High-Yield Exam Mnemonics
- IN-ulin = IN the glomerulus only.
Recall: Inulin clearance is the gold standard for GFR because inulin is freely filtered, not reabsorbed or secreted.
- Cold → MCD unfolds.
Recall: Viral URTIs commonly trigger MCD episodes in children.
- IgA stays in the MESangium.
Recall: Mesangial IgA deposition is diagnostic.
- Chvostek = Calcium low, Cheek twitches.
Recall: Facial muscle twitching on tapping facial nerve indicates hypocalcemia (neuromuscular irritability).
- Oligo = 400 (Four hundred).
Recall: Oliguria is <400 mL/day (or <0.5 mL/kg/hr).
- Diabetes = #1 Destroyer of kidneys.
Recall: Diabetic nephropathy is the leading cause of CKD and ESRD globally.
- 10^5 = Significant UTI confirmation.
Recall: ≥10^5 CFU/mL is significant bacteriuria confirming UTI.
- Syphilis = Smooth, painless, hard (indurated).
Recall: The syphilitic chancre is painless, indurated (hard), clean-based ulcer at inoculation site.
- Posterior = Pitocin (oxytocin) + Pressin (ADH).
Recall: The posterior pituitary stores and releases ADH (vasopressin) and oxytocin, which are synthesized in the hypothalamus.
- Ghrelin makes your stomach growl.
Recall: Ghrelin is secreted by gastric fundus cells and rises before meals, stimulating appetite via hypothalamic NPY/AgRP neurons.
- 3+ for 3 days = Relapse Rule of 3s.
Recall: Relapse is defined as urine protein ≥3+ (or ≥300 mg/dL, or protein:creatinine ratio ≥2) for 3 consecutive days after having achieved remission.
- PRE-renal = ConCENTRATED urine (>1.020).
Recall: In prerenal AKI, functioning tubules concentrate urine maximally to conserve water, resulting in specific gravity >1.020 and urine osmolality >500 mOsm/kg.
- Stage 5 = Single digit GFR approaching (<15).
Recall: CKD Stage 5 (kidney failure/ESKD) is defined as GFR <15 mL/min/1.73m² or requirement for dialysis/transplantation.
- DYS-genesis = DYS-functional thyroid development (most common).
Recall: Thyroid dysgenesis (agenesis, hypoplasia, ectopy) accounts for 80–85% of congenital hypothyroidism cases.
- Mother’s ANTIBODIES cross placenta, making baby THYROTOXIC.
Recall: Neonatal thyrotoxicosis results from transplacental transfer of maternal TSH receptor-stimulating antibodies (TRAb/TSI) from mothers with Graves disease.
- DAWN = Glucose goes UP with the SUN.
Recall: Dawn phenomenon is early morning (4–8 AM) hyperglycemia caused by overnight growth hormone and cortisol surges, which antagonize insulin.
- coli is the Enemy number one in UTI.
Recall: E. coli causes 80–85% of uncomplicated UTIs due to its uropathogenic properties and fecal colonization.
- Hydrocele lights up like a Lantern.
Recall: Transillumination is positive in hydrocele (light passes through fluid).
- Papillary is the Popular thyroid cancer.
Recall: Papillary carcinoma accounts for 80–85% of thyroid cancers.
- Debride and De-load the foot.
Recall: Wound debridement (removing necrotic tissue) and offloading (pressure redistribution) are essential.
- Distal is the most common and least severe.
Recall: Glanular/distal hypospadias (meatus on glans or distal shaft) accounts for 70–80% of cases.
- 130/80 protects diabetic organs.
Recall: BP target for diabetics is <130/80 mmHg to reduce micro- and macrovascular complications.
- Baby aspirin for Big protection.
Recall: Low-dose aspirin (75–100 mg/day) is recommended for secondary prevention in diabetics with established cardiovascular disease.
- Leopold = Locate the baby’s position.
Recall: Leopold’s maneuvers are four abdominal palpation techniques to assess fetal lie, presentation, position, and engagement.
- BPP = Breathing, Body movement, Posture (tone), Pool (AFI), Plus NST.
Recall: BPP includes: breathing, movement, tone, amniotic fluid (AFI), and NST.
- Ectopic = Expect ABP (Amenorrhea, Bleeding, Pain).
Recall: Ectopic pregnancy presents with amenorrhea, vaginal bleeding, and lower abdominal pain.
- Preeclampsia = Pressure + Protein.
Recall: Preeclampsia is hypertension (≥140/90) after 20 weeks with proteinuria (≥300 mg/24h) or end-organ dysfunction.
- Rubella = Requires vaccination before pregnancy.
Recall: Rubella vaccination before pregnancy (MMR vaccine) prevents congenital rubella syndrome.
- McRoberts = Moves legs first.
Recall: McRoberts maneuver (hyperflexion of maternal thighs) straightens the sacrum and increases pelvic diameter.
- Oxytocin = Original first choice.
Recall: Oxytocin is first-line for PPH prevention and treatment.
- PPD = First year Postpartum Depression.
Recall: Postpartum depression can begin within days to 12 months postpartum, most commonly within the first 3 months.
- Gadolinium + GFR <30 = NSF danger zone.
Recall: Gadolinium-based contrast agents can cause nephrogenic systemic fibrosis (NSF) in patients with severe renal impairment (GFR <30 mL/min), leading to skin thickening and fibrosis of internal organs.
- FRNS = Frequently Recurring after upper respiratory iNfectionS.
Recall: Frequently relapsing nephrotic syndrome (FRNS) is defined as ≥2 relapses within 6 months of initial response or ≥4 relapses in any 12-month period.
- ACE/ARB = Always Considered Essential for Albuminuria Reduction in Berger’s.
Recall: ACE inhibitors (or ARBs) are first-line therapy for IgA nephropathy with proteinuria – they reduce proteinuria, control blood pressure, and slow progression to ESRD.
- Chronic = kidneys had time to Compensate (raise HCO3).
Recall: Elevated PaCO2 with low pH indicates respiratory acidosis.
- Uremia + Rub + Diffuse ST elevation = Uremic pericarditis.
Recall: Uremic pericarditis occurs in severe uremia due to accumulation of uremic toxins causing pericardial inflammation.
- AEIOU = vowels for urgent dialysis indications.
Recall: Indications for urgent dialysis (AEIOU): Acidosis (refractory), Electrolyte abnormality (hyperkalemia with ECG changes), Intoxication (dialyzable toxins), Overload (fluid unresponsive to diuretics), Uremia (symptoms like pericarditis, encephalopathy).
- Obstruction + Infection = Urgent drainage.
Recall: Obstructed infected kidney (pyonephrosis) is a urological emergency requiring urgent decompression via percutaneous nephrostomy or ureteral stent placement in addition to antibiotics.
- Painful vesicles + Systemic symptoms = Primary Herpes.
Recall: Primary genital herpes (usually HSV-2) presents with painful grouped vesicles on erythematous base, often with systemic symptoms (fever, malaise) and bilateral tender lymphadenopathy.
- Obstructive = Epididymis has sperm (MESA/PESA); Non-obstructive = need Testis (TESA/TESE).
Recall: In obstructive azoospermia (vasectomy, CBAVD, epididymal obstruction), sperm production is normal, and sperm can be retrieved from the epididymis.
- Prolactin = Problems with Periods and Produces milk.
Recall: Prolactinoma is the most common functioning pituitary adenoma.
- SIADH = Small cell causes Inappropriate ADH.
Recall: SIADH (Syndrome of Inappropriate ADH secretion) presents with hyponatremia, low serum osmolality, and inappropriately concentrated urine.
- RAI can make eyes Really Angry–use steroids.
Recall: Radioactive iodine (RAI) can worsen Graves’ ophthalmopathy due to release of thyroid antigens triggering immune response.
- PTH and Calcium both UP = Primary hyperParaThyroidism.
Recall: Primary hyperparathyroidism (PHPT) shows elevated calcium with elevated (or inappropriately normal) PTH.
- Type 1 = Young, Thin, Ketosis-prone.
Recall: Young age, acute onset, significant weight loss, and diabetic ketoacidosis (high glucose with ketonuria) are classic for Type 1 DM.
- Metformin + kidney failure = risk of Lactic acidosis.
Recall: Metformin is contraindicated when eGFR <30 mL/min due to lactic acidosis risk.
- Ketoconazole Knocks down cortisol synthesis.
Recall: Ketoconazole inhibits adrenal steroidogenesis (blocks multiple cytochrome P450 enzymes) and is used to reduce cortisol before surgery or in patients unfit for surgery.
- APS-2 = Addison’s + Thyroid + Diabetes (autoimmune triad).
Recall: Autoimmune polyglandular syndrome type 2 (APS-2) includes Addison’s disease, autoimmune thyroid disease (Hashimoto’s or Graves’), and/or type 1 diabetes.
- Lose weight first = better outcomes for baby.
Recall: Weight loss of 5-10% improves ovulation in PCOS, reduces pregnancy complications (gestational diabetes, preeclampsia, macrosomia), and improves IVF success rates.
- High Aldosterone, Low Renin = Primary problem in adrenal.
Recall: Primary hyperaldosteronism (Conn’s syndrome) shows elevated aldosterone with suppressed renin (high aldosterone-to-renin ratio).
- Failed Steroids = FSGS (Focal Segmental GlomeruloSclerosis).
Recall: Focal Segmental Glomerulosclerosis (FSGS) should be suspected when a previously steroid-responsive child becomes steroid-resistant, especially with declining renal function.
- Aminoglycosides Attack tubules = Non-oliguric ATN.
Recall: Aminoglycosides (gentamicin, amikacin) cause nephrotoxicity through direct tubular toxicity.
- Iron First, then EPO = Feed the fire before fanning it.
Recall: Anemia in CKD results primarily from decreased erythropoietin production, but iron deficiency is extremely common and must be corrected before or alongside ESA therapy for optimal response.
- ESRD adolescents need a Team: Therapist, Education, And Peers.
Recall: Adolescents with ESRD face significant psychosocial challenges including depression, anxiety, body image concerns, social isolation, and disrupted schooling.
- Achondroplasia = Almost always a new (de novo) dominant FGFR3 mutation.
Recall: Achondroplasia is the most common skeletal dysplasia causing disproportionate short stature (rhizomelic – proximal limb shortening).
- Methimazole = Marrow warning (agranulocytosis) – fever + sore throat = STOP and check WBC.
Recall: Methimazole (and propylthiouracil) can cause agranulocytosis (severe neutropenia), a rare but potentially life-threatening side effect occurring in 0.2-0.5% of patients, typically within first 3 months.
- Basal = Background (hepatic suppression), Bolus = Bread (meal coverage).
Recall: Basal-bolus therapy mimics physiological insulin secretion.
- Somogyi = Sugar drops then Surges; Dawn = Direct rise (no dip).
Recall: The Somogyi effect (rebound hyperglycemia) occurs when nocturnal hypoglycemia triggers counter-regulatory hormones (glucagon, epinephrine, cortisol, growth hormone) that cause reactive hyperglycemia by morning.
- Hirschsprung = Hold onto stool (can’t pass), Huge explosion after rectal exam.
Recall: Hirschsprung disease (congenital aganglionic megacolon) results from failure of neural crest cell migration, causing absence of ganglion cells in the distal bowel (usually rectosigmoid).
- Double Bubble = Duodenal atresia; Down syndrome association.
Recall: The “double bubble” sign (two gas bubbles representing the stomach and dilated proximal duodenum, with no distal gas) is pathognomonic for duodenal atresia.
- Left varicocele that won’t Lie down = Look for mass.
Recall: A left-sided varicocele in an adolescent is usually primary (due to perpendicular drainage of left gonadal vein into renal vein).
- Sex-related UTIs = Single post-coital pill.
Recall: This young woman has recurrent uncomplicated UTIs (≥3/year) temporally related to sexual activity (spermicide use is a risk factor).
- Palpable Pulses + Pressure point = Pure Neuropathic ulcer.
Recall: Plantar ulcer at pressure point (metatarsal head) with palpable pulses in a diabetic indicates neuropathic ulcer from loss of protective sensation and repetitive mechanical stress.
- BCS = Breast radiation always; ER+ = Endocrine therapy; Chemo depends on risk.
Recall: After breast-conserving surgery, radiation to the breast is standard to reduce local recurrence.
- Orchidopexy: Before 1 year is ideal; no later than 18 months.
Recall: A palpable undescended testis that cannot be manipulated into the scrotum requires surgical orchidopexy, ideally between 6-18 months of age.
- Symptomatic + Sky-high HbA1c = Start Insulin first.
Recall: Symptomatic hyperglycemia with HbA1c ≥10% or glucose ≥300 mg/dL indicates significant glucose toxicity requiring insulin to rapidly restore glycemic control, relieve symptoms, and reduce glucotoxicity to beta cells.
- Diabetes 40-75 = Default statin; degree depends on risk.
Recall: All diabetic adults aged 40-75 years should receive statin therapy for primary prevention.
- High-grade T1 = TURBT + BCG to Blunt recurrence.
Recall: High-grade T1 bladder cancer (invades lamina propria) is treated with complete TURBT followed by intravesical BCG immunotherapy to reduce recurrence and progression.
- 4 mm = 40-80% passage; under 5, give it a try.
Recall: Spontaneous stone passage rates depend on size and location: <4 mm: ~80-90%; 4-5 mm: ~50-70%; 6-7 mm: ~25-50%; >7 mm: <20%.
- “Subtract 3, Add 7” – the classic Naegele formula.
Recall: Naegele’s rule: Add 7 days to LMP and subtract 3 months (or add 9 months).
- Variable = Cord (V looks like a compressed cord).
Recall: Variable decelerations are characterized by abrupt onset and variable shape, caused by umbilical cord compression.
- Amnio risk = About 1 in 200.
Recall: Modern amniocentesis carries approximately 0.1-0.5% (1 in 200 to 1 in 1000) procedure-related pregnancy loss risk when performed by experienced operators under ultrasound guidance.
- HELLP Headache Vision = Very severe preeclampsia.
Recall: Severe preeclampsia is diagnosed when BP ≥160/110 mmHg with proteinuria PLUS severe features (headache, visual disturbances, epigastric pain, thrombocytopenia, elevated liver enzymes, renal insufficiency, or pulmonary edema).
- Varicella = Scarred limbs in a Zigzag pattern.
Recall: Congenital varicella syndrome (infection <20 weeks) causes a distinctive pattern: limb hypoplasia (zigzag scarring following dermatomal distribution), cicatricial skin lesions, eye abnormalities (chorioretinitis, cataracts), and neurological defects (microcephaly, cortical atrophy).
- Turtle sign = Trapped shoulders.
Recall: The “turtle sign” (retraction of delivered head against perineum) indicates shoulder dystocia – impaction of the anterior fetal shoulder behind the maternal pubic symphysis.
- Traction causes inversion = Abnormally stuck placenta.
Recall: If the uterus inverts with cord traction, the placenta is abnormally adherent (placenta accreta spectrum).
- 6 weeks = ovulation possible even with breastfeeding.
Recall: Lactational amenorrhea method (LAM) provides >98% contraceptive protection IF: exclusive breastfeeding, amenorrhea persists, and <6 months postpartum.
- Third trimester = higher clearance = may need more lithium; reduce after delivery.
Recall: Renal lithium clearance increases by 30-50% in the third trimester due to increased glomerular filtration rate (GFR).
- “Go Look For The Adenoma’s Pattern” – GH, LH/FSH, TSH, ACTH, Prolactin.
Recall: Pituitary hormone loss follows a predictable sequence: GH → LH/FSH → TSH → ACTH → Prolactin (often elevated due to stalk effect).
- DI-SIADH-DI: the pituitary’s dying breath.
Recall: The triphasic response is classic after pituitary stalk injury: Phase 1 (days 1-5): DI from axonal shock; Phase 2 (days 5-10): SIADH from uncontrolled ADH release by dying neurons; Phase 3: permanent DI if >90% neurons destroyed, or recovery.
- CASK: Calcium >1, Age <50, Stones/Skeleton T ≤-2.5, Kidney CrCl <60.
Recall: Current surgical guidelines for asymptomatic primary HPT include: calcium >1 mg/dL above normal, age <50, T-score ≤-2.5 (not -2.0), creatinine clearance <60 mL/min, kidney stones or nephrocalcinosis, or elevated urinary calcium with stone risk.
- Heart failure + kidney failure = SGLT2 inhibitor, stop metformin.
Recall: Metformin is contraindicated when eGFR <30 mL/min (some guidelines <25) due to lactic acidosis risk.
- Finerenone FINES tunes kidney protection.
Recall: Finerenone (nonsteroidal MRA) provides additional renal and cardiovascular protection beyond ACEi/ARB + SGLT2i in diabetic nephropathy.
- Exogenous steroids = Cushing’s look + dead HPA axis.
Recall: Exogenous glucocorticoids cause iatrogenic Cushing’s syndrome while suppressing endogenous ACTH and cortisol production.
- Adrenal hemorrhage = acute Addison’s–treat like crisis.
Recall: Bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome, classically meningococcal; also anticoagulation, malignancy, trauma, or postoperative) causes acute primary adrenal insufficiency.
- Malabsorption → low D → soft bones + compensatory PTH.
Recall: Post-bariatric malabsorption causes vitamin D deficiency leading to osteomalacia (inadequate bone mineralization).
- Synpharyngitic = IgA.
Recall: Synpharyngitic hematuria (gross hematuria within 24-48 hours of URI) with dysmorphic RBCs, RBC casts, hypertension, and mild renal impairment is classic for IgA nephropathy.
- Midnight Microfilariae = Massive hydrocele.
Recall: Filarial hydrocele (secondary hydrocele) results from lymphatic obstruction by Wuchereria bancrofti infection.
- Micro-calcs + Irregular margins = Must biopsy.
Recall: High-risk ultrasound features (hypoechoic, irregular margins, microcalcifications, taller-than-wide) warrant FNA regardless of size when >1cm.
- Mastitis = Keep Milking + take Meds (oral antibiotics).
Recall: Puerperal mastitis (cellulitis without abscess) is treated with oral antibiotics covering Staphylococcus aureus (dicloxacillin or cephalexin) and continued breastfeeding/pumping to prevent stasis.
- Kidney protection = Keep the SGLT2i.
Recall: SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin) have proven renoprotective effects independent of glucose lowering, slowing GFR decline and reducing albuminuria (CREDENCE, DAPA-CKD trials).
- Albumin in urine = Add ACEi/ARB.
Recall: ACE inhibitors or ARBs are first-line for diabetic patients with albuminuria due to renoprotective effects beyond blood pressure lowering (reducing intraglomerular pressure and proteinuria).
- “Back to belly, baby’s doing well-y” – anterior position of the back is optimal.
Recall: The findings describe a longitudinal lie with cephalic presentation in left occipito-anterior (LOA) position.
- Brain-sparing = baby’s caring for itself but needs our caring too.
Recall: Elevated S/D ratio in umbilical artery indicates increased placental resistance.
- First bleed = First observe, Finish steroids, then plan delivery.
Recall: A low-lying placenta (edge <20 mm from os but not covering) with first bleeding episode warrants admission, corticosteroids for lung maturity, and close monitoring.
- GDM targets: <95 fasting, <120 postprandial; Failing = add insulin, don’t delay.
Recall: Glucose targets in GDM: fasting <95 mg/dL, 2-hour postprandial <120 mg/dL.
- Deep OP + distress + difficult station = direct to Cesarean.
Recall: After 2 hours of pushing in a multipara (3 hours for primipara), persistent OP position at +2 station with non-reassuring fetal heart rate (variable decelerations with slow recovery) indicates operative intervention.
- Posterior fontanelle Pointing to Pubis = Perfect OA Position.
Recall: Biparietal diameter at ischial spines = 0 station.
- DVT in postpartum: Diagnose with ultrasound, Dose LMWH promptly.
Recall: Clinical suspicion for DVT (asymmetric calf swelling, tenderness, risk factors: cesarean, transfusion) warrants compression ultrasound.
- Sertraline = Safe during breastfeeding; Small amounts, Support continuation.
Recall: Sertraline has low transfer into breast milk (relative infant dose <10%) and is one of the preferred SSRIs for breastfeeding mothers.