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{{Board review project}}
{{Board review project}}
[[Image:Main_help_page_small.PNG|100px|link=Help]][[Image:Projects.PNG|100px|link=Projects]][[Image:Editor's_Tools.PNG|100px|link=Help Menu]]
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'''Editors-In-Chief:''' [[User:William J Gibson|William J. Gibson, B.S.]][mailto:willjgibson@gmail.com]; [[User:Gonzalo Romero|Gonzalo A. Romero, M.D.]][mailto:gromero@wikidoc.org]
 
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<font color="Navy">'''1. Anatomy'''</font>
 
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==GI Anatomy==
==GI Anatomy==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport}}</font>
<font color="red">{{cquote|'''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport}}</font>
''From proximal to distal:''
''From proximal to distal:''
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# '''R'''ectum
# '''R'''ectum


==Acute Pancreatitis Causes==
</div></div>
<font color="red">{{cquote|'''GET SMASHED'''}}</font>
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"'''GET SMASHED'''"
 
# '''G'''all stones
==Brachial Plexus Organization==
# '''E'''thanol
 
# '''T'''rauma
<div class="mw-collapsible-content">
# '''S'''teroids
<font color="red">{{cquote|'''Radical Teachers Drink Cold Beers'''}}</font>
# '''M'''umps
<font color="red">{{cquote|'''Randy Travis Drinks Cold Beers'''}}</font>
# '''A'''utoimmune disease
<font color="red">{{cquote|'''Robert Taylor Drinks Cold Beer'''}}</font>
# '''S'''corpion venom
<font color="red">{{cquote|'''Red Trucks Drive Cats Nuts'''}}</font>
# '''H'''yperlipidemia
# Roots
# '''E'''RCP (dye)
# Trunks
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
# Divisions
# Cords
# Branches
 
</div></div>
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==Cranial Nerves==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''On Old Olympus Towering Tops, A Finn And German Viewed Some Hops'''}}</font>
<font color="red">{{cquote|'''Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen'''}}</font>
# I - olfactory
# II - optic
# III - oculomotor
# IV - trochlear
# V - trigeminal
# VI - abducens
# VII - facial
# VIII - acoustic (vestibulocochlear)
# IX - glossophrayngeal
# X - vagus
# XI - accessory
# XII - hypoglossal
 
</div></div>
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==Extraocular Muscles Innervation==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''LR6 SO4 3'''}}</font>
* '''LR 6''' - '''L'''ateral '''R'''ectus by the '''VI'''  cranial nerve (Abducens)
* '''SO 4''' - '''S'''uperior '''O'''blique by the '''IV''' cranial nerve (Trochlear)
* '''3''' - The remaining by the '''III''' cranial nerve (Occulomotor)
 
<font color="red">{{cquote|'''LAST'''}}</font>
* '''L''' - '''L'''ateral Rectus
* '''A''' - '''A'''bducens Nerve
* '''S''' - '''S'''uperior Oblique
* '''T''' - '''T'''rochlear Nerve
 
</div></div>
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==Facial Nerve Branches==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Two Zebras Bought My Car'''}}</font>
<font color="red">{{cquote|'''Two Zebras Bit My Cookie'''}}</font>
<font color="red">{{cquote|'''To Zanzibar By Motor Car'''}}</font>
<font color="red">{{cquote|'''Ten Zulus Buggered My Cat'''}}</font>
# Temporal
# Zygomatic
# Buccal
# Mandibular
# Cervical
 
</div></div>
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==Penis Innervation==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''P'''oint and '''S'''hoot}}</font>
* '''P'''arasympathetic causes erection
* '''S'''ympathetic causes ejaculation
 
<font color="red">{{cquote|'''S2, 3, 4 keep the penis off the floor'''}}</font>
* Innervation of the penis by branches of the pudendal nerve, derived from spinal cord levels '''S 2-4'''
 
</div></div>
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==Aorta Branches==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ABC'S'''}}</font>
* '''A'''ortic arch gives off the:
# '''B''' - '''B'''racheiocephalic trunk
# '''C''' - Left '''C'''ommon '''C'''arotid
# '''S''' - Left '''S'''ubclavian artery
 
</div></div>
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==Femoral Triangle Structures in Order==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''N (AVEL)'''}}</font>
* '''N'''erve
* '''A'''rtery
* '''V'''ein
* '''E'''mpty space
* '''L'''ymphatics
- Parenthesis includes things contained in the femoral sheath.
 
</div></div>
 
</div></div>
 
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<font color="Navy">'''2. Cell Biology'''</font>
 
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==Cell Division Phases==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''People Meet And Talk'''}}</font>
* '''P''' - '''P'''rophase
* '''M''' - '''M'''etaphase
* '''A''' - '''A'''naphase
* '''T''' - '''T'''elophase
 
</div></div>
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==Cell Cycle Stages==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Go Sally Go! Make Children!'''}}</font>
* '''G1''' phase - Growth phase 1
* '''S''' phase - DNA synthesis
* '''G2''' phase - Growth phase 2
* '''M''' phase - Mitosis
* '''C''' phase - Cytokinesis
 
</div></div>
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==Golgi Complex Functions==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Golgi Distributes A SPAM'''}}</font>
* '''Distributes''' proteins and lipids from ER
* '''A'''dd mannose onto specific lysosome proteins
* '''S'''ulfation of sugars and slected tyrosine
* '''P'''roteoglycan assembly
* '''A'''dd O-oligosugars to serine and threnonine
* '''M'''odify N-ologosugars on asparagine
 
</div></div>
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==Collagen==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''COLLAGEN'''}}</font>
* '''C''' - '''C'''-terminal propeptide (procollagen) / '''C'''ovalent '''C'''ross links/ '''C''' vitamin/ '''C'''onnective tissue/ '''C'''artilage/'''C'''hondroblasts/'''C'''opper Cofactor (Covalent Cross linking)
* '''O''' - '''O'''utside the cell is where collagen normally functions/ '''O'''steoblasts/ '''O'''steogenesis imperfecta
* '''L''' - '''L'''ysyl hydroxylase / '''L'''ysyl oxidase (oxidatively deaminates lysyl and hydroxylysyl residues to form collagen cross links, last biosynthesis step)
* '''L''' - '''L'''ong triple helical fibers / '''L'''igaments
* '''A''' - '''A'''lpha chains / '''A'''ttached by H bonds form triple helix / '''A'''scorbate for hydroxylation of lysyl and prolyl residues of pro-Alpha chains
(postranslational modification)
* '''G''' - '''G'''ly in every third position / '''G'''lycosylation of hydroxyl group of hydroxylysine with '''G'''lucose and '''G'''alactose;'''GO'''lgi allows procollagen to '''GO''' outside of cell
* '''E''' - '''E'''xtracellular matrix / '''E'''ye (cornea, sclera) / '''E'''hlers-Danlos Syndrome
* '''N''' - '''N'''-terminal propeptide (procollagen) / '''N'''onhelical terminal extensions
 
</div></div>
 
</div></div>
 
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<font color="Navy">'''3. Molecular Biology'''</font>
 
<div class="mw-collapsible-content">
 
<div class="mw-collapsible mw-collapsed">
 
==Carbon Monoxide: Electron Transport Chain Target==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''CO blocks CO'''}}</font>
Carbon monoxide '''(CO)''' blocks Cytochrome Oxidase '''(CO)'''
 
</div></div>
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==Hemoglobin Binding Curve: Right Shift Causes==
 
<div class="mw-collapsible-content">
 
<font color="red">{{cquote|'''CADET, face right!'''}}</font>
* 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
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==G-proteins Receptors==
 
<div class="mw-collapsible-content">
 
<font color="red">{{cquote|'''QISS & QIQ" (Kiss and Kick)'''}}</font>
In alphabetical order
* Q: alpha 1
* I: alpha 2
* S: beta 1
* S: beta 2
* &
* Q: M1
* I: M2
* Q: M3
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Adrenaline Mechanism==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ABC of Adrenaline'''}}</font>
* Adrenaline--> activates
* Beta receptors--> increases
* Cyclic AMP
 
</div></div>
 
</div></div>
 
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<font color="Navy">'''4. Biochemistry'''</font>
 
<div class="mw-collapsible-content">
 
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==Enzymes Classification==
 
<div class="mw-collapsible-content">
 
<font color="red">{{cquote|'''Over The HILL'''}}</font>
* '''O''' - '''O'''xidoreductases
* '''T''' - '''T'''ransferases
* '''H''' - '''H'''ydrolases
* '''I''' - '''I'''somerases
* '''L''' - '''L'''igases
* '''L''' - '''L'''yases
 
</div></div>
 
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==Glycolysis Enzymes==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Hungry Peter Pan And The Growling Pink Panther Eat Pies'''}}</font>
* Hexokinase
* Phosphohexo isomerase
* Phosphofructokinase-1 (6-phosphofructo-1 kinase)
* Aldolase, Triose phosphate isomerase
* Glyceraldehyde 3-phosphate dehydrogenase
* Phosphoglycerate kinase
* Phosphoglycerate mutase
* Enolase
* Pyruvate kinase
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Glycolysis Steps==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Goodness Gracious, Father Franklin Did Go By Picking Pumpkins (to) Prepare Pies'''}}</font>
* 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.
 
</div></div>
 
</div></div>
 
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<font color="Navy">'''5. Metabolism'''</font>
 
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<div class="mw-collapsible mw-collapsed">
 
 
==Metabolism Sites==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Use both arms to HUG'''}}</font>
# Heme synthesis
# Urea cycle
# Gluconeogenesis
These reactions occur in both cytoplasm and mitochondria
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==AcetylCoA and AcetacetylCoA==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''A Lighter Lease (A LyTr LeIs)'''}}</font>
Amino acids forming them:
* A=AcetylCoA or Acetoacetyl CoA
* Ly=Lysine
* Tr=Tryptophan
* Le=Leucine
* Is=Isoleucine
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Citric Acid Cycle Compounds==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Our City Is Kept Safe And Sound From Malice'''}}</font>
* Oxaloacetate
* Citrate
* Isocitrate
* alpha-Ketoglutarate
* Succinyl-CoA
* Succinate
* Fumarate
* Malate
 
<font color="red">{{cquote|'''Can I Keep Selling Sex For Money, Officer?'''}}</font>
* Citrate
* Isocitrate
* alpha-Ketogluterate
* Succinyl CoA
* Succinate
* Fumerate
* Malate
* Oxaloacetate
 
<font color="red">{{cquote|'''Oh! Can I Keep Some Succinate For Myself?'''}}</font>
<font color="red">{{cquote|'''Oh Citric Acid Is Of (course) A SiLly STupid Funny Molecule'''}}</font>
* Oxaloacetate
* Citrate
* Isocitrate, alpha-Ketoglutarate
* Succinyl CoA
* Succinate
* Fumarate
* Malate
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Citric Acid Cycle Enzymes==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Corrupt Anti Intelligence Agent Spoke Slander For Money'''}}</font>
* Citrate synthatase
* Aconitase
* Isocitrate dehydrogenase
* Alpha ketogluturate dehydrogenase
* Succinyl CoA synthetase
* Succinate dehydrogenase
* Fumarase
* Malate Dehydrogenase
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==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|'''PVT. TIM HALL'''}}</font>
<font color="red">{{cquote|'''"PVT. TIM HALL always argues, never tires"'''}}</font>
* '''P''' - '''P'''he
* '''V''' - '''V'''al
* '''T''' - '''T'''hr
* '''T''' - '''T'''rp
* '''I''' - '''I'''le
* '''M''' - '''M'''et
* '''H''' - '''H'''is
* '''A''' - '''A'''rg
* '''L''' - '''L'''eu
* '''L''' - '''L'''ys
* Pvt. is short for Private in the military
* Arg and His are considered semi-essential
* Alternatively: '''MATT VIL PHLy'''
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Creatine Phosphate: Amino Acid Precursors==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Nice GAMs!'''}}</font>
* '''G''' - '''G'''lycine
* '''A''' - '''A'''rginine
* '''M''' - '''M'''ethionine
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Branched Chain Amino Acids Catabolism Steps==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Truck hit the Ox to Death'''}}</font>
* '''T''' - '''T'''ransamination
* '''O''' - '''O'''xidative decarboxylation
* '''D''' - '''D'''ehydrogenation
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Muscles LIVe fast'''}}</font>
* Leucine
* Isoleucine
* Valine
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==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>
* '''O''' - '''O'''rnithine
* '''C''' - '''C'''arbamoyl
* '''C''' - '''C'''itrulline
* '''A''' - '''A'''spartate
* '''A''' - '''A'''rginosuccinate
* '''F''' - '''F'''umarate
* '''A''' - '''A'''rginine
* '''U''' - '''U'''rea
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Pyrimidines Nucleotides==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''CUT the PY (pie)'''}}</font>
* '''C'''ytosine
* '''U'''racil
* '''T'''hiamine
* '''T'''he
* '''PY'''rimidines
 
</div></div>
 
</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>
* Antibiotic (eg: sufamethoxazole)
* Antimalarial (eg: primaquine)
* Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Pompe's Disease==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''Type "Police: Po + lys"'''}}</font>
* '''PO'''mpe's disease is a '''LYS'''osomal storage disease (alpha 1,4 glucosidase)
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Galactosemia==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''GALIPUT'''}}</font>
* Galactose 1 Phosphate Uridyl Transferase
* There is an assay called the Galiput test for this
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Fabry's Disease==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''FABRY ' S'''}}</font>
* '''F''' - '''F'''oam cells found in glomeruli and tubules / '''F'''ebrile episodes
* '''A''' - '''A'''lpha galactosidase '''A''' deficiency / '''A'''ngiokeratomas
* '''B''' - '''B'''urning pain in extremities / '''B'''UN increased in serum / '''B'''oys
* '''R''' - '''R'''enal failure
* '''Y''' - '''Y'''X genotype (male, X linked recessive)
* '''S''' - '''S'''phingolipidoses
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Hurler Syndrome Features==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''HURLER'S'''}}</font>
*'''H'''eptosplenomegaly
*'''U'''gly facies
*'''R'''ecessive (AR inheritance)
*'''L'''-iduronidase deficiency (alpha)
*'''E'''yes clouded
*'''R'''etarded
*'''S'''tubby fingers/'''S'''hort
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Acute Intermittent Porphyria==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''5  P's '''}}</font>
* '''P'''ain in abdomen
* '''P'''olyneuropathy
* '''P'''sychologial abnormalities
* '''P'''ink urine
* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)
 
</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==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''The Rhythm Nearly Proved Contagious'''}}</font>
In increasing order:
* '''T''' - '''T'''hiamine (B1)
* '''R''' - '''R'''iboflavin (B2)
* '''N''' - '''N'''iacin (B3)
* '''P''' - '''P'''yridoxine (B6)
* '''C''' - '''C'''obalamin (B12)
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Niacin Deficiency==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''The famous 4 D's'''}}</font>
# Diarrhea
# Dermatitis
# Dementia
# Death (if untreated)
<font color="red">{{cquote|'''The 3D's of pellagra'''}}</font>
Vitamin B3 (niacin, nicotinic acid) deficiency
# Dermatitis
# Diarrhea
# Dementia
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Folate Deficiency Causes==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''A FOLIC DROP'''}}</font>
* Alcoholism
* Folic acid antagonists
* Oral contraceptives
* Low dietary intake
* Infection with Giardia
* Celiac sprue
* Dilatin
* Relative folate deficiency
* Old
* Pregnant
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Fat Soluble Vitamins==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''The FAT cat is in the ADEK (attic)'''}}</font>
Fat soluble vitamins are ''A,D,E,K.'''
 
</div></div>
<div class="mw-collapsible mw-collapsed">
 
==Hypervitaminosis A==
 
<div class="mw-collapsible-content">
<font color="red">{{cquote|Increased Vitamin A makes you '''HARD'''}}</font>
* '''H''' - '''H'''eadache / '''H'''epatomegaly
* '''A''' - '''A'''norexia / '''A'''lopecia
* '''R''' - '''R'''eally painful bones
* '''D''' - '''D'''ry skin / '''D'''rowsiness


Alcohol and Gallstones are the most common causes.
</div></div>


==APGAR Score==
</div></div>
<font color="red">{{cquote|'''APGAR'''}}</font>
* '''A'''ppearance (color): blue/pale, trunk pink, all pink
* '''P'''ulse (heart rate): 0, <100, 100+
* '''G'''rimace (reflex irritability): 0, grimace, grimace+cough
* '''A'''ctivity (muscle tone): limp, some, active
* '''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.


==Multiple Endocrine Neoplasia (MEN)==
<div class="mw-collapsible mw-collapsed">
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>
# '''P'''ituitary
# '''P'''arathyroid
# '''P'''ancreas
# Plus Adrenal cortex


<font color="red">{{cquote|'''MEN II:  2 C's'''}}</font>
<font color="Navy">'''8. History Taking'''</font>
# '''C'''arcinoma of thyroid
# '''C'''atacholamines (pheochromocytoma)
- MEN IIA: parathyroid
- MEN IIB (MEN III): mucocutaneous neuromas for


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


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


==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==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''DAVE WILMINGTON'''}}</font>
* '''D'''iet
* '''A'''ctivity
* '''V'''ital signs: how often to monitor
* '''E'''xcrement: test urine/stool
* '''W'''eight: how often to monitor
* '''I''' / O: monitor input/output
* '''L'''abs: which/how often
* '''M'''eds: which/route/interval
* '''I''' V fluids: what/at what rate
* '''N'''ursing care: e.g. position, wound care, up in chair, ostomy care
* '''G'''eneral care: e.g. physical/respiratory therapy
* '''T'''ests: e.g. X-ray/EKG/EEG
* '''O'''bserve for: reaction/seizure/neuro exams
* '''N'''otify 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.
<font color="red">{{cquote|'''ADC VAAN DIML''', pronounced ADC van dim(e)L}}</font>
* '''A'''dmit: 23 hours, full admit, service of attending
* '''D'''iagnosis
* '''C'''ondition: "Stable"/"Guarded"
* '''V'''itals: post-op, routine, q 1 hour
* '''A'''llergies
* '''A'''ctivities: strict bed rest/fall precautions/ad lib/bathroom privileges
* '''N'''ursing: strict I&O's/daily weights/call P.R.N.
* '''D'''iet: NPO/regular/clears/advance diet as tolerated/2000 cal ADA/renal
* '''I'''V fluids: D5, 1/2 NS, 20 KCL at 110 ml/hr, LR @ 100 ml/hr
* '''M'''eds: scheduled and PRN's
* '''L'''abs 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).
</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
Line 105: Line 759:
* '''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
Line 120: Line 779:
* '''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
Line 130: Line 794:
# Paralysis
# Paralysis


==Hospital Admission Orders==
</div></div>
<font color="red">{{cquote|'''DAVE WILMINGTON'''}}</font>
 
* '''D'''iet
</div></div>
* '''A'''ctivity
 
* '''V'''ital signs: how often to monitor
<div class="mw-collapsible mw-collapsed">
* '''E'''xcrement: test urine/stool
 
* '''W'''eight: how often to monitor
<font color="Navy">'''9. Pathology'''</font>
* '''I''' / O: monitor input/output
* '''L'''abs: which/how often
* '''M'''eds: which/route/interval
* '''I''' V fluids: what/at what rate
* '''N'''ursing care: e.g. position, wound care, up in chair, ostomy care
* '''G'''eneral care: e.g. physical/respiratory therapy
* '''T'''ests: e.g. X-ray/EKG/EEG
* '''O'''bserve for: reaction/seizure/neuro exams
* '''N'''otify 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.
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ADC VAAN DIML''', pronounced ADC van dim(e)L}}</font>
* '''A'''dmit: 23 hours, full admit, service of attending
* '''D'''iagnosis
* '''C'''ondition: "Stable"/"Guarded"
* '''V'''itals: post-op, routine, q 1 hour
* '''A'''llergies
* '''A'''ctivities: strict bed rest/fall precautions/ad lib/bathroom privileges
* '''N'''ursing: strict I&O's/daily weights/call P.R.N.
* '''D'''iet: NPO/regular/clears/advance diet as tolerated/2000 cal ADA/renal
* '''I'''V fluids: D5, 1/2 NS, 20 KCL at 110 ml/hr, LR @ 100 ml/hr
* '''M'''eds: scheduled and PRN's
* '''L'''abs 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).
<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
Line 173: Line 818:
*'''N'''eoplastic
*'''N'''eoplastic
*'''C'''ongenital
*'''C'''ongenital
</div></div>
<div class="mw-collapsible mw-collapsed">
==Signs of Inflammation==
<div class="mw-collapsible-content">
# '''Rubor''': redness/erythema
# '''Calor''': raised temperature
# '''Tumor''': swelling
# '''Dolor''': pain
# '''Functio Laesa''': loss of function
- Described by Celsus
</div></div>
<div class="mw-collapsible mw-collapsed">
==Hypersentivity Reactions (Gell & Goombs Classification)==
<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 II  '''C'''ytotoxic-mediated
# Type III '''I'''mmune-complex
# Type IV  '''D'''elayed hypersensitivity
</div></div>
<div class="mw-collapsible mw-collapsed">
==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.
<font color="red">{{cquote|'''MEN I:  3 P's'''}}</font>
# '''P'''ituitary
# '''P'''arathyroid
# '''P'''ancreas
# Plus Adrenal cortex
<font color="red">{{cquote|'''MEN II:  2 C's'''}}</font>
# '''C'''arcinoma of thyroid
# '''C'''atacholamines (pheochromocytoma)
- MEN IIA: parathyroid
- MEN IIB (MEN III): mucocutaneous neuromas for
</div></div>
<div class="mw-collapsible mw-collapsed">
==Acute Pneumonia Infiltrates==
<div class="mw-collapsible-content">
* '''P'''yogenic bacteria: '''P'''MN infiltrate
* '''M'''iscellaneous microbes: '''M'''ononuclear infiltrate
</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>
</div></div>
<div class="mw-collapsible mw-collapsed">
==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'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}</font>
<font color="red">{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}</font>
# '''N'''eutrophils: '''60'''%
# '''L'''ymphocytes: '''30'''%
# '''M'''onocytes: '''6'''%
# '''E'''osinophils: '''3'''%
# '''B'''asophils: '''1'''%
</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 184: Line 921:
* '''E'''thanol poisoning
* '''E'''thanol poisoning
* '''S'''alicylate ingestion
* '''S'''alicylate ingestion
</div></div>
==Metabolic Acidosis (Normal Anion-Gap) Causes==
<div class="mw-collapsible mw-collapsed">
===With Hyperkalemia===
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''RAISE K+'''}}</font>
* RTA type 4
* Aldosterone or mineralocorticord deficiency
* Iatrogenic: NH4Cl, HCl
* "Stenosis": obstructive uropathy
* Early uremia
</div></div>
<div class="mw-collapsible mw-collapsed">
===With hypokalemia===
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ReDUCE K+'''}}</font>
* Renal TA type 1 and 2
* Diarrhoea
* Urine diversion into gut
* Carbonate anhydrase inhibitor
* Ex-hyperventilation
</div></div>
<div class="mw-collapsible mw-collapsed">
==BUN & Creatinine Elevation Causes==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''ABCD'''}}</font>
* '''A''' - '''A'''zotremia (pre-renal)
* '''B''' - '''B'''leeding (GI)
* '''C''' - '''C'''atabolic status
* '''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 199: 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 208: Line 990:
Also consider Addison's disease, thiazide diuretics and simple lab error
Also consider Addison's disease, thiazide diuretics and simple lab error


==5 SIGNS OF INFLAMMATION (as described by Celsus)==
</div></div>
# '''Rubor''': redness/erythema
<div class="mw-collapsible mw-collapsed">
# '''Calor''': raised temperature
# '''Tumor''': swelling
# '''Dolor''': pain
# '''Functio Laesa''': loss of function


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


==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|'''GET SMASHED'''}}</font>
<font color="red">{{cquote|'''N'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}</font>
# '''G'''all stones
<font color="red">{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}</font>
# '''E'''thanol
* '''N'''eutrophils: '''60'''%
# '''T'''rauma
* '''L'''ymphocytes: '''30'''%
# '''S'''teroids
* '''M'''onocytes: '''6'''%
# '''M'''umps
* '''E'''osinophils: '''3'''%
# '''A'''utoimmune disease
* '''B'''asophils: '''1'''%
# '''S'''corpion venom
# '''H'''yperlipidemia
# '''E'''RCP (dye)
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
Alcohol and Gallstones are the most common causes.


==Malignant Hyperthermia Treatment==
</div></div>
<font color="red">{{cquote|'''Sunday Hot Day, Better Give Iced Fluids Today!'''}}</font>
<div class="mw-collapsible mw-collapsed">
* '''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


==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 253: 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
</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>


==Brachial Plexus Organization==
</div></div>
<font color="red">{{cquote|'''Radical Teachers Drink Cold Beers'''}}</font>
<div class="mw-collapsible mw-collapsed">
<font color="red">{{cquote|'''Randy Travis Drinks Cold Beers'''}}</font>
<font color="red">{{cquote|'''Robert Taylor Drinks Cold Beer'''}}</font>
<font color="red">{{cquote|'''Red Trucks Drive Cats Nuts'''}}</font>
# Roots
# Trunks
# Divisions
# Cords
# Branches


==Cranial Nerves==
==Malignant Hyperthermia Treatment==
<font color="red">{{cquote|'''On Old Olympus Towering Tops, A Finn And German Viewed Some Hops'''}}</font>
<font color="red">{{cquote|'''Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen'''}}</font>
# I - olfactory
# II - optic
# III - oculomotor
# IV - trochlear
# V - trigeminal
# VI - abducens
# VII - facial
# VIII - acoustic (vestibulocochlear)
# IX - glossophrayngeal
# X - vagus
# XI - accessory
# XII - hypoglossal


==Extraocular Muscles Innervation==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''LR6 SO4 3'''}}</font>
* '''LR6''' - Lateral Rectus --> CN VI Abducens
* '''SO4''' - Superior Oblique --> CN IV Trochlear
* '''3''' - The remaining 4 eyeball movers --> CN III Occulomotor


<font color="red">{{cquote|'''LAST'''}}</font>
<font color="red">{{cquote|'''Sunday Hot Day, Better Give Iced Fluids Today!'''}}</font>
* '''L'''-'''L'''ateral Rectus
* '''S'''- Stop all triggering agents, give 100% O2
* '''A'''-'''A'''bducens Nerve
* '''H'''- Hyperventillate
* '''S'''-'''S'''uperior Oblique
* '''D'''- Dantrolene 2.5 mg/kg
* '''T'''-'''T'''rochlear Nerve
* '''B'''- Bicarbonate
* '''G'''- Glucose and Insulin
* '''I'''- IV Fluids, Cooling Blanket
* '''F'''- Fluid Output; Furosemide
* '''T'''- Tachycardia, be prepared to treat V Tach


==Facial Nerve Branches==
</div></div>
<font color="red">{{cquote|'''Two Zebras Bought My Car'''}}</font>
<font color="red">{{cquote|'''Two Zebras Bit My Cookie'''}}</font>
<font color="red">{{cquote|'''To Zanzibar By Motor Car'''}}</font>
<font color="red">{{cquote|'''Ten Zulus Buggered My Cat'''}}</font>
# Temporal
# Zygomatic
# Buccal
# Mandibular
# Cervical


==Penis Innervation==
</div></div>
<font color="red">{{cquote|'''P'''oint and '''S'''hoot}}</font>
* '''P'''arasympathetic causes erection
* '''S'''ympathetic causes ejaculation


<font color="red">{{cquote|'''S2, 3, 4 keep the penis off the floor'''}}</font>
<div class="mw-collapsible mw-collapsed">
* Innervation of the penis by branches of the pudendal nerve, derived from spinal cord levels S2-4


==Aorta Branches==
<font color="Navy">'''12. Genetics'''</font>
<font color="red">{{cquote|'''ABC'S'''}}</font>
* '''A'''ortic arch gives off the
* '''B'''racheiocephalic trunk
* Left '''C'''ommon '''C'''arotid
* And left Subclavian artery


==Femoral Triangle Structures in Order==
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''N (AVEL)'''}}</font>
* '''N'''erve
* '''A'''rtery
* '''V'''ein
* '''E'''mpty space
* '''L'''ymphatics
- Parenthesis includes things contained in the femoral sheath.


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


==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 348: 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 358: 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 364: 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|'''D'''rink 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>


==Pyrimidines Nucleotides==
</div></div>
<font color="red">{{cquote|'''CUT the PY (pie)'''}}</font>
<div class="mw-collapsible mw-collapsed">
* '''C'''ytosine
* '''U'''racil
* '''T'''hiamine


* '''T'''he
==DiGeorge (Velocardiofacial) Syndrome==
* '''PY'''rimidines


==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
* '''A'''bnormal facies
* '''A'''bnormal facies
Line 393: 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 401: 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)


==Cell Cycle Stages==
</div></div>
<font color="red">{{cquote|'''Go Sally Go! Make Children!'''}}</font>
<div class="mw-collapsible mw-collapsed">
* '''G1''' phase - Growth phase 1
* '''S''' phase - DNA synthesis
* '''G2''' phase - Growth phase 2
* '''M''' phase - Mitosis
* '''C''' phase - Cytokinesis


==APKD==
==Adult Polycystic Kidney Disease==
<font color="red">{{cquote|''' '''}}</font>
ADult Polycystic Kidney Disease is  Autosomal Dominant
Also, "Polycystic kidney" has 16 letters and is due to a defect on chromosome 16.


==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|'"Polycystic kidney"' has '''16 letters'''}}</font>
* '''P''' - '''P'''he
Also,  and is due to a defect on chromosome 16.
* '''V''' - '''V'''al
<font color="red">{{cquote|'''APKD'''}}</font>
* '''T''' - '''T'''hr
ADult Polycystic Kidney Disease is Autosomal Dominant
* '''T''' - '''T'''rp
* '''I''' - '''I'''le
* '''M''' - '''M'''et
* '''H''' - '''H'''is
* '''A''' - '''A'''rg
* '''L''' - '''L'''eu
* '''L''' - '''L'''ys


==Urea Cycle==
</div></div>
<font color="red">{{cquote|'''O'''rdinarily '''C'''areless '''C'''rappers '''A'''re '''A'''lso '''F'''rivolous '''A'''bout '''U'''rination!}}</font>


* '''O''' - '''O'''rnithine
</div></div>
* '''C''' - '''C'''arbamoyl
* '''C''' - '''C'''itrulline
* '''A''' - '''A'''spartate
* '''A''' - '''A'''rginosuccinate
* '''F''' - '''F'''umarate
* '''A''' - '''A'''rginine
* '''U''' - '''U'''rea


==Cell Division Phases==
<div class="mw-collapsible mw-collapsed">
<font color="red">{{cquote|'''People Meet And Talk'''}}</font>
* '''P''' - '''P'''rophase
* '''M''' - '''M'''etaphase
* '''A''' - '''A'''naphase
* '''T''' - '''T'''elophase


==Acute Intermittent Porphyria==
<font color="Navy">'''13. Pediatrics'''</font>
<font color="red">{{cquote|'''5  P's '''}}</font>
* '''P'''ain in abdomen


* '''P'''olyneuropathy
<div class="mw-collapsible-content">


* '''P'''sychologial abnormalities
<div class="mw-collapsible mw-collapsed">


* '''P'''ink urine
==APGAR Score==


* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)
<div class="mw-collapsible-content">
<font color="red">{{cquote|'''APGAR'''}}</font>
* '''A'''ppearance (color): blue/pale, trunk pink, all pink
* '''P'''ulse (heart rate): 0, <100, 100+
* '''G'''rimace (reflex irritability): 0, grimace, grimace+cough
* '''A'''ctivity (muscle tone): limp, some, active
* '''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.


==BUN & Creatinine Elevation==
</div></div>
<font color="red">{{cquote|'''ABCD'''}}</font>
* '''A''' - '''A'''zotremia (pre-renal)
* '''B''' - '''B'''leeding (GI)
* '''C''' - '''C'''atabolic status
* '''D''' - '''D'''iet (high protein parenteral nutrition)
 
==G6PD: oxidant drugs inducing hemolytic anemia AAA==
<font color="red">{{cquote|''' '''}}</font>
Antibiotic (eg: sufamethoxazole)
Antimalarial (eg: primaquine)
Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)
Vitamin B3 (niacin, nicotinic acid) deficiency: pellagra
 
==The 3'''D''' 's of pellagra==
<font color="red">{{cquote|''' '''}}</font>
Pellegra: Vitamin B3 (niacin, nicotinic acid) deficiency
# Dermatitis
# Diarrhea
# Dementia
 
==Pompe's disease: type "Police = Po + lys"==
<font color="red">{{cquote|''' '''}}</font>
Pompe's disease is a lysosomal storage disease (alpha 1,4 glucosidase).
 
==Metabolic acidosis (normal anion-gap) causes==
<font color="red">{{cquote|''' '''}}</font>
#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
 
==Galactosaemia: enzyme deficiency==
<font color="red">{{cquote|''' '''}}</font>
GALIPUT: Galactose 1 Phosphate Uridyl Transferase.
• There is an assay called the Galiput test for this.
 
==Folate deficiency: causes A FOLIC DROP==* Alcoholism
<font color="red">{{cquote|''' '''}}</font>
 
 
* Folic acid antagonists
* Oral contraceptives
* Low dietary intake
* Infection with Giardia
* Celiac sprue
* Dilatin
* Relative folate deficiency
* Old
* Pregnant
 
==The FAT cat is in the ADEK (attic)==
<font color="red">{{cquote|''' '''}}</font>
''Vitamins: which are fat soluble''
Fat soluble vitamins are A,D,E,K.
 
==Hemoglobin binding curve: causes of shift to right==
<font color="red">{{cquote|''' '''}}</font>
"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 for respective receptors==
<font color="red">{{cquote|''' '''}}</font>
"QISS & QIQ" (Kiss and Kick):
 
==G-proteins and their respective receptors (alphabetical order)==
<font color="red">{{cquote|''' '''}}</font>
Q: alpha 1 I: alpha 2 S: beta 1 S: beta 2 &
Q: M1 I: M2 Q: M3
 
==Adrenaline mechanism==
<font color="red">{{cquote|''' '''}}</font>
"ABC of Adrenaline":
* Adrenaline--> activates
* Beta receptors--> increases
* Cyclic AMP
 
==Carbon monoxide: electron transport chain target==
<font color="red">{{cquote|''' '''}}</font>
"CO blocks CO"
Carbon monoxide (CO) blocks Cytochrome Oxidase (CO)
 
==Metabolism sites==
<font color="red">{{cquote|''' '''}}</font>
"Use both arms to HUG":
Heme synthesis Urea cycle Gluconeogenesis • These reactions occur in both cytoplasm and mitochondria.
 
==AcetylCoA and acetacetylCoA==
<font color="red">{{cquote|''' '''}}</font>
"A Lighter Lease" (A LyTr LeIs): amino acids forming them
* A=AcetylCoA or Acetoacetyl CoA
* Ly=Lysine
* Tr=Tryptophan
* Le=Leucine
* Is=Isoleucine
 
==Fasting state: branched-chain amino acids used by skeletal muscles==
<font color="red">{{cquote|''' '''}}</font>
"Muscles LIVe fast":
* Leucine
* Isoleucine
* Valine
 
==Glycolysis steps==
<font color="red">{{cquote|''' '''}}</font>
"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.
 
==Glycolysis Enzymes==
<font color="red">{{cquote|''' '''}}</font>
“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
 
==Citric acid cycle compounds==
<font color="red">{{cquote|''' '''}}</font>
"Our City Is Kept Safe And Sound From Malice":
Oxaloacetate
Citrate
Isocitrate
alpha-Ketoglutarate
Succinyl-CoA
Succinate
Fumarate
Malate
 
==Citric acid cycle compounds==
<font color="red">{{cquote|''' '''}}</font>
"Can I Keep Selling Sex For Money, Officer?":
* Citrate
* Isocitrate
* alpha-Ketogluterate
* Succinyl CoA
* Succinate
* Fumerate
* Malate
* Oxaloacetate
 
==Citric acid cycle compounds==
<font color="red">{{cquote|''' '''}}</font>
"Oh! Can I Keep Some Succinate For Myself?":
* Oxaloacetate
* Citrate
* Isocitrate, alpha-Ketoglutarate
* Succinyl CoA
* Succinate
* Fumarate
* Malate
 
==Citric acid cycle compounds==
<font color="red">{{cquote|''' '''}}</font>
"Oh Citric Acid Is Of (course) A SiLly STupid Funny Molecule":
* Oxaloacetate
* Citrate
* Isocitrate, alpha-Ketoglutarate
* Succinyl CoA
* Succinate
* Fumarate
* Malate
 
==Citrate Cycle Enzymes==
<font color="red">{{cquote|''' '''}}</font>
"Corrupt Anti Intelligence Agent Spoke Slander For Money."
* Citrate synthatase
* aconitase
* Isocitrate dehydrogenase
* Alpha ketogluturate dehydrogenase
* Succinyl CoA synthetase
* Succinate dehydrogenase
* Fumarase
* Malate Dehydrogenase
 
==Fabry's disease: FABRY'S==
<font color="red">{{cquote|''' '''}}</font>
* Foam cells found in glomeruli and tubules/ Febrile episodes
* Alpha galactosidase A deficiency/ Angiokeratomas
* Burning pain in extremities/ BUN increased in serum/ Boys
* Renal failure
* YX genotype (male, X linked recessive)
* Sphingolipidoses
 
==B Vitamins==
<font color="red">{{cquote|'''The Rhythm Nearly Proved Contagious'''}}</font>
In increasing order:
* Thiamine (B1)
* Riboflavin (B2)
* Niacin (B3)
* Pyridoxine (B6)
* Cobalamin (B12)
 
==Essential Amino Acids==
<font color="red">{{cquote|'''PVT. TIM HALL'''}}</font>
Phe Val Thr Trp Ile Met His Arg Leu Lys
Pvt. is short for Private in the military.
Arg and His are considered semiessential.
Alternatively: "MATT VIL PHLy".
 
<font color="red">{{cquote|'''"PVT. TIM HALL always argues, never tires"'''}}</font>
* Phe
* Val
* Thr
* Trp
* Ile
* Met
* His
* Arg
* Lue
* Lys
 
==Golgi Complex Functions==
<font color="red">{{cquote|'''Golgi Distributes A SPAM'''}}</font>
* '''Distributes''' proteins and lipids from ER
* '''A'''dd mannose onto specific lysosome proteins
* '''S'''ulfation of sugars and slected tyrosine
* '''P'''roteoglycan assembly
* '''A'''dd O-oligosugars to serine and threnonine
* '''M'''odify N-ologosugars on asparagine
 
==Catabolism Steps of Branched Chain Amino Acids==
<font color="red">{{cquote|'''Truck hit the Ox to Death'''}}</font>
* '''T''' - '''T'''ransamination
* '''O''' - '''O'''xidative decarboxylation
* '''D''' - '''D'''ehydrogenation
 
==Niacin Deficiency==
<font color="red">{{cquote|'''The famous 4 D's'''}}</font>
# Diarrhea
# Dermatitis
# Dementia
# Death (if untreated)
 
==Creatine Phosphate: Amino Acid Precursors==
<font color="red">{{cquote|'''Nice GAMs!'''}}</font>
* '''G''' - '''G'''lycine
 
* '''A''' - '''A'''rginine
 
* '''M''' - '''M'''ethionine
 
==Enzymes Classification==
<font color="red">{{cquote|'''Over The HILL'''}}</font>
* '''O''' - '''O'''xidoreductases
 
* '''T''' - '''T'''ransferases
 
* '''H''' - '''H'''ydrolases
 
* '''I''' - '''I'''somerases
 
* '''L''' - '''L'''igases
 
* '''L''' - '''L'''yases
 
==Collagen==
<font color="red">{{cquote|'''COLLAGEN'''}}</font>
* '''C''' - '''C'''-terminal propeptide (procollagen) / '''C'''ovalent '''C'''ross links/ '''C''' vitamin/ '''C'''onnective tissue/ '''C'''artilage/ '''C'''hondroblasts/ '''C'''opper Cofactor (Covalent Cross linking)
 
* '''O''' - '''O'''utside the cell is where collagen normally functions/ '''O'''steoblasts/ '''O'''steogenesis imperfecta
 
* '''L''' - '''L'''ysyl hydroxylase / '''L'''ysyl oxidase (oxidatively deaminates lysyl and hydroxylysyl residues to form collagen cross links, last biosynthesis step)
 
* '''L''' - '''L'''ong triple helical fibers / '''L'''igaments
 
* '''A''' - '''A'''lpha chains / '''A'''ttached by H bonds form triple helix / '''A'''scorbate for hydroxylation of lysyl and prolyl residues of pro-Alpha chains
(postranslational modification)
 
* '''G''' - '''G'''ly in every third position / '''G'''lycosylation of hydroxyl group of hydroxylysine with '''G'''lucose and '''G'''alactose; '''GO'''lgi allows procollagen to '''GO''' outside of cell
* '''E''' - '''E'''xtracellular matrix / '''E'''ye (cornea, sclera) / '''E'''hlers-Danlos Syndrome
* '''N''' - '''N'''-terminal propeptide (procollagen) / '''N'''onhelical terminal extensions
 
==Essential Amino Acids==
 
 
==Hypervitaminosis A==
<font color="red">{{cquote|Increased Vitamin A makes you '''HARD'''}}</font>
* '''H''' - '''H'''eadache / '''H'''epatomegaly
* '''A''' - '''A'''norexia / '''A'''lopecia
* '''R''' - '''R'''eally painful bones
* '''D''' - '''D'''ry skin / '''D'''rowsiness

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.