Mnemonic Monday: PERCH on a "Peak" – Picornavirus

By Molly Lewis

Viruses… not only can they literally make you sick to your stomach from gastroenteritis, but trying to remember their classifications can cause significant nausea as well!

The solution? No, it’s not oral rehydration therapy or ondansetron – try a mnemonic!

One of my favorites:

– for the picornaviruses:

PERCH on a Peak

– “peak” ~ pico = Picornaviruses

Perch on a Peak

P = Poliovirus
E = Enteroviruses
R = Rhinoviruses
C = Coxsackie viruses
H = HAV – Hepatitis A virus




– polio (flaccid (lower motor neuron) ascending (starts with distal muscles and moves proximally) paralysis)


– aseptic (viral) meningitis


– common cold (especially in fall and early winter, vs Coronavirus = later winter and spring)

Coxsackie viruses

– type A = hand, foot, mouth disease

– type B = herpangina; myocarditis

HAV – Hepatitis A virus

– hepatitis (known for outbreaks in day care centers, in which the kids get just viral gastroenteritis symptoms, but the adults get jaundice)



– picoRNAviruses = RNA viruses

– pico = “small amount” in Spanish, and these viruses are small RNA viruses!


Picornaviruses are naked single stranded RNA (ssRNA). Since they are naked (without a membrane envelope), they can survive stomach acid and are therefore spread via fecal-oral transmission.


Like this mnemonic? Find many more like this one for viruses, bacteria, parasites, and fungi in First Aid for the USMLE Step 1 2013!



– Technically, the E in the mnemonic should stand for Echovirus (causes aseptic meningitis), since the viruses in the PERC part of the mnemonic are all in the Enterovirus genus of the Picornavirus species, but I’ve found in practice and on tests that this version of the mnemonic works well!).

– There is a significant amount of cross-over in the diseases each virus causes (for example, most of these viruses are known for causing aseptic meningitis (except with Rhinovirus and HAV), enterovirus 71 can cause Hand, foot, mouth disease, and polio can cause aseptic meningitis without paralysis), but I listed the classic (AKA- on the USMLE) associations here.



mnemonic: First Aid for the USMLE Step 1 2012 p. 187

virus info:


Categories: Mnemonics

4 replies »

Leave a Comment

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s