WBR0025

2014-03-15T20:46:39Z

Gonzalo Romero:

WBR0025

2014-03-15T20:45:09Z

Gonzalo Romero:

Gonzalo Romero:

{{WBRQuestion
|QuestionAuthor=Raviteja Reddy Guddeti MBBS, Aarti Narayan MBBS (Reviewed by Gonzalo Romero)
|ExamType=USMLE Step 2 CK
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|MainCategory=Internal medicine
|MainCategory=Internal medicine
|SubCategory=Cardiovascular
|Prompt=A-65-year old male presents to the ER due to a crushing retrosternal chest pain, which started 20 minutes ago. Additionally, he has nausea and diaphoresis. Following 2 hours of ER arrival, percutaneous coronary intervention is performed; he recovers over the next 5 days. 6 weeks following discharge, he returns to the office due to a mild retrosternal chest pain, which is aggravated when lying flat, and relieved when sitting up. Concomitantly, he has a mild cough and runny nose consistent with a recent upper respiratory tract infection. Complete blood count is within normal limits. What is the most likely diagnosis?
|Explanation=This patient is returning to the office due to [[Dressler syndrome]], which is a post myocardial infarction syndrome. It is a form of pericarditis that occurs in the setting of injury to the heart (myocardial infarction). Typically, it occurs 2 to 10 weeks following a myocardial infarction.
* [[Acute pericarditis]] presents between 6 weeks to 6 months of the disease onset. Acute pericarditis is more common than chronic pericarditis, and often occurs as a complication of viral infections, immunologic conditions, or as a result of a heart attack (myocardial infarction).
* Subacute pericarditis presents within 6 weeks to 6 months of the disease onset
* Chronic pericarditis manifests after 6 months of the disease onset. Chronic pericarditis is less common. It may manifest as scarring of the pericardium, which is a condition known as constrictive pericarditis.

<table>
<tr class="Diagnosis"><td> </td><td>'''Typical Presentation'''</td><td>'''Diagnostic Tests''' </td></tr>
<tr><td>'''Pericarditis'''</td><td>Pain aggravated by lying and alleviated when sitting, friction rub</td><td>EKG with diffuse ST elevation and PR depressions followed by T-wave inversions </td></tr>
<tr><td>'''Costochondritis'''</td><td>Localized chest tenderness to palpation, localized</td><td>Physical examination</td></tr>
<tr><td>'''Aortic dissection'''</td><td>Acute onset, tearing pain radiated to the back, asymmetric pulses and BP between upper extremities, chronic hypertension</td><td>CXR with mediastinal widening, chest CT angiogram, MRI or TEE</td></tr>
<tr><td>'''Pulmonary embolus'''</td><td>Sudden onset dyspnea, tachycardia and tachypnea</td><td>Spiral CT, V/Q scan</td></tr>
<tr><td>'''Pneumothorax'''</td><td>Pleuritic pain, shortness of breath, deviated trachea, trauma</td><td>CXR</td></tr>
<tr><td>'''Pneumonia'''</td><td>Productive cough, hemoptysis, fever</td><td>CXR</td></tr>
<tr><td>'''GERD'''</td><td>Acidic taste, chronic cough, hoarsenss</td><td>Response to PPIs and antiacids</td></tr>
<tr><td>'''PUD'''</td><td>Burning pain, change with eating</td><td>Upper endoscopy</td></tr>
</table>
|AnswerA=Viral pericarditis
|AnswerAExp=Viral pericarditis caused by different virus, commonly Coxsackie B virus, Echovirus, HIV or Adenovirus. It typically presents as an acute pericarditis.
It is important to consider the timeline of the chest pain occurring after the MI, which is 6 weeks in this case. The history of this patient is consistent with Dressler's syndrome.
|AnswerB=Tuberculous pericarditis
|AnswerBExp=There is nothing else in the patient history to suggest a different form of pericarditis, and no past medical history of [[tuberculosis]].
|AnswerC=Post-cardiac injury pericarditis
|AnswerCExp=Post-cardiac injury pericarditis, also known as post-myocardial infarction pericarditis has similar clinical presentation, but it occurs 2-4 days following an MI. The pathophysiology is thought to be of autoimmune origin due to a reaction to the myocardial neo-antigens.
|AnswerD=Dressler’s syndrome
|AnswerDExp=This patient is returning to the office due to [[Dressler syndrome]], which is a post myocardial infarction syndrome. It is a form of pericarditis that occurs in the setting of injury to the heart (myocardial infarction). Typically, it occurs 2 to 10 weeks following a myocardial infarction.
|AnswerE=Aortic dissection
|AnswerEExp=The history of MI suggests that [[myocardial infarction]] is the inciting factor for the pericarditis.
|EducationalObjectives=#[[Dressler syndrome]] is a form of pericarditis that presents 2 to 10 weeks following a myocardial infarction.
# The symptoms of pericarditis include: retrosternal chest pain aggravated when lying down and alleviated by sitting up. The EKG may show diffuse ST segment elevations and PR interval depression.
Remember the causes of pericarditis using this mnemonic '''CARDIAC RIND''', which stands for:
* Collagen vascular disease
* Aortic dissection
* Radiation
* Drugs
* Infections
* Acute renal failure
* Cardiac (MI)
* Rheumatic fever
* Injury
* Neoplasms
* Dressler's syndrome
|References=Master the Boards for Step 2CK 2013 edition, page 54
 Read more here: http://www.ncbi.nlm.nih.gov/pubmed/20194155
|RightAnswer=D
|WBRKeyword=MI, Pericarditis, Chest pain
|Approved=Yes
}}

WBR0017

2014-03-15T18:55:05Z

Gonzalo Romero:

2014-02-03T20:19:18Z

WBR mnemonics

2014-02-01T00:11:44Z

Gonzalo Romero:

__NOTOC__
{{Board review project}}
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'''Editor-In-Chief:''' [[User:William J Gibson|Will Gibson]]; {{AE}} [[User:Gonzalo Romero|Gonzalo A. Romero, M.D.]][mailto:gromero@wikidoc.org];{{Rim}};[[User:Sergekorjian|Serge Korjian]]; [[User:YazanDaaboul|Yazan Daaboul]]; {{VR}}; {{M.P}}; {{AO}}; {{MS}};

'''1. ANATOMY'''
==GI Anatomy==
{{cquote|'''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport}}
''From proximal to distal:''
# '''D'''uodenum
# '''J'''ejunum
# '''I'''leum
# '''A'''ppendix
# '''C'''olon
# '''S'''igmoid
# '''R'''ectum

==Brachial Plexus Organization==
{{cquote|'''Radical Teachers Drink Cold Beers'''}}
{{cquote|'''Randy Travis Drinks Cold Beers'''}}
{{cquote|'''Robert Taylor Drinks Cold Beer'''}}
{{cquote|'''Red Trucks Drive Cats Nuts'''}}
# Roots
# Trunks
# Divisions
# Cords
# Branches

==Cranial Nerves==
{{cquote|'''On Old Olympus Towering Tops, A Finn And German Viewed Some Hops'''}}
{{cquote|'''Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen'''}}
# 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==
{{cquote|'''LR6 SO4 3'''}}
* '''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)

{{cquote|'''LAST'''}}
* '''L''' - '''L'''ateral Rectus
* '''A''' - '''A'''bducens Nerve
* '''S''' - '''S'''uperior Oblique
* '''T''' - '''T'''rochlear Nerve

==Facial Nerve Branches==
{{cquote|'''Two Zebras Bought My Car'''}}
{{cquote|'''Two Zebras Bit My Cookie'''}}
{{cquote|'''To Zanzibar By Motor Car'''}}
{{cquote|'''Ten Zulus Buggered My Cat'''}}
# Temporal
# Zygomatic
# Buccal
# Mandibular
# Cervical

==Penis Innervation==
{{cquote|'''P'''oint and '''S'''hoot}}
* '''P'''arasympathetic causes erection
* '''S'''ympathetic causes ejaculation

{{cquote|'''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==
{{cquote|'''ABC'S'''}}
* '''A'''ortic arch gives off the:
# '''B''' - '''B'''racheiocephalic trunk
# '''C''' - Left '''C'''ommon '''C'''arotid
# '''S''' - Left '''S'''ubclavian artery

==Femoral Triangle Structures in Order==
{{cquote|'''N (AVEL)'''}}
* '''N'''erve
* '''A'''rtery
* '''V'''ein
* '''E'''mpty space
* '''L'''ymphatics
- Parenthesis includes things contained in the femoral sheath.
 
'''2. CELL BIOLOGY'''
==Cell Division Phases==
{{cquote|'''People Meet And Talk'''}}
* '''P''' - '''P'''rophase
* '''M''' - '''M'''etaphase
* '''A''' - '''A'''naphase
* '''T''' - '''T'''elophase

==Cell Cycle Stages==
{{cquote|'''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==
{{cquote|'''Golgi Distributes A SPAM'''}}
* '''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

==Collagen==
{{cquote|'''COLLAGEN'''}}
* '''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

==Carbon Monoxide: Electron Transport Chain Target==
{{cquote|'''CO blocks CO'''}}
Carbon monoxide '''(CO)''' blocks Cytochrome Oxidase '''(CO)'''

==Hemoglobin Binding Curve: Right Shift Causes==
{{cquote|'''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
 
'''3. RECEPTORS'''
==G-proteins Receptors==
{{cquote|'''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==
{{cquote|'''ABC of Adrenaline'''}}
* Adrenaline--> activates
* Beta receptors--> increases
* Cyclic AMP
 
'''4. BIOCHEMISTRY'''
==Enzymes Classification==
{{cquote|'''Over The HILL'''}}
* '''O''' - '''O'''xidoreductases
* '''T''' - '''T'''ransferases
* '''H''' - '''H'''ydrolases
* '''I''' - '''I'''somerases
* '''L''' - '''L'''igases
* '''L''' - '''L'''yases

==Glycolysis Enzymes==
{{cquote|'''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==
{{cquote|'''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==
{{cquote|'''Use both arms to HUG'''}}
# Heme synthesis
# Urea cycle
# Gluconeogenesis
These reactions occur in both cytoplasm and mitochondria

==AcetylCoA and AcetacetylCoA==
{{cquote|'''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==
{{cquote|'''Our City Is Kept Safe And Sound From Malice'''}}
* Oxaloacetate
* Citrate
* Isocitrate
* alpha-Ketoglutarate
* Succinyl-CoA
* Succinate
* Fumarate
* Malate

{{cquote|'''Can I Keep Selling Sex For Money, Officer?'''}}
* Citrate
* Isocitrate
* alpha-Ketogluterate
* Succinyl CoA
* Succinate
* Fumerate
* Malate
* Oxaloacetate

{{cquote|'''Oh! Can I Keep Some Succinate For Myself?'''}}
{{cquote|'''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==
{{cquote|'''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==
{{cquote|'''P''' ri '''V''' a '''T''' e '''TIM HALL'''}}
{{cquote|'''PVT. TIM HALL'''}}
{{cquote|'''"PVT. TIM HALL always argues, never tires"'''}}
* '''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'''

==Creatine Phosphate: Amino Acid Precursors==
{{cquote|'''Nice GAMs!'''}}
* '''G''' - '''G'''lycine
* '''A''' - '''A'''rginine
* '''M''' - '''M'''ethionine

==Branched Chain Amino Acids Catabolism Steps==
{{cquote|'''Truck hit the Ox to Death'''}}
* '''T''' - '''T'''ransamination
* '''O''' - '''O'''xidative decarboxylation
* '''D''' - '''D'''ehydrogenation

==Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)==
{{cquote|'''Muscles LIVe fast'''}}
* Leucine
* Isoleucine
* Valine

==Urea Cycle==
{{cquote|'''O'''rdinarily '''C'''areless '''C'''rappers '''A'''re '''A'''lso '''F'''rivolous '''A'''bout '''U'''rination!}}
* '''O''' - '''O'''rnithine
* '''C''' - '''C'''arbamoyl
* '''C''' - '''C'''itrulline
* '''A''' - '''A'''spartate
* '''A''' - '''A'''rginosuccinate
* '''F''' - '''F'''umarate
* '''A''' - '''A'''rginine
* '''U''' - '''U'''rea

==Pyrimidines Nucleotides==
{{cquote|'''CUT the PY (pie)'''}}
* '''C'''ytosine
* '''U'''racil
* '''T'''hiamine
* '''T'''he
* '''PY'''rimidines
 
'''6. ENZYME DEFICIENCIES'''
==G6PD: Oxidant Drugs Inducing Hemolytic Anemia ==
{{cquote|'''AAA'''}}
* Antibiotic (eg: sufamethoxazole)
* Antimalarial (eg: primaquine)
* Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)

==Pompe's Disease==
{{cquote|'''Type "Police: Po + lys"'''}}
* '''PO'''mpe's disease is a '''LYS'''osomal storage disease (alpha 1,4 glucosidase)

==Galactosemia==
{{cquote|'''GALIPUT'''}}
* Galactose 1 Phosphate Uridyl Transferase
* There is an assay called the Galiput test for this

==Fabry's Disease==
{{cquote|'''FABRY ' S'''}}
* '''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

==Hurler Syndrome Features==
{{cquote|'''HURLER'S'''}}
*'''H'''eptosplenomegaly
*'''U'''gly facies
*'''R'''ecessive (AR inheritance)
*'''L'''-iduronidase deficiency (alpha)
*'''E'''yes clouded
*'''R'''etarded
*'''S'''tubby fingers/'''S'''hort

==Acute Intermittent Porphyria==
{{cquote|'''5 P's '''}}
* '''P'''ain in abdomen
* '''P'''olyneuropathy
* '''P'''sychologial abnormalities
* '''P'''ink urine
* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)
 
'''7. VITAMINS'''
==B Vitamins==
{{cquote|'''The Rhythm Nearly Proved Contagious'''}}
In increasing order:
* '''T''' - '''T'''hiamine (B1)
* '''R''' - '''R'''iboflavin (B2)
* '''N''' - '''N'''iacin (B3)
* '''P''' - '''P'''yridoxine (B6)
* '''C''' - '''C'''obalamin (B12)

==Niacin Deficiency==
{{cquote|'''The famous 4 D's'''}}
# Diarrhea
# Dermatitis
# Dementia
# Death (if untreated)
{{cquote|'''The 3D's of pellagra'''}}
Vitamin B3 (niacin, nicotinic acid) deficiency
# Dermatitis
# Diarrhea
# Dementia

==Folate Deficiency Causes==
{{cquote|'''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==
{{cquote|'''The FAT cat is in the ADEK (attic)'''}}
Fat soluble vitamins are ''A,D,E,K.'''

==Hypervitaminosis A==
{{cquote|Increased Vitamin A makes you '''HARD'''}}
* '''H''' - '''H'''eadache / '''H'''epatomegaly
* '''A''' - '''A'''norexia / '''A'''lopecia
* '''R''' - '''R'''eally painful bones
* '''D''' - '''D'''ry skin / '''D'''rowsiness
 
'''8. HISTORY TAKING'''
==Alcoholism Screening==
{{cquote|'''CAGE'''}}
* Have you ever felt it necessary to '''C'''UT DOWN on your drinking?
* Have you ever been '''A'''NNOYED when people suggest you cut down on 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?

==Chief Complaint==
{{cquote|'''OPQRST'''}}
* '''O''' - '''O'''nset of pain: what was the patient doing when the pain started?
* '''P''' - '''P'''alliative or '''P'''rovocative factors for the pain
* '''Q''' - '''Q'''uality of pain (burning, stabbing, aching, etc.)
* '''R''' - '''R'''adiation (up to jaw, down left arm, etc.)
* '''S''' - '''S'''everity of pain (usually 1 - 10 scale)
* '''T''' - '''T'''iming of pain (eg: after meals, in the morning, how long it lasts, etc.)

{{cquote|'''SOCRATES'''}}
* '''S''' - '''S'''ite of pain
* '''O''' - '''O'''nset of pain
* '''C''' - '''C'''haracter of pain: dull, sharp, aching, stabbing, tearing
* '''R''' - '''R'''adiation of pain: central abdominal pain radiating to Right Iliac Fossa
* '''A''' - '''A'''ssociated factors: eg. nausea/vomiting
* '''T''' - '''T'''iming of pain/duration
* '''E''' - '''E'''xacerbating/alleviating factors
* '''S''' - '''S'''everity of pain (1 - 10 scale)

{{cquote|'''ASCLAST'''}}
* '''A''' - '''A'''ggravatiing and '''A'''lleviating factors
* '''S''' - '''S'''everity
* '''C''' - '''C'''haracter, quality
* '''L''' - '''L'''ocation
* '''A''' - '''A'''ssociated symptoms
* '''S''' - '''S'''etting
* '''T''' - '''T'''iming

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

==Hospital Admission Orders==
{{cquote|'''DAVE WILMINGTON'''}}
* '''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.
{{cquote|'''ADC VAAN DIML''', pronounced ADC van dim(e)L}}
* '''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).

==Post-Op Fever Causes==
{{cquote|'''Five W's'''}}
* '''W'''ind: pneumonia, atelectasis
* '''W'''ound: wound infections
* '''W'''ater: urinary tract infection
* '''W'''alking: DVT/PE (walking can help reduce DVT/PE)
* '''W'''onderdrugs: especially anesthesia

==Predisposing Conditions for Pulmonary Embolism==
{{cquote|'''TOM SCH PREFER'''}}
* '''T''' - '''T'''rauma
* '''O''' - '''O'''besity
* '''M''' - '''M'''alignancy
* '''S''' - '''S'''urgery
* '''C''' - '''C'''ardiac disease
* '''H''' - '''H'''ospitalization
* '''P''' - '''P'''ast history
* '''R''' - '''R'''est (bed-bound)
* '''E''' - '''E'''strogen, pregnancy, post-partum
* '''F''' - '''F'''racture
* '''E''' - '''E'''lderly
* '''R''' - '''R'''oad trip

==Compartment Syndrome Signs (Arterial Occlusion)==
{{cquote|'''6 P's'''}}
# Pain
# Pale (Pallor)
# Perishing with Cold (Poikilothermia)
# Pulseless
# Paresthesias
# Paralysis
 
'''9. PATHOLOGY'''
==Causes of Diseases==
{{cquote|'''VITAMIN C'''}}
*'''V'''ascular
*'''I'''nfectious
*'''T'''rauma
*'''A'''uto-immune
*'''M'''etabolic
*'''I'''diopathic/Iatrogenic
*'''N'''eoplastic
*'''C'''ongenital

==5 Signs of Inflammation==
# '''Rubor''': redness/erythema
# '''Calor''': raised temperature
# '''Tumor''': swelling
# '''Dolor''': pain
# '''Functio Laesa''': loss of function
- Described by Celsus

==Hypersentivity Reactions (Gell & Goombs Classification)==
{{cquote|'''ACID'''}} {{cquote|'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill}}
# Type I '''A'''naphylaxis
# Type II '''C'''ytotoxic-mediated
# Type III '''I'''mmune-complex
# Type IV '''D'''elayed hypersensitivity

==Multiple Endocrine Neoplasia (MEN)==
Each of the MENs is a disease of '''three or two letters plus a feature'''; all are autosomal dominant.
{{cquote|'''MEN I: 3 P's'''}}
# '''P'''ituitary
# '''P'''arathyroid
# '''P'''ancreas
# Plus Adrenal cortex

{{cquote|'''MEN II: 2 C's'''}}
# '''C'''arcinoma of thyroid
# '''C'''atacholamines (pheochromocytoma)
- MEN IIA: parathyroid
- MEN IIB (MEN III): mucocutaneous neuromas for

==Acute Pneumonia Infiltrates==
* '''P'''yogenic bacteria: '''P'''MN infiltrate
* '''M'''iscellaneous microbes: '''M'''ononuclear infiltrate

==Takayasu's Disease/Pulseless Disease==
{{cquote|'''When you have Takayasu's, I can't Tak'a yu pulse'''}}

==CBC Normal Differential==
{{cquote|'''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas}}
{{cquote|'''N'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}
{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}
# '''N'''eutrophils: '''60'''%
# '''L'''ymphocytes: '''30'''%
# '''M'''onocytes: '''6'''%
# '''E'''osinophils: '''3'''%
# '''B'''asophils: '''1'''%
 
'''10. CAUSES'''
==Metabolic Acidosis Causes==
{{cquote|'''MUDPILES'''}}
* '''M'''ethanol poisoning
* '''U'''remia
* '''D'''iabetic Keto-acidosis
* '''P'''ara-aldehyde ingestion
* '''I'''schemia
* '''L'''actic Acidosis
* '''E'''thanol poisoning
* '''S'''alicylate ingestion

==Metabolic Acidosis (Normal Anion-Gap) Causes==
===With Hyperkalemia===
{{cquote|'''RAISE K+'''}}
* RTA type 4
* Aldosterone or mineralocorticord deficiency
* Iatrogenic: NH4Cl, HCl
* "Stenosis": obstructive uropathy
* Early uremia
===With hypokalemia===
{{cquote|'''ReDUCE K+'''}}
* Renal TA type 1 and 2
* Diarrhoea
* Urine diversion into gut
* Carbonate anhydrase inhibitor
* Ex-hyperventilation

==BUN & Creatinine Elevation Causes==
{{cquote|'''ABCD'''}}
* '''A''' - '''A'''zotremia (pre-renal)
* '''B''' - '''B'''leeding (GI)
* '''C''' - '''C'''atabolic status
* '''D''' - '''D'''iet (high protein parenteral nutrition)

==Hypercalcemia Causes==
{{cquote|'''PAM SCHMIDT'''}}
* '''P'''aget's Disease
* '''A'''myloid
* '''M'''ultiple Myeloma
* '''S'''arcoid
* '''C'''ancer
* '''H'''ormomal (para-thyroid)
* '''M'''ilk-alkali Syndrome
* '''I'''mmobilization
* '''D'''-vitamin overdose
* '''T'''hyrotoxicosis

'''OR'''
{{cquote|'''MISHAP'''}}
* '''M'''alignancy
* '''I'''ntoxication (hypervitaminosis)
* '''S'''arcoidosis
* '''H'''yperparathyroidism
* '''A'''lkali (Milk) syndrome
* '''P'''aget's Disease (bone)
Also consider Addison's disease, thiazide diuretics and simple lab error

==Acute Pancreatitis Causes==
{{cquote|'''GET SMASHED'''}}
# '''G'''all stones
# '''E'''thanol
# '''T'''rauma
# '''S'''teroids
# '''M'''umps
# '''A'''utoimmune disease
# '''S'''corpion venom
# '''H'''yperlipidemia
# '''E'''RCP (dye)
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
Alcohol and Gallstones are the most common causes.

==Back Pain Causes==
{{cquote|'''DISK MASS'''}}
* '''D'''-'''D'''egeneration: DJD, Osteoporosis, spondylosis
* '''I'''-'''I'''nfection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture
* '''S'''-'''S'''pondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
* '''K'''-'''K'''idney stones/infarction/infection (pyelo/abscess)
* '''M'''-'''M'''ultiple myeloma, '''M'''etastasis from breast, prostate, lung, thyroid, kidney CA
* '''A'''-'''A'''neurysm, '''A'''bdominal pain referred to the back (see acute abdominal pain)
* '''S'''-'''S'''lipped disk, '''S'''pondylolisthesis
* '''S'''-'''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster
 
'''11. TREATMENT'''
==Syncope Management==
{{cquote|'''If the face is red, raise the head!'''}}
{{cquote|'''If the face is pale, raise the tail!'''}}

==Malignant Hyperthermia Treatment==
{{cquote|'''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==
{{cquote|'''CHILD HAS PROBLEM!'''}}
* '''C'''ongenital heart disease/ '''C'''ataracts
* '''H'''ypotonia/ Hypothyroidism
* '''I'''ncure 5th finger/ '''I'''ncreased gap between 1st and 2nd toe
* '''L'''eukemia risk x2/ '''L'''ung problem
* '''D'''uodenal atresia/ '''D'''elayed development
* '''H'''irshsprung's disease/ '''H'''earing loss
* '''A'''lzheimer's disease/ Alantoaxial instability
* '''S'''quint/ Short neck
* '''P'''rotruding tongue/ '''P'''alm crease
* '''R'''ound face/ '''R'''olling eye (nystagmus)
* '''O'''cciput flat/ '''O'''blique eye fissure
* '''B'''rushfield spot/ '''B'''rachycephaly
* '''L'''ow nasal bridge/ '''L'''anguage problem
* '''E'''picanthic fold/ '''E'''ar folded
* '''M'''ental retardation/ '''M'''yoclonus

{{cquote|'''DOWN'''}}
* '''D'''ecreased alpha-fetoprotein and unconjugated estriol (maternal)
* '''O'''ne extra chromosome twenty-one
* '''W'''omen of advanced age
* '''N'''on-disjunction during maternal meiosis

{{cquote|'''Drink at 21'''}}
Chromosome 21

==Patau's Syndrome - Chromosome 13==
{{cquote|'''P'''uberty at 13}}

==Edward's Syndrome - Chromosome 18==
{{cquote|Election voter at 18}}

==DiGeorge (Velocardiofacial) Syndrome==
{{cquote|'''CATCH 22'''}}
* '''C'''ardiac abnormalities
* '''A'''bnormal facies
* '''T'''hymic aplasia
* '''C'''left palate
* '''H'''ypocalcemia
* '''22'''q11 deletion

==Marfan Syndrome Features==
# '''M'''itral valve prolapse - MVP
# '''A'''ortic Aneurysm
# '''R'''etinal detachment
# '''F'''ibrillin
# '''A'''rachnodactyly
# '''N'''egative '''N'''itroprusside test (differentiates from homocystinuria)

==Adult Polycystic Kidney Disease==
{{cquote|'"Polycystic kidney"' has '''16 letters'''}}
Also, and is due to a defect on chromosome 16.
{{cquote|'''APKD'''}}
ADult Polycystic Kidney Disease is Autosomal Dominant
 
'''13. PEDIATRICS'''
==APGAR Score==
{{cquote|'''APGAR'''}}
* '''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.

WBR mnemonics

2014-02-01T00:01:39Z

Gonzalo Romero: /* Adrenaline Mechanism */

__NOTOC__
{{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]]
'''Editor-In-Chief:''' [[User:William J Gibson|Will Gibson]]; {{AE}} [[User:Gonzalo Romero|Gonzalo A. Romero, M.D.]][mailto:gromero@wikidoc.org];{{Rim}};[[User:Sergekorjian|Serge Korjian]]; [[User:YazanDaaboul|Yazan Daaboul]]; {{VR}}; {{M.P}}; {{AO}}; {{MS}};

==ANATOMY==
==GI Anatomy==
{{cquote|'''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport}}
''From proximal to distal:''
# '''D'''uodenum
# '''J'''ejunum
# '''I'''leum
# '''A'''ppendix
# '''C'''olon
# '''S'''igmoid
# '''R'''ectum

==Brachial Plexus Organization==
{{cquote|'''Radical Teachers Drink Cold Beers'''}}
{{cquote|'''Randy Travis Drinks Cold Beers'''}}
{{cquote|'''Robert Taylor Drinks Cold Beer'''}}
{{cquote|'''Red Trucks Drive Cats Nuts'''}}
# Roots
# Trunks
# Divisions
# Cords
# Branches

==Cranial Nerves==
{{cquote|'''On Old Olympus Towering Tops, A Finn And German Viewed Some Hops'''}}
{{cquote|'''Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen'''}}
# 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==
{{cquote|'''LR6 SO4 3'''}}
* '''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)

{{cquote|'''LAST'''}}
* '''L''' - '''L'''ateral Rectus
* '''A''' - '''A'''bducens Nerve
* '''S''' - '''S'''uperior Oblique
* '''T''' - '''T'''rochlear Nerve

==Facial Nerve Branches==
{{cquote|'''Two Zebras Bought My Car'''}}
{{cquote|'''Two Zebras Bit My Cookie'''}}
{{cquote|'''To Zanzibar By Motor Car'''}}
{{cquote|'''Ten Zulus Buggered My Cat'''}}
# Temporal
# Zygomatic
# Buccal
# Mandibular
# Cervical

==Penis Innervation==
{{cquote|'''P'''oint and '''S'''hoot}}
* '''P'''arasympathetic causes erection
* '''S'''ympathetic causes ejaculation

{{cquote|'''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==
{{cquote|'''ABC'S'''}}
* '''A'''ortic arch gives off the:
# '''B''' - '''B'''racheiocephalic trunk
# '''C''' - Left '''C'''ommon '''C'''arotid
# '''S''' - Left '''S'''ubclavian artery

==Femoral Triangle Structures in Order==
{{cquote|'''N (AVEL)'''}}
* '''N'''erve
* '''A'''rtery
* '''V'''ein
* '''E'''mpty space
* '''L'''ymphatics
- Parenthesis includes things contained in the femoral sheath.

==CELL BIOLOGY==
==Cell Division Phases==
{{cquote|'''People Meet And Talk'''}}
* '''P''' - '''P'''rophase
* '''M''' - '''M'''etaphase
* '''A''' - '''A'''naphase
* '''T''' - '''T'''elophase

==Cell Cycle Stages==
{{cquote|'''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==
{{cquote|'''Golgi Distributes A SPAM'''}}
* '''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

==Collagen==
{{cquote|'''COLLAGEN'''}}
* '''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

==Carbon Monoxide: Electron Transport Chain Target==
{{cquote|'''CO blocks CO'''}}
Carbon monoxide '''(CO)''' blocks Cytochrome Oxidase '''(CO)'''

==Hemoglobin Binding Curve: Right Shift Causes==
{{cquote|'''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

==RECEPTORS==
==G-proteins Receptors==
{{cquote|'''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==
{{cquote|'''ABC of Adrenaline'''}}
* Adrenaline--> activates
* Beta receptors--> increases
* Cyclic AMP

==BIOCHEMISTRY==
==Enzymes Classification==
{{cquote|'''Over The HILL'''}}
* '''O''' - '''O'''xidoreductases
* '''T''' - '''T'''ransferases
* '''H''' - '''H'''ydrolases
* '''I''' - '''I'''somerases
* '''L''' - '''L'''igases
* '''L''' - '''L'''yases

==Glycolysis Enzymes==
{{cquote|'''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==
{{cquote|'''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.

==METABOLISM==
==Metabolism Sites==
{{cquote|'''Use both arms to HUG'''}}
# Heme synthesis
# Urea cycle
# Gluconeogenesis
These reactions occur in both cytoplasm and mitochondria

==AcetylCoA and AcetacetylCoA==
{{cquote|'''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==
{{cquote|'''Our City Is Kept Safe And Sound From Malice'''}}
* Oxaloacetate
* Citrate
* Isocitrate
* alpha-Ketoglutarate
* Succinyl-CoA
* Succinate
* Fumarate
* Malate

{{cquote|'''Can I Keep Selling Sex For Money, Officer?'''}}
* Citrate
* Isocitrate
* alpha-Ketogluterate
* Succinyl CoA
* Succinate
* Fumerate
* Malate
* Oxaloacetate

{{cquote|'''Oh! Can I Keep Some Succinate For Myself?'''}}
{{cquote|'''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==
{{cquote|'''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==
{{cquote|'''P''' ri '''V''' a '''T''' e '''TIM HALL'''}}
{{cquote|'''PVT. TIM HALL'''}}
{{cquote|'''"PVT. TIM HALL always argues, never tires"'''}}
* '''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'''

==Creatine Phosphate: Amino Acid Precursors==
{{cquote|'''Nice GAMs!'''}}
* '''G''' - '''G'''lycine
* '''A''' - '''A'''rginine
* '''M''' - '''M'''ethionine

==Branched Chain Amino Acids Catabolism Steps==
{{cquote|'''Truck hit the Ox to Death'''}}
* '''T''' - '''T'''ransamination
* '''O''' - '''O'''xidative decarboxylation
* '''D''' - '''D'''ehydrogenation

==Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)==
{{cquote|'''Muscles LIVe fast'''}}
* Leucine
* Isoleucine
* Valine

==Urea Cycle==
{{cquote|'''O'''rdinarily '''C'''areless '''C'''rappers '''A'''re '''A'''lso '''F'''rivolous '''A'''bout '''U'''rination!}}
* '''O''' - '''O'''rnithine
* '''C''' - '''C'''arbamoyl
* '''C''' - '''C'''itrulline
* '''A''' - '''A'''spartate
* '''A''' - '''A'''rginosuccinate
* '''F''' - '''F'''umarate
* '''A''' - '''A'''rginine
* '''U''' - '''U'''rea

==Pyrimidines Nucleotides==
{{cquote|'''CUT the PY (pie)'''}}
* '''C'''ytosine
* '''U'''racil
* '''T'''hiamine
* '''T'''he
* '''PY'''rimidines

==ENZYME DEFICIENCIES==
==G6PD: Oxidant Drugs Inducing Hemolytic Anemia ==
{{cquote|'''AAA'''}}
* Antibiotic (eg: sufamethoxazole)
* Antimalarial (eg: primaquine)
* Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)

==Pompe's Disease==
{{cquote|'''Type "Police: Po + lys"'''}}
* '''PO'''mpe's disease is a '''LYS'''osomal storage disease (alpha 1,4 glucosidase)

==Galactosemia==
{{cquote|'''GALIPUT'''}}
* Galactose 1 Phosphate Uridyl Transferase
* There is an assay called the Galiput test for this

==Fabry's Disease==
{{cquote|'''FABRY ' S'''}}
* '''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

==Hurler Syndrome Features==
{{cquote|'''HURLER'S'''}}
*'''H'''eptosplenomegaly
*'''U'''gly facies
*'''R'''ecessive (AR inheritance)
*'''L'''-iduronidase deficiency (alpha)
*'''E'''yes clouded
*'''R'''etarded
*'''S'''tubby fingers/'''S'''hort

==Acute Intermittent Porphyria==
{{cquote|'''5 P's '''}}
* '''P'''ain in abdomen
* '''P'''olyneuropathy
* '''P'''sychologial abnormalities
* '''P'''ink urine
* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)

==VITAMINS==
==B Vitamins==
{{cquote|'''The Rhythm Nearly Proved Contagious'''}}
In increasing order:
* '''T''' - '''T'''hiamine (B1)
* '''R''' - '''R'''iboflavin (B2)
* '''N''' - '''N'''iacin (B3)
* '''P''' - '''P'''yridoxine (B6)
* '''C''' - '''C'''obalamin (B12)

==Niacin Deficiency==
{{cquote|'''The famous 4 D's'''}}
# Diarrhea
# Dermatitis
# Dementia
# Death (if untreated)
{{cquote|'''The 3D's of pellagra'''}}
Vitamin B3 (niacin, nicotinic acid) deficiency
# Dermatitis
# Diarrhea
# Dementia

==Folate Deficiency Causes==
{{cquote|'''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==
{{cquote|'''The FAT cat is in the ADEK (attic)'''}}
Fat soluble vitamins are ''A,D,E,K.'''

==Hypervitaminosis A==
{{cquote|Increased Vitamin A makes you '''HARD'''}}
* '''H''' - '''H'''eadache / '''H'''epatomegaly
* '''A''' - '''A'''norexia / '''A'''lopecia
* '''R''' - '''R'''eally painful bones
* '''D''' - '''D'''ry skin / '''D'''rowsiness

==HISTORY TAKING==
==Alcoholism Screening==
{{cquote|'''CAGE'''}}
* Have you ever felt it necessary to '''C'''UT DOWN on your drinking?
* Have you ever been '''A'''NNOYED when people suggest you cut down on 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?

==Chief Complaint==
{{cquote|'''OPQRST'''}}
* '''O''' - '''O'''nset of pain: what was the patient doing when the pain started?
* '''P''' - '''P'''alliative or '''P'''rovocative factors for the pain
* '''Q''' - '''Q'''uality of pain (burning, stabbing, aching, etc.)
* '''R''' - '''R'''adiation (up to jaw, down left arm, etc.)
* '''S''' - '''S'''everity of pain (usually 1 - 10 scale)
* '''T''' - '''T'''iming of pain (eg: after meals, in the morning, how long it lasts, etc.)

{{cquote|'''SOCRATES'''}}
* '''S''' - '''S'''ite of pain
* '''O''' - '''O'''nset of pain
* '''C''' - '''C'''haracter of pain: dull, sharp, aching, stabbing, tearing
* '''R''' - '''R'''adiation of pain: central abdominal pain radiating to Right Iliac Fossa
* '''A''' - '''A'''ssociated factors: eg. nausea/vomiting
* '''T''' - '''T'''iming of pain/duration
* '''E''' - '''E'''xacerbating/alleviating factors
* '''S''' - '''S'''everity of pain (1 - 10 scale)

{{cquote|'''ASCLAST'''}}
* '''A''' - '''A'''ggravatiing and '''A'''lleviating factors
* '''S''' - '''S'''everity
* '''C''' - '''C'''haracter, quality
* '''L''' - '''L'''ocation
* '''A''' - '''A'''ssociated symptoms
* '''S''' - '''S'''etting
* '''T''' - '''T'''iming

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

==Hospital Admission Orders==
{{cquote|'''DAVE WILMINGTON'''}}
* '''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.
{{cquote|'''ADC VAAN DIML''', pronounced ADC van dim(e)L}}
* '''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).

==Post-Op Fever Causes==
{{cquote|'''Five W's'''}}
* '''W'''ind: pneumonia, atelectasis
* '''W'''ound: wound infections
* '''W'''ater: urinary tract infection
* '''W'''alking: DVT/PE (walking can help reduce DVT/PE)
* '''W'''onderdrugs: especially anesthesia

==Predisposing Conditions for Pulmonary Embolism==
{{cquote|'''TOM SCH PREFER'''}}
* '''T''' - '''T'''rauma
* '''O''' - '''O'''besity
* '''M''' - '''M'''alignancy
* '''S''' - '''S'''urgery
* '''C''' - '''C'''ardiac disease
* '''H''' - '''H'''ospitalization
* '''P''' - '''P'''ast history
* '''R''' - '''R'''est (bed-bound)
* '''E''' - '''E'''strogen, pregnancy, post-partum
* '''F''' - '''F'''racture
* '''E''' - '''E'''lderly
* '''R''' - '''R'''oad trip

==Compartment Syndrome Signs (Arterial Occlusion)==
{{cquote|'''6 P's'''}}
# Pain
# Pale (Pallor)
# Perishing with Cold (Poikilothermia)
# Pulseless
# Paresthesias
# Paralysis

==PATHOLOGY==
==Causes of Diseases==
{{cquote|'''VITAMIN C'''}}
*'''V'''ascular
*'''I'''nfectious
*'''T'''rauma
*'''A'''uto-immune
*'''M'''etabolic
*'''I'''diopathic/Iatrogenic
*'''N'''eoplastic
*'''C'''ongenital

==5 Signs of Inflammation==
# '''Rubor''': redness/erythema
# '''Calor''': raised temperature
# '''Tumor''': swelling
# '''Dolor''': pain
# '''Functio Laesa''': loss of function
- Described by Celsus

==Hypersentivity Reactions (Gell & Goombs Classification)==
{{cquote|'''ACID'''}} {{cquote|'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill}}
# Type I '''A'''naphylaxis
# Type II '''C'''ytotoxic-mediated
# Type III '''I'''mmune-complex
# Type IV '''D'''elayed hypersensitivity

==Multiple Endocrine Neoplasia (MEN)==
Each of the MENs is a disease of '''three or two letters plus a feature'''; all are autosomal dominant.
{{cquote|'''MEN I: 3 P's'''}}
# '''P'''ituitary
# '''P'''arathyroid
# '''P'''ancreas
# Plus Adrenal cortex

{{cquote|'''MEN II: 2 C's'''}}
# '''C'''arcinoma of thyroid
# '''C'''atacholamines (pheochromocytoma)
- MEN IIA: parathyroid
- MEN IIB (MEN III): mucocutaneous neuromas for

==Acute Pneumonia Infiltrates==
* '''P'''yogenic bacteria: '''P'''MN infiltrate
* '''M'''iscellaneous microbes: '''M'''ononuclear infiltrate

==Takayasu's Disease/Pulseless Disease==
{{cquote|'''When you have Takayasu's, I can't Tak'a yu pulse'''}}

==CBC Normal Differential==
{{cquote|'''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas}}
{{cquote|'''N'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}
{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}
# '''N'''eutrophils: '''60'''%
# '''L'''ymphocytes: '''30'''%
# '''M'''onocytes: '''6'''%
# '''E'''osinophils: '''3'''%
# '''B'''asophils: '''1'''%

==CAUSES==
==Metabolic Acidosis Causes==
{{cquote|'''MUDPILES'''}}
* '''M'''ethanol poisoning
* '''U'''remia
* '''D'''iabetic Keto-acidosis
* '''P'''ara-aldehyde ingestion
* '''I'''schemia
* '''L'''actic Acidosis
* '''E'''thanol poisoning
* '''S'''alicylate ingestion

==Metabolic Acidosis (Normal Anion-Gap) Causes==
===With Hyperkalemia===
{{cquote|'''RAISE K+'''}}
* RTA type 4
* Aldosterone or mineralocorticord deficiency
* Iatrogenic: NH4Cl, HCl
* "Stenosis": obstructive uropathy
* Early uremia
===With hypokalemia===
{{cquote|'''ReDUCE K+'''}}
* Renal TA type 1 and 2
* Diarrhoea
* Urine diversion into gut
* Carbonate anhydrase inhibitor
* Ex-hyperventilation

==BUN & Creatinine Elevation Causes==
{{cquote|'''ABCD'''}}
* '''A''' - '''A'''zotremia (pre-renal)
* '''B''' - '''B'''leeding (GI)
* '''C''' - '''C'''atabolic status
* '''D''' - '''D'''iet (high protein parenteral nutrition)

==Hypercalcemia Causes==
{{cquote|'''PAM SCHMIDT'''}}
* '''P'''aget's Disease
* '''A'''myloid
* '''M'''ultiple Myeloma
* '''S'''arcoid
* '''C'''ancer
* '''H'''ormomal (para-thyroid)
* '''M'''ilk-alkali Syndrome
* '''I'''mmobilization
* '''D'''-vitamin overdose
* '''T'''hyrotoxicosis

'''OR'''
{{cquote|'''MISHAP'''}}
* '''M'''alignancy
* '''I'''ntoxication (hypervitaminosis)
* '''S'''arcoidosis
* '''H'''yperparathyroidism
* '''A'''lkali (Milk) syndrome
* '''P'''aget's Disease (bone)
Also consider Addison's disease, thiazide diuretics and simple lab error

==Acute Pancreatitis Causes==
{{cquote|'''GET SMASHED'''}}
# '''G'''all stones
# '''E'''thanol
# '''T'''rauma
# '''S'''teroids
# '''M'''umps
# '''A'''utoimmune disease
# '''S'''corpion venom
# '''H'''yperlipidemia
# '''E'''RCP (dye)
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
Alcohol and Gallstones are the most common causes.

==Back Pain Causes==
{{cquote|'''DISK MASS'''}}
* '''D'''-'''D'''egeneration: DJD, Osteoporosis, spondylosis
* '''I'''-'''I'''nfection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture
* '''S'''-'''S'''pondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
* '''K'''-'''K'''idney stones/infarction/infection (pyelo/abscess)
* '''M'''-'''M'''ultiple myeloma, '''M'''etastasis from breast, prostate, lung, thyroid, kidney CA
* '''A'''-'''A'''neurysm, '''A'''bdominal pain referred to the back (see acute abdominal pain)
* '''S'''-'''S'''lipped disk, '''S'''pondylolisthesis
* '''S'''-'''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster

==TREATMENT==
==Syncope Management==
{{cquote|'''If the face is red, raise the head!'''}}
{{cquote|'''If the face is pale, raise the tail!'''}}

==Malignant Hyperthermia Treatment==
{{cquote|'''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

==GENETICS==
==Down Syndrome Features==
{{cquote|'''CHILD HAS PROBLEM!'''}}
* '''C'''ongenital heart disease/ '''C'''ataracts
* '''H'''ypotonia/ Hypothyroidism
* '''I'''ncure 5th finger/ '''I'''ncreased gap between 1st and 2nd toe
* '''L'''eukemia risk x2/ '''L'''ung problem
* '''D'''uodenal atresia/ '''D'''elayed development
* '''H'''irshsprung's disease/ '''H'''earing loss
* '''A'''lzheimer's disease/ Alantoaxial instability
* '''S'''quint/ Short neck
* '''P'''rotruding tongue/ '''P'''alm crease
* '''R'''ound face/ '''R'''olling eye (nystagmus)
* '''O'''cciput flat/ '''O'''blique eye fissure
* '''B'''rushfield spot/ '''B'''rachycephaly
* '''L'''ow nasal bridge/ '''L'''anguage problem
* '''E'''picanthic fold/ '''E'''ar folded
* '''M'''ental retardation/ '''M'''yoclonus

{{cquote|'''DOWN'''}}
* '''D'''ecreased alpha-fetoprotein and unconjugated estriol (maternal)
* '''O'''ne extra chromosome twenty-one
* '''W'''omen of advanced age
* '''N'''on-disjunction during maternal meiosis

{{cquote|'''Drink at 21'''}}
Chromosome 21

==Patau's Syndrome - Chromosome 13==
{{cquote|'''P'''uberty at 13}}

==Edward's Syndrome - Chromosome 18==
{{cquote|Election voter at 18}}

==DiGeorge (Velocardiofacial) Syndrome==
{{cquote|'''CATCH 22'''}}
* '''C'''ardiac abnormalities
* '''A'''bnormal facies
* '''T'''hymic aplasia
* '''C'''left palate
* '''H'''ypocalcemia
* '''22'''q11 deletion

==Marfan Syndrome Features==
# '''M'''itral valve prolapse - MVP
# '''A'''ortic Aneurysm
# '''R'''etinal detachment
# '''F'''ibrillin
# '''A'''rachnodactyly
# '''N'''egative '''N'''itroprusside test (differentiates from homocystinuria)

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

==PEDIATRICS==
==APGAR Score==
{{cquote|'''APGAR'''}}
* '''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.

WBR mnemonics

2014-01-31T23:59:10Z

Gonzalo Romero:

__NOTOC__
{{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]]
'''Editor-In-Chief:''' [[User:William J Gibson|Will Gibson]]; {{AE}} [[User:Gonzalo Romero|Gonzalo A. Romero, M.D.]][mailto:gromero@wikidoc.org];{{Rim}};[[User:Sergekorjian|Serge Korjian]]; [[User:YazanDaaboul|Yazan Daaboul]]; {{VR}}; {{M.P}}; {{AO}}; {{MS}};

==ANATOMY==
==GI Anatomy==
{{cquote|'''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport}}
''From proximal to distal:''
# '''D'''uodenum
# '''J'''ejunum
# '''I'''leum
# '''A'''ppendix
# '''C'''olon
# '''S'''igmoid
# '''R'''ectum

==Brachial Plexus Organization==
{{cquote|'''Radical Teachers Drink Cold Beers'''}}
{{cquote|'''Randy Travis Drinks Cold Beers'''}}
{{cquote|'''Robert Taylor Drinks Cold Beer'''}}
{{cquote|'''Red Trucks Drive Cats Nuts'''}}
# Roots
# Trunks
# Divisions
# Cords
# Branches

==Cranial Nerves==
{{cquote|'''On Old Olympus Towering Tops, A Finn And German Viewed Some Hops'''}}
{{cquote|'''Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen'''}}
# 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==
{{cquote|'''LR6 SO4 3'''}}
* '''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)

{{cquote|'''LAST'''}}
* '''L''' - '''L'''ateral Rectus
* '''A''' - '''A'''bducens Nerve
* '''S''' - '''S'''uperior Oblique
* '''T''' - '''T'''rochlear Nerve

==Facial Nerve Branches==
{{cquote|'''Two Zebras Bought My Car'''}}
{{cquote|'''Two Zebras Bit My Cookie'''}}
{{cquote|'''To Zanzibar By Motor Car'''}}
{{cquote|'''Ten Zulus Buggered My Cat'''}}
# Temporal
# Zygomatic
# Buccal
# Mandibular
# Cervical

==Penis Innervation==
{{cquote|'''P'''oint and '''S'''hoot}}
* '''P'''arasympathetic causes erection
* '''S'''ympathetic causes ejaculation

{{cquote|'''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==
{{cquote|'''ABC'S'''}}
* '''A'''ortic arch gives off the:
# '''B''' - '''B'''racheiocephalic trunk
# '''C''' - Left '''C'''ommon '''C'''arotid
# '''S''' - Left '''S'''ubclavian artery

==Femoral Triangle Structures in Order==
{{cquote|'''N (AVEL)'''}}
* '''N'''erve
* '''A'''rtery
* '''V'''ein
* '''E'''mpty space
* '''L'''ymphatics
- Parenthesis includes things contained in the femoral sheath.

==CELL BIOLOGY==
==Cell Division Phases==
{{cquote|'''People Meet And Talk'''}}
* '''P''' - '''P'''rophase
* '''M''' - '''M'''etaphase
* '''A''' - '''A'''naphase
* '''T''' - '''T'''elophase

==Cell Cycle Stages==
{{cquote|'''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==
{{cquote|'''Golgi Distributes A SPAM'''}}
* '''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

==Collagen==
{{cquote|'''COLLAGEN'''}}
* '''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

==Carbon Monoxide: Electron Transport Chain Target==
{{cquote|'''CO blocks CO'''}}
Carbon monoxide '''(CO)''' blocks Cytochrome Oxidase '''(CO)'''

==Hemoglobin Binding Curve: Right Shift Causes==
{{cquote|'''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

==RECEPTORS==
==G-proteins Receptors==
{{cquote|'''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==
{{cquote|'''ABC of Adrenaline'''}}
* Adrenaline--> activates
* Beta receptors--> increases
* Cyclic AMP

==BIOCHEMISTRY==
==Enzymes Classification==
{{cquote|'''Over The HILL'''}}
* '''O''' - '''O'''xidoreductases
* '''T''' - '''T'''ransferases
* '''H''' - '''H'''ydrolases
* '''I''' - '''I'''somerases
* '''L''' - '''L'''igases
* '''L''' - '''L'''yases

==Glycolysis Enzymes==
{{cquote|'''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==
{{cquote|'''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.

==METABOLISM==
==Metabolism Sites==
{{cquote|'''Use both arms to HUG'''}}
# Heme synthesis
# Urea cycle
# Gluconeogenesis
These reactions occur in both cytoplasm and mitochondria

==AcetylCoA and AcetacetylCoA==
{{cquote|'''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==
{{cquote|'''Our City Is Kept Safe And Sound From Malice'''}}
* Oxaloacetate
* Citrate
* Isocitrate
* alpha-Ketoglutarate
* Succinyl-CoA
* Succinate
* Fumarate
* Malate

{{cquote|'''Can I Keep Selling Sex For Money, Officer?'''}}
* Citrate
* Isocitrate
* alpha-Ketogluterate
* Succinyl CoA
* Succinate
* Fumerate
* Malate
* Oxaloacetate

{{cquote|'''Oh! Can I Keep Some Succinate For Myself?'''}}
{{cquote|'''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==
{{cquote|'''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==
{{cquote|'''P''' ri '''V''' a '''T''' e '''TIM HALL'''}}
{{cquote|'''PVT. TIM HALL'''}}
{{cquote|'''"PVT. TIM HALL always argues, never tires"'''}}
* '''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'''

==Creatine Phosphate: Amino Acid Precursors==
{{cquote|'''Nice GAMs!'''}}
* '''G''' - '''G'''lycine
* '''A''' - '''A'''rginine
* '''M''' - '''M'''ethionine

==Branched Chain Amino Acids Catabolism Steps==
{{cquote|'''Truck hit the Ox to Death'''}}
* '''T''' - '''T'''ransamination
* '''O''' - '''O'''xidative decarboxylation
* '''D''' - '''D'''ehydrogenation

==Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)==
{{cquote|'''Muscles LIVe fast'''}}
* Leucine
* Isoleucine
* Valine

==Urea Cycle==
{{cquote|'''O'''rdinarily '''C'''areless '''C'''rappers '''A'''re '''A'''lso '''F'''rivolous '''A'''bout '''U'''rination!}}
* '''O''' - '''O'''rnithine
* '''C''' - '''C'''arbamoyl
* '''C''' - '''C'''itrulline
* '''A''' - '''A'''spartate
* '''A''' - '''A'''rginosuccinate
* '''F''' - '''F'''umarate
* '''A''' - '''A'''rginine
* '''U''' - '''U'''rea

==Pyrimidines Nucleotides==
{{cquote|'''CUT the PY (pie)'''}}
* '''C'''ytosine
* '''U'''racil
* '''T'''hiamine
* '''T'''he
* '''PY'''rimidines

==ENZYME DEFICIENCIES==
==G6PD: Oxidant Drugs Inducing Hemolytic Anemia ==
{{cquote|'''AAA'''}}
* Antibiotic (eg: sufamethoxazole)
* Antimalarial (eg: primaquine)
* Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)

==Pompe's Disease==
{{cquote|'''Type "Police: Po + lys"'''}}
* '''PO'''mpe's disease is a '''LYS'''osomal storage disease (alpha 1,4 glucosidase)

==Galactosemia==
{{cquote|'''GALIPUT'''}}
* Galactose 1 Phosphate Uridyl Transferase
* There is an assay called the Galiput test for this

==Fabry's Disease==
{{cquote|'''FABRY ' S'''}}
* '''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

==Hurler Syndrome Features==
{{cquote|'''HURLER'S'''}}
*'''H'''eptosplenomegaly
*'''U'''gly facies
*'''R'''ecessive (AR inheritance)
*'''L'''-iduronidase deficiency (alpha)
*'''E'''yes clouded
*'''R'''etarded
*'''S'''tubby fingers/'''S'''hort

==Acute Intermittent Porphyria==
{{cquote|'''5 P's '''}}
* '''P'''ain in abdomen
* '''P'''olyneuropathy
* '''P'''sychologial abnormalities
* '''P'''ink urine
* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)

==VITAMINS==
==B Vitamins==
{{cquote|'''The Rhythm Nearly Proved Contagious'''}}
In increasing order:
* '''T''' - '''T'''hiamine (B1)
* '''R''' - '''R'''iboflavin (B2)
* '''N''' - '''N'''iacin (B3)
* '''P''' - '''P'''yridoxine (B6)
* '''C''' - '''C'''obalamin (B12)

==Niacin Deficiency==
{{cquote|'''The famous 4 D's'''}}
# Diarrhea
# Dermatitis
# Dementia
# Death (if untreated)
{{cquote|'''The 3D's of pellagra'''}}
Vitamin B3 (niacin, nicotinic acid) deficiency
# Dermatitis
# Diarrhea
# Dementia

==Folate Deficiency Causes==
{{cquote|'''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==
{{cquote|'''The FAT cat is in the ADEK (attic)'''}}
Fat soluble vitamins are ''A,D,E,K.'''

==Hypervitaminosis A==
{{cquote|Increased Vitamin A makes you '''HARD'''}}
* '''H''' - '''H'''eadache / '''H'''epatomegaly
* '''A''' - '''A'''norexia / '''A'''lopecia
* '''R''' - '''R'''eally painful bones
* '''D''' - '''D'''ry skin / '''D'''rowsiness

==HISTORY TAKING==
==Alcoholism Screening==
{{cquote|'''CAGE'''}}
* Have you ever felt it necessary to '''C'''UT DOWN on your drinking?
* Have you ever been '''A'''NNOYED when people suggest you cut down on 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?

==Chief Complaint==
{{cquote|'''OPQRST'''}}
* '''O''' - '''O'''nset of pain: what was the patient doing when the pain started?
* '''P''' - '''P'''alliative or '''P'''rovocative factors for the pain
* '''Q''' - '''Q'''uality of pain (burning, stabbing, aching, etc.)
* '''R''' - '''R'''adiation (up to jaw, down left arm, etc.)
* '''S''' - '''S'''everity of pain (usually 1 - 10 scale)
* '''T''' - '''T'''iming of pain (eg: after meals, in the morning, how long it lasts, etc.)

{{cquote|'''SOCRATES'''}}
* '''S''' - '''S'''ite of pain
* '''O''' - '''O'''nset of pain
* '''C''' - '''C'''haracter of pain: dull, sharp, aching, stabbing, tearing
* '''R''' - '''R'''adiation of pain: central abdominal pain radiating to Right Iliac Fossa
* '''A''' - '''A'''ssociated factors: eg. nausea/vomiting
* '''T''' - '''T'''iming of pain/duration
* '''E''' - '''E'''xacerbating/alleviating factors
* '''S''' - '''S'''everity of pain (1 - 10 scale)

{{cquote|'''ASCLAST'''}}
* '''A''' - '''A'''ggravatiing and '''A'''lleviating factors
* '''S''' - '''S'''everity
* '''C''' - '''C'''haracter, quality
* '''L''' - '''L'''ocation
* '''A''' - '''A'''ssociated symptoms
* '''S''' - '''S'''etting
* '''T''' - '''T'''iming

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

==Hospital Admission Orders==
{{cquote|'''DAVE WILMINGTON'''}}
* '''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.
{{cquote|'''ADC VAAN DIML''', pronounced ADC van dim(e)L}}
* '''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).

==Post-Op Fever Causes==
{{cquote|'''Five W's'''}}
* '''W'''ind: pneumonia, atelectasis
* '''W'''ound: wound infections
* '''W'''ater: urinary tract infection
* '''W'''alking: DVT/PE (walking can help reduce DVT/PE)
* '''W'''onderdrugs: especially anesthesia

==Predisposing Conditions for Pulmonary Embolism==
{{cquote|'''TOM SCH PREFER'''}}
* '''T''' - '''T'''rauma
* '''O''' - '''O'''besity
* '''M''' - '''M'''alignancy
* '''S''' - '''S'''urgery
* '''C''' - '''C'''ardiac disease
* '''H''' - '''H'''ospitalization
* '''P''' - '''P'''ast history
* '''R''' - '''R'''est (bed-bound)
* '''E''' - '''E'''strogen, pregnancy, post-partum
* '''F''' - '''F'''racture
* '''E''' - '''E'''lderly
* '''R''' - '''R'''oad trip

==Compartment Syndrome Signs (Arterial Occlusion)==
{{cquote|'''6 P's'''}}
# Pain
# Pale (Pallor)
# Perishing with Cold (Poikilothermia)
# Pulseless
# Paresthesias
# Paralysis

==PATHOLOGY==
==Causes of Diseases==
{{cquote|'''VITAMIN C'''}}
*'''V'''ascular
*'''I'''nfectious
*'''T'''rauma
*'''A'''uto-immune
*'''M'''etabolic
*'''I'''diopathic/Iatrogenic
*'''N'''eoplastic
*'''C'''ongenital

==5 Signs of Inflammation==
# '''Rubor''': redness/erythema
# '''Calor''': raised temperature
# '''Tumor''': swelling
# '''Dolor''': pain
# '''Functio Laesa''': loss of function
- Described by Celsus

==Hypersentivity Reactions (Gell & Goombs Classification)==
{{cquote|'''ACID'''}} {{cquote|'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill}}
# Type I '''A'''naphylaxis
# Type II '''C'''ytotoxic-mediated
# Type III '''I'''mmune-complex
# Type IV '''D'''elayed hypersensitivity

==Multiple Endocrine Neoplasia (MEN)==
Each of the MENs is a disease of '''three or two letters plus a feature'''; all are autosomal dominant.
{{cquote|'''MEN I: 3 P's'''}}
# '''P'''ituitary
# '''P'''arathyroid
# '''P'''ancreas
# Plus Adrenal cortex

{{cquote|'''MEN II: 2 C's'''}}
# '''C'''arcinoma of thyroid
# '''C'''atacholamines (pheochromocytoma)
- MEN IIA: parathyroid
- MEN IIB (MEN III): mucocutaneous neuromas for

==Acute Pneumonia Infiltrates==
* '''P'''yogenic bacteria: '''P'''MN infiltrate
* '''M'''iscellaneous microbes: '''M'''ononuclear infiltrate

==Takayasu's Disease/Pulseless Disease==
{{cquote|'''When you have Takayasu's, I can't Tak'a yu pulse'''}}

==CBC Normal Differential==
{{cquote|'''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas}}
{{cquote|'''N'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}
{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}
# '''N'''eutrophils: '''60'''%
# '''L'''ymphocytes: '''30'''%
# '''M'''onocytes: '''6'''%
# '''E'''osinophils: '''3'''%
# '''B'''asophils: '''1'''%

==CAUSES==
==Metabolic Acidosis Causes==
{{cquote|'''MUDPILES'''}}
* '''M'''ethanol poisoning
* '''U'''remia
* '''D'''iabetic Keto-acidosis
* '''P'''ara-aldehyde ingestion
* '''I'''schemia
* '''L'''actic Acidosis
* '''E'''thanol poisoning
* '''S'''alicylate ingestion

==Metabolic Acidosis (Normal Anion-Gap) Causes==
===With Hyperkalemia===
{{cquote|'''RAISE K+'''}}
* RTA type 4
* Aldosterone or mineralocorticord deficiency
* Iatrogenic: NH4Cl, HCl
* "Stenosis": obstructive uropathy
* Early uremia
===With hypokalemia===
{{cquote|'''ReDUCE K+'''}}
* Renal TA type 1 and 2
* Diarrhoea
* Urine diversion into gut
* Carbonate anhydrase inhibitor
* Ex-hyperventilation

==BUN & Creatinine Elevation Causes==
{{cquote|'''ABCD'''}}
* '''A''' - '''A'''zotremia (pre-renal)
* '''B''' - '''B'''leeding (GI)
* '''C''' - '''C'''atabolic status
* '''D''' - '''D'''iet (high protein parenteral nutrition)

==Hypercalcemia Causes==
{{cquote|'''PAM SCHMIDT'''}}
* '''P'''aget's Disease
* '''A'''myloid
* '''M'''ultiple Myeloma
* '''S'''arcoid
* '''C'''ancer
* '''H'''ormomal (para-thyroid)
* '''M'''ilk-alkali Syndrome
* '''I'''mmobilization
* '''D'''-vitamin overdose
* '''T'''hyrotoxicosis

'''OR'''
{{cquote|'''MISHAP'''}}
* '''M'''alignancy
* '''I'''ntoxication (hypervitaminosis)
* '''S'''arcoidosis
* '''H'''yperparathyroidism
* '''A'''lkali (Milk) syndrome
* '''P'''aget's Disease (bone)
Also consider Addison's disease, thiazide diuretics and simple lab error

==Acute Pancreatitis Causes==
{{cquote|'''GET SMASHED'''}}
# '''G'''all stones
# '''E'''thanol
# '''T'''rauma
# '''S'''teroids
# '''M'''umps
# '''A'''utoimmune disease
# '''S'''corpion venom
# '''H'''yperlipidemia
# '''E'''RCP (dye)
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
Alcohol and Gallstones are the most common causes.

==Back Pain Causes==
{{cquote|'''DISK MASS'''}}
* '''D'''-'''D'''egeneration: DJD, Osteoporosis, spondylosis
* '''I'''-'''I'''nfection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture
* '''S'''-'''S'''pondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
* '''K'''-'''K'''idney stones/infarction/infection (pyelo/abscess)
* '''M'''-'''M'''ultiple myeloma, '''M'''etastasis from breast, prostate, lung, thyroid, kidney CA
* '''A'''-'''A'''neurysm, '''A'''bdominal pain referred to the back (see acute abdominal pain)
* '''S'''-'''S'''lipped disk, '''S'''pondylolisthesis
* '''S'''-'''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster

==TREATMENT==
==Syncope Management==
{{cquote|'''If the face is red, raise the head!'''}}
{{cquote|'''If the face is pale, raise the tail!'''}}

==Malignant Hyperthermia Treatment==
{{cquote|'''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

==GENETICS==
==Down Syndrome Features==
{{cquote|'''CHILD HAS PROBLEM!'''}}
* '''C'''ongenital heart disease/ '''C'''ataracts
* '''H'''ypotonia/ Hypothyroidism
* '''I'''ncure 5th finger/ '''I'''ncreased gap between 1st and 2nd toe
* '''L'''eukemia risk x2/ '''L'''ung problem
* '''D'''uodenal atresia/ '''D'''elayed development
* '''H'''irshsprung's disease/ '''H'''earing loss
* '''A'''lzheimer's disease/ Alantoaxial instability
* '''S'''quint/ Short neck
* '''P'''rotruding tongue/ '''P'''alm crease
* '''R'''ound face/ '''R'''olling eye (nystagmus)
* '''O'''cciput flat/ '''O'''blique eye fissure
* '''B'''rushfield spot/ '''B'''rachycephaly
* '''L'''ow nasal bridge/ '''L'''anguage problem
* '''E'''picanthic fold/ '''E'''ar folded
* '''M'''ental retardation/ '''M'''yoclonus

{{cquote|'''DOWN'''}}
* '''D'''ecreased alpha-fetoprotein and unconjugated estriol (maternal)
* '''O'''ne extra chromosome twenty-one
* '''W'''omen of advanced age
* '''N'''on-disjunction during maternal meiosis

{{cquote|'''Drink at 21'''}}
Chromosome 21

==Patau's Syndrome - Chromosome 13==
{{cquote|'''P'''uberty at 13}}

==Edward's Syndrome - Chromosome 18==
{{cquote|Election voter at 18}}

==DiGeorge (Velocardiofacial) Syndrome==
{{cquote|'''CATCH 22'''}}
* '''C'''ardiac abnormalities
* '''A'''bnormal facies
* '''T'''hymic aplasia
* '''C'''left palate
* '''H'''ypocalcemia
* '''22'''q11 deletion

==Marfan Syndrome Features==
# '''M'''itral valve prolapse - MVP
# '''A'''ortic Aneurysm
# '''R'''etinal detachment
# '''F'''ibrillin
# '''A'''rachnodactyly
# '''N'''egative '''N'''itroprusside test (differentiates from homocystinuria)

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

==PEDIATRICS==
==APGAR Score==
{{cquote|'''APGAR'''}}
* '''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.

WBR mnemonics

2014-01-31T23:43:57Z

Gonzalo Romero:

__NOTOC__
{{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]]
'''Editor-In-Chief:''' [[User:William J Gibson|Will Gibson]]; {{AE}} [[User:Gonzalo Romero|Gonzalo A. Romero, M.D.]][mailto:gromero@wikidoc.org];{{Rim}};[[User:Sergekorjian|Serge Korjian]]; [[User:YazanDaaboul|Yazan Daaboul]]; {{VR}}; {{M.P}}; {{AO}}; {{MS}};

==GI==
==GI Anatomy==
{{cquote|'''D'''ow '''J'''ones '''I'''ndustrial '''A'''verage '''C'''losing '''S'''tock '''R'''eport}}
''From proximal to distal:''
# '''D'''uodenum
# '''J'''ejunum
# '''I'''leum
# '''A'''ppendix
# '''C'''olon
# '''S'''igmoid
# '''R'''ectum

==Acute Pancreatitis Causes==
{{cquote|'''GET SMASHED'''}}
# '''G'''all stones
# '''E'''thanol
# '''T'''rauma
# '''S'''teroids
# '''M'''umps
# '''A'''utoimmune disease
# '''S'''corpion venom
# '''H'''yperlipidemia
# '''E'''RCP (dye)
# '''D'''rugs (Azathioprine, Asparginase, Mercaptopurines, Pentamidine)
Alcohol and Gallstones are the most common causes.

==ANATOMY====Brachial Plexus Organization==
{{cquote|'''Radical Teachers Drink Cold Beers'''}}
{{cquote|'''Randy Travis Drinks Cold Beers'''}}
{{cquote|'''Robert Taylor Drinks Cold Beer'''}}
{{cquote|'''Red Trucks Drive Cats Nuts'''}}
# Roots
# Trunks
# Divisions
# Cords
# Branches

==Cranial Nerves==
{{cquote|'''On Old Olympus Towering Tops, A Finn And German Viewed Some Hops'''}}
{{cquote|'''Our Only Object To Touch And Feel Virgin Girls Vagina And Hymen'''}}
# 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==
{{cquote|'''LR6 SO4 3'''}}
* '''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)

{{cquote|'''LAST'''}}
* '''L''' - '''L'''ateral Rectus
* '''A''' - '''A'''bducens Nerve
* '''S''' - '''S'''uperior Oblique
* '''T''' - '''T'''rochlear Nerve

==Facial Nerve Branches==
{{cquote|'''Two Zebras Bought My Car'''}}
{{cquote|'''Two Zebras Bit My Cookie'''}}
{{cquote|'''To Zanzibar By Motor Car'''}}
{{cquote|'''Ten Zulus Buggered My Cat'''}}
# Temporal
# Zygomatic
# Buccal
# Mandibular
# Cervical

==Penis Innervation==
{{cquote|'''P'''oint and '''S'''hoot}}
* '''P'''arasympathetic causes erection
* '''S'''ympathetic causes ejaculation

{{cquote|'''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==
{{cquote|'''ABC'S'''}}
* '''A'''ortic arch gives off the:
# '''B''' - '''B'''racheiocephalic trunk
# '''C''' - Left '''C'''ommon '''C'''arotid
# '''S''' - Left '''S'''ubclavian artery

==Femoral Triangle Structures in Order==
{{cquote|'''N (AVEL)'''}}
* '''N'''erve
* '''A'''rtery
* '''V'''ein
* '''E'''mpty space
* '''L'''ymphatics
- Parenthesis includes things contained in the femoral sheath.

==PEDIATRICS==
==APGAR Score==
{{cquote|'''APGAR'''}}
* '''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.

==HISTORY TAKING==
==Alcoholism Screening==
{{cquote|'''CAGE'''}}
* Have you ever felt it necessary to '''C'''UT DOWN on your drinking?
* Have you ever been '''A'''NNOYED when people suggest you cut down on 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?

==Chief Complaint==
{{cquote|'''OPQRST'''}}
* '''O''' - '''O'''nset of pain: what was the patient doing when the pain started?
* '''P''' - '''P'''alliative or '''P'''rovocative factors for the pain
* '''Q''' - '''Q'''uality of pain (burning, stabbing, aching, etc.)
* '''R''' - '''R'''adiation (up to jaw, down left arm, etc.)
* '''S''' - '''S'''everity of pain (usually 1 - 10 scale)
* '''T''' - '''T'''iming of pain (eg: after meals, in the morning, how long it lasts, etc.)

{{cquote|'''SOCRATES'''}}
* '''S''' - '''S'''ite of pain
* '''O''' - '''O'''nset of pain
* '''C''' - '''C'''haracter of pain: dull, sharp, aching, stabbing, tearing
* '''R''' - '''R'''adiation of pain: central abdominal pain radiating to Right Iliac Fossa
* '''A''' - '''A'''ssociated factors: eg. nausea/vomiting
* '''T''' - '''T'''iming of pain/duration
* '''E''' - '''E'''xacerbating/alleviating factors
* '''S''' - '''S'''everity of pain (1 - 10 scale)

{{cquote|'''ASCLAST'''}}
* '''A''' - '''A'''ggravatiing and '''A'''lleviating factors
* '''S''' - '''S'''everity
* '''C''' - '''C'''haracter, quality
* '''L''' - '''L'''ocation
* '''A''' - '''A'''ssociated symptoms
* '''S''' - '''S'''etting
* '''T''' - '''T'''iming

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

==Hospital Admission Orders==
{{cquote|'''DAVE WILMINGTON'''}}
* '''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.
{{cquote|'''ADC VAAN DIML''', pronounced ADC van dim(e)L}}
* '''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).

==Post-Op Fever Causes==
{{cquote|'''Five W's'''}}
* '''W'''ind: pneumonia, atelectasis
* '''W'''ound: wound infections
* '''W'''ater: urinary tract infection
* '''W'''alking: DVT/PE (walking can help reduce DVT/PE)
* '''W'''onderdrugs: especially anesthesia

==Predisposing Conditions for Pulmonary Embolism==
{{cquote|'''TOM SCH PREFER'''}}
* '''T''' - '''T'''rauma
* '''O''' - '''O'''besity
* '''M''' - '''M'''alignancy
* '''S''' - '''S'''urgery
* '''C''' - '''C'''ardiac disease
* '''H''' - '''H'''ospitalization
* '''P''' - '''P'''ast history
* '''R''' - '''R'''est (bed-bound)
* '''E''' - '''E'''strogen, pregnancy, post-partum
* '''F''' - '''F'''racture
* '''E''' - '''E'''lderly
* '''R''' - '''R'''oad trip

==Compartment Syndrome Signs (Arterial Occlusion)==
{{cquote|'''6 P's'''}}
# Pain
# Pale (Pallor)
# Perishing with Cold (Poikilothermia)
# Pulseless
# Paresthesias
# Paralysis

==PATHOLOGY==
==Causes of Diseases==
{{cquote|'''VITAMIN C'''}}
*'''V'''ascular
*'''I'''nfectious
*'''T'''rauma
*'''A'''uto-immune
*'''M'''etabolic
*'''I'''diopathic/Iatrogenic
*'''N'''eoplastic
*'''C'''ongenital

==5 Signs of Inflammation==
# '''Rubor''': redness/erythema
# '''Calor''': raised temperature
# '''Tumor''': swelling
# '''Dolor''': pain
# '''Functio Laesa''': loss of function
- Described by Celsus

==Hypersentivity Reactions (Gell & Goombs Classification)==
{{cquote|'''ACID'''}} {{cquote|'''A'''nna '''C'''ycled '''I'''mmediately '''D'''ownhill}}
# Type I '''A'''naphylaxis
# Type II '''C'''ytotoxic-mediated
# Type III '''I'''mmune-complex
# Type IV '''D'''elayed hypersensitivity

==Multiple Endocrine Neoplasia (MEN)==
Each of the MENs is a disease of '''three or two letters plus a feature'''; all are autosomal dominant.
{{cquote|'''MEN I: 3 P's'''}}
# '''P'''ituitary
# '''P'''arathyroid
# '''P'''ancreas
# Plus Adrenal cortex

{{cquote|'''MEN II: 2 C's'''}}
# '''C'''arcinoma of thyroid
# '''C'''atacholamines (pheochromocytoma)
- MEN IIA: parathyroid
- MEN IIB (MEN III): mucocutaneous neuromas for

==Acute Pneumonia Infiltrates==
* '''P'''yogenic bacteria: '''P'''MN infiltrate
* '''M'''iscellaneous microbes: '''M'''ononuclear infiltrate

==Takayasu's Disease/Pulseless Disease==
{{cquote|'''When you have Takayasu's, I can't Tak'a yu pulse'''}}

==CBC Normal Differential==
{{cquote|'''N'''ever '''L'''et '''M'''onkeys '''E'''at '''B'''ananas}}
{{cquote|'''N'''ice '''L'''adies '''M'''ake '''E'''aster '''B'''read"}}
{{cquote|'''60''', '''30''', '''6''', '''3''', '''1'''}}
# '''N'''eutrophils: '''60'''%
# '''L'''ymphocytes: '''30'''%
# '''M'''onocytes: '''6'''%
# '''E'''osinophils: '''3'''%
# '''B'''asophils: '''1'''%

==Metabolic Acidosis Causes==
{{cquote|'''MUDPILES'''}}
* '''M'''ethanol poisoning
* '''U'''remia
* '''D'''iabetic Keto-acidosis
* '''P'''ara-aldehyde ingestion
* '''I'''schemia
* '''L'''actic Acidosis
* '''E'''thanol poisoning
* '''S'''alicylate ingestion

==Metabolic Acidosis (Normal Anion-Gap) Causes==
===With Hyperkalemia===
{{cquote|'''RAISE K+'''}}
* RTA type 4
* Aldosterone or mineralocorticord deficiency
* Iatrogenic: NH4Cl, HCl
* "Stenosis": obstructive uropathy
* Early uremia
===With hypokalemia===
{{cquote|'''ReDUCE K+'''}}
* Renal TA type 1 and 2
* Diarrhoea
* Urine diversion into gut
* Carbonate anhydrase inhibitor
* Ex-hyperventilation

==BUN & Creatinine Elevation==
{{cquote|'''ABCD'''}}
* '''A''' - '''A'''zotremia (pre-renal)
* '''B''' - '''B'''leeding (GI)
* '''C''' - '''C'''atabolic status
* '''D''' - '''D'''iet (high protein parenteral nutrition)

==Hypercalcemia Causes==
{{cquote|'''PAM SCHMIDT'''}}
* '''P'''aget's Disease
* '''A'''myloid
* '''M'''ultiple Myeloma
* '''S'''arcoid
* '''C'''ancer
* '''H'''ormomal (para-thyroid)
* '''M'''ilk-alkali Syndrome
* '''I'''mmobilization
* '''D'''-vitamin overdose
* '''T'''hyrotoxicosis

'''OR'''
{{cquote|'''MISHAP'''}}
* '''M'''alignancy
* '''I'''ntoxication (hypervitaminosis)
* '''S'''arcoidosis
* '''H'''yperparathyroidism
* '''A'''lkali (Milk) syndrome
* '''P'''aget's Disease (bone)
Also consider Addison's disease, thiazide diuretics and simple lab error

==Malignant Hyperthermia Treatment==
{{cquote|'''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

==Back Pain Causes==
{{cquote|'''DISK MASS'''}}
* '''D'''-'''D'''egeneration: DJD, Osteoporosis, spondylosis
* '''I'''-'''I'''nfection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture
* '''S'''-'''S'''pondylitis, ankylosing Spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
* '''K'''-'''K'''idney stones/infarction/infection (pyelo/abscess)
* '''M'''-'''M'''ultiple myeloma, '''M'''etastasis from breast, prostate, lung, thyroid, kidney CA
* '''A'''-'''A'''neurysm, '''A'''bdominal pain referred to the back (see acute abdominal pain)
* '''S'''-'''S'''lipped disk, '''S'''pondylolisthesis
* '''S'''-'''S'''train, '''S'''coliosis/lordosis, '''S'''kin: herpes zoster

==Syncope Management==
{{cquote|'''If the face is red, raise the head!'''}}
{{cquote|'''If the face is pale, raise the tail!'''}}

==GENETICS==
==Down Syndrome Features==
{{cquote|'''CHILD HAS PROBLEM!'''}}
* '''C'''ongenital heart disease/ '''C'''ataracts
* '''H'''ypotonia/ Hypothyroidism
* '''I'''ncure 5th finger/ '''I'''ncreased gap between 1st and 2nd toe
* '''L'''eukemia risk x2/ '''L'''ung problem
* '''D'''uodenal atresia/ '''D'''elayed development
* '''H'''irshsprung's disease/ '''H'''earing loss
* '''A'''lzheimer's disease/ Alantoaxial instability
* '''S'''quint/ Short neck
* '''P'''rotruding tongue/ '''P'''alm crease
* '''R'''ound face/ '''R'''olling eye (nystagmus)
* '''O'''cciput flat/ '''O'''blique eye fissure
* '''B'''rushfield spot/ '''B'''rachycephaly
* '''L'''ow nasal bridge/ '''L'''anguage problem
* '''E'''picanthic fold/ '''E'''ar folded
* '''M'''ental retardation/ '''M'''yoclonus

{{cquote|'''DOWN'''}}
* '''D'''ecreased alpha-fetoprotein and unconjugated estriol (maternal)
* '''O'''ne extra chromosome twenty-one
* '''W'''omen of advanced age
* '''N'''on-disjunction during maternal meiosis

{{cquote|'''Drink at 21'''}}
Chromosome 21

==Patau's Syndrome - Chromosome 13==
{{cquote|'''P'''uberty at 13}}

==Edward's Syndrome - Chromosome 18==
{{cquote|Election voter at 18}}

==Hurler Syndrome Features==
{{cquote|'''HURLER'S'''}}
*'''H'''eptosplenomegaly
*'''U'''gly facies
*'''R'''ecessive (AR inheritance)
*'''L'''-iduronidase deficiency (alpha)
*'''E'''yes clouded
*'''R'''etarded
*'''S'''tubby fingers/'''S'''hort

==DiGeorge (Velocardiofacial) Syndrome==
{{cquote|'''CATCH 22'''}}
* '''C'''ardiac abnormalities
* '''A'''bnormal facies
* '''T'''hymic aplasia
* '''C'''left palate
* '''H'''ypocalcemia
* '''22'''q11 deletion

==MARFAN Syndrome Features==
# '''M'''itral valve prolapse - MVP
# '''A'''ortic Aneurysm
# '''R'''etinal detachment
# '''F'''ibrillin
# '''A'''rachnodactyly
# '''N'''egative '''N'''itroprusside test (differentiates from homocystinuria)

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

==Essential Amino Acids==
{{cquote|'''P''' ri '''V''' a '''T''' e '''TIM HALL'''}}
{{cquote|'''PVT. TIM HALL'''}}
{{cquote|'''"PVT. TIM HALL always argues, never tires"'''}}
* '''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'''

==Urea Cycle==
{{cquote|'''O'''rdinarily '''C'''areless '''C'''rappers '''A'''re '''A'''lso '''F'''rivolous '''A'''bout '''U'''rination!}}
* '''O''' - '''O'''rnithine
* '''C''' - '''C'''arbamoyl
* '''C''' - '''C'''itrulline
* '''A''' - '''A'''spartate
* '''A''' - '''A'''rginosuccinate
* '''F''' - '''F'''umarate
* '''A''' - '''A'''rginine
* '''U''' - '''U'''rea

==CELL BIOLOGY==
==Cell Division Phases==
{{cquote|'''People Meet And Talk'''}}
* '''P''' - '''P'''rophase
* '''M''' - '''M'''etaphase
* '''A''' - '''A'''naphase
* '''T''' - '''T'''elophase

==Cell Cycle Stages==
{{cquote|'''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==
{{cquote|'''Golgi Distributes A SPAM'''}}
* '''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

==Collagen==
{{cquote|'''COLLAGEN'''}}
* '''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

==Acute Intermittent Porphyria==
{{cquote|'''5 P's '''}}
* '''P'''ain in abdomen
* '''P'''olyneuropathy
* '''P'''sychologial abnormalities
* '''P'''ink urine
* '''P'''recipitated by drugs (eg barbiturates, oral contraceptives, sulpha drugs)

==G6PD: Oxidant Drugs Inducing Hemolytic Anemia ==
{{cquote|'''AAA'''}}
* Antibiotic (eg: sufamethoxazole)
* Antimalarial (eg: primaquine)
* Antipyretics (eg: acetanilid, but not aspirin or acetaminophen)

==Pompe's Disease==
{{cquote|'''Type "Police: Po + lys"'''}}
* '''PO'''mpe's disease is a '''LYS'''osomal storage disease (alpha 1,4 glucosidase)

==Galactosemia==
{{cquote|'''GALIPUT'''}}
* Galactose 1 Phosphate Uridyl Transferase
* There is an assay called the Galiput test for this

==G-proteins Receptors==
{{cquote|'''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==
{{cquote|'''ABC of Adrenaline'''}}
* Adrenaline--> activates
* Beta receptors--> increases
* Cyclic AMP

==Carbon Monoxide: Electron Transport Chain Target==
{{cquote|'''CO blocks CO'''}}
Carbon monoxide '''(CO)''' blocks Cytochrome Oxidase '''(CO)'''

==Hemoglobin Binding Curve: Right Shift Causes==
{{cquote|'''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

==BIOCHEMISTRY==
==Enzymes Classification==
{{cquote|'''Over The HILL'''}}
* '''O''' - '''O'''xidoreductases
* '''T''' - '''T'''ransferases
* '''H''' - '''H'''ydrolases
* '''I''' - '''I'''somerases
* '''L''' - '''L'''igases
* '''L''' - '''L'''yases

==AcetylCoA and AcetacetylCoA==
{{cquote|'''A Lighter Lease (A LyTr LeIs)'''}}
Amino acids forming them:
* A=AcetylCoA or Acetoacetyl CoA
* Ly=Lysine
* Tr=Tryptophan
* Le=Leucine
* Is=Isoleucine

==Branched-chain Amino Acids Used by Skeletal Muscle (Fasting State)==
{{cquote|'''Muscles LIVe fast'''}}
* Leucine
* Isoleucine
* Valine

==Glycolysis Steps==
{{cquote|'''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.

==METABOLISM==
==Metabolism Sites==
{{cquote|'''Use both arms to HUG'''}}
# Heme synthesis
# Urea cycle
# Gluconeogenesis
These reactions occur in both cytoplasm and mitochondria

==Glycolysis Enzymes==
{{cquote|'''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==
{{cquote|'''Our City Is Kept Safe And Sound From Malice'''}}
* Oxaloacetate
* Citrate
* Isocitrate
* alpha-Ketoglutarate
* Succinyl-CoA
* Succinate
* Fumarate
* Malate

{{cquote|'''Can I Keep Selling Sex For Money, Officer?'''}}
* Citrate
* Isocitrate
* alpha-Ketogluterate
* Succinyl CoA
* Succinate
* Fumerate
* Malate
* Oxaloacetate

{{cquote|'''Oh! Can I Keep Some Succinate For Myself?'''}}
{{cquote|'''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==
{{cquote|'''Corrupt Anti Intelligence Agent Spoke Slander For Money'''}}
* Citrate synthatase
* Aconitase
* Isocitrate dehydrogenase
* Alpha ketogluturate dehydrogenase
* Succinyl CoA synthetase
* Succinate dehydrogenase
* Fumarase
* Malate Dehydrogenase

==B Vitamins==
{{cquote|'''The Rhythm Nearly Proved Contagious'''}}
In increasing order:
* '''T''' - '''T'''hiamine (B1)
* '''R''' - '''R'''iboflavin (B2)
* '''N''' - '''N'''iacin (B3)
* '''P''' - '''P'''yridoxine (B6)
* '''C''' - '''C'''obalamin (B12)

==Niacin Deficiency==
{{cquote|'''The famous 4 D's'''}}
# Diarrhea
# Dermatitis
# Dementia
# Death (if untreated)
{{cquote|'''The 3D's of pellagra'''}}
Vitamin B3 (niacin, nicotinic acid) deficiency
# Dermatitis
# Diarrhea
# Dementia

==Folate Deficiency Causes==
{{cquote|'''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==
{{cquote|'''The FAT cat is in the ADEK (attic)'''}}
Fat soluble vitamins are ''A,D,E,K.'''

==Hypervitaminosis A==
{{cquote|Increased Vitamin A makes you '''HARD'''}}
* '''H''' - '''H'''eadache / '''H'''epatomegaly
* '''A''' - '''A'''norexia / '''A'''lopecia
* '''R''' - '''R'''eally painful bones
* '''D''' - '''D'''ry skin / '''D'''rowsiness

==Branched Chain Amino Acids Catabolism Steps==
{{cquote|'''Truck hit the Ox to Death'''}}
* '''T''' - '''T'''ransamination
* '''O''' - '''O'''xidative decarboxylation
* '''D''' - '''D'''ehydrogenation

==Creatine Phosphate: Amino Acid Precursors==
{{cquote|'''Nice GAMs!'''}}
* '''G''' - '''G'''lycine
* '''A''' - '''A'''rginine
* '''M''' - '''M'''ethionine

==Pyrimidines Nucleotides==
{{cquote|'''CUT the PY (pie)'''}}
* '''C'''ytosine
* '''U'''racil
* '''T'''hiamine
* '''T'''he
* '''PY'''rimidines

==Fabry's Disease==
{{cquote|'''FABRY ' S'''}}
* '''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

WBR team

2014-01-31T23:10:04Z

Gonzalo Romero:

Template:Board review project

2014-01-31T23:08:41Z

Gonzalo Romero:

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[[Category:Projects]]

Board review project

2014-01-31T23:05:32Z

Gonzalo Romero: /* Links */

WBR medical illustrations

2014-01-31T23:04:50Z

Gonzalo Romero: /* Examples of WBR Medical Illustrations */

WBR template questions

2014-01-31T22:58:21Z

Gonzalo Romero: /* Examples of WBR High Quality Questions */

WBR team

2014-01-31T22:49:02Z

Gonzalo Romero: