Pleural Effusions

Pleural effusions can be exudative (>30g/L protein) or transudative (<30g/L protein). Things that commonly cause effusions of each type are:

Also light's criteria - if any of the following are true then = exudative:

• Pleural/Serum protein ratio > 0.5
• Pleural/Serum LDH ratio > 0.5
• Pleural fluid LDH > 2/3 of serum LDH level.

Calcium Channel Blockers

Calcium channel Cow: is hypertensive and has angina (indications for calcium channel blockers).

To remember each of these drugs I just add something to calcium channel cow as shown below...

Na+ and K+ in Addisons and Cushings

On the ward the other day 3 of us got very confused by the changes in K+ and Na+ in addisions, Cushings and Conns. We worked back to first principles and figured it out in the end, but to save time I thought of this blatant generalisation:

Addisions can kill you, Cushings and Conns can't.

Helps me to remember that K+ is high in addisions but low in Cushings and Conns (follows that Na+ is the opposite).

* disclaimer: I'm sure cushings and conns could kill you, and addisons might not. Anyway the point is how to remember the changes in K+ !

ECG Update

A while back I posted this about ECG's. Here's an update for those who found it useful - now including which coronary artery each lead relates to:

• Coffee Cup with circle around it = Latte = Lateral leads (supplied by CIRCumflex)
• Info sign = InfeRior, supplied by right coronary (infoRmation)
• Ant with football = Anterior leads, the ant is a bit of a "lad" (left anterior descending)
• Septal leads = equally supplied by RCA and LAD depending on anatomical variance.

Route planner

Here's a useful resource for anoyone on central london firms at Barts....

Cranial foramina

A way of remembering the main cranial foramina from anterior to posterior (looking down on the skull base),... using a very surreal story:

After being in a bit of a daze thinking about the cranial foramina...

You open your eyes (optic canal)

Upon opening your eyes you notice a weird orb filled with what seems to be fish soup (superior orbital fissure)

A rotund man starts to walk over (foramen rotundem)

As you watch the orb of fish soup he traces a large oval (foramen ovale) over your spine (foramen spinosum) using a shoelace (foramen lacerum), which he then places into a jug (jugular foramen).

(ps. the person who thought of this may need psychological help)

NySTAGmus

A couple of things to remember about ny-STAG-mus:

• Can be caused by lesion to flocculonodular lobe (shaped like bow-tie) of cerebellum
  
• Gaze is controlled by vestibulo-cerebellum
  
• Vascular supply: Anterior Inferior Cerebellar Artery (AICA)

Explaination of image: This STAG is wearing a VEST with a BOW TIE. He's also talking to us asking if we like his bow-tie - so he must have some artificial intelligence (A.I. = AICA).

ps. for brownie points the deep nucleus of the vetibulo-cerebellum is the lateral vestibular or Deiter's nucleus. You could remember this by naming your stag "Deiter"...

Weber's and Rinne's test

This one is pretty well known but thought I'd add it anyway.

Weber's test -
tuning fork on forehead.
Loud on one side:
= conductive loss on same side
or
= sensorineural loss on opposite side

Rinne's test -
tuning fork next to ear and on mastoid process.
Normal = Air louder than bone (+ve rinne's)
Conduction loss = Bone louder than air (-ve rinne's)
Sensorineural = Both the same

Next time you see someone actually doing this test, please take a photo and sent it to me!