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Internal Medicine Medical (MD/DO) School Study Aid

Skills & Calculations
12 Picmonics to Learn | 26 mins

Next
Reading a Chest X-Ray
ABCDE Approach
Airway and Appliances
Bones
Cardiac
Diaphragm
Everything Else
Masses
Pulmonary Vasculature
Lung Parenchyma
2 mins
Wells' Criteria for Pulmonary Embolism
Scoring
Clinical Symptoms of DVT (+3)
Pulmonary Embolism Most Likely Diagnosis (+3)
Tachycardia (+1.5)
Immobilization > 3 Days (+1.5)
Previous DVT or PE (+1.5)
Hemoptysis (+1)
Malignancy (+1)
Probability
> 6 = High
2-6 = Moderate
< 2 = Low
2 mins
Light's Criteria
Use
Determines Transudative vs. Exudative Source of Pleural Effusion
Exudate if (At Least One of the Following):
Effusion/Serum Protein Ratio > 0.5
Effusion/Serum LDH Ratio > 0.6
Effusion LDH > Two-thirds Upper Serum LDH Range
1 min
Systemic Inflammatory Response Syndrome (SIRS) Criteria
Must have 2 or more of the following:
Temperature < 36C or > 38C
Pulse > 90 beats per minute
Respirations > 20/min or PCO2 < 32
WBC < 4,000 or > 12,000 or 10% bands
Mechanism
Subset of Cytokine Storm and Related to Sepsis
1 min
Winter's Formula
Evaluates Respiratory Compensation
Used in Metabolic Acidosis
Equation
(HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
Steps
Bicarbonate (HCO3) x 1.5
+ 8
± 2
= Expected Value for PCO2
1 min
Duke Criteria for Infective Endocarditis
Major Criteria
Blood Culture Positive
Endocardial Involvement
Minor Criteria
Fever
Immunologic Phenomena
Vascular Phenomena
Predisposition
Microbiological Evidence
Diagnosis
Two Major Criteria, or
One Major and Three Minor Criteria, or
Five Minor Criteria
3 mins
TIMI Score (Thrombolysis In Myocardial Infarction)
Use
Mortality Predictor
Unstable Angina or NSTEMI
2 Week Risk of Death and Ischemic Events
AMERICA (Each is +1)
Age Greater or Equal to 65
Markers Elevated
EKG ST Changes (Greater or Equal to 0.5mm)
Risk Factors for CAD (Coronary Artery Disease)
Ischemia (2 Anginal Events in 24 Hours)
Coronary Artery Disease (CAD)
Aspirin Use in the Last 7 Days
2 mins
CHA2DS2-VASc for Stroke Risk in Atrial Fibrillation
CHF (+1)
Hypertension (+1)
Age 75 + (+2)
Diabetes (+1)
Stroke or TIA or Thromboembolism History (+2)
Vascular Disease (+1)
Age 65-75 Years (+1)
Sex Female (+1)
Interpretation
0 = No Anticoagulation
1 = Consider Anticoagulation
2 = Anticoagulation
2 mins
Calcium Correction for Hypoalbuminemia
0.8 * (Normal Albumin - Patient Albumin) + Calcium
Steps
Multiply * 0.8
Subtract (Normal Albumin - Patient Albumin)
Add Calcium
1 min
Corrected Na+ for Hyperglycemia
Equation
[(Glucose-100) * 0.016 ] + Na+
Steps
Glucose-100
Multiply * 0.016
Add Na+
1 min
Quad Screen Results Interpretation
Markers
AFP
Estriol
hCG
Inhibin A
Aneuploidies
Down Syndrome = HIgh
Turner Syndrome = Very HIgh
Edward Syndrome = Low HEAp
Patau Syndrome = AFP is Normal
2 mins
Salter-Harris Fracture Classification
SMACK
Slipped Across Physis (Type 1)
Metaphysis and Physis (Type 2)
Articular-Epiphyseal (Type 3)
Complete Metaphysis and Epiphysis (Type 4)
Krushed Physis (Type 5)
2 mins

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