Napkin Drawing #2: D-dimer, FDP, and Rabbit Holes


By Mark Ard

Napkin Drawing 2 D-dimer, FDP, and Rabbit HolesI vividly remember this topic from Kaplan Q bank, UWorld, and my Step 1 test. It always boiled down to the same question, what’s the difference between elevated d-dimer and elevated fibrin degradation products (FDP). (If Step 1 questions were written like that, life would be so much easier).

Of course, a good Step 1 question will assume you know the basics and wants a deeper understanding. Did this patient recently have a radical prostatectomy and release a large amount of urokinase? Do you think his nosebleed is from picking it too aggressively, or is it the first sign of DIC, followed by bleeding out of every orifice and IV site? Does the fact that his liver enzymes are sky high explain the high FDP and low d-dimer (the answer is yes, the liver makes anti-plasmin). (more…)

Mnemonic Monday: Argyll-Robinson Pupil


By Haley Masterson

To remember the ocular symptoms of Argyll-Robinson Pupil, just take the first letter of each word – ARP – and read it forwards and backwards. Forwards, you have ARP – Accommodation Reflex Present. Backwards, you have PRA – Pupillary Reflex Absent.

Usually the constriction to light is stronger than constriction to a near stimulus, but the reverse is true in the case of Argyll-Robinson pupil. Remember that “accommodation” refers to the ability of the eyes to focus on a near object. This reflex is carried out in part by pupillary constriction – so the pupils will constrict as you bring a far object into the near eye field – for example, moving your finger close to the patient’s nose. However, the “pupillary reflex” refers to the ability of the eye to constrict when exposed to a bright stimulus, such as your pen light. (more…)

An Attempt to Clean the Mess of the GI Tract Plexuses


By Joe Savarese

Perhaps I am the only one out there with this particular problem, but for some reason, I would always confuse the gastrointestinal tract plexuses. Like most miscellaneous Step 1 topics, I remembered the concept well when as I was reviewing it, but give me a week or two during Step 1 studying and those layers became a mess.

So here is my gift to you. Since I created this mnemonic, I have never mixed up these layers. (more…)

Napkin Drawings Episode 1: Frank Starling and PV Curves


By Mark Ard

Welcome to a new type of mnemonics I like to call “napkin drawings.” This term describes diagrams that literally look like they were drawn on a napkin, devoid of proper axis labeling. They serve to highlight a few key concepts without getting bogged down in the details. Mine are drawn on Penultimate, but you should be able to copy them to your study resources (once you understand them!).

Let’s start with one of those simple on the surface concepts that the USMLE asks 101 different ways – Frank Starling and PV Curves. (more…)

Mnemonic Monday: The 5 Hs and 5 Ts of Cardiac Arrest


By Michael Spinner

Cardiac arrest, defined by the loss of functional circulation, is a true medical emergency that may rapidly progress to death if not addressed immediately.

Emergent stabilizing measures include defibrillation for patients with a “shockable rhythm” (i.e. ventricular fibrillation or pulseless ventricular tachycardia) and immediate CPR and epinephrine for patients with a “non-shockable rhythm” (i.e. asystole or pulseless electrical activity).

After calling a code and initiating these emergent stabilizing measures, the American Heart Association Advanced Cardiovascular Life Support (ACLS) program states that healthcare providers should assess for any potentially reversible causes of the arrest and treat the patient accordingly. Remember the 5Hs and 5Ts listed below to rapidly recall the causes of cardiac arrest:


Mnemonic Monday: The CURB-65 Criteria – Prognosis & Management of Pneumonia


By Michael Spinner

The CURB-65 Criteria – Prognosis & Management of PneumoniaThe prognosis and management of community-acquired pneumonia may vary considerably from patient to patient. Some are treated effectively with oral antibiotics in the outpatient setting, others should be hospitalized for IV antibiotics, and the most severe cases may require ICU admission to provide ventilatory and/or hemodynamic support. Use the CURB-65 criteria listed below to help estimate the prognosis and determine the appropriate management for patients with community-acquired pneumonia:

C – Confusion (new change in mental status)

U – Urea >7 mmol/L

R – Respiratory rate ³30

B – Blood pressure <90 systolic or £60 diastolic

65 – Age ³65


The Crazy Carpals: How to Remember Them All??


By Molly Lewis

So many wrist bones, so little time- how to remember them all? Try these mnemonics!

There are about a million mnemonics out there for the bones of your wrist (AKA carpals), some with higher moral standards than others :). Here are two to get you started:


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