Ace Your General Surgery Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Medicine (MD/DO) Students

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General Surgery | Medicine (MD/DO) School Study Aid

WBC Differential Lab Value

White Blood Cells (WBC)

5-10 (5,000-10,000)

Neutrophils (50%-70%)

Bands (2%-5%)

Segs (50%-70%)

Lymphocytes (20%-40%)

Monocytes (4%-8%)

Eosinophils (2%-4%)

Basophils (0.5%-1.5%)

2 mins

Casts in Urine (Differential Diagnosis)

RBC Casts

Glomerular Disease

WBC Casts

Acute Interstitial Nephritis

Acute Pyelonephritis

Fatty Casts

Maltese Cross Sign

Nephrotic Syndrome

Granular Muddy Brown Casts

Acute Tubular Necrosis (ATN)

Waxy Casts

End Stage Renal Disease (ESRD) (Chronic Renal Failure)

Hyaline Casts

Non-Specific

2 mins

Sepsis Assessment

Systemic Infectious Process

Fever

Hypotension

Change in LOC

Increased WBC

Shift to the Left

Tachycardia

Tachypnea

Hyperglycemia

Edema

2 mins

Severe Sepsis and Septic Shock Assessment

Microthrombi

DIC

Decreased Oxygen Saturation

Decreased WBC

Oliguria

High Output Heart Failure

Multiple Organ Failure

2 mins

Disseminated Intravascular Coagulation (DIC)

Bleeding State

Activation of Clotting Factors

Deficiency of Clotting Factors

Sepsis

Trauma

Obstetric Complications

Acute Pancreatitis

Malignancy

Nephrotic Syndrome

Transfusion

2 mins

Motor Neuron Signs UMN and LMN

Increased DTRs

Positive Babinski

Spastic Paralysis

Clasp-Knife Reaction

Decreased DTRs

Negative Babinski

Flaccid Paralysis

Muscle Atrophy

Fasciculations

2 mins

Glasgow Coma Scale

LOC Assessment

Score of 3 to 15

8 or Less = Coma

Eye Opening

Verbal Response

Motor Response

1 min

Lung Sounds - Wheezes

Throughout Lung

High Pitched

Musical

Air Moving through Narrowed Airways

38 secs

Lung Sounds - Crackles

Lower Lobes

Fine/Coarse

Fine: Twisting Hair through Fingers

Coarse: Velcro

Collapsed Small Airways and Alveoli "Popping Open"

1 min

Lung Sounds - Rhonchi

Trachea and Bronchi

Low Pitched Rumbling

Gurgling

Narrowed Airway

Secretions or Bronchospasm

49 secs

Neurovascular Assessment 6 P's

Pain

Paresthesia

Pulse

Pallor

Pressure

Paralysis

1 min

Lung Sounds - Pleural Friction Rub

Anterior Lateral Lung

Dry, Rubbing, or Squeaking

Rubbing a Balloon with Finger

Inflamed Pleura

50 secs

Skull, Scalp and Hair Assessment

Inspect Size, Shape and Contour

Inspect and Palpate Areas for Tenderness or Lesions

Inspect for Tenderness, Lesions or Rashes

Inspect for Dandruff

Inspect for Lice or Nits

Inspect Quality and General Appearance of Hair

Observe Hair Distribution

2 mins

Head, Face and Neck Assessment

Inspect Size and Shape of Skull

Palpate Temporal Artery

Observe Facial Expression

Inspect Facial Structures and Symmetry

Look for Symmetry

Check Range of Motion

Inspect Lymph Nodes and Thyroid Gland

Confirm Trachea is Midline

2 mins

Eye Assessment

Eye and Eyebrow Symmetry

Eyeball Alignment

Examine Cornea and Lens for Cloudiness

Iris and Pupil Shape and Size

Pupillary Light Reflex and Accommodation

P.E.R.R.L.A

2 mins

Throat and Mouth Assessment

Inspect for Color, Asymmetry and Swelling

Inspect Lips, Teeth, Gums and Oral Mucosa

Assess Tongue

Examine Pharynx with Tongue Depressor

2 mins

Reflexes Assessment

Hyperactive

Hypoactive

Biceps

Triceps

Brachioradialis

Patellar (Quadriceps)

Achilles Tendon

Plantar Reflex (Babinski Sign)

3 mins

Nail Assessment

View Index Finger at its Profile

Look at Consistency

Observe Color

Check Capillary Refill

2 mins

Ear Assessment

Inspect Position and Symmetry

Inspect for Lesions, Drainage, Nodules or Redness

Inspect Opening of Ear Canal

Insert Speculum

Position Scope

View Structures

Light Reflect

Whisper Test

Weber’s Test

Rinne Test

4 mins

Skin Assessment

Observe for Abnormal Skin Pigmentation

Inspect for Cyanosis

Observe Skin for Pallor

Observe for Jaundice

Inspect for Erythema

Check the Temperature

Inspect for Diaphoresis or Dehydration

Imprint Thumb Firmly for 3 to 4 Seconds

Note the Characteristics

Palpate Lesion

4 mins

Cerebellar Assessment

Observe Rapid Alternating Movements (RAM)

Touch Thumb to Each Finger

Finger-Nose-Finger Test

Heel-to-Shin Test

Observe Gait

2 mins

ROM Assessment

Active ROM (AROM)

Active Assisted ROM (AAROM)

Passive ROM (PROM)

Neck Flexion, Extension and Rotation

Shoulder Flexion, Extension and Rotation

Elbow Flexion and Extension

Fingers and Wrist Flexion and Extension

Hip and Knee Flexion

Hip Abduction and Rotation

Ankle Rotation

Toe Flexion and Extension

Lumbar Rotation and Spine Inspection

4 mins

Gastrointestinal System Assessment

Inspect Mouth, Jaw, Teeth, Gums and Oral Mucosa

Inspect Tongue

Palpate Areas for Tenderness/Lesions

Inspect Abdominal Quadrants

Auscultate

Percuss

Palpate

Light Palpation

Deep Palpation

Check for Rebound Tenderness and Ascites

Inspect Perianal Area

Palpate Rectum with Gloved Index Finger

6 mins

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