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<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">


<font color="Navy">'''1. ANATOMY'''</font>
<font color="Navy">'''1. Anatomy'''</font>


<div class="mw-collapsible-content">
<div class="mw-collapsible-content">
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* '''L'''ymphatics
* '''L'''ymphatics
- Parenthesis includes things contained in the femoral sheath.
- Parenthesis includes things contained in the femoral sheath.
<br><br>
<font color="navy">'''2. CELL BIOLOGY'''</font>


</div></div>
</div></div>
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<div class="mw-collapsible mw-collapsed">


<font color="Navy">'''2. Histology'''</font>
<font color="Navy">'''2. Cell Biology'''</font>


<div class="mw-collapsible-content">
<div class="mw-collapsible-content">
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<div class="mw-collapsible-content">
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''CO blocks CO'''}}</font>
<font color="red">{{cquote|'''CO blocks CO'''}}</font>
Carbon monoxide '''(CO)''' blocks Cytochrome Oxidase '''(CO)'''  
Carbon monoxide '''(CO)''' blocks Cytochrome Oxidase '''(CO)'''


</div></div>
</div></div>
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<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">


==G-proteins Receptors==  
==G-proteins Receptors==


<div class="mw-collapsible-content">
<div class="mw-collapsible-content">
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* Q: M1
* Q: M1
* I: M2
* I: M2
* Q: M3  
* Q: M3


</div></div>
</div></div>
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</div></div>
</div></div>
<font color="Navy">'''4. BIOCHEMISTRY'''</font>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''4. Biochemistry'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==Enzymes Classification==
==Enzymes Classification==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Over The HILL'''}}</font>
<font color="red">{{cquote|'''Over The HILL'''}}</font>
* '''O''' - '''O'''xidoreductases
* '''O''' - '''O'''xidoreductases
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* '''L''' - '''L'''igases
* '''L''' - '''L'''igases
* '''L''' - '''L'''yases
* '''L''' - '''L'''yases
</div></div>
<div class="mw-collapsible mw-collapsed">


==Glycolysis Enzymes==
==Glycolysis Enzymes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Hungry Peter Pan And The Growling Pink Panther Eat Pies'''}}</font>
<font color="red">{{cquote|'''Hungry Peter Pan And The Growling Pink Panther Eat Pies'''}}</font>
* Hexokinase
* Hexokinase
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* Enolase
* Enolase
* Pyruvate kinase
* Pyruvate kinase
</div></div>
<div class="mw-collapsible mw-collapsed">


==Glycolysis Steps==
==Glycolysis Steps==
<font color="red">{{cquote|'''Goodness Gracious, Father Franklin Did Go By Picking Pumpkins (to) Prepare Pies'''}}</font>  
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Goodness Gracious, Father Franklin Did Go By Picking Pumpkins (to) Prepare Pies'''}}</font>
* Glucose
* Glucose
* Glucose-6-P
* Glucose-6-P
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* 3-Phosphoglycerate
* 3-Phosphoglycerate
* 2-Phosphoglycerate (to)
* 2-Phosphoglycerate (to)
* Phosphoenolpyruvate [PEP] Pyruvate • 'Did', 'By' and 'Pies' tell you the first part of those three: di-, bi-, and py-.  
* Phosphoenolpyruvate [PEP] Pyruvate • 'Did', 'By' and 'Pies' tell you the first part of those three: di-, bi-, and py-.
• 'PrEPare' tells location of PEP in the process.  
• 'PrEPare' tells location of PEP in the process.
<br><br>
 
<font color="Navy">'''5. METABOLISM'''</font>
</div></div>
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''5. Metabolism'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
 
==Metabolism Sites==
==Metabolism Sites==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Use both arms to HUG'''}}</font>
<font color="red">{{cquote|'''Use both arms to HUG'''}}</font>
# Heme synthesis
# Heme synthesis
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# Gluconeogenesis
# Gluconeogenesis
These reactions occur in both cytoplasm and mitochondria
These reactions occur in both cytoplasm and mitochondria
</div></div>
<div class="mw-collapsible mw-collapsed">


==AcetylCoA and AcetacetylCoA==
==AcetylCoA and AcetacetylCoA==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''A Lighter Lease (A LyTr LeIs)'''}}</font>
<font color="red">{{cquote|'''A Lighter Lease (A LyTr LeIs)'''}}</font>
Amino acids forming them:
Amino acids forming them:
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* Tr=Tryptophan
* Tr=Tryptophan
* Le=Leucine
* Le=Leucine
* Is=Isoleucine  
* Is=Isoleucine
 
</div></div>
<div class="mw-collapsible mw-collapsed">


==Citric Acid Cycle Compounds==
==Citric Acid Cycle Compounds==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Our City Is Kept Safe And Sound From Malice'''}}</font>
<font color="red">{{cquote|'''Our City Is Kept Safe And Sound From Malice'''}}</font>
* Oxaloacetate
* Oxaloacetate
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* Succinate
* Succinate
* Fumarate
* Fumarate
* Malate  
* Malate
 
</div></div>
<div class="mw-collapsible mw-collapsed">


==Citric Acid Cycle Enzymes==
==Citric Acid Cycle Enzymes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Corrupt Anti Intelligence Agent Spoke Slander For Money'''}}</font>
<font color="red">{{cquote|'''Corrupt Anti Intelligence Agent Spoke Slander For Money'''}}</font>
* Citrate synthatase
* Citrate synthatase
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* Fumarase
* Fumarase
* Malate Dehydrogenase
* Malate Dehydrogenase
</div></div>
<div class="mw-collapsible mw-collapsed">


==Essential Amino Acids==
==Essential Amino Acids==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''P''' ri '''V''' a '''T''' e  '''TIM  HALL'''}}</font>
<font color="red">{{cquote|'''P''' ri '''V''' a '''T''' e  '''TIM  HALL'''}}</font>
<font color="red">{{cquote|'''PVT. TIM HALL'''}}</font>
<font color="red">{{cquote|'''PVT. TIM HALL'''}}</font>
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* Arg and His are considered semi-essential
* Arg and His are considered semi-essential
* Alternatively: '''MATT VIL PHLy'''
* Alternatively: '''MATT VIL PHLy'''
</div></div>
<div class="mw-collapsible mw-collapsed">


==Creatine Phosphate: Amino Acid Precursors==
==Creatine Phosphate: Amino Acid Precursors==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Nice GAMs!'''}}</font>
<font color="red">{{cquote|'''Nice GAMs!'''}}</font>
* '''G''' - '''G'''lycine
* '''G''' - '''G'''lycine
* '''A''' - '''A'''rginine
* '''A''' - '''A'''rginine
* '''M''' - '''M'''ethionine
* '''M''' - '''M'''ethionine
</div></div>
<div class="mw-collapsible mw-collapsed">


==Branched Chain Amino Acids Catabolism Steps==
==Branched Chain Amino Acids Catabolism Steps==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Truck hit the Ox to Death'''}}</font>
<font color="red">{{cquote|'''Truck hit the Ox to Death'''}}</font>
* '''T''' - '''T'''ransamination
* '''T''' - '''T'''ransamination
* '''O''' - '''O'''xidative decarboxylation
* '''O''' - '''O'''xidative decarboxylation
* '''D''' - '''D'''ehydrogenation
* '''D''' - '''D'''ehydrogenation
</div></div>
<div class="mw-collapsible mw-collapsed">


==Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)==
==Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Muscles LIVe fast'''}}</font>
<font color="red">{{cquote|'''Muscles LIVe fast'''}}</font>
* Leucine
* Leucine
* Isoleucine
* Isoleucine
* Valine
* Valine
</div></div>
<div class="mw-collapsible mw-collapsed">


==Urea Cycle==
==Urea Cycle==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''O'''rdinarily '''C'''areless '''C'''rappers '''A'''re '''A'''lso '''F'''rivolous '''A'''bout '''U'''rination!}}</font>
<font color="red">{{cquote|'''O'''rdinarily '''C'''areless '''C'''rappers '''A'''re '''A'''lso '''F'''rivolous '''A'''bout '''U'''rination!}}</font>
* '''O''' - '''O'''rnithine
* '''O''' - '''O'''rnithine
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* '''A''' - '''A'''rginine
* '''A''' - '''A'''rginine
* '''U''' - '''U'''rea
* '''U''' - '''U'''rea
</div></div>
<div class="mw-collapsible mw-collapsed">


==Pyrimidines Nucleotides==
==Pyrimidines Nucleotides==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''CUT the PY (pie)'''}}</font>
<font color="red">{{cquote|'''CUT the PY (pie)'''}}</font>
* '''C'''ytosine
* '''C'''ytosine
* '''U'''racil
* '''U'''racil
* '''T'''hiamine  
* '''T'''hiamine
* '''T'''he
* '''T'''he
* '''PY'''rimidines  
* '''PY'''rimidines
<br><br>
 
<font color="Navy">'''6. ENZYME DEFICIENCIES'''</font>
</div></div>
==G6PD: Oxidant Drugs Inducing Hemolytic Anemia ==  
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''6. Enzyme Deficiencies'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==G6PD: Oxidant Drugs Inducing Hemolytic Anemia==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''AAA'''}}</font>
<font color="red">{{cquote|'''AAA'''}}</font>
* Antibiotic (eg: sufamethoxazole)
* Antibiotic (eg: sufamethoxazole)
* Antimalarial (eg: primaquine)
* Antimalarial (eg: primaquine)
* Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)
* Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)
</div></div>
<div class="mw-collapsible mw-collapsed">


==Pompe's Disease==
==Pompe's Disease==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Type "Police: Po + lys"'''}}</font>
<font color="red">{{cquote|'''Type "Police: Po + lys"'''}}</font>
* '''PO'''mpe's disease is a '''LYS'''osomal storage disease (alpha 1,4 glucosidase)
* '''PO'''mpe's disease is a '''LYS'''osomal storage disease (alpha 1,4 glucosidase)
</div></div>
<div class="mw-collapsible mw-collapsed">


==Galactosemia==
==Galactosemia==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''GALIPUT'''}}</font>
<font color="red">{{cquote|'''GALIPUT'''}}</font>
* Galactose 1 Phosphate Uridyl Transferase
* Galactose 1 Phosphate Uridyl Transferase
* There is an assay called the Galiput test for this
* There is an assay called the Galiput test for this
</div></div>
<div class="mw-collapsible mw-collapsed">


==Fabry's Disease==
==Fabry's Disease==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''FABRY ' S'''}}</font>
<font color="red">{{cquote|'''FABRY ' S'''}}</font>
* '''F''' - '''F'''oam cells found in glomeruli and tubules / '''F'''ebrile episodes
* '''F''' - '''F'''oam cells found in glomeruli and tubules / '''F'''ebrile episodes
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* '''S''' - '''S'''phingolipidoses
* '''S''' - '''S'''phingolipidoses


==Hurler Syndrome Features==  
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Hurler Syndrome Features==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''HURLER'S'''}}</font>
<font color="red">{{cquote|'''HURLER'S'''}}</font>
*'''H'''eptosplenomegaly  
*'''H'''eptosplenomegaly
*'''U'''gly facies  
*'''U'''gly facies
*'''R'''ecessive (AR inheritance)  
*'''R'''ecessive (AR inheritance)
*'''L'''-iduronidase deficiency (alpha)  
*'''L'''-iduronidase deficiency (alpha)
*'''E'''yes clouded  
*'''E'''yes clouded
*'''R'''etarded  
*'''R'''etarded
*'''S'''tubby fingers/'''S'''hort  
*'''S'''tubby fingers/'''S'''hort


==Acute Intermittent Porphyria==  
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Acute Intermittent Porphyria==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''5  P's '''}}</font>
<font color="red">{{cquote|'''5  P's '''}}</font>
* '''P'''ain in abdomen
* '''P'''ain in abdomen
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* '''P'''ink urine
* '''P'''ink urine
* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)
* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)
<br><br>
 
<font color="Navy">'''7. VITAMINS'''</font>
</div></div>
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''7. Vitamins'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==B Vitamins==
==B Vitamins==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''The Rhythm Nearly Proved Contagious'''}}</font>
<font color="red">{{cquote|'''The Rhythm Nearly Proved Contagious'''}}</font>
In increasing order:  
In increasing order:
* '''T''' - '''T'''hiamine (B1)
* '''T''' - '''T'''hiamine (B1)
* '''R''' - '''R'''iboflavin (B2)
* '''R''' - '''R'''iboflavin (B2)
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* '''P''' - '''P'''yridoxine (B6)
* '''P''' - '''P'''yridoxine (B6)
* '''C''' - '''C'''obalamin (B12)
* '''C''' - '''C'''obalamin (B12)
</div></div>
<div class="mw-collapsible mw-collapsed">


==Niacin Deficiency==
==Niacin Deficiency==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''The famous 4 D's'''}}</font>
<font color="red">{{cquote|'''The famous 4 D's'''}}</font>
# Diarrhea
# Diarrhea
# Dermatitis
# Dermatitis
# Dementia
# Dementia
# Death (if untreated)  
# Death (if untreated)
<font color="red">{{cquote|'''The 3D's of pellagra'''}}</font>
<font color="red">{{cquote|'''The 3D's of pellagra'''}}</font>
Vitamin B3 (niacin, nicotinic acid) deficiency
Vitamin B3 (niacin, nicotinic acid) deficiency
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# Diarrhea
# Diarrhea
# Dementia
# Dementia
</div></div>
<div class="mw-collapsible mw-collapsed">


==Folate Deficiency Causes==
==Folate Deficiency Causes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''A FOLIC DROP'''}}</font>
<font color="red">{{cquote|'''A FOLIC DROP'''}}</font>
* Alcoholism
* Alcoholism
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* Relative folate deficiency
* Relative folate deficiency
* Old
* Old
* Pregnant  
* Pregnant
 
</div></div>
<div class="mw-collapsible mw-collapsed">


==Fat Soluble Vitamins==
==Fat Soluble Vitamins==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''The FAT cat is in the ADEK (attic)'''}}</font>
<font color="red">{{cquote|'''The FAT cat is in the ADEK (attic)'''}}</font>
Fat soluble vitamins are ''A,D,E,K.'''
Fat soluble vitamins are ''A,D,E,K.'''
</div></div>
<div class="mw-collapsible mw-collapsed">


==Hypervitaminosis A==
==Hypervitaminosis A==
<div class="mw-collapsible-content">
<font color="red">{{cquote|Increased Vitamin A makes you '''HARD'''}}</font>
<font color="red">{{cquote|Increased Vitamin A makes you '''HARD'''}}</font>
* '''H''' - '''H'''eadache / '''H'''epatomegaly
* '''H''' - '''H'''eadache / '''H'''epatomegaly
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* '''R''' - '''R'''eally painful bones
* '''R''' - '''R'''eally painful bones
* '''D''' - '''D'''ry skin / '''D'''rowsiness
* '''D''' - '''D'''ry skin / '''D'''rowsiness
<br><br>
 
<font color="Navy">'''8. HISTORY TAKING'''</font>
</div></div>
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''8. History Taking'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==Alcoholism Screening==
==Alcoholism Screening==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''CAGE'''}}</font>
<font color="red">{{cquote|'''CAGE'''}}</font>
* Have you ever felt it necessary to '''C'''UT DOWN on your drinking?
* Have you ever felt it necessary to '''C'''UT DOWN on your drinking?
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* Have you ever felt '''G'''UILTY about your drinking?
* Have you ever felt '''G'''UILTY about your drinking?
* Have you ever felt the need to have a drink in the morning for an '''E'''YE OPENER?
* Have you ever felt the need to have a drink in the morning for an '''E'''YE OPENER?
</div></div>
<div class="mw-collapsible mw-collapsed">


==Chief Complaint==
==Chief Complaint==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''OPQRST'''}}</font>
<font color="red">{{cquote|'''OPQRST'''}}</font>
* '''O''' - '''O'''nset of pain:  what was the patient doing when the pain started?
* '''O''' - '''O'''nset of pain:  what was the patient doing when the pain started?
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NOTE: ASCLAST means let the patient talk first, then ask him/her specific questions.
NOTE: ASCLAST means let the patient talk first, then ask him/her specific questions.
</div></div>
<div class="mw-collapsible mw-collapsed">


==Hospital Admission Orders==
==Hospital Admission Orders==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''DAVE WILMINGTON'''}}</font>
<font color="red">{{cquote|'''DAVE WILMINGTON'''}}</font>
* '''D'''iet
* '''D'''iet
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Note that IV fluids follows Diet. If one writes NPO, then '''all''' such patients get maintenance fluids (use the 4-2-1 rule).
Note that IV fluids follows Diet. If one writes NPO, then '''all''' such patients get maintenance fluids (use the 4-2-1 rule).
</div></div>
<div class="mw-collapsible mw-collapsed">


==Post-Op Fever Causes==
==Post-Op Fever Causes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Five W's'''}}</font>
<font color="red">{{cquote|'''Five W's'''}}</font>
* '''W'''ind: pneumonia, atelectasis
* '''W'''ind: pneumonia, atelectasis
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* '''W'''alking: DVT/PE (walking can help reduce DVT/PE)
* '''W'''alking: DVT/PE (walking can help reduce DVT/PE)
* '''W'''onderdrugs: especially anesthesia
* '''W'''onderdrugs: especially anesthesia
</div></div>
<div class="mw-collapsible mw-collapsed">


==Predisposing Conditions for Pulmonary Embolism==
==Predisposing Conditions for Pulmonary Embolism==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''TOM SCH PREFER'''}}</font>
<font color="red">{{cquote|'''TOM SCH PREFER'''}}</font>
* '''T''' - '''T'''rauma
* '''T''' - '''T'''rauma
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* '''E''' - '''E'''lderly
* '''E''' - '''E'''lderly
* '''R''' - '''R'''oad trip
* '''R''' - '''R'''oad trip
</div></div>
<div class="mw-collapsible mw-collapsed">


==Compartment Syndrome Signs (Arterial Occlusion)==
==Compartment Syndrome Signs (Arterial Occlusion)==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''6 P's'''}}</font>
<font color="red">{{cquote|'''6 P's'''}}</font>
# Pain
# Pain
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# Paresthesias
# Paresthesias
# Paralysis
# Paralysis
<br><br>
 
<font color="Navy">'''9. PATHOLOGY'''</font>
</div></div>
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''9. Pathology'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==Causes of Diseases==
==Causes of Diseases==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''VITAMIN C'''}}</font>
<font color="red">{{cquote|'''VITAMIN C'''}}</font>
*'''V'''ascular
*'''V'''ascular
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*'''C'''ongenital
*'''C'''ongenital


==5 Signs of Inflammation==
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
==Signs of Inflammation==
 
<div class="mw-collapsible-content">
 
# '''Rubor''': redness/erythema
# '''Rubor''': redness/erythema
# '''Calor''': raised temperature
# '''Calor''': raised temperature
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# '''Functio Laesa''': loss of function
# '''Functio Laesa''': loss of function
- Described by Celsus
- Described by Celsus
</div></div>
<div class="mw-collapsible mw-collapsed">


==Hypersentivity Reactions (Gell & Goombs Classification)==
==Hypersentivity Reactions (Gell & Goombs Classification)==
<font color="red">{{cquote|'''ACID'''}}</font> <font color="red">{{cquote|'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill}}</font>  
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ACID'''}}</font> <font color="red">{{cquote|'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill}}</font>
# Type I  '''A'''naphylaxis
# Type I  '''A'''naphylaxis
# Type II  '''C'''ytotoxic-mediated
# Type II  '''C'''ytotoxic-mediated
# Type III '''I'''mmune-complex
# Type III '''I'''mmune-complex
# Type IV  '''D'''elayed hypersensitivity
# Type IV  '''D'''elayed hypersensitivity
</div></div>
<div class="mw-collapsible mw-collapsed">


==Multiple Endocrine Neoplasia (MEN)==
==Multiple Endocrine Neoplasia (MEN)==
<div class="mw-collapsible-content">
Each of the MENs is a disease of '''three or two letters plus a feature'''; all are autosomal dominant.
Each of the MENs is a disease of '''three or two letters plus a feature'''; all are autosomal dominant.
<font color="red">{{cquote|'''MEN I:  3 P's'''}}</font>
<font color="red">{{cquote|'''MEN I:  3 P's'''}}</font>
Line 646: Line 864:
- MEN IIA: parathyroid
- MEN IIA: parathyroid
- MEN IIB (MEN III): mucocutaneous neuromas for
- MEN IIB (MEN III): mucocutaneous neuromas for
</div></div>
<div class="mw-collapsible mw-collapsed">


==Acute Pneumonia Infiltrates==
==Acute Pneumonia Infiltrates==
<div class="mw-collapsible-content">
* '''P'''yogenic bacteria: '''P'''MN infiltrate
* '''P'''yogenic bacteria: '''P'''MN infiltrate
* '''M'''iscellaneous microbes: '''M'''ononuclear infiltrate
* '''M'''iscellaneous microbes: '''M'''ononuclear infiltrate


==Takayasu's Disease/Pulseless Disease==  
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Takayasu's Disease/Pulseless Disease==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''When you have Takayasu's, I can't Tak'a yu pulse'''}}</font>
<font color="red">{{cquote|'''When you have Takayasu's, I can't Tak'a yu pulse'''}}</font>
</div></div>
<div class="mw-collapsible mw-collapsed">


==CBC Normal Differential==
==CBC Normal Differential==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas}}</font>
<font color="red">{{cquote|'''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas}}</font>
<font color="red">{{cquote|'''N'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}</font>
<font color="red">{{cquote|'''N'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}</font>
<font color="red">{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}</font>
<font color="red">{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}</font>
# '''N'''eutrophils: '''60'''%
# '''N'''eutrophils: '''60'''%
Line 663: Line 896:
# '''E'''osinophils: '''3'''%
# '''E'''osinophils: '''3'''%
# '''B'''asophils: '''1'''%
# '''B'''asophils: '''1'''%
<br><br>
 
<font color="Navy">'''10. CAUSES'''</font>
</div></div>
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''10. Causes'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==Metabolic Acidosis Causes==
==Metabolic Acidosis Causes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''MUDPILES'''}}</font>
<font color="red">{{cquote|'''MUDPILES'''}}</font>
* '''M'''ethanol poisoning
* '''M'''ethanol poisoning
Line 675: Line 921:
* '''E'''thanol poisoning
* '''E'''thanol poisoning
* '''S'''alicylate ingestion
* '''S'''alicylate ingestion
</div></div>


==Metabolic Acidosis (Normal Anion-Gap) Causes==
==Metabolic Acidosis (Normal Anion-Gap) Causes==
<div class="mw-collapsible mw-collapsed">
===With Hyperkalemia===
===With Hyperkalemia===
<font color="red">{{cquote|'''RAISE K+'''}}</font>  
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''RAISE K+'''}}</font>
* RTA type 4
* RTA type 4
* Aldosterone or mineralocorticord deficiency
* Aldosterone or mineralocorticord deficiency
* Iatrogenic: NH4Cl, HCl
* Iatrogenic: NH4Cl, HCl
* "Stenosis": obstructive uropathy
* "Stenosis": obstructive uropathy
* Early uremia  
* Early uremia
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
===With hypokalemia===
===With hypokalemia===
<font color="red">{{cquote|'''ReDUCE K+'''}}</font>  
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ReDUCE K+'''}}</font>
* Renal TA type 1 and 2
* Renal TA type 1 and 2
* Diarrhoea
* Diarrhoea
Line 691: Line 949:
* Carbonate anhydrase inhibitor
* Carbonate anhydrase inhibitor
* Ex-hyperventilation
* Ex-hyperventilation
</div></div>
<div class="mw-collapsible mw-collapsed">


==BUN & Creatinine Elevation Causes==
==BUN & Creatinine Elevation Causes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ABCD'''}}</font>
<font color="red">{{cquote|'''ABCD'''}}</font>
* '''A''' - '''A'''zotremia (pre-renal)
* '''A''' - '''A'''zotremia (pre-renal)
Line 698: Line 961:
* '''C''' - '''C'''atabolic status
* '''C''' - '''C'''atabolic status
* '''D''' - '''D'''iet (high protein parenteral nutrition)
* '''D''' - '''D'''iet (high protein parenteral nutrition)
</div></div>
<div class="mw-collapsible mw-collapsed">


==Hypercalcemia Causes==
==Hypercalcemia Causes==
<font color="red">{{cquote|'''PAM SCHMIDT'''}}</font>                      
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''PAM SCHMIDT'''}}</font>
* '''P'''aget's Disease
* '''P'''aget's Disease
* '''A'''myloid
* '''A'''myloid
Line 713: Line 981:


'''OR'''
'''OR'''
<font color="red">{{cquote|'''MISHAP'''}}</font>  
<font color="red">{{cquote|'''MISHAP'''}}</font>
* '''M'''alignancy
* '''M'''alignancy
* '''I'''ntoxication (hypervitaminosis)
* '''I'''ntoxication (hypervitaminosis)
Line 721: Line 989:
* '''P'''aget's Disease (bone)
* '''P'''aget's Disease (bone)
Also consider Addison's disease, thiazide diuretics and simple lab error
Also consider Addison's disease, thiazide diuretics and simple lab error
</div></div>
<div class="mw-collapsible mw-collapsed">


==Acute Pancreatitis Causes==
==Acute Pancreatitis Causes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''GET SMASHED'''}}</font>
<font color="red">{{cquote|'''GET SMASHED'''}}</font>
# '''G'''all stones
# '''G'''all stones
Line 735: Line 1,008:
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
Alcohol and Gallstones are the most common causes.
Alcohol and Gallstones are the most common causes.
</div></div>
<div class="mw-collapsible mw-collapsed">


==Back Pain Causes==
==Back Pain Causes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''DISK MASS'''}}</font>
<font color="red">{{cquote|'''DISK MASS'''}}</font>
* '''D'''-'''D'''egeneration: DJD, Osteoporosis, spondylosis
* '''D'''-'''D'''egeneration: DJD, Osteoporosis, spondylosis
Line 746: Line 1,024:
* '''S'''-'''S'''lipped disk, '''S'''pondylolisthesis
* '''S'''-'''S'''lipped disk, '''S'''pondylolisthesis
* '''S'''-'''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster
* '''S'''-'''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster
<br><br>
 
<font color="Navy">'''11. TREATMENT'''</font>
</div></div>
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''11. Treatment'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==Syncope Management==
==Syncope Management==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''If the face is red, raise the head!'''}}</font>
<font color="red">{{cquote|'''If the face is red, raise the head!'''}}</font>
<font color="red">{{cquote|'''If the face is pale, raise the tail!'''}}</font>
<font color="red">{{cquote|'''If the face is pale, raise the tail!'''}}</font>
</div></div>
<div class="mw-collapsible mw-collapsed">


==Malignant Hyperthermia Treatment==
==Malignant Hyperthermia Treatment==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Sunday Hot Day, Better Give Iced Fluids Today!'''}}</font>
<font color="red">{{cquote|'''Sunday Hot Day, Better Give Iced Fluids Today!'''}}</font>
* '''S'''- Stop all triggering agents, give 100% O2
* '''S'''- Stop all triggering agents, give 100% O2
Line 762: Line 1,058:
* '''F'''- Fluid Output; Furosemide
* '''F'''- Fluid Output; Furosemide
* '''T'''- Tachycardia, be prepared to treat V Tach
* '''T'''- Tachycardia, be prepared to treat V Tach
<br><br>
 
<font color="Navy">'''12. GENETICS'''</font>
</div></div>
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''12. Genetics'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==Down Syndrome Features==
==Down Syndrome Features==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''CHILD HAS PROBLEM!'''}}</font>
<font color="red">{{cquote|'''CHILD HAS PROBLEM!'''}}</font>
* '''C'''ongenital heart disease/ '''C'''ataracts
* '''C'''ongenital heart disease/ '''C'''ataracts
Line 770: Line 1,080:
* '''I'''ncure 5th finger/ '''I'''ncreased gap between 1st and 2nd toe
* '''I'''ncure 5th finger/ '''I'''ncreased gap between 1st and 2nd toe
* '''L'''eukemia risk x2/ '''L'''ung problem
* '''L'''eukemia risk x2/ '''L'''ung problem
* '''D'''uodenal atresia/ '''D'''elayed development  
* '''D'''uodenal atresia/ '''D'''elayed development
* '''H'''irshsprung's disease/ '''H'''earing loss
* '''H'''irshsprung's disease/ '''H'''earing loss
* '''A'''lzheimer's disease/ Alantoaxial instability
* '''A'''lzheimer's disease/ Alantoaxial instability
* '''S'''quint/ Short neck  
* '''S'''quint/ Short neck
* '''P'''rotruding tongue/ '''P'''alm crease
* '''P'''rotruding tongue/ '''P'''alm crease
* '''R'''ound face/ '''R'''olling eye (nystagmus)
* '''R'''ound face/ '''R'''olling eye (nystagmus)
Line 780: Line 1,090:
* '''L'''ow nasal bridge/ '''L'''anguage problem
* '''L'''ow nasal bridge/ '''L'''anguage problem
* '''E'''picanthic fold/ '''E'''ar folded
* '''E'''picanthic fold/ '''E'''ar folded
* '''M'''ental retardation/ '''M'''yoclonus  
* '''M'''ental retardation/ '''M'''yoclonus


<font color="red">{{cquote|'''DOWN'''}}</font>
<font color="red">{{cquote|'''DOWN'''}}</font>
Line 786: Line 1,096:
* '''O'''ne extra chromosome twenty-one
* '''O'''ne extra chromosome twenty-one
* '''W'''omen of advanced age
* '''W'''omen of advanced age
* '''N'''on-disjunction during maternal meiosis  
* '''N'''on-disjunction during maternal meiosis


<font color="red">{{cquote|'''Drink at 21'''}}</font>
<font color="red">{{cquote|'''Drink at 21'''}}</font>
Chromosome 21
Chromosome 21
</div></div>
<div class="mw-collapsible mw-collapsed">


==Patau's Syndrome - Chromosome 13==
==Patau's Syndrome - Chromosome 13==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''P'''uberty at 13}}</font>
<font color="red">{{cquote|'''P'''uberty at 13}}</font>
</div></div>
<div class="mw-collapsible mw-collapsed">


==Edward's Syndrome - Chromosome 18==
==Edward's Syndrome - Chromosome 18==
<div class="mw-collapsible-content">
<font color="red">{{cquote|Election voter at 18}}</font>
<font color="red">{{cquote|Election voter at 18}}</font>
</div></div>
<div class="mw-collapsible mw-collapsed">


==DiGeorge (Velocardiofacial) Syndrome==
==DiGeorge (Velocardiofacial) Syndrome==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''CATCH 22'''}}</font>
<font color="red">{{cquote|'''CATCH 22'''}}</font>
* '''C'''ardiac abnormalities
* '''C'''ardiac abnormalities
Line 804: Line 1,129:
* '''C'''left palate
* '''C'''left palate
* '''H'''ypocalcemia
* '''H'''ypocalcemia
* '''22'''q11 deletion  
* '''22'''q11 deletion
 
</div></div>
<div class="mw-collapsible mw-collapsed">


==Marfan Syndrome Features==
==Marfan Syndrome Features==
<div class="mw-collapsible-content">
# '''M'''itral valve prolapse - MVP
# '''M'''itral valve prolapse - MVP
# '''A'''ortic Aneurysm
# '''A'''ortic Aneurysm
Line 812: Line 1,142:
# '''F'''ibrillin
# '''F'''ibrillin
# '''A'''rachnodactyly
# '''A'''rachnodactyly
# '''N'''egative '''N'''itroprusside test (differentiates from homocystinuria)  
# '''N'''egative '''N'''itroprusside test (differentiates from homocystinuria)
 
</div></div>
<div class="mw-collapsible mw-collapsed">


==Adult Polycystic Kidney Disease==
==Adult Polycystic Kidney Disease==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'"Polycystic kidney"' has '''16 letters'''}}</font>
<font color="red">{{cquote|'"Polycystic kidney"' has '''16 letters'''}}</font>
Also,  and is due to a defect on chromosome 16.
Also,  and is due to a defect on chromosome 16.
<font color="red">{{cquote|'''APKD'''}}</font>
<font color="red">{{cquote|'''APKD'''}}</font>
ADult Polycystic Kidney Disease is  Autosomal Dominant
ADult Polycystic Kidney Disease is  Autosomal Dominant
<br><br>
 
<font color="Navy">'''13. PEDIATRICS'''</font>
</div></div>
 
</div></div>
 
<div class="mw-collapsible mw-collapsed">
 
<font color="Navy">'''13. Pediatrics'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==APGAR Score==
==APGAR Score==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''APGAR'''}}</font>
<font color="red">{{cquote|'''APGAR'''}}</font>
* '''A'''ppearance (color): blue/pale, trunk pink, all pink
* '''A'''ppearance (color): blue/pale, trunk pink, all pink
Line 829: Line 1,177:
* '''R'''espiration (respiratory effort): 0, irregular, regular
* '''R'''espiration (respiratory effort): 0, irregular, regular
- Score 0-2 at 1 and 5 minutes in each of 5 categories, being 10 the perfect score.
- Score 0-2 at 1 and 5 minutes in each of 5 categories, being 10 the perfect score.
</div></div>

Latest revision as of 23:03, 3 February 2014

WikiDoc Board Review
The Project
The Team
Guidelines
Question List
Quality Checklist
Medical Illustrations
Question Template
High Yield!
Normal Labs
Mnemonics
Test Taking Tips
Resources

1. Anatomy

GI Anatomy

“ Dow Jones Industrial Average Closing Stock Report ”

From proximal to distal:

  1. Duodenum
  2. Jejunum
  3. Ileum
  4. Appendix
  5. Colon
  6. Sigmoid
  7. Rectum

Brachial Plexus Organization

“ Radical Teachers Drink Cold Beers ”

“ Randy Travis Drinks Cold Beers ”

“ Robert Taylor Drinks Cold Beer ”

“ Red Trucks Drive Cats Nuts ”
  1. Roots
  2. Trunks
  3. Divisions
  4. Cords
  5. Branches

Cranial Nerves

“ On Old Olympus Towering Tops, A Finn And German Viewed Some Hops ”

“ Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen ”
  1. I - olfactory
  2. II - optic
  3. III - oculomotor
  4. IV - trochlear
  5. V - trigeminal
  6. VI - abducens
  7. VII - facial
  8. VIII - acoustic (vestibulocochlear)
  9. IX - glossophrayngeal
  10. X - vagus
  11. XI - accessory
  12. XII - hypoglossal

Extraocular Muscles Innervation

“ LR6 SO4 3 ”
  • LR 6 - Lateral Rectus by the VI cranial nerve (Abducens)
  • SO 4 - Superior Oblique by the IV cranial nerve (Trochlear)
  • 3 - The remaining by the III cranial nerve (Occulomotor)

“ LAST ”
  • L - Lateral Rectus
  • A - Abducens Nerve
  • S - Superior Oblique
  • T - Trochlear Nerve

Facial Nerve Branches

“ Two Zebras Bought My Car ”

“ Two Zebras Bit My Cookie ”

“ To Zanzibar By Motor Car ”

“ Ten Zulus Buggered My Cat ”
  1. Temporal
  2. Zygomatic
  3. Buccal
  4. Mandibular
  5. Cervical

Penis Innervation

“ Point and Shoot ”
  • Parasympathetic causes erection
  • Sympathetic causes ejaculation

“ S2, 3, 4 keep the penis off the floor ”
  • Innervation of the penis by branches of the pudendal nerve, derived from spinal cord levels S 2-4

Aorta Branches

“ ABC'S ”
  • Aortic arch gives off the:
  1. B - Bracheiocephalic trunk
  2. C - Left Common Carotid
  3. S - Left Subclavian artery

Femoral Triangle Structures in Order

“ N (AVEL) ”
  • Nerve
  • Artery
  • Vein
  • Empty space
  • Lymphatics

- Parenthesis includes things contained in the femoral sheath.

2. Cell Biology

Cell Division Phases

“ People Meet And Talk ”
  • P - Prophase
  • M - Metaphase
  • A - Anaphase
  • T - Telophase

Cell Cycle Stages

“ Go Sally Go! Make Children! ”
  • G1 phase - Growth phase 1
  • S phase - DNA synthesis
  • G2 phase - Growth phase 2
  • M phase - Mitosis
  • C phase - Cytokinesis

Golgi Complex Functions

“ Golgi Distributes A SPAM ”
  • Distributes proteins and lipids from ER
  • Add mannose onto specific lysosome proteins
  • Sulfation of sugars and slected tyrosine
  • Proteoglycan assembly
  • Add O-oligosugars to serine and threnonine
  • Modify N-ologosugars on asparagine

Collagen

“ COLLAGEN ”
  • C - C-terminal propeptide (procollagen) / Covalent Cross links/ C vitamin/ Connective tissue/ Cartilage/Chondroblasts/Copper Cofactor (Covalent Cross linking)
  • O - Outside the cell is where collagen normally functions/ Osteoblasts/ Osteogenesis imperfecta
  • L - Lysyl hydroxylase / Lysyl oxidase (oxidatively deaminates lysyl and hydroxylysyl residues to form collagen cross links, last biosynthesis step)
  • L - Long triple helical fibers / Ligaments
  • A - Alpha chains / Attached by H bonds form triple helix / Ascorbate for hydroxylation of lysyl and prolyl residues of pro-Alpha chains

(postranslational modification)

  • G - Gly in every third position / Glycosylation of hydroxyl group of hydroxylysine with Glucose and Galactose;GOlgi allows procollagen to GO outside of cell
  • E - Extracellular matrix / Eye (cornea, sclera) / Ehlers-Danlos Syndrome
  • N - N-terminal propeptide (procollagen) / Nonhelical terminal extensions

3. Molecular Biology

Carbon Monoxide: Electron Transport Chain Target

“ CO blocks CO ”

Carbon monoxide (CO) blocks Cytochrome Oxidase (CO)

Hemoglobin Binding Curve: Right Shift Causes

“ CADET, face right! ”
  • C = Increase in carbon dioxide
  • A = Acidosis (low ph)
  • D = Increase in 2,3 DPG aka 2,3 BPG
  • E = Exercise
  • T = increase in temperature

G-proteins Receptors

“ QISS & QIQ" (Kiss and Kick) ”

In alphabetical order

  • Q: alpha 1
  • I: alpha 2
  • S: beta 1
  • S: beta 2
  • &
  • Q: M1
  • I: M2
  • Q: M3

Adrenaline Mechanism

“ ABC of Adrenaline ”
  • Adrenaline--> activates
  • Beta receptors--> increases
  • Cyclic AMP

4. Biochemistry

Enzymes Classification

“ Over The HILL ”
  • O - Oxidoreductases
  • T - Transferases
  • H - Hydrolases
  • I - Isomerases
  • L - Ligases
  • L - Lyases

Glycolysis Enzymes

“ Hungry Peter Pan And The Growling Pink Panther Eat Pies ”
  • Hexokinase
  • Phosphohexo isomerase
  • Phosphofructokinase-1 (6-phosphofructo-1 kinase)
  • Aldolase, Triose phosphate isomerase
  • Glyceraldehyde 3-phosphate dehydrogenase
  • Phosphoglycerate kinase
  • Phosphoglycerate mutase
  • Enolase
  • Pyruvate kinase

Glycolysis Steps

“ Goodness Gracious, Father Franklin Did Go By Picking Pumpkins (to) Prepare Pies ”
  • Glucose
  • Glucose-6-P
  • Fructose-6-P
  • Fructose-1,6-diP
  • Dihydroxyacetone-P
  • Glyceraldehyde-P
  • 1,3-Biphosphoglycerate
  • 3-Phosphoglycerate
  • 2-Phosphoglycerate (to)
  • Phosphoenolpyruvate [PEP] Pyruvate • 'Did', 'By' and 'Pies' tell you the first part of those three: di-, bi-, and py-.

• 'PrEPare' tells location of PEP in the process.

5. Metabolism


Metabolism Sites

“ Use both arms to HUG ”
  1. Heme synthesis
  2. Urea cycle
  3. Gluconeogenesis

These reactions occur in both cytoplasm and mitochondria

AcetylCoA and AcetacetylCoA

“ A Lighter Lease (A LyTr LeIs) ”

Amino acids forming them:

  • A=AcetylCoA or Acetoacetyl CoA
  • Ly=Lysine
  • Tr=Tryptophan
  • Le=Leucine
  • Is=Isoleucine

Citric Acid Cycle Compounds

“ Our City Is Kept Safe And Sound From Malice ”
  • Oxaloacetate
  • Citrate
  • Isocitrate
  • alpha-Ketoglutarate
  • Succinyl-CoA
  • Succinate
  • Fumarate
  • Malate

“ Can I Keep Selling Sex For Money, Officer? ”
  • Citrate
  • Isocitrate
  • alpha-Ketogluterate
  • Succinyl CoA
  • Succinate
  • Fumerate
  • Malate
  • Oxaloacetate

“ Oh! Can I Keep Some Succinate For Myself? ”

“ Oh Citric Acid Is Of (course) A SiLly STupid Funny Molecule ”
  • Oxaloacetate
  • Citrate
  • Isocitrate, alpha-Ketoglutarate
  • Succinyl CoA
  • Succinate
  • Fumarate
  • Malate

Citric Acid Cycle Enzymes

“ Corrupt Anti Intelligence Agent Spoke Slander For Money ”
  • Citrate synthatase
  • Aconitase
  • Isocitrate dehydrogenase
  • Alpha ketogluturate dehydrogenase
  • Succinyl CoA synthetase
  • Succinate dehydrogenase
  • Fumarase
  • Malate Dehydrogenase

Essential Amino Acids

“ P ri V a T e TIM HALL ”

“ PVT. TIM HALL ”

“ "PVT. TIM HALL always argues, never tires" ”
  • P - Phe
  • V - Val
  • T - Thr
  • T - Trp
  • I - Ile
  • M - Met
  • H - His
  • A - Arg
  • L - Leu
  • L - Lys
  • Pvt. is short for Private in the military
  • Arg and His are considered semi-essential
  • Alternatively: MATT VIL PHLy

Creatine Phosphate: Amino Acid Precursors

“ Nice GAMs! ”
  • G - Glycine
  • A - Arginine
  • M - Methionine

Branched Chain Amino Acids Catabolism Steps

“ Truck hit the Ox to Death ”
  • T - Transamination
  • O - Oxidative decarboxylation
  • D - Dehydrogenation

Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)

“ Muscles LIVe fast ”
  • Leucine
  • Isoleucine
  • Valine

Urea Cycle

“ Ordinarily Careless Crappers Are Also Frivolous About Urination! ”
  • O - Ornithine
  • C - Carbamoyl
  • C - Citrulline
  • A - Aspartate
  • A - Arginosuccinate
  • F - Fumarate
  • A - Arginine
  • U - Urea

Pyrimidines Nucleotides

“ CUT the PY (pie) ”
  • Cytosine
  • Uracil
  • Thiamine
  • The
  • PYrimidines

6. Enzyme Deficiencies

G6PD: Oxidant Drugs Inducing Hemolytic Anemia

“ AAA ”
  • Antibiotic (eg: sufamethoxazole)
  • Antimalarial (eg: primaquine)
  • Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)

Pompe's Disease

“ Type "Police: Po + lys" ”
  • POmpe's disease is a LYSosomal storage disease (alpha 1,4 glucosidase)

Galactosemia

“ GALIPUT ”
  • Galactose 1 Phosphate Uridyl Transferase
  • There is an assay called the Galiput test for this

Fabry's Disease

“ FABRY ' S ”
  • F - Foam cells found in glomeruli and tubules / Febrile episodes
  • A - Alpha galactosidase A deficiency / Angiokeratomas
  • B - Burning pain in extremities / BUN increased in serum / Boys
  • R - Renal failure
  • Y - YX genotype (male, X linked recessive)
  • S - Sphingolipidoses

Hurler Syndrome Features

“ HURLER'S ”
  • Heptosplenomegaly
  • Ugly facies
  • Recessive (AR inheritance)
  • L-iduronidase deficiency (alpha)
  • Eyes clouded
  • Retarded
  • Stubby fingers/Short

Acute Intermittent Porphyria

“ 5 P's ”
  • Pain in abdomen
  • Polyneuropathy
  • Psychologial abnormalities
  • Pink urine
  • Precipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)

7. Vitamins

B Vitamins

“ The Rhythm Nearly Proved Contagious ”

In increasing order:

  • T - Thiamine (B1)
  • R - Riboflavin (B2)
  • N - Niacin (B3)
  • P - Pyridoxine (B6)
  • C - Cobalamin (B12)

Niacin Deficiency

“ The famous 4 D's ”
  1. Diarrhea
  2. Dermatitis
  3. Dementia
  4. Death (if untreated)

“ The 3D's of pellagra ”

Vitamin B3 (niacin, nicotinic acid) deficiency

  1. Dermatitis
  2. Diarrhea
  3. Dementia

Folate Deficiency Causes

“ A FOLIC DROP ”
  • Alcoholism
  • Folic acid antagonists
  • Oral contraceptives
  • Low dietary intake
  • Infection with Giardia
  • Celiac sprue
  • Dilatin
  • Relative folate deficiency
  • Old
  • Pregnant

Fat Soluble Vitamins

“ The FAT cat is in the ADEK (attic) ”

Fat soluble vitamins are A,D,E,K.'

Hypervitaminosis A

“ Increased Vitamin A makes you HARD ”
  • H - Headache / Hepatomegaly
  • A - Anorexia / Alopecia
  • R - Really painful bones
  • D - Dry skin / Drowsiness

8. History Taking

Alcoholism Screening

“ CAGE ”
  • Have you ever felt it necessary to CUT DOWN on your drinking?
  • Have you ever been ANNOYED when people suggest you cut down on your drinking?
  • Have you ever felt GUILTY about your drinking?
  • Have you ever felt the need to have a drink in the morning for an EYE OPENER?

Chief Complaint

“ OPQRST ”
  • O - Onset of pain: what was the patient doing when the pain started?
  • P - Palliative or Provocative factors for the pain
  • Q - Quality of pain (burning, stabbing, aching, etc.)
  • R - Radiation (up to jaw, down left arm, etc.)
  • S - Severity of pain (usually 1 - 10 scale)
  • T - Timing of pain (eg: after meals, in the morning, how long it lasts, etc.)

“ SOCRATES ”
  • S - Site of pain
  • O - Onset of pain
  • C - Character of pain: dull, sharp, aching, stabbing, tearing
  • R - Radiation of pain: central abdominal pain radiating to Right Iliac Fossa
  • A - Associated factors: eg. nausea/vomiting
  • T - Timing of pain/duration
  • E - Exacerbating/alleviating factors
  • S - Severity of pain (1 - 10 scale)

“ ASCLAST ”
  • A - Aggravatiing and Alleviating factors
  • S - Severity
  • C - Character, quality
  • L - Location
  • A - Associated symptoms
  • S - Setting
  • T - Timing

NOTE: ASCLAST means let the patient talk first, then ask him/her specific questions.

Hospital Admission Orders

“ DAVE WILMINGTON ”
  • Diet
  • Activity
  • Vital signs: how often to monitor
  • Excrement: test urine/stool
  • Weight: how often to monitor
  • I / O: monitor input/output
  • Labs: which/how often
  • Meds: which/route/interval
  • I V fluids: what/at what rate
  • Nursing care: e.g. position, wound care, up in chair, ostomy care
  • General care: e.g. physical/respiratory therapy
  • Tests: e.g. X-ray/EKG/EEG
  • Observe for: reaction/seizure/neuro exams
  • Notify parameters: e.g. Temperature > 100 F / respiration changes

After noting date and time of admission as well as diagnosis and condition (ADC), use the mnemonic to ensure all areas are addressed, but not all apply to every patient.

“ ADC VAAN DIML, pronounced ADC van dim(e)L ”
  • Admit: 23 hours, full admit, service of attending
  • Diagnosis
  • Condition: "Stable"/"Guarded"
  • Vitals: post-op, routine, q 1 hour
  • Allergies
  • Activities: strict bed rest/fall precautions/ad lib/bathroom privileges
  • Nursing: strict I&O's/daily weights/call P.R.N.
  • Diet: NPO/regular/clears/advance diet as tolerated/2000 cal ADA/renal
  • IV fluids: D5, 1/2 NS, 20 KCL at 110 ml/hr, LR @ 100 ml/hr
  • Meds: scheduled and PRN's
  • Labs and X-ray: CBC in AM, PCXR in PACU

Note that IV fluids follows Diet. If one writes NPO, then all such patients get maintenance fluids (use the 4-2-1 rule).

Post-Op Fever Causes

“ Five W's ”
  • Wind: pneumonia, atelectasis
  • Wound: wound infections
  • Water: urinary tract infection
  • Walking: DVT/PE (walking can help reduce DVT/PE)
  • Wonderdrugs: especially anesthesia

Predisposing Conditions for Pulmonary Embolism

“ TOM SCH PREFER ”
  • T - Trauma
  • O - Obesity
  • M - Malignancy
  • S - Surgery
  • C - Cardiac disease
  • H - Hospitalization
  • P - Past history
  • R - Rest (bed-bound)
  • E - Estrogen, pregnancy, post-partum
  • F - Fracture
  • E - Elderly
  • R - Road trip

Compartment Syndrome Signs (Arterial Occlusion)

“ 6 P's ”
  1. Pain
  2. Pale (Pallor)
  3. Perishing with Cold (Poikilothermia)
  4. Pulseless
  5. Paresthesias
  6. Paralysis

9. Pathology

Causes of Diseases

“ VITAMIN C ”
  • Vascular
  • Infectious
  • Trauma
  • Auto-immune
  • Metabolic
  • Idiopathic/Iatrogenic
  • Neoplastic
  • Congenital

Signs of Inflammation

  1. Rubor: redness/erythema
  2. Calor: raised temperature
  3. Tumor: swelling
  4. Dolor: pain
  5. Functio Laesa: loss of function

- Described by Celsus

Hypersentivity Reactions (Gell & Goombs Classification)

“ ACID ”
“ Anna Cycled Immediately Downhill ”
  1. Type I Anaphylaxis
  2. Type II Cytotoxic-mediated
  3. Type III Immune-complex
  4. Type IV Delayed hypersensitivity

Multiple Endocrine Neoplasia (MEN)

Each of the MENs is a disease of three or two letters plus a feature; all are autosomal dominant.

“ MEN I: 3 P's ”
  1. Pituitary
  2. Parathyroid
  3. Pancreas
  4. Plus Adrenal cortex

“ MEN II: 2 C's ”
  1. Carcinoma of thyroid
  2. Catacholamines (pheochromocytoma)

- MEN IIA: parathyroid - MEN IIB (MEN III): mucocutaneous neuromas for

Acute Pneumonia Infiltrates

  • Pyogenic bacteria: PMN infiltrate
  • Miscellaneous microbes: Mononuclear infiltrate

Takayasu's Disease/Pulseless Disease

“ When you have Takayasu's, I can't Tak'a yu pulse ”

CBC Normal Differential

“ Never Let Monkeys Eat Bananas ”

“ Nice Ladies Make Easter Bread" ”

“ 60, 30, 6, 3, 1 ”
  1. Neutrophils: 60%
  2. Lymphocytes: 30%
  3. Monocytes: 6%
  4. Eosinophils: 3%
  5. Basophils: 1%

10. Causes

Metabolic Acidosis Causes

“ MUDPILES ”
  • Methanol poisoning
  • Uremia
  • Diabetic Keto-acidosis
  • Para-aldehyde ingestion
  • Ischemia
  • Lactic Acidosis
  • Ethanol poisoning
  • Salicylate ingestion

Metabolic Acidosis (Normal Anion-Gap) Causes

With Hyperkalemia

“ RAISE K+ ”
  • RTA type 4
  • Aldosterone or mineralocorticord deficiency
  • Iatrogenic: NH4Cl, HCl
  • "Stenosis": obstructive uropathy
  • Early uremia

With hypokalemia

“ ReDUCE K+ ”
  • Renal TA type 1 and 2
  • Diarrhoea
  • Urine diversion into gut
  • Carbonate anhydrase inhibitor
  • Ex-hyperventilation

BUN & Creatinine Elevation Causes

“ ABCD ”
  • A - Azotremia (pre-renal)
  • B - Bleeding (GI)
  • C - Catabolic status
  • D - Diet (high protein parenteral nutrition)

Hypercalcemia Causes

“ PAM SCHMIDT ”
  • Paget's Disease
  • Amyloid
  • Multiple Myeloma
  • Sarcoid
  • Cancer
  • Hormomal (para-thyroid)
  • Milk-alkali Syndrome
  • Immobilization
  • D-vitamin overdose
  • Thyrotoxicosis

OR

“ MISHAP ”
  • Malignancy
  • Intoxication (hypervitaminosis)
  • Sarcoidosis
  • Hyperparathyroidism
  • Alkali (Milk) syndrome
  • Paget's Disease (bone)

Also consider Addison's disease, thiazide diuretics and simple lab error

Acute Pancreatitis Causes

“ GET SMASHED ”
  1. Gall stones
  2. Ethanol
  3. Trauma
  4. Steroids
  5. Mumps
  6. Autoimmune disease
  7. Scorpion venom
  8. Hyperlipidemia
  9. ERCP (dye)
  10. Drugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)

Alcohol and Gallstones are the most common causes.

Back Pain Causes

“ DISK MASS ”
  • D-Degeneration: DJD, Osteoporosis, spondylosis
  • I-Infection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture
  • S-Spondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
  • K-Kidney stones/infarction/infection (pyelo/abscess)
  • M-Multiple myeloma, Metastasis from breast, prostate, lung, thyroid, kidney CA
  • A-Aneurysm, Abdominal pain referred to the back (see acute abdominal pain)
  • S-Slipped disk, Spondylolisthesis
  • S-Strain, Scoliosis/lordosis, Skin: herpes zoster

11. Treatment

Syncope Management

“ If the face is red, raise the head! ”

“ If the face is pale, raise the tail! ”

Malignant Hyperthermia Treatment

“ Sunday Hot Day, Better Give Iced Fluids Today! ”
  • S- Stop all triggering agents, give 100% O2
  • H- Hyperventillate
  • D- Dantrolene 2.5 mg/kg
  • B- Bicarbonate
  • G- Glucose and Insulin
  • I- IV Fluids, Cooling Blanket
  • F- Fluid Output; Furosemide
  • T- Tachycardia, be prepared to treat V Tach

12. Genetics

Down Syndrome Features

“ CHILD HAS PROBLEM! ”
  • Congenital heart disease/ Cataracts
  • Hypotonia/ Hypothyroidism
  • Incure 5th finger/ Increased gap between 1st and 2nd toe
  • Leukemia risk x2/ Lung problem
  • Duodenal atresia/ Delayed development
  • Hirshsprung's disease/ Hearing loss
  • Alzheimer's disease/ Alantoaxial instability
  • Squint/ Short neck
  • Protruding tongue/ Palm crease
  • Round face/ Rolling eye (nystagmus)
  • Occiput flat/ Oblique eye fissure
  • Brushfield spot/ Brachycephaly
  • Low nasal bridge/ Language problem
  • Epicanthic fold/ Ear folded
  • Mental retardation/ Myoclonus

“ DOWN ”
  • Decreased alpha-fetoprotein and unconjugated estriol (maternal)
  • One extra chromosome twenty-one
  • Women of advanced age
  • Non-disjunction during maternal meiosis

“ Drink at 21 ”

Chromosome 21

Patau's Syndrome - Chromosome 13

“ Puberty at 13 ”

Edward's Syndrome - Chromosome 18

“ Election voter at 18 ”

DiGeorge (Velocardiofacial) Syndrome

“ CATCH 22 ”
  • Cardiac abnormalities
  • Abnormal facies
  • Thymic aplasia
  • Cleft palate
  • Hypocalcemia
  • 22q11 deletion

Marfan Syndrome Features

  1. Mitral valve prolapse - MVP
  2. Aortic Aneurysm
  3. Retinal detachment
  4. Fibrillin
  5. Arachnodactyly
  6. Negative Nitroprusside test (differentiates from homocystinuria)

Adult Polycystic Kidney Disease

“ '"Polycystic kidney"' has 16 letters ”

Also, and is due to a defect on chromosome 16.

“ APKD ”

ADult Polycystic Kidney Disease is Autosomal Dominant

13. Pediatrics

APGAR Score

“ APGAR ”
  • Appearance (color): blue/pale, trunk pink, all pink
  • Pulse (heart rate): 0, <100, 100+
  • Grimace (reflex irritability): 0, grimace, grimace+cough
  • Activity (muscle tone): limp, some, active
  • Respiration (respiratory effort): 0, irregular, regular

- Score 0-2 at 1 and 5 minutes in each of 5 categories, being 10 the perfect score.

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