Drugs causing hepatic necrosis

Remember "Very Angry Hepatocytes":
Valproic acid
Acetaminophen
Halothane

Puddle's Sign

Some signs can be better understood and remembered by knowing the meaning of word. Of course, most of the signs are named after people, but we are lucky to have few signs otherwise. For example, when I asked one medical student why Puddle's sign is named so, he told me that it was named after Dr. Puddle and he didnot remember what the sign was about.

So what's a puddle? A puddle is a small collection of liquid, usually we refer to a puddle of water in the ground after a rain etc. This is used to detect minimal fluid collection in the abdomen i.e. minimal ascitis.

Now to remember, you have the picture given below. There's a puddle, a sign board reading 120 ml and a Gorilla. Puddle sign can detect ascitis as less as 120 ml. What's the Gorilla doing there? The Gorilla's position is the position we use to elicit puddle sign. To make this more clear, let us see how to elicit this sign.

 Let patient lie prone for 5 minutes, after which he/she has to rise on his/her elbow and knees (that's like the Gorilla!) and by the method of auscultatory percussion you find that there is resonant note in the flanks and dull note towards the center of abdomen i.e. the puddle forms at the central part of abdomen.

Digestive system song videos

If you are a DJ, you will remember your lessons better by making music albums out of the confusing points. Take for instance the following two videos. The first video works with models of GIT with real actors and actress, whereas the second deals with medical animation mnemonics or medical graphic mnemonics with songs in background.

Download Gastroenterology Mnemonics

Download pdf file here.

Lengths of intestines

• Lengths of first 3 parts of the digestive system after the stomach i.e. Duodenum, Jejunum and Ileum: 

To remember the lengths , remember the story of a tiger, which ate a dozen doctors who had gone to the forest for a picnic, including the famous Doctor Indiana Jones. News reported in Radio: One (tiger) Ate 12 (1-8-12) , including Dr. Indiana Jones referring to 1, 8 and 12 feets, which are the respective  lengths of Duodenum, Ileum and Jejunum.

• Lengths of 4 parts of Duodenum ( Remember : 1-2-3-4 = 2-3-4-1 ) :

1st part = 2 inches

2nd part = 3"

3rd part = 4"

4th part = 1"

Criggler Najjar Syndrome, Gilbert syndrome

What is the problem in Criggler NaJJar & Gillbert syndrome?
The defect is in CoNJuGatIon