ABG made simple

Watch this video to simplify the understanding of Respiratory / metabollic alkalosis / acidosis.

Alkaline phosphatase elevated - Bone origin or Liver origin?

The mnemonic was revealed when I got a patient with very high Alkaline phosphatase who had no clear cut evidence of bone / GI disease. So I read through the various tests to differentiate between ALP of Bone and Liver origin. There were various tests including GGT, Heat stability, Bone scan, Ct scan.... etc etc. But the point of Heat stability of ALP of liver origin has this interesting code:
Bone Burns first, Liver Lasts / LIVEs
Explanation : ALP of Bone origin is heat labile (Burns), while that of Liver origin is heat stable (Lasts / Lives).

VDRL : False Positive cases

VDRL is false positive in "Missed Positive VDRL"
Malaria
Pregnancy
Viral diseases - Hepatitis, IMN
Drugs
Rheumatic fever, Rheumatoid arthritis
Leprosy, Lupus

Orthopaedic investigations : Table

Memorising this table will help to differentiate the above orthopaedic conditions.

Micro organisms which don't Gram stain well

 List of Microbes which may not gram stain well:
Remember: " These Microscopic Rascals May Look Colourless "
Treponema
Mycobacteria 
Rickettsia
Mycoplasma
Legionella
Chlamydia

Blood group

O Negative (O -ve) blood group is universal dONor

BT, CT, PT, PTT

Bleeding time gives Platlet response ( Remember BP )
Clotting time gives idea about Coagulation pathway ( Remember CC )

Also remember the following about Prothrombin Time (PT) and Partial Thromboplastin Time (PTT):
PTT - Intrinsic and common pathway
PT - Extrinsic and common pathway
( Remember this by imagining that Peter is going to take part in a Tea drinking contest. To be IN to the contest Peter must drink two Teas (TT) - PTT gives idea about INtrinsic and common pathway. If Peter drinks only one T, he is OUT = Extrinsic and common pathway represented by PT )

LFT : SGOT vs SGPT, Direct BR vs Indirect BR

SGOT = AST, SGPT = ALT
SGOT is elevated in alcholic hepatitis.

I always get confused between the two. Here's how to remember: When you drink alcOHOL, you get hepatitis and your liver gets HOLes. So there are more HOLEs in SGOT - That's why SGOT is present in mitOchOndria and cytOsOl. SGPT is present only in cytosol.

To remember SGOT = AST and SGPT = ALT, strike out the common letters on both sides. You get O = S and P = L. Now remember "The OS (operting system) of your life gets corrupted with alchol". Remember OS for O=S --> SGOT = AST.

The other confusion is between Direct and Indirect bilirubin. Which is more? The level of Indirect is more - remember the number of letters in 'Indirect' are also more as compared to 'Direct'. Indirect = Unconjugated BR. ( Note that both have prefixes ). Therfore, Direct = Conjugated BR.

Normal Differential Count Values

WBC Differential Count (DC) :

Remember :"Never Let Monkeys Eat Bananas" and "60, 30, 6, 3, 1" 

Neutrophils 60% 
Lymphocytes 30% 
Monocytes 6% 
Eosinophils 3% 
Basophils 1%

Sodium and Potassium

Sodium is EXtracellular, Potassium INtracellular (SEX, PIN)

What are normal values of Sodium and Potassium in serum ? They are 135 - 145 and 3.5 - 5.5 respectively. I used to get confused between these values when I first heard them. This is how I remembered it: Sodium is EXTRAcellular - has EXTRA values, so the larger value is for it - that is 1-3-5, the first three odd numbers and for the smaller potassium, take only second & third odd numbers i.e. 3-5, make it to 3.5

Iron content in body and in milk

Total quantity of " I R O N " in human body is 4 gms (=  number of letters inthe word " I R O N ")

Iron content in Milk = 0.4 mg

Microbiology - Special Stains

You know Gram stain is for Bacteria, Acid Fast for Mycobacterium (also Nocardia). Remember other special stains below:


Giemsa : CAmpylobacter, Malaria, Leishmaniasis (CAMeL) (Remember the picture of Giemsa Camel above)
Silver stain : pNEumocystis (CARnii), FUNgi, LEGionella (Remember the picture above : it's a SILVER NEW CAR with FUNny LEGs)
MuciCaRmine - CRyptococci
Periodic Acid Schiff: FUNgi, amoeba (A FUNny amoeba just PASsed away)