Medical Mnemonics: Symptoms of Kawasaki Disease

Medical Mnemonic for Kawasaki Disease – “CREAM”

Kawasaki disease (mucocutaneous lymph node syndrome) is a rare childhood disease that causes inflammation in the walls of small-sized and medium sized arteries. It is most often seen in children under the age of 5 of Asian descent (primarily Japanese of Korean). It is somewhat more common in boys than girls.

There is no known cause for this disease and it is not contagious.

There is no single test for Kawasaki disease and in order to diagnose it, you must look for symptoms. The symptoms and criteria for diagnosis can be remembered by the mnemonic “CREAM”. The criteria defined for diagnosis is that the child must have fever for greater than 5 days and must show four of the following five symptoms.

• C: Conjunctivitis (non-exudative)
• R: Rash (polymorphous non-vesicular)
• E: Edema (or erythema of hands or feet)
• A: Adenopathy (cervical, often unilateral)
• M: Mucosal involvement (erythema or fissures or crusting)

This is the fourth in our series of Medical Mnemonics Monday posts. You can all previous Knowmedge medical mnemonics posts.

Medical Mnemonics: Types of Hypersensitivity Reactions

Medical Mnemonics / Internal Medicine Board Review: 

There are four types of hypersensitivity reactions.

• Type I is IgE-mediated and occurs very quickly after exposure. It is associated with allergens such as bee stings, peanuts, and certain medications, to name a few. This can lead to a life-threatening condition called anaphylaxis.
• Type II hypersensitivity reactions are cytotoxic/antibody-mediated. Some examples in this category are hemolytic reactions, goodpasture syndrome and hyperacute graft rejection.
• Type III is known as immune complex/IgG/IgM mediated and includes certain diagnoses like hypersensitivity pneumonitis, systemic lupus erythematosus, polyarteritis nodosa and serum sickness.
• Type IV is known as delayed or cell-mediated hypersensitivity reaction. Examples include chronic graft rejections, purified protein derivative (PPD), latex, nickel and poison ivy.

A quick mnemonic to use to remember these is ACID:

• Type I – Allergic
• Type II – Cytotoxic
• Type III – Immune complex deposition
• Type IV – Delayed

You can view all previous and future medical mnemonics here.

Medical Mnemonics: Symptoms of Normal Pressure Hydrocephalus

Medical Mnemonic: “Wacky, Wobbly, Wet”

Patients who present with the triad of urinary incontinence, wide-based gait and dementia are likely to have normal pressure hydrocephalus (NPH). Symptoms for these patients are often remembered by the mnemonic “wacky, wobbly, and wet.”

• Wacky: Dementia and mental impairment
• Wobbly: Wide based gait (Difficulty walking)
• Wet: Urinary Incontinence

NPH is a condition where excess cerebrospinal fluid (CSF) has slowly built up in the ventricles. Patients with NPH are generally older (over the age of 60). CT or MRI of the brain would reveal dilated ventricles without dilatation of sulci.

This is the second in our series of Medical Mnemonics Monday posts. You can all previous and future medical mnemonics here.

Medical Mnemonics: Major and Minor Criteria for Rheumatic Fever

Medical Mnemonic ("Jones Cafe Pal"): 

Rheumatic fever occurs after a streptococcal infection (usually caused by Group A Beta-Hemolytic Strep (GABHS)). It is an inflammatory condition that affects the joints, skin, heart and brain. Major criteria are referred to as Jones criteria and can be remembered by the mnemonic of the same name.

J – Joint involvement which is usually migratory and inflammatory joint involvement that starts in the lower joints and ascends to upper joints

O – (“O” Looks like heart shape) – indicating that patients can develop myocarditis or inflammation of the heart

N – Nodules that are subcutaneous

E – Erythema marginatum which is a rash of ring-like lesions that can start in the trunk or arms. When joined with other rings, it can create a snake-like appearance

S – Sydenham chorea is a late feature which is characterized by jerky, uncontrollable, and purposeless movements resembling twitches

Minor criteria include

C – CRP Increased

A – Arthralgia

F – Fever

E – Elevated ESR

P – Prolonged PR Interval

A – Anamesis

L – Leukocytosis

Diagnosis of rheumatic fever is made after a strep infection (indicated by either throat cultures growing GABHS OR elevated anti-streptolysin O titers in the blood) and:

Two major criteria OR

One major criterion and two minor criteria

Mnemonics by themselves are not the answer to remembering everything. However, if you know the basics and underlying issues, then a mnemonic can serve to help you recall the exam details that can easily get lost.

This is the first in our series of Medical Mnemonics Monday posts. You can all previous and future medical mnemonics here.