USMLE Step 1 Notes @usmle1mikmonics - Tumblr Blog

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dostudent

ETC shortcuts

FADH2 goes to complex II since 2 hydrogens

RotenONE inhibits complex ONE

AntImIcIn A, 3 III’s ==> Antimycin A inhibits complex 3

Cyan COlored Complex IV ==> Cyanide and CO inhibit complex IV

24 brown fatty aspirins break up ==> 2,4 dnp, aspirin and brown fat are etc uncouplers

#biochem mnemonics #biochem #ETC mnemonics #ETC #mnemonics

wibblywobblynurseywursey-blog

usmle1mikmonics

How is this the first time I've seen this ditty??? Why I love tumblr...

#cardio mnemonics #mnemonics #Cardiology #cardio #EKG mnemomnics #EKG

dostudent

renal tubular acidosis

RTA 1 ==> one too many H, defect in intercalated cells

RTA 2 ==> too little bicarb, defect in PCT to reabsorb bicarb

RTA 4 ==> no 4ldosterone (4 looks like an A),

#nephrology #RTA #renal tubular acidosis #neph mnemonics #mnemonics

i swear you are not alone...

I just wanted to throw out a quick message out to anyone who might be feeling like they are the only medical school/step 1 slackers who exist on Tumblr- you are not alone! There are plenty of us who created a special step-1-specific tumblr blog (and didn't even feel weird about it at the time) and started following anyone and everyone who ever posted anything remotely helpful on tumblr (because anything is better than planning to read First Aid front to back and back again right?).. But just because we follow and re-post and what not, it does NOT mean we are all rockstars of random biochemical minutiae.I know you've read a ton about the many fool-proof plans to step 1 success, and I'm here to tell you that you are not the only person in the history of Step 1 to not reach every goal you set out for yourself. So get some sleep and do what you can and leave what you can't until next time and breath in, breath out... remember, there was a time when the MCAT was supposedly going to be the death of you....

Dose Dependent effects of Dopamine mnemonic

Simplified version of Dopamine's dose-dependent MAJOR effects:

low doses - activates D1 receptors (Gs) - vasodilates renal blood vessels*

med.doses - activates B1 receptors (Gs) - increases heart rate/contractility etc..

high doses - activates A1 (Gq) - vasoconstricts,

*increased renal perfusion, GFR, also vasodilates mesenteric and coronary vessels

source: http://reference.medscape.com/drug/intropin-dopamine-342435

#pharm mnemonics #pharm picmonics #pharmacology #dopamine #mikmonics #picmonics

had a UWorld question on NF-kB which let to a google search which led to this :D

I am such a visual learner, if you know of more like this please share

btw: NF-kB is a transcription factor responsible for cytokine production (including TNF-a) in the immune response to infectious pathogens. Crohn's disease is associated with increased NF-kB activity

#immunology #youtube #immunology youtube #NF-kB

First Aid 2014 super fast review

Hi all,

Just wanted to quickly share my thoughts on the 2014 edition of First Aid. I was hesitant to buy it because I've already dropped some serious $$$$ on this exam, I've been burned before on "new" editions that end up being pretty identical to the cheaper editions available and I've been using the 2013 edition all year. I ended up tossing it in my Amazon cart for $37 thinking what's another $37 bucks after the cost of the Step 1 registration alone?

I'm so happy I did. More pictures, colors, mnemonics, information (like treatments of choice) and overall much better organized. Here are some examples:

Brain tumors (447-448) in the 2013 ed. has 2 pictures total for the 10 tumors. 2014 ed. (448-489 )has 20 pictures, 2 each per tumor. Much more helpful than having to flip back and forth between First Aid and Pathoma to see the histology. Also for the kidney stones they included a picture of each type of crystal.

Simple fixes in organization like including the epilepsy drug side effects IN the epilepsy drugs chart instead of on the backside of that page, including the brachial plexus lesions on the same page as the brachial plexus diagram, etc..

Much better diagrams for the Antimicrobial, Antifungal and Antiviral overviews (illustrating what works where) as well as a new one for Immunosuppression targets.

Anyways, I'm not affiliated with the people who make Step 1 in any way but I just wanted to let you all know in case you find colors and pictures as helpful as I do.

Good luck!

- Mikaela

Neuromuscular Blocking Drugs

Lots of great stuff at sketchymedicine.com including this breakdown of the train-of-four responses and what not of neuromuscular blocking drugs http://sketchymedicine.com/2013/11/1216/

Depolarizing: Succinylcholine

Nondepolarizing: -curarine, -curium, -curonium

Here's a super simplified mnemonic for which does what in case of a brain freeze

#neuro mnemonics #neurology #sketchymedicine #mnemonics #mikmonics #neuro pharm mnemonics #pharm mnemonics #neuromuscular blockade

BACman! Class 1 Antiarrhythmic (Na+ Blockers) mnemonic

I love visual mnemonics! Here's one to help you remember the effect on the AP duration of the different Class 1 Anti-arrhythmics from: http://imindmaps.blogspot.com/2013/06/antiarrhytmics-na-channel-blockers.html - visit the site for the full description.

Also remember that:

when the Batmobile is broken down, BACman has to take a slow CAB.

from strongest binding strength (ie slowest to release) to weakest (less time spent bound): 1C<1A<1B. Class 1C are the slowest to dissociate and their blocking effects can accumulate over multiple cardiac cycles - contraindicated in post MI.

Class 1B Bolts outta there, and is Best for post-MI.

The BACman face silhouette is the normal curve. See the phase 3 of the curve to apply the mnemonic:

IB antiarrhytmics show the line Before the (normal) face.

IA antiarrhytmics show the line After the (normal) face.

IC antiarrhytmics show the line Cara (spanish world of face), because is the same as normal in phase 3.

Antiarrhytmic type I Meds menmonic (3 words each one):

Before you started eating healthy (salads): Lettuce + Tomatoes + Mayo

Current you eat so so (fries): More + Fries + Please

After you will eat so fat: Double + Quarter + Pounder

#cardiac pharm #pharmacology #pharmacology mnemonics #cardiology #cardiac pharm mnemonics #mnemonics #mikmonics #picmonics #cardiac picmonics #cardiac pharm picmonics

medicowesome

Amyotrophic lateral sclerosis

#medicowsome #ALS #neurology

Rule of 4 of the Brainstem

Ugh got destroyed by another brainstem lesion question on Qbank- went searching for some help and was THRILLED to find Robert Gate's Rule of 4 of the Brainstem and this diagram to go with it:

Below the summarized Rules of 4 and a link for the full-size diagram and a link to an online powerpoint that summarizes it all and walks you through practice questions. I recommend printing out the diagram and writing your notes over it because its a bit hard to read- then go through the powerpoint with it.

I realize its an oversimplification but its crunch time now and I'm all for simplifying the brainstem!

Cheers!

link to diagram: http://lifeinthefastlane.com/the-rule-of-4-of-the-brainstem/

link to powerpoint: http://www.slideshare.net/guest2f088d1/brainstem-lesions

In the rule of 4 there are 4 rules

There are 4 structures in the ‘midline‘ beginning with M

There are 4 structures to the ‘side‘ (lateral) beginning with S

There are 4 cranial nerves in the medulla, 4 in the pons and 4 above the pons (2 in the midbrain)

The 4 motor nuclei that are in the midline are those that divide equally into 12 except for 1 and 2, that is 3, 4, 6 and 12

(5, 7, 9 and 11 are in the lateral brainstem)

The 4 Medial structures and the associated deficits are:

1)Motor pathway (or corticospinal tract): CL weakness of the arm and leg

2)Medial Lemniscus: CL loss of vibration and proprioception in the arm and leg

3)MLF: IPSI inter-nuclear ophthalmoplegia (failure of adduction of the IPSI eye +nystagmus in the opposite eye as it looks laterally)

4)Motor nucleus and nerve: IPSI loss of the cranial nerve that is affected (3, 4, 6 or 12)

The 4 ’Side’ (lateral) structures and the associated deficits are:

1) Spinocerebellar pathway: IPSI ataxia of the arm and leg

2) Spinothalamic pathway: CL alteration of pain and temperature affecting the arm, leg and rarely the trunk

3) Sensory nucleus of the 5th cranial nerve: IPSI alteration of pain and temperature on the face in the distribution

4) Sympathetic pathway: IPSI Homer’s syndrome, that is partial ptosis and a small pupil (miosis)

The 4 cranial nerves in the medulla are CN9-12:

1) Glossopharyngeal (CN9): IPSI loss of pharyngeal sensation

2) Vagus (CN10): IPSI palatal weakness

3) Spinal accessory (CN11): IPSI weakness of the trapezius and stemocleidomastoid muscles

4) Hypoglossal (CN12): IPSI weakness of the

The 4 cranial nerves in the pons are CN5-8:

1) Trigeminal (CN5):IPSI alteration of pain, temperature and light touch on the face back as far as the anterior two-thirds of the scalp and sparing the angle of the jaw.

2) Abducent (CN6): IPSI weakness of abduction (lateral movement) of the eye (lateral rectus).

3) Facial (CN7): IPSI facial weakness.

4) Auditory (CN8): IPSI deafness. The 6th cranial nerve is the motor nerve in the medial pons.

The 7th is a motor nerve but it also carries pathways of taste, and using the rule of 4 it does not divide equally in to 12 and thus it is not a motor nerve that is in the midline.

The vestibular portion of the 8th nerve is not included in order to keep the concept simple and to avoid confusion. Nausea and vomiting and vertigo are often more common with involvement of the vestibular connections in the lateral medulla.

The 4 cranial nerves above the pons are CN1-4: Olfactory and Optic not in midbrain

1) Oculomotor (CN3): impaired adduction, supradduction and infradduction of the IPSI eye with or without a dilated pupil. The eye is turned out and slightly down.

2) Trochlear (CN4): eye unable to look down when the eye is looking in towards the nose (superior oblique). The 3rd and 4th cranial nerves are the motor nerves in the midbrain.

Thus a medial brainstem syndrome will consist of the 4 M’s and the relevant motor cranial nerves, and a lateral brainstem syndrome will consist of the 4 S’s and either

the 9-11th cranial nerve if the lesion is in the medulla, or the 5th, 7th and 8th cranial nerve if the lesion is in the pons.

Handy tip: If there are signs of both a lateral and a medial (paramedian) brainstem syndrome, then one needs to consider a basilar artery problem, possibly an occlusion.

#brainstem #neurology #brainstem rules of 4 #mikmonics #neuro mnemonics

Disulfiram-like reaction mnemonic

No FO’TE’s for A-MAN OPERAting a METRO or PROCAR or he’ll SULF-er a GRISzly TOLL

Cephalosprorins: ceFOTEtan, cefAMANdole, cefOPERAzone

METROnidazole

PROCARbazine

1st gen SULFonylureas: TOLbutamide, chlorpropramide

GRISeofulvin

way more depressing version (but reminds you this mnemonic is for disulfiram-like reactions)

Want to Die-sulfering-like? or get a grizzly toll? Give fo’te’s to an alcoholic man operating a metro or procar

These medications cause a disulfiram-like reaction to alcohol and should be avoided in alcoholics. Disulfiram inhibits acetaldehyde dehydrogenase in alcohol metabolism causing an accumulation of acetaldehyde if alcohol is ingested- producing an immediate and severe negative reaction to alcohol intake - like a severe hangover.

#mikmonics #disulfiram #disulfiram-like reaction mnemonic #pharmacology #mnemonics #pharm mnemonics

artofapa-deactivated20251207

Cranial Nerves from J. Muniz

#cranial nerves #medcomics #neurology #picmonics

medicowesome

Antifungal drugs (with mechanism of action) mnemonic

Hola! Me again!

Drugs and their mechanisms can be difficult to remember.. I like pairing the action with the drug name to make it easy. We are doing anti-fungals today (Yaay!)

Mr. Ampho tears holes in the fungal membrane. Mister rhymes with Nyster and it reminds me of Nystatin. Ampho is Amphotericin.

The word “Squatter" reminds me that Squalene epoxidase is inhibited by terbinafine.

"Azole pazole” sounds so funny! *giggles*

Anyway, P450 inhibited by Azole. Hope pazole works for you as well =D

“Casper the friendly ghost”

Caspofungin the friendly glycan inhibitor xP

Griseofulvin is greasy. And if you put grease on tubules, they won’t move!

Griseofulvin inhibits the formation of the microtubule.

That’s all! Pray for me =)

-IkaN

usmle1mikmonics

Love it IkaN! Here's a few more (including ones from the pharMnemonics cards series and a bunch were from one source online but I can't remember which, sorry!)

Azoles:

Fluconazole - Fluid Fluco flows into CNS (used for cryptococcal meningitis)

Clotrimazole - Cutaneous (topical) (also Miconazole, a stretch!)

Voriconazole - inVasive aspergillosis, Visual disturbances

Posaconazole - Potent Posa - decreases Potassium levels, Platelet count, Prophylaxis for invasive aspergillosis, candida in immunocomp.

Echinocandins:

EchinocanDIN's- end in GIN: Glucan INhibitors: CaspofunGIN, MicafunGIN

Caspofungin used for invasive Candida, Aspergillosis,

ClASPs MAST cells - side effect - flushing from histamine release (picture clasping the mast cells so hard that they release histamine)

Terbinafine - makes nails fine, takes away the squalor - inhibits squalene epoxidase, treats onychomycosis- can also picture putting a little terbin (turban) on a toe character that falls down too low - can't see (visual disturbances)

Polyenes Punch Holes- AmphoTerrible and Nasty Nystatin

AMPHTERICIN B

A nemia M uscle spasms P hlebitis H eadaches/hypotension/hypokalemia T hrombocytopenia E mesis, encephalopathy R espiratory strida I ncreased temperature (fever) C hills I mmediate hypersensitivity (anaphylaxis) N ephrotoxicity--important! B ronchospasm

alternative- Just think of a terrible chef making a shake n bake (fever, chills) - its SO terrible that you grow pale at the sight of it (anemia) heart starts racing (arrthymia) and almost faint (hypotension). To make it better you wash it down with tons of water (so it doesnt hurt your kidneys) and you sprinkle on supplemental K/Mg.

Nasty Nystatin - Not absorbed (by skin and gut). Only safe oral/topical

#anti-fungals #mikmonics #pharm mnemonics #micro mnemonics #micro pharm #microbiology #fungi

CD what?? Cluster of Designation/Differentiation mnemonics

I had a UWorld question today asking me which surface marker is most specific for the large cells with abundant pale cytoplasm surrounding caseous necrosis (macrophages) - I had no idea (it's CD14) so I hunted down some mnemonics. Here's mine: