Title: Bone Wizardry / Mnemonics / Psychiatry
Tags: bw-mnemonics psychiatry

Acronym: SIG E CAPS
Title: Major Depressive Disorder
System: psychiatry
Emoji: 😔
Path: ? S
. Sleep disturbances
? I
. Interest / libido loss
? G
. Guilt / worthlessness
? E
. Energy loss
? C
. Concentration loss
? A
. Appetite change
? P
. Psychomotor agitation
? S
. Suicidal ideation
? Note
. Need 5 of 9 for 2 weeks
? Note
. #1 psychiatric diagnosis
? Note
. Pseudo-dementia mimics in elderly

Acronym: DIGFAST
Title: Mania Criteria
System: psychiatry
Emoji: 🚀
Path: ? D
. Distractibility
? I
. Irresponsibility / impulsivity
? G
. Grandiosity
? F
. Flight of ideas
? A
. Activity increased
? S
. Sleep decreased
? T
. Talkativeness
? Note
. Need 3+ for 1 week
? Note
. Bipolar I = full mania
? Note
. Bipolar II = hypomania (still functional)

Acronym: SAD PERSONS
Title: Suicide Risk Assessment
System: psychiatry
Emoji: ⚠️
Path: ? S
. Sex (male)
? A
. Age (young or elderly)
? D
. Depression
? P
. Previous attempts (#1 risk)
? E
. Ethanol / drug use
? R
. Rational thinking loss
? S
. Social support lacking
? O
. Organized plan
? N
. No spouse
? S
. Sickness
? Note
. Previous attempt = #1 risk factor
? Note
. Protective: parenthood, pregnancy
? Note
. Male completes > female attempts

Acronym: 4-4-4-4
Title: EPS Timeline (Antipsychotics)
System: psychiatry
Emoji: ⏱️
Path: ? 4h
. Acute Dystonia
? 4d
. Parkinsonian symptoms (4 days to 4 wks)
? 4w
. Akathisia (4 wks to 4 mos)
? 4m
. Tardive Dyskinesia (4 mos to 4 yrs)
? Note
. Tx dystonia: Benztropine/diphenhydramine
? Note
. TD is irreversible
? Note
. Clozapine = lowest EPS risk

Acronym: TIPS
Title: MAO Inhibitors
System: psychiatry
Emoji: 💊
Path: ? T
. Tranylcypromine
? I
. Isocarboxazid
? P
. Phenelzine
? S
. Selegiline (MAO-B only = Brain)
? Note
. Tyramine + MAOI = hypertensive crisis
? Note
. MAOI to SSRI: wait 15 days
? Note
. SSRI to MAOI: wait 30 days

Acronym: TrazoBONE: Trazodone → Priapism
Title: Trazodone Side Effect
System: psychiatry
Emoji: 🦴
Path: ? TrazoBONE
. 🦴 Trazodone causes priapism (prolonged painful erection)
? Note
. Alpha-1 blockade mechanism
? Note
. Also causes orthostatic hypotension
? Note
. Used off-label as sleep aid at low doses

Acronym: Benzos = Frequency ↑; Barbiturates = Duration ↑
Title: GABA-A Cl- Channel Mechanisms
System: psychiatry
Emoji: ⏲️
Path: ? Benzos
. ⚡ Increase FREQUENCY of Cl- channel opening
? Barbiturates
. ⏳ Increase DURATION of Cl- channel opening
? Note
. Barbiturates can open channel WITHOUT GABA (OD risk)
? Note
. Benzos have ceiling effect: safer in overdose
? Note
. Flumazenil reverses benzos; no specific barb reversal

Acronym: Lithium: HypoNa, HypoThyroid, Nephrogenic DI, Ebstein (teratogen), Tremors
Title: Lithium Adverse Effects
System: psychiatry
Emoji: 🔋
Path: ? Hyponatremia
. 🧂 Li+ looks like Na+, potentiates toxicity
? Hypothyroidism
. 🦋 Inhibits thyroid hormone synthesis
? Nephrogenic DI
. 🚰 Blocks ADH at collecting duct → polyuria
? Ebstein Anomaly
. 👶 Teratogen: tricuspid valve displaced
? Tremors
. 🤚 Fine at therapeutic, coarse at toxic levels
? Note
. Narrow therapeutic index (0.6-1.2 mEq/L)
? Note
. Thiazides and NSAIDs increase lithium levels
? Note
. Monitor: TSH, Cr, lithium levels regularly

Acronym: 4 Hyperthermic Crisis Syndromes
Title: Crisis Syndrome Comparison
System: psychiatry
Emoji: 🆘
Path: ? Hypertensive
. 🧀 MAOI + tyramine → massive catecholamine release
? Malignant Hyperthermia
. 🔥 Succinylcholine → ryanodine receptor; Tx: dantrolene
? NMS
. 💊 Antipsychotics → rigidity, fever, high CK; Tx: dantrolene + bromocriptine
? Serotonin Syndrome
. ⚡ SSRI + MAOI → CLONUS, hyperthermia; Tx: cyproheptadine
? Note
. Clonus = key feature distinguishing serotonin syndrome from NMS
? Note
. NMS: "lead pipe" rigidity
? Note
. All four cause hyperthermia by different mechanisms

Acronym: MAOI→SSRI = 15 days; SSRI→MAOI = 30 days
Title: Antidepressant Switching Washout
System: psychiatry
Emoji: ⏳
Path: ? MAOI to SSRI
. 15 15 days (MAO enzyme regeneration)
? SSRI to MAOI
. 30 30 days (5 half-lives SSRI clearance)
? Note
. Fluoxetine needs 5-6 weeks (extra long half-life)
? Note
. Risk: serotonin syndrome → death
? Note
. Never combine: MAOI+SSRI, MAOI+meperidine, MAOI+tyramine

Acronym: 5 Stages of Grief
Title: Kubler-Ross model
System: psychiatry
Emoji: 😢
Path: ? Denial
. 🙈 Does not face the truth
? Anger
. 😠 Blame game
? Bargaining
. 🙏 Wishful thinking, offerings
? Depression and guilt
. 😞 Intense sadness, decreased sleep
? Acceptance
. ✅ Accepting reality

Acronym: 3 Criteria for MDD Diagnosis During Grief
Title: When grief becomes MDD
System: psychiatry
Emoji: ⚠️
Path: ? Dysfunction
. 📉 Cannot carry on daily life
? Suicidal ideation
. ⚠️ Thoughts of self-harm
? Feelings of worthlessness
. 😞 Beyond normal grief

Acronym: 4 Sleep Disturbances in MDD
Title: Sleep pattern in depression
System: psychiatry
Emoji: 😴
Path: ? Excessive sleepiness
. 😴 Hypersomnia
? Short bursts of REM
. 💤 Go in and out quickly
? More REM overall
. 💤 Still do not feel rested
? Early morning awakenings
. 🌅 Classic finding

Acronym: 5 Side Effects of Lithium
Title: Lithium adverse effects
System: psychiatry
Emoji: 💊
Path: ? Hyponatremia
. 🧪 Li+ competes with Na+
? Hypothyroidism
. 🦋 Competes with iodine
? Nephrogenic DI
. 🫘 Blocks ADH receptors
? Teratogen (Ebstein anomaly)
. 🤰 Cardiac defect in newborn
? Tremors
. 🤚 Motor side effect

Acronym: 4 Crisis Syndromes
Title: Hypertensive, MH, NMS, Serotonin
System: psychiatry
Emoji: 🆘
Path: ? Hypertensive crisis
. 🔴 MAOI + tyramine; vasoconstriction; Rx: phenoxybenzamine
? Malignant hyperthermia
. 🔴 AD; ryanodine receptor mutation; succinylcholine; Rx: dantrolene
? NMS
. 🔴 Antipsychotic overdose; rhabdomyolysis; Rx: dantrolene
? Serotonin syndrome
. 🔴 SSRI + MAOI; opposing effects; Rx: cyproheptadine

Acronym: EPS Timeline
Title: Extrapyramidal syndrome progression
System: psychiatry
Emoji: ⏰
Path: ? Acute dystonia (4 hours)
. 💪 Sustained contraction; torticollis; Rx: benztropine, diphenhydramine
? Parkinsonian (4 days-4 weeks)
. 🤖 Stiffness; Rx: anticholinergics
? Akathisia (4 weeks-4 months)
. 🏃 Restlessness; Rx: beta-blocker
? Tardive dyskinesia (4 months-4 years)
. 👅 Lip smacking, tongue protrusion; Rx: switch to clozapine

Acronym: 3 Personality Disorder Clusters
Title: A, B, and C
System: psychiatry
Emoji: 🧠
Path: ? Cluster A: Weird
. 🔮 Paranoid, Schizoid, Schizotypal
? Cluster B: Wild
. 🔥 Antisocial, Borderline, Histrionic, Narcissistic
? Cluster C: Worried
. 😰 Avoidant, Obsessive-compulsive, Dependent

Acronym: Sleep Stages and Features
Title: Non-REM and REM
System: psychiatry
Emoji: 😴
Path: ? Stage 1
. 🌊 Alpha/theta waves; brief, easily woken
? Stage 2
. 🌊 Sleep spindles and K complexes; 20 min; decreased HR
? Stage 3
. 🌊 Delta waves; transition to deep sleep
? Stage 4
. 🌊 Delta waves; hardest to wake; bedwetting/sleepwalking; growth/repair
? REM
. 🌊 Sawtooth waves; dreams, eye movement; muscles relaxed; brain active

Acronym: 4 Sleep Neurotransmitters
Title: NT changes during sleep
System: psychiatry
Emoji: 🧠
Path: ? Serotonin
. ⬆️ Initiates sleep
? Acetylcholine
. ⬆️ REM sleep
? Norepinephrine
. ⬇️ Decreases
? Dopamine
. ⬆️ Arousal and wakefulness