its rapid action, extreme toxicity, and historical use in homicides.

  1. “Brain needs oxygen FIVE to survive” – 5 minutes is critical.

Recall: 3-5 minutes Brain cells begin dying after 3-5 minutes of oxygen deprivation, making this the minimum time for asphyxial death.

  1. “3-4 kg = Just the head weight” – even partial suspension kills.

Recall: 3-4 kg Only 3-4 kg of pressure is needed to occlude jugular veins, explaining why partial hanging (body partially supported) is often fatal.

  1. Throttling = Thumb marks and nail Traces.

Recall: Throttling (manual strangulation) Throttling involves hands gripping the neck, leaving crescent-shaped fingernail abrasions and fingertip contusions.

  1. “DIAtoms = Drowned In Actual water” – proves victim breathed water while alive.

Recall: Drowning Diatoms (microscopic algae) found in bone marrow, organs, or brain confirm antemortem drowning because they can only reach these sites via circulation in living persons.

  1. “SMOthering = Silent Murder Often” – hardest to detect.

Recall: Smothering Smothering (covering nose/mouth with soft material) often leaves minimal or no external injuries, making it difficult to prove.

  1. Peanuts are Perfect size to Plug the Pediatric airway.

Recall: Peanuts Peanuts are the most common aspirated foreign bodies in children due to size, shape, and tendency to swell when wet, causing complete obstruction and chemical pneumonitis.

  1. MASQUE = Mask on face from crushing ASphyxia.

Recall: Traumatic asphyxia Masque ecchymotique refers to intense cyanosis and petechiae confined to face, neck, and upper chest (above compression level) due to impaired venous return in traumatic asphyxia.

  1. “Mustard Burns the MUST-eat parts” – skin, eyes, lungs all blistered.

Recall: Airway burns and pulmonary edema Mustard gas (sulfur mustard) is a vesicant causing severe burns to skin, eyes, and respiratory mucosa, leading to airway damage, pulmonary edema, and secondary infections.

  1. Trans fats Transform arteries to blocked pipes.

Recall: Trans fats increase LDL cholesterol and decrease HDL cholesterol, significantly raising cardiovascular risk.

  1. Target organs = “Brain, Heart, Kidney, Eyes” (BHKE – sounds like “bike”).

Recall: Hypertension primarily damages the brain (stroke), heart (LVH, heart failure), kidneys (nephrosclerosis), eyes (retinopathy), and blood vessels.

  1. Lymph nodes = Leading extrapulmonary site.

Recall: Lymph node TB (tuberculous lymphadenitis/scrofula) is the most common extrapulmonary TB site, often affecting cervical nodes.

  1. DOTS = Don’t Omit Taking Seriously.

Recall: DOTS aims to ensure treatment completion and cure through direct observation of drug intake, preventing default and drug resistance.

  1. COVID = Can’t smell or taste.

Recall: Anosmia (loss of smell) and ageusia (loss of taste) are relatively specific to COVID-19 and less common in influenza.

  1. Respiratory infections = Risk for asthma attacks.

Recall: Respiratory infections (especially viral) are the most common triggers for asthma exacerbations.

  1. Hygiene hypothesis = Too Hygienic early life.

Recall: The hygiene hypothesis proposes that reduced exposure to infections in early childhood (due to improved hygiene) may increase allergic diseases including asthma.

  1. Asbestos = Affects pleura → Mesothelioma.

Recall: Asbestos exposure specifically increases risk of mesothelioma (pleural cancer) and lung cancer.

  1. Bordetella = Barking/whooping cough Bacteria.

Recall: Bordetella pertussis is a gram-negative coccobacillus causing whooping cough.

  1. Babies <6 months = Biggest risk.

Recall: Infants <6 months have highest pertussis morbidity and mortality because they haven’t completed primary vaccination series and have immature airways prone to apnea.

  1. Spasm needs Calcium Channel Blockers – CCB for Coronary spasm.

Recall: Calcium channel blockers (e.g., amlodipine, diltiazem) are first-line for Prinzmetal’s (vasospastic) angina because they directly relax coronary smooth muscle, relieving spasm.

  1. Nitrates + Sildenafil = cGMP overload = BP drops to the floor.

Recall: Nitrates increase cGMP by releasing nitric oxide, while sildenafil inhibits PDE-5 (which breaks down cGMP).

  1. Ezetimibe Enters via NPC1L1 blockade.

Recall: Ezetimibe inhibits the NPC1L1 protein on intestinal brush border, blocking cholesterol absorption.

  1. Warfarin Wipes out 1972 – factors II, VII, IX, X.

Recall: Warfarin inhibits vitamin K epoxide reductase, blocking the carboxylation of vitamin K-dependent clotting factors II, VII, IX, and X (plus proteins C and S).

  1. LMWH = Less thrombin inhibition, More Xa inhibition.

Recall: LMWH has shorter chain length that provides predominantly anti-Xa activity with less anti-IIa activity (anti-Xa:anti-IIa ratio of 3:1 to 4:1), compared to unfractionated heparin (1:1).

  1. Clopidogrel Closes P2Y12.

Recall: Clopidogrel’s active metabolite irreversibly binds to the P2Y12 ADP receptor on platelets, preventing ADP-mediated platelet activation and aggregation.

  1. Tranexamic Traps plasmin = stops fibrinolysis.

Recall: Tranexamic acid (and aminocaproic acid) are antifibrinolytic agents that inhibit plasminogen activation and plasmin activity, helping control bleeding from thrombolytics.

  1. ACE inhibitors = Awful for baby’s kidneys.

Recall: ACE inhibitors and ARBs are contraindicated in pregnancy (especially 2nd/3rd trimester) due to fetal toxicity: oligohydramnios, renal dysgenesis, pulmonary hypoplasia, and death.

  1. Digoxin Disables the Na/K pump → More Ca2+ → stronger Contraction.

Recall: Digoxin inhibits the Na+/K+-ATPase pump, increasing intracellular sodium.

  1. Spironolactone Stops cardiac Scarring from aldosterone.

Recall: Spironolactone blocks aldosterone receptors, preventing aldosterone-mediated cardiac fibrosis, collagen deposition, and adverse remodeling.

  1. Amiodarone = Abundant Iodine = thyroid trouble.

Recall: Amiodarone contains 37% iodine by weight and releases significant iodine during metabolism.

  1. Sotalol = QT Stretching = Torsades risk.

Recall: Sotalol (Class III) prolongs QT interval by blocking potassium channels.

  1. Guaifenesin = Gets fluid Going into airways.

Recall: Guaifenesin increases the volume and reduces the viscosity of respiratory tract secretions, making cough more productive and mucus easier to clear.

  1. INH needs pyridoxine to Neutralize Neuropathy.

Recall: INH interferes with pyridoxine (B6) metabolism, depleting pyridoxal phosphate and causing peripheral neuropathy (especially in malnourished, diabetic, or slow acetylators).

  1. PZA works in Phagocytes where pH is low (acidic).

Recall: Pyrazinamide (PZA) is a prodrug converted to pyrazinoic acid, which is active only at acidic pH (as found inside macrophages and in inflammatory lesions).

  1. ICS = Inflammation Control Steroids.

Recall: Inhaled corticosteroids (ICS) are the most effective anti-inflammatory agents for asthma.

  1. Ipratropium Inhibits muscarinic constriction.

Recall: Ipratropium is a short-acting muscarinic antagonist (SAMA) that blocks M3 receptors on airway smooth muscle, preventing acetylcholine-mediated bronchoconstriction.

  1. Cromolyn = Calms mast Cells.

Recall: Cromolyn sodium stabilizes mast cell membranes, preventing release of histamine, leukotrienes, and other mediators that cause bronchoconstriction and inflammation.

  1. PRIMORDIAL = PREVENT risk factors from being BORN (before they exist).

Recall: Primordial prevention aims to prevent risk factors from developing in the first place through population-wide policies.

  1. DOTS = Doctor OBSERVES patient Taking medication Strictly.

Recall: DOTS stands for Directly Observed Treatment, Short-course.

  1. Previously treated = ≥1 month of Past Treatment.

Recall: A “previously treated case” is anyone who received TB treatment for ≥1 month in the past and now has active disease (regardless of previous outcome).

  1. MDR = Most Dangerous Resistance = resistance to the two most Important drugs (H and R).

Recall: MDR-TB is defined as resistance to at least Isoniazid AND Rifampicin, the two most powerful first-line drugs.

  1. DRIFT = small, like drifting slowly; SHIFT = big, like tectonic shift causing earthquakes (pandemics).

Recall: Antigenic drift refers to gradual, minor changes from point mutations in HA and NA genes, causing seasonal variations that require annual vaccine updates.

  1. 6 feet, 15 minutes = 6 + 15 = 21 – quarantine for 21 days (old guideline).

Recall: Close contact is defined as being within 6 feet (approximately 2 meters) of an infected person for ≥15 minutes (cumulative over 24 hours).

  1. DUST mites = most DOMINANT indoor trigger.

Recall: House dust mites are the most common indoor allergen triggering asthma worldwide, including Pakistan.

  1. Diphtheria DISRUPTS protein synthesis – ‘D’ for Diphtheria, ‘D’ for DOESN’T make proteins.

Recall: Diphtheria toxin inhibits protein synthesis by ADP-ribosylating elongation factor 2 (EF-2), halting ribosomal translation.

  1. “THIN caps RUPTURE” – Thin fibrous cap + Inflammation → Rupture → Thrombus.

Recall: Acute myocardial infarction results from rupture of a vulnerable plaque (thin fibrous cap, large lipid core, abundant inflammatory cells) with superimposed thrombosis causing acute coronary occlusion.

  1. “HEART failure → HEMOSIDERIN → HF cells” – all start with H.

Recall: “Heart failure cells” are hemosiderin-laden alveolar macrophages resulting from phagocytosis of red blood cells that have leaked into alveoli due to pulmonary congestion.

  1. TRIcuspid = TRI = THREE letters = IV drug users’ favorite valve.

Recall: In IV drug users, acute bacterial endocarditis predominantly affects the tricuspid valve (right-sided) due to direct venous inoculation.

  1. “VALVES fail → VARICOSE veins” – both start with VA. Pulmonary Pathology

Recall: Varicose veins develop from incompetent venous valves leading to retrograde blood flow and sustained venous hypertension, causing vessel dilation and tortuosity.

  1. Reid index > 0.5 = Half the wall is GLAND = Chronic Bronchitis.

Recall: Chronic bronchitis is defined by chronic productive cough and shows mucus gland hypertrophy (Reid index >0.5 = ratio of gland thickness to bronchial wall thickness).

  1. SVC syndrome = Swollen Veins in Collar and face.

Recall: Superior vena cava (SVC) syndrome results from compression or invasion of the SVC by mediastinal malignancies, most commonly small cell lung cancer.

  1. SARCOIDOSIS = Schaumann + Asteroid bodies, NO caseation.

Recall: Sarcoidosis presents with non-caseating granulomas containing Schaumann bodies (laminated calcium and protein concretions) and asteroid bodies (stellate inclusions within giant cells).

  1. LEGIONELLA = Legion of symptoms (lung + brain + GI) + Legionnaire’s hotel + Lethal in elderly.

Recall: Legionella pneumophila causes severe pneumonia with CNS symptoms (confusion), GI symptoms, and hyponatremia.

  1. “LEGIONELLA = Hotels + Hospitals + Heated water systems” – all have H2O aerosolization.

Recall: Legionella pneumophila is transmitted through inhalation of aerosolized water from contaminated cooling towers, air conditioners, or plumbing systems.

  1. “MDR = Must Drop Rifampin AND Isoniazid” – resistance to both.

Recall: MDR-TB is defined as resistance to at least isoniazid AND rifampin, the two most effective first-line drugs.

  1. LEGIONELLA Loves Lukewarm water systems.

Recall: Legionella pneumophila thrives in warm water (25-45°C) and causes outbreaks through aerosolization from cooling towers, hot water tanks, and plumbing systems.

  1. “30-70 is the premature zone” – this age range defines premature NCD mortality globally.

Recall: The WHO “25 by 25” framework uses unconditional probability of dying between ages 30-70 years from major NCDs (including CVD) as the primary indicator, capturing premature mortality.

  1. Measure, counsel, refer – the LHW tier.

Recall: Task-shifting to community health workers should involve non-prescribing tasks like BP measurement, health education, medication adherence support, and lifestyle counseling.

  1. Rif-resistant = immediate MDR protocol, no waiting.

Recall: GeneXpert MTB/RIF provides simultaneous detection of TB and rifampicin resistance.

  1. PPM = Partner with Private, don’t Penalize or Push away.

Recall: Public-Private Mix (PPM) DOTS engages private practitioners as partners in TB care, providing them training, diagnostic support, free medications, and reporting linkages.

  1. Global evidence, local validation – context is king for implementation.

Recall: External evidence must be validated in local context before policy change.

  1. T-cells don’t care about spike drift – they target conserved bits.

Recall: T-cell epitopes are more conserved than antibody-binding sites across variants.

  1. SeNsitivity = Snout (rule out) = catch the sick ones = TP/(TP+FN).

Recall: Sensitivity = True Positives / (True Positives + False Negatives) = TP/(TP+FN).

  1. Eggshell calcification = silica signature; miners get both coal and rock.

Recall: Eggshell calcification of hilar nodes is pathognomonic for silicosis, while nodular upper lobe opacities are consistent with both silicosis and CWP.

  1. Diphtheria contacts = drugs for all, don’t wait for symptoms.

Recall: Diphtheria contacts require immediate chemoprophylaxis (erythromycin or penicillin) regardless of vaccination status because even vaccinated individuals can become carriers.

  1. Better coverage = better clinics = better surveillance = more detected cases.

Recall: Districts with higher vaccination coverage often have stronger health systems and better disease surveillance, leading to more case detection and reporting.

  1. aP = fewer antigens, faster fading, possible carriage; wP = broad, lasting, but bumpy ride.

Recall: Acellular vaccines contain 1-5 purified antigens versus hundreds in whole-cell vaccines, inducing narrower immunity that wanes faster (typically 5-7 years vs.

  1. No lab = no certainty; is it really diphtheria or a lookalike?

Recall: Without laboratory confirmation, clinical diphtheria diagnosis cannot distinguish toxigenic diphtheria (requiring antitoxin and public health response) from other causes of membranous pharyngitis (infectious mononucleosis, streptococcal infection, Vincent’s angina).