Memory AnchorsNLE · Psychiatric DisordersReal content

NLE Psychiatric Disorders — Mood Disorders: Depression and Bipolar DisorderMemory Anchors

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Quick-recall memory tricks for NLE Psychiatric Disorders — Mood Disorders: Depression and Bipolar Disorder. Acronyms, rhymes, visual hooks, and association techniques that turn rote memorisation into reliable recall. Built specifically for the concepts Professional Regulation Commission (PRC) — Board of Nursing tests most often.

Exam context

On the NLE 2026, the Psychiatric Disorders subtest carries a "Core" weight in Professional Regulation Commission (PRC) — Board of Nursing's pattern. Mood Disorders: Depression and Bipolar Disorder lands at position 2nd out of 7 in the standard review order. Target score is 75% weighted average with no sub-test below 60%, and roughly 50 items come from Psychiatric Disorders on a typical NLE paper.

Mood Disorders: Depression and Bipolar Disorder - Memory Anchors

Memory techniques transform dry clinical facts into vivid, unforgettable mental images. Research confirms that emotionally charged stories, absurd analogies, and rhythmic mnemonics are encoded far more deeply than rote repetition alone — because they engage multiple brain regions simultaneously. For the NLE, where a single forgotten lithium level or missed MAOI food interaction can cost you a correct answer, memory anchors are your clinical safety net. Each anchor below gives you a mental 'hook' — think of it like a jeepney route sign: the moment you see the trigger word, your brain automatically follows the correct route to the right answer.

Anchors

Topic

Major Depressive Disorder

Concept

SIG E CAPS — the 8 symptoms of Major Depressive Disorder

Anchor Id

Difficulty

easy

Memory Aid

Imagine a doctor writing a PRESCRIPTION (SIG = prescription in pharmacy) for E CAPS (energy capsules). The depressed patient needs: Sleep changes, Interest lost (anhedonia), Guilt, Energy gone, Concentration poor, Appetite changed, Psychomotor changes, Suicide thoughts. The doctor keeps writing 'SIG E CAPS' on every chart because depressed patients need ALL these assessed.

Anchor Type

acronym

Why It Works

SIG is a real pharmacy abbreviation students already know (directions for use), making it a memorable hook. CAPS suggests capsules — a medication reminder tied to a medical context.

Example Usage

NLE question asks: 'Which symptom cluster is characteristic of MDD?' Immediately think SIG E CAPS → Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation → ≥5 for ≥2 weeks.

Recall Trigger

Think: 'What does the doctor SIG (prescribe to assess) for CAPS (depression)?'

Topic

Suicide Risk

Concept

Suicide is the HIGHEST priority in psychiatric nursing

Anchor Id

Difficulty

easy

Memory Aid

Picture Maslow's pyramid — but at the very PEAK, instead of self-actualization, there is a giant RED STOP SIGN with the word SUICIDE. No other priority can go above it. Every nursing action pauses at that stop sign first. In psychiatric nursing, safety (suicide) is your Maslow PEAK — physiological needs come first in medical nursing, but in psych, safety TOPS the pyramid.

Anchor Type

visual_association

Why It Works

Filipino nursing students drill Maslow's hierarchy extensively. Re-imagining the peak with a stop sign creates a strong visual override — it is unexpected and therefore memorable.

Example Usage

Any NLE question with a suicidal client among multiple options → automatically choose the safety/suicide-related intervention FIRST before nutrition, medication administration, or therapeutic communication.

Recall Trigger

Picture Maslow's pyramid with a red STOP SIGN at the very top.

Topic

Suicide Risk Assessment

Concept

Asking about suicide does NOT plant the idea — it opens the door

Anchor Id

Difficulty

easy

Memory Aid

Think of asking about suicide like turning on a light in a dark room. The darkness (suicidal thought) was ALREADY THERE — turning on the light (asking directly) does not create the darkness; it simply allows you to SEE it and address it. Many new nurses fear the question, but the darkness existed before the light switch.

Anchor Type

analogy

Why It Works

This analogy directly counters the common misconception in a visual, logical way. It uses a universally understood experience (dark room, light switch) to replace a false belief with the correct clinical principle.

Example Usage

NLE scenario: A nurse hesitates to ask a depressed patient about suicide. The correct action is: Ask directly — 'Are you thinking of killing yourself?' Asking does NOT increase risk; it opens therapeutic communication.

Recall Trigger

Remember: 'Turn on the light — the darkness was already there.'

Topic

Suicide Warning Signs

Concept

Warning signs of imminent suicide: Giving away possessions, sudden calm, saying goodbye

Anchor Id

Difficulty

medium

Memory Aid

Story: 'Lolo Rodrigo suddenly gave his alagang manok (fighting cock) to his neighbor, said a warm goodbye to each grandchild, and was unusually CALM after weeks of crying. The barangay nurse recognized the signs — Rodrigo had made his decision.' The three red flags: GIVES THINGS AWAY, SAYS GOODBYE, SUDDEN CALM (decision has been made). Remember: G-G-C = Gives, Goodbye, Calm.

Anchor Type

micro_story

Why It Works

Filipino cultural context (lolo, manok, barangay nurse) makes the story resonate personally and emotionally. Emotional stories are remembered up to 22 times longer than neutral facts.

Example Usage

NLE question asks what behavior MOST indicates imminent suicide risk → sudden calm after deep depression (energy returned + decision made) = highest concern. Also recognize giving possessions away and saying goodbyes.

Recall Trigger

Think of Lolo Rodrigo and his manok — GGC (Gives, Goodbye, Calm).

Topic

Suicide Risk During Treatment

Concept

Suicide risk INCREASES early in treatment as energy returns before mood lifts

Anchor Id

Difficulty

medium

Memory Aid

Imagine a car with an empty gas tank (no energy = no action) and broken steering (hopeless thinking). When you first refuel the tank (antidepressant starts working — energy returns), the steering is STILL broken. The car now has fuel but no direction — it can now MOVE DANGEROUSLY. Only after several more weeks does the steering (mood, hope) get fixed. Watch the car most carefully RIGHT AFTER the first refuel.

Anchor Type

analogy

Why It Works

The car metaphor separates energy (fuel) from mood/hope (steering) in a tangible, mechanistic way — perfectly illustrating why early recovery is the danger zone.

Example Usage

NLE asks: When is suicide risk highest in a depressed client starting antidepressants? → During the EARLY TREATMENT period, when energy returns before mood and hope improve. Increase observation at this time.

Recall Trigger

Think: 'Full tank, broken steering — danger zone!'

Topic

Bipolar Disorder

Concept

Bipolar I vs Bipolar II — the difference

Anchor Id

Difficulty

easy

Memory Aid

Use the Roman numerals as clues: Bipolar I (one = full = MANIA, the BIG one). Bipolar II (two = toned-down = HYPOMANIA, the lesser one, plus depression). Memory trick: 'ONE = full MANIA, TWO = just hypo-MANIA too.' OR visualize it: Bipolar I has ONE tall mountain (full mania), Bipolar II has TWO shorter hills (hypomania + depression valley).

Anchor Type

mnemonic

Why It Works

The Roman numeral I and II are already associated with 'more' and 'less' in everyday language. Adding a visual of mountains vs hills solidifies the distinction between mania and hypomania.

Example Usage

NLE stem says: 'A client has episodes of elevated mood NOT requiring hospitalization plus major depression.' → This is Bipolar II (hypomania, not full mania, never required hospitalization). If hospitalized for mania → Bipolar I.

Recall Trigger

I = One BIG mountain (full mania). II = Two smaller hills (hypomania + depression).

Topic

Bipolar Disorder — Mania

Concept

Nursing management of the manic client: reduce stimulation, finger foods, firm limits

Anchor Id

Difficulty

easy

Memory Aid

For the manic client, remember the 3 F's: 'FFF — Finger foods, Few stimuli, Firm limits.' Picture a manic patient zooming around the ward: you cannot make them sit, so FINGER FOODS travel with them (high-calorie, on the go), you move them to a FEWER-STIMULI room (quiet corner), and you set FIRM, consistent limits on their behavior — calmly, not punitively.

Anchor Type

acronym

Why It Works

Three parallel F's create phonetic anchoring. The vivid image of a patient literally zooming around makes the rationale (they cannot sit still) intuitive rather than just memorized.

Example Usage

NLE asks: Which meal is BEST for a manic patient who refuses to sit at the table? → High-calorie FINGER FOODS (sandwiches, bananas, nuts) that can be eaten while moving — not a full plated meal requiring sitting.

Recall Trigger

Think: 'FFF — Finger foods, Few stimuli, Firm limits' for the manic client.

Topic

SSRI Pharmacology

Concept

SSRIs are first-line antidepressants; take 2–4 weeks for full effect

Anchor Id

Difficulty

easy

Memory Aid

'SSRIs are the FIRST in LINE — but give them TWO to FOUR weeks TIME.' Rhyme it: 'S-S-R-I, first and fine, wait two to four weeks down the line.' Common ones: Fluoxetine, Sertraline, Paroxetine, Escitalopram, Citalopram — remember FSPEC (Five SSRIs: Fluoxetine, Sertraline, Paroxetine, Escitalopram, Citalopram).

Anchor Type

rhyme

Why It Works

Rhymes activate phonological memory loops, making them highly resistant to forgetting. The rhyme embeds both the priority (first-line) and the time frame (2–4 weeks) in one phrase.

Example Usage

NLE question: A newly diagnosed MDD patient asks when they will feel better on fluoxetine. Correct response: Explain that full therapeutic effect takes 2–4 weeks and they must continue the medication even before noticing improvement.

Recall Trigger

Hum: 'S-S-R-I, first and fine, wait two to four weeks down the line.'

Topic

TCA Pharmacology

Concept

TCAs are cardiotoxic in overdose — dangerous in suicidal clients

Anchor Id

Difficulty

medium

Memory Aid

Picture the TCA molecule as a TRIPLE HEART — it has THREE rings (tricyclic). Now imagine those three hearts turning BLACK with a skull-and-crossbones in overdose. TCA = Triple-ring = Triple danger to the HEART in overdose. The anticholinergic side effects spell DRY BUS: Dry mouth, Retention of urine, blurred vision (like You can't see the bus), Blurred, Urinary retention, Slowed gut (constipation). Cardiotoxicity = dysrhythmias = death in overdose.

Anchor Type

visual_association

Why It Works

The visual of black hearts combines with an existing mental schema (tricyclic = three rings). DRY BUS is a local Filipino transit reference making the anticholinergic side effects culturally memorable.

Example Usage

NLE: A suicidal client is prescribed amitriptyline. Priority nursing action? → Dispense LIMITED quantities per visit; monitor for hoarding. Reason: cardiotoxicity in overdose — dysrhythmias are the primary cause of TCA overdose death.

Recall Trigger

Triple black hearts (TCA) + DRY BUS side effects.

Topic

MAOI Pharmacology

Concept

MAOI + Tyramine foods → Hypertensive Crisis

Anchor Id

A10

Difficulty

medium

Memory Aid

Story: 'Ate Maria is taking phenelzine (an MAOI) for depression. At a Noche Buena party, she eats aged kesong puti, queso de bola, cured ham, and sips red wine. Within an hour she has a POUNDING headache at the back of her head (occipital), stiff neck, racing heart, and skyrocketing blood pressure. This is a HYPERTENSIVE CRISIS.' Remember: MAOI + ANY aged/fermented/cured food = Maria's CRISIS. The party that almost killed Maria.

Anchor Type

micro_story

Why It Works

Filipino holiday foods (Noche Buena, queso de bola, cured ham) make the tyramine-rich food list immediately recognizable and personally relevant. Crisis = emergency recall.

Example Usage

NLE question: Which food should the nurse teach a client taking phenelzine to AVOID? → Aged cheese (queso de bola), cured meats, fermented foods, red wine, draft beer, soy sauce. Signs of hypertensive crisis: severe occipital headache, stiff neck, palpitations, dangerously elevated BP.

Recall Trigger

Think of Maria's Noche Buena CRISIS — MAOI + aged/fermented foods = hypertensive crisis.

Topic

MAOI Dietary Restrictions

Concept

Tyramine-rich foods to AVOID with MAOIs

Anchor Id

A11

Difficulty

medium

Memory Aid

Remember the acronym 'ABCDEF' for tyramine-rich foods: A = Aged cheeses (queso de bola, cheddar, blue cheese), B = Beer (tap/draft) and Bottle of red wine, C = Cured/smoked meats (cured ham, longganisa, pepperoni), D = Dried and fermented foods (toyo/soy sauce, miso, bagoong connection — fermented), E = Everything overripe/spoiled (overripe avocado, overripe banana), F = Fermented/yeast extracts (marmite, yeast bread in excess). ABCDEF = All Bad Choices During MAOI Eating From now on.

Anchor Type

acronym

Why It Works

The A-B-C-D-E-F structure provides a familiar sequential anchor. Filipino-specific examples (bagoong, toyo, longganisa) make abstract dietary restrictions concrete and locally relevant.

Example Usage

NLE: What dietary teaching is priority for a client starting phenelzine? → Teach to avoid ABCDEF foods: aged cheese, beer/red wine, cured meats, dried/fermented foods, everything overripe, fermented/yeast extracts. Report severe headache or palpitations immediately.

Recall Trigger

ABCDEF — All Bad Choices During MAOI Eating From now on.

Topic

Serotonin Syndrome

Concept

Serotonin Syndrome — causes, signs, and treatment

Anchor Id

A12

Difficulty

hard

Memory Aid

Serotonin Syndrome = TOO MUCH SEROTONIN from drug combinations. Remember the triad with 'AMN' (think: AMNA = too much): A = Altered mental status (agitation, confusion), M = Motor/neuromuscular problems (hyperreflexia, myoclonus, rigidity, clonus, tremor), N = NOT stable autonomically (hyperthermia, tachycardia, diaphoresis, labile BP). CAUSE: SSRI + MAOI, or SSRI + tramadol/triptans/St. John's wort. TREATMENT: STOP the drug → Supportive care → Cyproheptadine (serotonin antagonist).

Anchor Type

mnemonic

Why It Works

AMN creates a three-part structure matching the three diagnostic criteria. The phonetic similarity to 'Amna' (a familiar name in Filipino culture) adds personal resonance.

Example Usage

NLE: A client on fluoxetine is started on tramadol and develops fever, agitation, and muscle twitching. Priority action? → Recognize SEROTONIN SYNDROME → STOP the offending drug immediately → notify physician → supportive care → expect cyproheptadine order.

Recall Trigger

AMN — Altered mentation, Motor problems, Not autonomically stable. Cause: combo drugs. Fix: STOP + cyproheptadine.

Topic

SSRI-MAOI Drug Interaction

Concept

SSRI-to-MAOI washout: 2 weeks (most SSRIs); 5 weeks for fluoxetine

Anchor Id

A13

Difficulty

hard

Memory Aid

Rhyme: 'Most SSRIs — wait TWO weeks to be free. But FLUOXETINE — wait FIVE, it lingers you see!' Why? Fluoxetine has a very LONG half-life — it stays in the body much longer. Think: FLUoxetine = FLU season lasts LONGER than a cold — 5 weeks to wash out.

Anchor Type

rhyme

Why It Works

The rhyme separates the two washout periods clearly and attaches a logical rationale (long half-life) to fluoxetine's unique 5-week requirement, preventing confusing them.

Example Usage

NLE: A client wants to switch from fluoxetine to phenelzine. How long must the nurse advise waiting? → At least 5 WEEKS (not 2) after stopping fluoxetine before starting an MAOI. Reason: fluoxetine's long half-life; washout prevents serotonin syndrome.

Recall Trigger

Flu season lasts longer — fluoxetine = 5-week washout.

Topic

Lithium Pharmacology

Concept

Lithium therapeutic range: 0.6–1.2 mEq/L; toxicity starts above 1.5 mEq/L

Anchor Id

A14

Difficulty

medium

Memory Aid

Chunk the lithium levels into a TRAFFIC LIGHT: GREEN ZONE (safe): 0.6–1.2 mEq/L = Go (therapeutic). YELLOW ZONE (caution): 1.2–1.5 mEq/L = Slow down, monitor closely. RED ZONE (danger/toxic): above 1.5 mEq/L = STOP — toxicity begins. DEEP RED (emergency): above 2.0 mEq/L = Severe toxicity — crisis. EXTREME RED: above 2.5–3.0 mEq/L = Cardiovascular collapse, death risk. Remember: '0.6 to 1.2 — that's GREEN for me!'

Anchor Type

chunking

Why It Works

Traffic light is a universally understood three-tier system. Filipino students encounter traffic lights daily, making this schema instantly retrievable under exam pressure.

Example Usage

NLE: A client's lithium level is 1.8 mEq/L. What is the nurse's priority? → Level is in RED ZONE (>1.5 = toxic). Expect signs: coarse tremor, ataxia, confusion. HOLD lithium, notify physician, monitor vitals, prepare for supportive care/possible hemodialysis.

Recall Trigger

LITHIUM TRAFFIC LIGHT: Green 0.6–1.2, Yellow 1.2–1.5, Red >1.5, Deep Red >2.0.

Topic

Lithium Toxicity

Concept

Lithium early toxicity signs vs. severe toxicity signs

Anchor Id

A15

Difficulty

medium

Memory Aid

EARLY toxicity (1.5–2.0): Think of a person who JUST started getting SEASICK on a boat — NAUSEA, VOMITING, DIARRHEA, FINE TREMOR (like shaking on a boat), THIRST, POLYURIA, DROWSINESS, SLURRED SPEECH. Early = GI STORM + fine shake. SEVERE toxicity (>2.0): The boat CAPSIZED — COARSE TREMOR (violent shaking), ATAXIA (can't walk = falling in water), CONFUSION (disoriented in water), SEIZURES, COMA. Memory: 'Fine tremor on a boat (early) → Coarse tremor, capsized (severe).'

Anchor Type

mnemonic

Why It Works

The progressive boat metaphor (seasick → capsized) physically demonstrates how toxicity worsens with rising levels. The sensory imagery of a boat makes fine vs. coarse tremor visually distinct.

Example Usage

NLE: A client on lithium reports nausea, thirst, and hand tremors. Lithium level is 1.6 mEq/L. This represents: → EARLY/MILD toxicity (1.5–2.0 range). Nurse should: HOLD dose, notify physician, check serum sodium and hydration, prepare to draw repeat level.

Recall Trigger

Seasick (early, fine shake) → Capsized (severe, coarse shake, seizures, coma).

Topic

Lithium and Sodium Interaction

Concept

Lithium follows sodium — low sodium = lithium toxicity

Anchor Id

A16

Difficulty

hard

Memory Aid

Think of lithium and sodium as IDENTICAL TWINS trying to get on the same jeepney (kidneys). When there is a SHORTAGE of sodium twins (low-sodium diet, sweating, diarrhea), the kidney jeepney driver cannot tell them apart and picks up MORE lithium twins instead. The jeepney fills up with lithium → serum lithium RISES → TOXICITY. Lesson: Keep sodium consistent so the jeepney does NOT over-collect lithium. Drink 2–3 liters of water daily, maintain normal salt intake.

Anchor Type

analogy

Why It Works

The jeepney metaphor is uniquely Filipino and perfectly illustrates competitive reabsorption in the kidney tubule. The 'identical twins' concept communicates why the kidney cannot distinguish between Na+ and Li+.

Example Usage

NLE: A client on lithium has been on a low-sodium diet for 1 week due to hypertension. What is the nurse's priority concern? → LITHIUM TOXICITY. Low sodium causes increased lithium reabsorption → rising levels. Instruct to maintain consistent, normal sodium intake and adequate fluid intake (2–3 L/day).

Recall Trigger

JEEPNEY KIDNEYS: Shortage of sodium twins → kidneys grab more lithium twins → toxicity!

Topic

Lithium Drug Interactions

Concept

Drugs that RAISE lithium levels: NSAIDs and Thiazide diuretics

Anchor Id

A17

Difficulty

medium

Memory Aid

Remember: 'NSAIDs and Thiazides are LITHIUM LEVEL LIFTERS (LLL).' The drugs that raise lithium are those that reduce sodium → kidney grabs more lithium (same jeepney principle). NSAIDs reduce renal prostaglandins → decrease sodium clearance → lithium rises. Thiazides → sodium wasted in urine → kidney compensates by reabsorbing more lithium. Memory: 'N-T Lift Lithium' or 'Never Take (NSAIDs-Thiazides) without checking Lithium.'

Anchor Type

mnemonic

Why It Works

The LLL (Lithium Level Lifters) acronym plus the connection back to the jeepney sodium principle integrates this new fact into an already-established memory structure.

Example Usage

NLE: A client on lithium begins taking ibuprofen for arthritis pain. What is the priority nursing action? → Monitor lithium levels closely. NSAIDs raise lithium levels — risk of toxicity. Advise avoiding NSAIDs; consult physician. Acetaminophen is a safer alternative.

Recall Trigger

LLL — NSAIDs and Thiazides are Lithium Level Lifters.

Topic

Lithium Monitoring

Concept

Lithium blood level must be drawn 12 HOURS after the last dose (trough level)

Anchor Id

A18

Difficulty

easy

Memory Aid

Picture a CLOCK at 12 o'clock with a blood drop at the bottom (trough/lowest point). When a patient takes lithium at night (e.g., 10 PM), draw blood at 10 AM — exactly 12 hours later, when the blood level is at its TROUGH (lowest between doses). Drawing too early = falsely HIGH level → wrong clinical decision. Always draw at TROUGH = 12 HOURS after the LAST DOSE.

Anchor Type

visual_association

Why It Works

The clock image with a blood drop at the 12-position is simple, visual, and directly ties the number '12' to the concept of 'trough.' Visual encoding of numbers dramatically improves numerical recall.

Example Usage

NLE: When is the correct time to draw a lithium blood level? → 12 hours after the LAST DOSE (trough level). A client who took lithium at 9 PM should have blood drawn at 9 AM the next morning.

Recall Trigger

CLOCK at 12 with a blood drop at the trough position — 12 hours after last dose.

Topic

Electroconvulsive Therapy (ECT)

Concept

ECT nursing care — before and after

Anchor Id

A19

Difficulty

medium

Memory Aid

BEFORE ECT — remember 'CAN IV': Consent (informed), Atropine (to reduce secretions), NPO (nothing by mouth), remove Items (dentures, jewelry, hairpins), Void (bladder empty). AFTER ECT — remember 'SRO': Side position (lateral to maintain airway), Reorient (client will be confused), Observe vitals and respiratory status. Memory: Before ECT = 'CAN IV be ready?' After ECT = 'SRO — Side, Reorient, Observe.'

Anchor Type

acronym

Why It Works

Two separate acronyms (CAN IV and SRO) clearly partition pre- and post-procedure care into manageable chunks that each contain the most critical assessments.

Example Usage

NLE: A nurse is preparing a client for ECT. Which action is most important? → Ensure informed CONSENT is obtained, client is NPO, bladder is voided, and remove all metal objects. After ECT → position on the SIDE (lateral) to prevent aspiration; expect transient confusion and memory loss — reassure client.

Recall Trigger

'CAN IV' before ECT → 'SRO' after ECT.

Topic

Philippine Mental Health Law

Concept

RA 11036 — Mental Health Act: protects rights of persons with mental health conditions in the Philippines

Anchor Id

A20

Difficulty

easy

Memory Aid

Story: 'In 2018, the Philippine government finally answered the call of millions of Filipinos struggling silently with depression, bipolar disorder, and schizophrenia. RA 11036 — the Mental Health Act — became the law that said: HINDI KA NAIIWANAN (You are not abandoned). It mandates humane treatment, community-based care, and protects patients from discrimination. Even involuntary admission for suicide risk must follow proper safeguards and documentation under this law.' Key numbers: RA 11036 = 110 (like 1-1-0, emergency) + 36 (mental health needs your attention 36 days a year? — just for the number memory).

Anchor Type

micro_story

Why It Works

The Filipino phrase 'Hindi ka naiiwanan' creates emotional resonance and national pride while embedding the law's spirit. The numerical chunking (110-36) provides a hook for the RA number.

Example Usage

NLE question references legal framework for psychiatric care in the Philippines → RA 11036 (Mental Health Act). Involuntary treatment for imminent suicide risk is permitted under RA 11036 WITH proper safeguards and documentation.

Recall Trigger

RA 11036 = 'Hindi ka naiiwanan' — Mental Health Act, humane treatment, patient rights.

Revision Game

SIG E CAPS (the mnemonic for MDD symptoms: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation)

Clue

I am a prescription that is NOT for pills — I am a checklist for sadness lasting at least two weeks. What is my name?

Memory Link

Anchor A1 — SIG E CAPS prescription analogy

1.2 mEq/L — the upper limit of the therapeutic lithium range (0.6–1.2 mEq/L = green/safe zone)

Clue

I am a number that is GREEN. I keep you safe. But go even one point above me and you start to feel sick on the boat. What am I?

Memory Link

Anchor A14 — Lithium Traffic Light and Anchor A15 — Seasick boat analogy

She is taking an MAOI (e.g., phenelzine). This is a HYPERTENSIVE CRISIS caused by MAOI + tyramine-rich foods.

Clue

Maria brought aged cheese, red wine, and cured ham to the party. Now she has a POUNDING headache and her BP is through the roof. What medication is she taking and what emergency is this?

Memory Link

Anchor A10 — Maria's Noche Buena Crisis story

Low sodium causes the kidneys to reabsorb more LITHIUM (the wrong passenger), raising serum lithium levels and causing TOXICITY.

Clue

A jeepney driver keeps picking up the WRONG passenger because all the sodium twins are gone. What problem does this cause, and what drug is the 'wrong passenger'?

Memory Link

Anchor A16 — Jeepney Kidney analogy for lithium-sodium interaction

Electroconvulsive Therapy (ECT). CAN IV = pre-ECT checklist (Consent, Atropine, NPO, Items removed, Void). SRO = post-ECT care (Side position, Reorient, Observe vitals).

Clue

I come AFTER the seizure in a controlled setting. First, check CAN IV. After, do SRO. What procedure am I?

Memory Link

Anchor A19 — CAN IV and SRO for ECT care

Full MANIA = Bipolar I (tall mountain, requires hospitalization). HYPOMANIA = Bipolar II (smaller hill, does not cause marked impairment, no hospitalization needed).

Clue

I am the mountain that makes you Bipolar ONE. I am tall enough to need a hospital. My smaller cousin only needs a hill. Who am I, and who is my cousin?

Memory Link

Anchor A6 — One mountain (Bipolar I) vs. two hills (Bipolar II)

Waiting 5 weeks after stopping FLUOXETINE before starting an MAOI. Leaving fluoxetine's long half-life behind. (Other SSRIs need only 2 weeks.)

Clue

The FLU lasts longer than a cold. That is why I must wait FIVE weeks, not two. What am I waiting to start, and what am I leaving behind?

Memory Link

Anchor A13 — Flu = Five rhyme for fluoxetine washout

The three GGC warning signs of imminent suicide: Gives prized possessions away, says Goodbye, appears suddenly Calm after deep depression. GGC = imminent suicide risk — highest priority.

Clue

Lolo Rodrigo gave away his fighting cock, said goodbye to his apos, and was unusually calm. The barangay nurse was alarmed. What three things did the nurse recognize, and what do they spell?

Memory Link

Anchor A4 — Lolo Rodrigo's GGC story

NLE questions about drug switching, timing of MAOI initiation, or preventing serotonin syndrome when changing antidepressant classes.

What Each Part Means

2 weeks = standard washout for short-half-life SSRIs (sertraline, paroxetine, escitalopram, citalopram); 5 weeks = extended washout for fluoxetine due to its active metabolite (norfluoxetine) with a half-life of 4–16 days; washout ensures drug clearance before introducing MAOI

S — SSRIs: FIRST-LINE, safest, 2–4 week onset, serotonin syndrome risk with MAOIs
T — TCAs: Cardiotoxic in overdose, anticholinergic (DRY BUS), 2–4 week onset, limit supply in suicidal patients
M — MAOIs: Last resort/treatment-resistant, tyramine-free diet, hypertensive crisis risk, 2-week (5-week for fluoxetine) washout from SSRIs

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NLE Psychiatric Disorders — Mood Disorders: Depression and Bipolar DisorderMemory Anchors

Exam context

Mood Disorders: Depression and Bipolar Disorder - Memory Anchors

Anchors

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