Step I Mneumonics
Terms
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Causes of Eosinophilia
NAACP -
Neoplasia
Asthma
Allergy
Collagen vascular diseases
Parasites - Embryology Week of 2's
-
Week 2
2 layered trophoblast (cyto-/syncitio-)
2 layered embryoblast (epi-/hypo-)
2 fluid cavities (amniotic, yolk sac) -
Embryology Week of 3's
Gastrulation -
3 embryonic layers
ectoderm: cns/pns, epidermis, sensory epithelium
mesoderm: musc/bone/CT, vessels, blood, GU
endoderm: GI, glands, lungs, trachea, liver, pancreas -
Fetal Erythropoiesis
Young Liver Synthesizes Blood -
Yolk Sac wk 3-8
Liver wk 6-30
Spleen wk 9-28
Bone Marrow wk 28+ -
5 secondary vesicles of neural tube
Tell Diane she Messed up when she Met My brother -
Telencephalon
Diencephalon
Mesencephalon
Metencephalon
Myencephalon -
1st branchial arch derivatives
1st arch is MAXimal -
MAXillary and sphenopalatine artery
MAXilla, Mandible, Incus,Malleus
Masseter, Medial Pterygoid, teMporalis, ant belly of digastric, tensor veli palatini, tensor tempani
CN V2,V3 trigeminal -
2nd branchial arch derivatives
Second starts with S -
Stapedial and hyoid artery
Stapes, superior horn of the hyoid
Stapedius, facial muscles, post belly of digastric
CN VII facial -
3rd branchial arch derivatives
C is the 3rd letter -
Common Carotid and ICA
inferior horn of hyoid
stylopharyngeus
CN IX glossopharyngeal
inferior parathyroid glands and thymus -
4th branchial arch derivatives
4th supplies 4 limbs
Fourth is for Food -
aortic arch and right subclavian
thyroid/cricoid/arytenoid cartilage
pharyngeal constrictors
superior parathyroid glands
CN X -
6th branchial arch derivatives
Sixth is for Singing -
Pulmonary artery, PDA
intrinic laryngeal muscles
CN X (recurrent laryngeal nerve) -
Diaphragm Embryology
Several Parts Build the Diaphragm -
Septum transversum
Pleuroperiotoneal folds
Body wall mesoderm
Dorsal mesentery of esophagus - Mekel's Diverticulum Rule of 2s
-
2 inches long
2 feet from iliocecal valve
2% of population
2 years old and younger
2 types of epithelia (pancreatic or oxyntic)
2 symptoms: bleeding or obstruction -
Mesonephric/Wolffian Duct derivatives
SEED -
Seminal Vesicles
Epididymis
Ejaculatory duct
Ductus deferens - Potter's Disease
- Babies with Potter's can't Pee, have Pulmonary hyPoPlasia
- Dermatomes: T4, T10, L1, L4
-
T4 at the Teat Pore
T10 at the belly butTEN
L1 at IL (Inguinal Ligament)
L4 = down on all fours (knee) -
Rotator cuff muscles
Humerus SItS in shoulder joint -
Supraspinatus (Abd)
Infraspinatus & Teres Minor (Add, Lat rot)
Subscapularis (Add, Med rot) - Bronchopulmonary segments
- Arteries run with Airways
-
Femoral triangle contains:
lateral to medial -
NAVEL - nerve, artery, vein, empty space, lymphatics
artery and vein within femoral sheath - INdirect hernia
- through INguinal canal INto scrotum, occurs in INfants due to failed closure of processus vaginalis (lateral to inf epigastric vessels)
- Portal Systemic Anastamoses
- Gut, Butt, and Caput
- Ureter course: Water under the bridge
- Pass under uterine artery and ductus deferens
- Male Sexual Response and the ANS: Point and Shoot
-
Parasympathetic - arousal
Sympathetic - Ejaculation - Peripheral Nerve Layer: perineurium
- Permeability barrier
-
Sensory Corpuscles:
My Frend Deb Pours Coffee and Vanilla Latte's -
Meissner's, Fine touch, in Dermis
Pacinian, Course touch and Vibration, in Ligaments - Inner ear fluid compositions
-
Perilymph needs Potassium
eNdolymph needs Na -
Collagen types
Be (So Totally)
Cool
Read
Books -
type I: Bone, Skin, Tendon
type II: Cartilage
type III: Reticular fibers
type IV: Basement membrane -
Epidermal layers:
Californians Like Girls in String Bikinis -
stratum corneum
stratum lucidum
stratum granulosum
stratum spinosum
stratum basalis - Adrenal Cortex layers: GFR
-
zona Glomerulosa: Aldo
zona Fasciculata: Cortisol
zona Reticularis: Androgens - Peyer's Patch product: IgA
-
Intra-Gut Antibody: produced by plasma cells in lamina propria
Dimer with secretory (J) component secreted into lumen by enterocytes
Induced via M cell IL-5 -
Lower extremity nerve injury:
PED/TIP -
Peroneal (L4-S2) nerve everts and dorsiflexes
injury leads to foot drop
Tibial nerve (L4-S3) inverts and plantarflexes
injuries reduce tip-toeing - Blood Brain Barrier: protected by the CIA
-
Choroid plexus epithelium
(cuboidal cells with tight jxns)
Intracerebral Capillary Epithelium
(BL, fenestrated endothelium)
Arachnoid mater -
Hypothalamic functions:
TAN HATS -
Thirst (ADH-suproptic)
Adenohypophysis (releasing factors)
Neurohypophysis (oxytocin)
Hunger, satiety (lateral, ventromedial)
Autonomics
(parasymp = anterior, circadian = suprachiasmatic)
Temperature (anterior = heat loss, posterior = heat production)
Sexuality (Septate nucleus) - Thirst and Sleep control centers: drink warm milk before bed
-
Supraoptic (rostral to suprachiasmatic) = ADH
Suprachiasmatic = circadian rhythm -
Body temperature control:
A/C and Poikilotherms -
Anterior = Cooling
lesions to the Posterior nuclues
= inability to raise temperature
(poikilotherm, aka cold-blooded) -
Thalamic nuclei functions: LGN and MGN
VPL and VPM -
LateralGN to Look
MedialGN for Music
VPLateral = sensation from legs (and body)
VPMedial = sensation from mouth (and face) -
Aphasias
Broca's
Wernicke's
Arcuate Fasciculus -
BROca lesions = BROken mouth
Wernicke's = Wordy, no sensibility/comprehension
aRcuate fasciculus = no Repetition -
Cranial Foramina:
Obviously, Standing Room Only, Silly, At Jenn's Half-Marathon -
Optic canal (CN II, opthalmic a, retinal v)
Superior orbital fissure (CN III,IV,V1,VI, ophthalmic v)
foramen Rotundum (CN V2)
foramen Ovale (CN V3)
foramen Spinosum (middle meningeal a)
internal Auditory meatus (CN VII,VIII)
Jugular foramen (CN IX,X,XI, IJV)
Hypoglossal canal (CN XII)
foramen Magnum (medulla, vertebral a) - CN functions: Sensory, Motor, or Both
-
Some
Say
Marry
Money
But
My
Brother
Says
Big
Brains
Matter
Most - Vagal nuclei: the vagus wanders because it's SAD
-
nucleus Solitarius - visceral sensory (taste/GI)
nucleus Ambiguus - somatic motor (pharynx/larynx)
Dorsal motor nucleus - parasympathetic reflexes -
Dorsal Column organization
Fasciculi Gracilis and Cuneatus -
graciLis = Leg
cuneAtus = Arm -
Bell's Palsy causes:
ALexander Bell with STD -
AIDS
Lyme Disease
Sarcoidosis
Tumor
Diabetes
with central lesions: remember b/l innervation to upper face - Radial nerve innervates the BEST muscles
-
Brachioradialis
Extensors of Wrist/Fingers
Supinator
Triceps - Forearm Supination
-
to hold a bowl of SoUP
innervated by radial n. - Sensitivity vs. Specificity
-
SNOUT - Sn rules out (few false pos)
= true pos/dz prev
SPIN - Sp rules in (few false neg)
= true neg/health prev -
Reportable Diseases:
B A SSSMMART Cookie or you're Gone -
hep B
hep A
Salmonella
Shigella
Syphilis
Measles
Mumps
AIDS
Rubella
TB
Chickenpox
Gonorrhea -
Risk factors for suicide completion:
SAD PERSONS -
Sex (male)
Age
Depression
Previous attempts
Ethanol abuse
Rational thought
Sickness
Organized plan
No spouse
Social support lacking -
Informed Concent:
PDF -
Patient agrees
Discuss pertinent info
Free from coersion - APGAR score
-
Appearance
Pulse rate
Grimace reflex
Activity/muscle tone
Respiration -
Developmental Milestones:
1, 2, 3, 4 -
1 yr - plays alone
2 yrs - 2 play parallel (side by side)
3 yrs - 3 play in group
4 yrs - 4 play as teams (cooperative) -
Kubler Ross dying stages:
Death Arrives Bringing Grave Adjustments -
Denial
Anger
Bargaining
Grieving
Acceptance -
Sleep Stages:
at night, BATS Drink Blood -
awake, eyes open = beta waves
awake, eyes closed = alpha waves
light sleep = theta waves
deep sleep = sleep spindles
deeper/nonREM = delta waves
REM sleep = beta waves -
Major depressive episode:
SIGECAPS -
depressed mood OR anhedonia
with 5 of the following, lasting 2+ wks:
Sleep disturbance
Interest decreased
Energy Guilt
decreased
Concentration decreased
Appetite altered
Psychomotor retardation
Suicidal ideation -
Manic Episode:
DIG FAST -
3 of the following, lasting 1+ wk:
Distractability
Insomnia
Grandiosity
Flight of Ideas
Activity (increased goal-setting)
Speech (rapid, pressured)
Thoughtless pleasure-seeking -
Infant Deprivation Effects:
4 W's - Weak, Wordless, Wanting (socially), and Wary
- PANIC disorder
-
4 of the following:
Palpitations
Abd distress
Nausea
Increased perspiration
Chest pain/chills/choking -
Personality Disorders:
Clusters A, B, C = Weird, Wild, Worried -
A (Weird)
Paranoid, Schizoid, Schizotypal
B (Wild)
Antisocial, Borderline, Histrionic, Narcissistic
C (Worried)
Avoidant, Obsessive-Compulsive, Dependent - Schizophrenia: 5 A's
-
Ambivalence (uncertainty)
Autism (self preoccupation)
Affect (blunted)
Associations (loose)
Auditory hallucinations -
Mature Ego defenses:
Mature women wear a SASH -
Sublimation (finding new outlets)
Altruism (guilt -> giving)
Suppression
Humor - Nucleotides
-
PURines are PURe As Gold - adenine/guanine
CUT the PY for PYrimidines - cytosine/thymidine/uracil - Types of RNA
-
mRNA is massive in size
rRNA is rampant in quantity
tRNA is tiny in size - RNA polymerases
- 1, 2, 3 - RMT
- Start and Stop codons
-
start: AUG = are you going?
stop: UGA = u go away, UAA - u are away, UAG = u are gone - Introns and extrons
-
INtrons stay in nucleus
EXons EXit the nucleus as mature mRNA - ATP and GTP in translation
-
ATP for tRNA Activation (charging)
GTP for tRNA Gripping (binding) and Going (translocation) -
Molecular Biology Blots:
SNoW DRoP -
Southern = DNA-DNA
Northern = RNA-DNA
Western = Protein+Ab
Southwestern = Protein-DNA -
Imprinting Diseases:
angelMan's and Prader-willi -
angelMan's = Maternal
Prader-willi = Paternal - TCA cycle: Cindy Is Kind So She's Friendly More Often
-
Citrate
Isocitrate
alpha Ketoglutarate
Succinyl CoA
Succinate
Fumarate
Malate
Oxaloacetate -
Essential Amino Acids:
PriVaTe TIM HALL -
Phenylalanine
Valine
Tryptophan
Threonine
Isoleucine
Methionine
Histidine
Arginine
Leusine
Lysine - Cystinuria: COLA
-
defect in renal tubular transporter for:
cystine, ornithine, lysine, arginine -
Maple Syrup Urine Disease:
I Love Vermont Maple Syrup -
branched chain aa accumulation
defect in alpha ketoglu dehydrogenase
Isoleucine
Leucine
Valine - 5 P's of Porphyria
-
Painful abdomen
Pink urine
Polyneuropathy
Psychiatric disturbances
Precipitated by drugs -
Glycogen storage diseases:
Very Poor Carbohydrate Metabolism -
Von Gierke - glucose6Pase def
>hypogly, inc glycogen, hyperlipidemia, lactic acidosis
Pompe's - a1,4 glucosidase def
>cardiomegaly/myopathy, hepatomegaly
Cori's -a1,6 glucosidase def
McArdle's - musc glycogenPase def
>inc glycogen, musc cramps, myoglobinuria - Lesch Nyan Syndrome (LNS)
- Lacks Nucleotide Salvage (via HGPRT)
- Apolipoproteins: A, B, C, E
-
A - Activates LCAT
B - Binds LDL R
C - Cofactor for lipoprotein lipase
E - Extra/remnant uptake - Thiamine Deficiency (Vit B1)
- Ber1 Ber1
- Riboflavin deficiency (Vit B2): 2 C's
- cheilosis, corneal vascularization
- Niacin deficiency (Vit B3): 3 D's
-
Dermatitis, Dementia, Diarrhea
and beefy glossitis
from tryptophan - Causes of Hypercalcemia: MISHAP
-
Malignancy
Intoxication with Vit D
Sarcoidosis
Hyperparathyroidism
Alkali syndrome
Paget's Dz of bone - Vitamin E
- Erythrocyte antioxidant
-
Gram Stain Limitations:
These Rascals May Microscopically Lack Color -
Treponema
Rickettsia
Mycobacteria
Mycoplasma
Legionella pneumophilia
Chlamydia -
Fermentation:
N. MeninGitidis and N. Gonorrhea -
Ferment:
Maltose and Glucose
or just Glucose -
Obligate Aerobes:
Nagging Pests Must Breathe -
Nocardia
Pseudomonas aeruginosa
Mycobacterium tuberculosis
Bacillus anthracis -
Strep Pneumo:
AEIOU -
Alpha hemolytic
Encapsulated
IgA proteases
Optochin sensitive
quellUng rxn+ - Viridans Strep is not afraid of-the-chin
- Optochin resistant
- Clostridium species toxings
-
TETanus causes TETany/spastic paralysis
BOTulinum is found in BOTtled and canned food
PERFringens PERForates tissues via lecithinase
DIfficile causes DIarrhea - Treating Nocardia and Actinomyces: SNAP
-
Sulfa drugs for Nocardia
Actinomyces = PCN G -
Enterobactericeae characteristics:
COFFEe -
Capsular
O antigen (LPS polysaccharide)
Flagellar Ag
Ferment glucose
Enterobactericeae - hAEMOPhilus diseases
-
Arthritis (septic)
Epiglottitis
Meningitis
Otitis media
Pneumonia -
Legionella Pneumophilia:
French Legionnaire wearing silver helmet, sitting next to campfire with iron dagger - he's no sissy -
Legionella
Silver stain
Charcoal medium with
Fe/Cystine supplements - PSEUDomonas diseases
-
Pneumonia (CF pts)
Sepsis (black skin lesions)
External otitis (swimmer's ear)
UTI
Dermal burn infxn -
Lactose fermenting enterobactericeae:
Lactose is KEE -
Klebsiella
E. Coli
Enterobacter -
Zoonotic bacteria:
Bugs From Your Pet -
Borrelia burgdorferi
Lyme dz, ixodes tick from deer
Brucella
Undulant fever, unpasteurized dairy
Francisella Tularensis
fleas of rabbits/deer
Yersinia Pestis
The Plague, fleas from rodents
Pasteurella multocida
Cellulitis, animal bites -
Chlamydial triad:
VHF -
Vasculitis (rash)
Headache
Fever -
Rickettsial endemic tyPHus v.
Rocky mtn Spotted fever -
tyPHus: rash w/ centriPHugal spread
sPotted fever: rash w/ centriPetal spread
begins on palms and soles - VDRL false positives
-
Viruses
Drugs
Rheumatic fever/arthritis
Lupus or Leprosy - Blastomyces appearance
- Big, Broad-Based, Budding yeast
-
DNA viruses:
HHAPPPy
Naked PAP -
Hepadnaviridae
Herpesvirus
Adenovirus (naked)
Papovavirus (naked)
Parvovirus (naked)
Poxvirus - Mumps = mOMPs
-
Orchitis
Meningitis
Parotitis - Measles: 3 C's
-
Coryza
Cough
Conjunctivitis -
Herpes:
get herpes in a CHEVrolet -
CMV
HSV 1 & 2
EBV
VZV -
Congenital CMV infxn:
patients can't go HOME -
Hepatoslenoomegaly
Ototoxicity
Microcephaly
Ears (deafness) - Hepatitis Viruses: ABCDE
-
A = Asymptomatic
B = Blood borne
C = Chronic, Cirrhosis
D = Dependent on B
E = Expectant mothers -
Interleukins:
Hot T-BONE stEAk -
IL1 - pyrogen = Hot
IL2 - from T cells
IL3 - induces BONE marrow diff'n
IL4 - induces IgE and IgG
IL5 - induces IgA -
Hypersensitivities I - IV:
ACID -
I - Anaphylaxis, Atopic
II - Cytotoxic
III - Immune Complex
IV - Delayed Hypersensitivity - BRUTon's agammaglobulinemia
-
Boys (x-linked Recessive)
Underproduction of Igs
Tyrosine kinase deficiency -
Wiskott-Aldrich syndrome:
WIPE -
Wiskott
IgM deficiency
Pyogenic infections
Eczema -
Ampicillin coverage:
HELPS kill Enterococcus -
H. Flu
E. Coli
Listeria
Proteus
Salmonella/Shigella
Enterococcus -
1st generation Cephalosporins:
PEcK -
Proteus
E. Coli
Klebsiella -
2nd generation Cephalosporins:
HEN PEcKS -
H. flu
Enterobacter
Neisseria
Proteus
E. Coli
Klebsiella
Serratia -
Protein synthesis inhibitors:
buy AT 30, SCELL at 50 -
bind 30 S ribosomal subunit:
Aminoglycosides
Tetracyclines
bind 50S ribosomal subunit:
Synercid
Chloramphenicol
Erythromycin
cLindamycin
Linezolid -
Vancomycin:
NOT a lot of side effects -
Nephrotoxicity
Ototoxicity
Thrombophlebitis -
Tetracyclines:
VACUUM Before TRL -
Vibrio Cholera
Acne
Chlamydia
Ureaplasma Urealyticum
Mycoplasma
Borrelia
Tularemia
Rickettsia
Leptospira -
Trimethoprim (TMP):
Treats Marrow Poorly -
megaloblastic anemia
leukopenia
granulocytopenia - FluoroquinolONES
-
hurt your bONES:
cartilage damage in fetus/children
tendonitis and rupture in adults -
Metronidazole:
GET on the Metro for BCG -
Giardia
Enameoba
Trichomonas
Bacteroides
Clostridium Diff
Gardnerella Vaginalis - INH
- injures neurons and hepatocytes
- Rifampin: 4 R's
-
RNA polymerase inhibitor
Revs up p450
Red/orange secretions
Rapid resistance if used alone -
Anti-TB drugs:
help you RESPIrE -
Rifampin
Ethambutol
Streptomycin
Pyrazinamide
INH
Ethionamide
all hepatotoxic!