Title: Bone Wizardry / Mnemonics / Biochemistry
Tags: bw-mnemonics biochem
On every note of this deck, unless a note says otherwise:
System: biochem

Acronym: PVT TIM HALL
Title: Essential Amino Acids
Emoji: 💪
Path: ? P
. Phenylalanine
? V
. Valine
? T
. Tryptophan
? T
. Threonine
? I
. Isoleucine
? M
. Methionine
? H
. Histidine
? A
. Arginine
? L
. Leucine
? L
. Lysine
? Note
. Cannot synthesize: must eat
? Note
. Deficiency = muscle wasting
? Note
. PKU = Phe accumulates

Acronym: COLA
Title: Cystinuria Amino Acids
Emoji: 🪨
Path: ? C
. Cystine
? O
. Ornithine
? L
. Lysine
? A
. Arginine
? Note
. Hexagonal crystals on UA
? Note
. Autosomal dominant
? Note
. Alkalinize urine to treat

Acronym: PLAN-F
Title: Pyruvate Dehydrogenase Cofactors
Emoji: ⚡
Path: ? P
. Pyrophosphate (TPP / B1)
? L
. Lipoic Acid (B4)
? A
. CoA (Pantothenic / B5)
? N
. NAD (Niacin / B3)
? F
. FAD (Riboflavin / B2)
? Note
. Same cofactors for alpha-KG DH
? Note
. Also branched-chain AA DH
? Note
. All are B vitamins

Acronym: Tender Loving Care For Nancy
Title: PDH Cofactor ORDER
Emoji: 🔢
Path: ? T
. TPP first
? L
. Lipoic acid second
? C
. CoA third
? F
. FAD fourth
? N
. NAD last
? Note
. Flip last two of PLAN-F
? Note
. Sequence matters for boards
? Note
. Tests cofactor action order

Acronym: OHOT
Title: Beta-Oxidation Steps
Emoji: 🔥
Path: ? O
. Oxidation (yields FADH2)
? H
. Hydration (adds H2O)
? O
. Oxidation (yields NADH)
? T
. Thiolysis (releases AcCoA)
? Note
. Removes 2 carbons per round
? Note
. Palmitate (C16) = 7 rounds
? Note
. Carnitine shuttle required

Acronym: SNoW DRoP
Title: Blotting Techniques
Emoji: 🧬
Path: ? S
. Southern = DNA
? N
. Northern = RNA
? W
. Western = Proteins
? Note
. Capital letters = the target
? Note
. PCR amplifies DNA/RNA
? Note
. ELISA detects antibodies

Acronym: PIGI
Title: Disulfide Bond Hormones
Emoji: 🔗
Path: ? P
. Prolactin
? I
. Insulin
? G
. Growth Hormone
? I
. Inhibin
? Note
. S-S bonds for stability
? Note
. Alcohol breaks disulfide bonds
? Note
. Explains alcoholic endocrinopathy

Acronym: LIV
Title: Branched-Chain Amino Acids
Emoji: 🌿
Path: ? L
. Leucine
? I
. Isoleucine
? V
. Valine
? Note
. "Can't LIV without them"
? Note
. Same renal transport protein
? Note
. Defect = Maple Syrup Urine Disease

Acronym: Starvation Energy Order: Glucose → Glycogen → Proteolysis → Lipolysis → Ketogenesis
Title: Starvation fuel timeline over days
Emoji: ⏱️
Path: ? Glucose
. 🍬 First 2-4 hours: blood glucose used up
? Glycogen
. 🏪 Liver glycogen lasts 24-28 hours
? Proteolysis
. 💪 Day 2: muscle protein breakdown begins
? Lipolysis
. 🧈 End of day 2: fat mobilization kicks in
? Ketogenesis
. 🔥 Ketone bodies become primary brain fuel
? Note
. Brain switches to ketones to spare muscle protein
? Note
. Glycogen depletion triggers glucagon surge
? Note
. Proteolysis provides AAs for gluconeogenesis

Acronym: Glycogen Storage Diseases
Title: Enzyme deficiencies in glycogen metabolism
Emoji: 🏗️
Path: ? Von Gierke
. 🧪 Glucose-6-Phosphatase deficiency (Type I): severe hypoglycemia
? Anderson
. 🌳 Branching enzyme deficiency (Type IV): abnormal glycogen
? Cori
. ✂ Debranching enzyme deficiency (Type III): limit dextrins
? Hers
. 🫁 Liver Phosphorylase deficiency (Type VI): mild hepatomegaly
? McArdle
. 🏃 Muscle Phosphorylase deficiency (Type V): exercise intolerance
? Pompe
. ❤️ Lysosomal Glucosidase deficiency (Type II): cardiomegaly
? Note
. Pompe trashes the Pump (heart)
? Note
. McArdle = Muscle (both M)
? Note
. Von Gierke = doll-like facies + massive hepatomegaly

Acronym: SAM = Methyl Donor Everywhere EXCEPT Nucleotides; THF = Methyl Donor for Nucleotides
Title: Methyl donor compartmentalization
Emoji: 🎁
Path: ? SAM
. 📦 S-adenosylmethionine: universal methyl donor (DNA, catecholamines, creatine)
? THF
. 🧬 Tetrahydrofolate: methyl donor for purine/pyrimidine synthesis only
? Note
. Folate deficiency impairs DNA synthesis (megaloblastic anemia)
? Note
. B12 traps folate as N5-methyl-THF (methyl trap)
? Note
. SAM made from methionine + ATP

Acronym: Fatty Acid Formulas: Rounds = C/2 minus 1, NADPHs = C minus 2, ATPs = C minus 1
Title: Beta-oxidation yield calculations
Emoji: 🔢
Path: ? Rounds
. 🔄 Beta-oxidation cycles = (Carbons / 2) minus 1
? NADPHs
. ⚡ NADH + FADH2 produced = Carbons minus 2
? ATPs
. 💰 Net ATP from activation = Carbons minus 1
? Note
. Palmitate (C16) = 7 rounds, 14 reducing equivalents, 15 net ATP
? Note
. Even-chain FAs yield acetyl-CoA; odd-chain yield propionyl-CoA
? Note
. Subtract 2 ATP for initial fatty acyl-CoA activation

Acronym: 3 Things for Membrane Movement: ATP, Calcium, Microtubules
Title: Requirements for vesicular transport
Emoji: 🚚
Path: ? ATP
. ⚡ Energy for motor proteins and membrane fusion
? Calcium
. 🪨 Ca2+ triggers exocytosis and vesicle fusion
? Microtubules
. 🛤️ Tracks for kinesin (anterograde) and dynein (retrograde)
? Note
. Colchicine blocks microtubules = blocks WBC migration in gout
? Note
. Ca2+ influx triggers neurotransmitter release at synapses
? Note
. All three required for any active membrane transport

Acronym: Anabolic = Cytoplasm, Catabolic = Mitochondria; 5 in Both
Title: Metabolic pathway compartmentalization
Emoji: 🏠
Path: ? Anabolic
. 🏗️ Building pathways in cytoplasm (insulin, parasympathetic)
? Catabolic
. 🔥 Breakdown in mitochondria (exception: glycolysis in cytoplasm)
? 5 in Both
. 🔄 Heme, Gluconeogenesis, Urea, FA synthesis, Pyrimidine synthesis
? Note
. Glycolysis = the one catabolic pathway in cytoplasm
? Note
. Citrate shuttle connects mito acetyl-CoA to cytoplasmic FA synthesis
? Note
. Lead hits heme at ALA dehydratase (cyto) and ferrochelatase (mito)

Acronym: De Novo vs Salvage: High PRPP = De Novo (Cancer/Growth), Low PRPP = Salvage (Normal)
Title: Purine synthesis pathway selection
Emoji: ♻️
Path: ? De Novo
. 🚀 High PRPP = rapidly dividing cells (cancer, growth)
? Salvage
. ♻️ Low PRPP = recycles hypoxanthine and guanine (normal state)
? PRPP
. 🔑 Phosphoribosyl pyrophosphate is the branch-point regulator
? Note
. Lesch-Nyhan = HGPRT deficiency = no salvage = massive uric acid
? Note
. Methotrexate/5-FU target de novo pathway to kill cancer
? Note
. PRPP synthetase overactivity = gout

Acronym: DKA #1 Death During Treatment: Arrhythmia from Hypokalemia
Title: K+ must be in first IV bag
Emoji: 💀
Path: ? Arrhythmia . 💔 #1 cause of death during DKA treatment ? Hypokalemia . 📉 Insulin drives K+ into cells, dropping serum K+ ? K+ First . 💉 Potassium must be in the first IV bag before/with insulin ? Note . Total body K+ depleted even if serum K+ appears normal/high ? Note . Never give insulin if K+ < 3.3 ? Note . Cerebral edema = #1 DKA death in children (different mechanism)

Acronym: Thiamine 100mg BEFORE Glucose in Alcoholics
Title: Prevents Wernicke Encephalopathy
Emoji: 🍺
Path: ? Thiamine FIRST
. 💊 Give B1 before glucose: cofactor for pyruvate dehydrogenase
? Glucose WITHOUT B1
. 🍬 Exhausts remaining thiamine stores in brain
? Wernicke
. 🧠 Confusion + Ophthalmoplegia + Ataxia (irreversible if precipitated)
? Note
. Wernicke reversible if caught early; Korsakoff (confabulation) is permanent
? Note
. Mammillary bodies and medial thalamus damaged
? Note
. Always give thiamine to ANY malnourished patient before glucose

Acronym: Collagen Types: 1=Skin/Bone, 2=Cartilage, 3=Arteries, 4=Basement Membrane
Title: Structural protein distribution
Emoji: 🦴
Path: ? Type 1
. 🦴 Skin, bone, tendon, cornea (90% of body collagen)
? Type 2
. 🦵 Cartilage, vitreous humor, nucleus pulposus
? Type 3
. 🫀 Arteries, uterus, granulation tissue (reticular fibers)
? Type 4
. 🧱 Basement membrane (floor of epithelium)
? Note
. Type 1 deficiency = Osteogenesis Imperfecta (blue sclera)
? Note
. Type 3 deficiency = Ehlers-Danlos vascular (arterial rupture)
? Note
. Type 4 deficiency = Alport (hematuria, deafness) + Goodpasture target

Acronym: Trinucleotide Repeat Diseases: Huntington, Fragile X, Friedreich, Prader-Willi, Myotonic Dystrophy
Title: Genetic anticipation disorders
Emoji: 🔁
Path: ? Huntington
. 🧠 CAG on chr 4: caudate atrophy, chorea, dementia
? Fragile X
. 🧬 CGG: #1 inherited intellectual disability, large testes
? Friedreich
. 🦵 GAA: autosomal RECESSIVE (unique), spinocerebellar + cardiomyopathy
? Prader-Willi
. 🍔 Paternal deletion 15q: hypotonia, hyperphagia, obesity
? Myotonic
. 💪 CTG: myotonia, cataracts, cardiac defects, frontal balding
? Note
. Anticipation = worsens each generation (more repeats)
? Note
. Friedreich is the ONLY autosomal recessive trinucleotide disease
? Note
. Father transmits worse Huntington anticipation

Acronym: HMG-CoA Reductase Peaks at 8 PM
Title: Late meals = atherosclerosis
Emoji: 🌙
Path: ? 8 PM Peak
. 🕗 Rate-limiting cholesterol enzyme peaks at night
? Late Meals
. 🍔 Substrate when enzyme most active = max cholesterol
? Statins
. 💊 Short-acting statins taken at bedtime to match peak
? Note
. Atorvastatin/rosuvastatin are long-acting = any time
? Note
. Why intermittent fasting may reduce CV risk
? Note
. HMG-CoA reductase = target of ALL statin drugs

Acronym: ETC Inhibitors: I=Amytal/Rotenone, II=Malonate, III=Antimycin, IV=CO/CN, V=Oligomycin
Title: Electron transport chain poisons
Emoji: ⛓️
Path: ? Complex I
. 🧪 Amytal (barbiturate) + Rotenone (pesticide)
? Complex II
. 🧪 Malonate (competitive inhibitor of succinate DH)
? Complex III
. 🧪 Antimycin A (blocks cytochrome bc1)
? Complex IV
. 💀 CO + Cyanide + Chloramphenicol (blocks cytochrome c oxidase)
? Complex V
. 🧪 Oligomycin (blocks ATP synthase proton channel)
? Note
. Cyanide: cherry-red skin, almond breath; Tx: nitrites + thiosulfate
? Note
. CO binds Hb 200x stronger than O2; Tx: 100% O2 or hyperbaric
? Note
. Oligomycin stops ATP but ETC still runs = gradient builds

Acronym: 3 Uncouplers: DNP, Aspirin (Reye Syndrome), Free Fatty Acids
Title: Dissipate proton gradient as heat
Emoji: 🌡️
Path: ? DNP
. 💊 2,4-Dinitrophenol: carries protons across membrane (dangerous diet pill)
? Aspirin
. 🤒 High-dose in children → Reye syndrome (fatty liver + encephalopathy)
? Free Fatty Acids
. 🧈 Natural uncouplers; thermogenin (UCP1) in brown fat for heat
? Note
. Uncouplers = gradient → HEAT instead of ATP
? Note
. DNP deaths: uncontrolled hyperthermia
? Note
. Brown fat in neonates uses UCP1 for non-shivering thermogenesis

Acronym: Pure As Gold (Purines = A, G) / CUT the Pyrimidines (C, U, T)
Title: Nucleotide base classification
Emoji: 🧬
Path: ? PURe As Gold
. 💛 Purines = Adenine + Guanine (2 rings, larger)
? CUT
. ✂ Pyrimidines = Cytosine + Uracil + Thymine (1 ring, smaller)
? Note
. Purines 2 rings (bigger word = bigger molecule)
? Note
. Uracil replaces Thymine in RNA
? Note
. Pyrimidine dimers from UV radiation (thymine-thymine)

Acronym: Rapidly Dividing Cell Lines
Title: Cells that die first in low energy state
Emoji: 🔬
Path: ? Skin, hair, nails (epithelial)
. 💇 Dry, brittle, flaky
? GI tract mucosa
. 🫁 Malabsorption, N/V/D
? Respiratory epithelium
. 🌬️ Cilia stop, infections
? Renal PCT
. 🫘 Decreased reabsorption
? Endometrium
. 🩸 Secondary amenorrhea
? Breast ductal epithelium
. 🔻 Atrophy
? Seminiferous tubules
. ⬇️ Low sperm count
? Endothelium
. 🩹 Vasculitis, schistocytes
? Stem cells
. 🧬 Overdrive then failure
? Bone marrow
. 🦴 Pancytopenia

Acronym: Cell Division Classification
Title: Labile vs Stable vs Permanent cells
Emoji: 🔄
Path: ? Labile cells
. 🔁 Constantly dividing (epithelial, bone marrow)
? Stable cells
. ⏸️ Divide when necessary (liver, pancreas, fibroblasts, smooth muscle)
? Permanent cells
. 🚫 Cannot divide (neurons, cardiac myocytes, skeletal myocytes)

Acronym: 3 Reasons Body Needs Stem Cell Replication
Title: Why stem cells must replicate
Emoji: 🧫
Path: ? Apoptosis
. 📅 Scheduled cell death, daily replacement
? Necrosis
. 💥 Unscheduled cell death by accident
? Mutation
. 🧬 Live cells with mutations (cancer)

Acronym: Cancer Development Order in Low Energy
Title: Where cancer develops first
Emoji: 🎯
Path: ? Skin
. ☀️ First, exposed to sunlight radiation
? GI tract
. 🍽️ Second, inhaled/ingested radioactivity
? Bone marrow
. 🩸 Third, all toxins circulate here

Acronym: 3 Requirements for Membrane Movement
Title: ATP, Calcium, Microtubules
Emoji: ⚡
Path: ? ATP
. 🔋 Energy source
? Calcium
. 🧪 Ion signaling
? Microtubules
. 🧵 Structural transport

Acronym: 2 Most Common Symptoms of Low Energy State
Title: What brings patient to doctor
Emoji: 🏥
Path: ? Weakness
. 💪 Cannot go to work
? Shortness of breath
. 😰 Scares patient, fear of death

Acronym: 3 Sources of Energy
Title: Sugars, Fats, Proteins
Emoji: ⚡
Path: ? Sugars
. 🍬 40% diet, 4 kcal/g, fastest to mobilize, shortest lasting
? Fats
. 🧈 30% diet, 9 kcal/g, slowest to mobilize, longest lasting
? Proteins
. 🥩 30% diet, 4 kcal/g, 60% body weight

Acronym: Energy Utilization During Starvation
Title: Order of fuel sources
Emoji: 📉
Path: ? Plasma glucose
. ⏱️ Lasts 2-4 hours; hormones: epinephrine, glucagon
? Liver glycogen
. ⏱️ Lasts 24-28 hours; hormones: epinephrine, glucagon
? Proteolysis
. ⏱️ Starts at 2 days; hormones: cortisol, GH
? Lipolysis
. ⏱️ Begins end of day 2; hormone: glucagon
? Ketogenesis
. ⏱️ Last resort; hormone: glucagon

Acronym: Top 3 Causes of Mental Retardation
Title: MCC of intellectual disability
Emoji: 🧠
Path: ? Fetal alcohol syndrome
. 🍺 Poisons nuclear division, affects philtrum
? Fragile X syndrome
. 🧬 Large testes after puberty, pill-shaped head
? Down syndrome
. 🧬 Trisomy 21

Acronym: 7 Newborn Screening Tests
Title: Conditions screened at birth
Emoji: 👶
Path: ? PKU (Guthrie test)
. 🧪 Phenylacetate and phenylpyruvate
? Hypothyroidism
. 🧪 TSH
? CAH
. 🧪 17-hydroxyprogesterone
? Biotinidase deficiency
. 🧪 Treat with 10mg biotin daily
? Galactosemia
. 🧪 Enzyme deficiency
? Celiac sprue
. 🧪 Tissue transglutaminase
? Cystic fibrosis
. 🧪 Immunoreactive trypsin

Acronym: Purely Ketogenic Amino Acids
Title: Only 2 amino acids
Emoji: 🧪
Path: ? Lysine
. 🔑 Broken into acetyl-CoA only
? Leucine
. 🔑 Broken into acetyl-CoA only

Acronym: Aromatic Amino Acids
Title: Cut by chymotrypsin
Emoji: 🧪
Path: ? Phenylalanine
. 🔬 Aromatic, big and bulky
? Tryptophan
. 🔬 Aromatic, big and bulky
? Tyrosine
. 🔬 Aromatic, big and bulky

Acronym: Restriction Peptidases
Title: Enzymes that cut proteins
Emoji: ✂️
Path: ? Trypsin
. ✂️ Cuts right of LYS, ARG
? Chymotrypsin
. ✂️ Cuts right of PHE, TRP, TYR
? Elastase
. ✂️ Cuts right of GLY, ALA, SER (3 smallest)
? CNBr
. ✂️ Cuts right of MET
? Aminopeptidase
. ✂️ Cuts right of amino terminal
? Carboxypeptidase
. ✂️ EXCEPTION: cuts LEFT of carboxyl terminal

Acronym: 6 Actions of TCAs
Title: Tricyclic antidepressant mechanisms
Emoji: 💊
Path: ? Block catecholamine reuptake
. ⬆️ Increases sympathetic tone
? Strongly anticholinergic
. 🔥 Hot, dry skin, no sweating, hyperthermia
? Block alpha-1 receptors
. ⬇️ Vasodilation, hypotension
? Block sodium channels in ventricle
. ⚡ Arrhythmia risk
? Block AV conduction
. 💓 Prolonged QT
? Antihistaminic
. 😴 Sedation

Acronym: 4 Types of Protein Structure
Title: Primary through Quaternary
Emoji: 🏗️
Path: ? Primary
. 📝 Sequence of amino acids; peptide bonds
? Secondary
. 🌀 Alpha helix or beta-pleated sheet; hydrogen bonds
? Tertiary
. 📦 3D single polypeptide; hydrophobic/hydrophilic interactions
? Quaternary
. 🔗 Multiple subunits; cooperativity/allosterism

Acronym: 3 Drugs with Rapid Zero-Order Elimination
Title: Reach zero-order quickly
Emoji: ⚠️
Path: ? Alcohol
. 🍺 Must be carefully monitored
? Aspirin
. 💊 Overdose risk
? Phenytoin
. 💊 Narrow therapeutic window

Acronym: Causes of Myositis/Rhabdomyolysis
Title: CPK and myoglobin elevation
Emoji: 💪
Path: ? Hypothyroidism
. 🦋 MCC of myositis
? Cushing syndrome
. 💊 Endocrine cause
? Drugs (statins, INH, rifampin, steroids)
. 💊 #2 cause of myositis
? Infections (Trichinella, Taenia)
. 🦠 Raw meat
? Trauma/crush injury
. 🚗 MCC of rhabdomyolysis

Acronym: 4 Types of Collagen
Title: Where each type is found
Emoji: 🧬
Path: ? Type 1
. 🧴 Skin
? Type 2
. 🔗 Connective tissue
? Type 3
. 🫀 Arteries
? Type 4
. 🧱 Basement membrane

Acronym: 7 Components of Collagen Synthesis
Title: What you need to make collagen
Emoji: 🧪
Path: ? Glycine
. 🔬 Every third amino acid
? Lysine
. 🔬 Crosslinking
? Proline
. 🔬 17% of collagen
? Hydroxyproline
. 🔬 Modified proline
? Hydroxylysine
. 🔬 Modified lysine
? Vitamin C
. 🍊 Hydroxylation
? Copper
. 🔗 Lysine oxidase

Acronym: 6 Types of Amyloidosis
Title: Amyloid protein classification
Emoji: 🔬
Path: ? AA
. 🔴 Acute phase reactants; chronic inflammatory disease
? AB
. 🧠 Beta/Tau protein; Alzheimer disease
? AB-2
. 🫘 Beta-2 macroglobulin; chronic renal failure
? AE/AF
. 🦋 Endocrine/Familial; MEN-II
? AL
. 🩸 Light chains; Multiple Myeloma
? Transthyretin
. 👴 Senile plaques; aging; MCC hereditary familial

Acronym: Lead Poisoning Management by Level
Title: Treatment thresholds
Emoji: ⚠️
Path: ? 5-14 ug/dL
. 📋 Recheck 6 months, educate parents
? 15-44 ug/dL
. 📋 Notify public health, no chelation
? 45-69 ug/dL
. 🏠 Remove child, DMSA (Succimer)
? Above 70 ug/dL
. 🏥 Hospitalize, EDTA + BAL + Penicillamine

Acronym: 5 Pathways in Both Mitochondria and Cytoplasm
Title: Dual-compartment pathways
Emoji: 🔄
Path: ? Heme synthesis
. 🔬 Starts in mitochondria
? Gluconeogenesis
. 🔬 Both compartments
? Urea cycle
. 🔬 Both compartments
? Fatty acid synthesis
. 🔬 Both compartments
? Pyrimidine synthesis
. 🔬 Both compartments

Acronym: 5 Steps of Cyanide Poisoning Treatment
Title: Treatment sequence
Emoji: 💊
Path: ? Amyl nitrite
. 1️⃣ Oxidize iron to MetHb to bind CN
? Vitamin B12
. 2️⃣ Binds cyanide, excretes via kidney
? B12 cyanocobalamin
. 3️⃣ Most current management
? Methylene blue
. 4️⃣ Reduce iron back to 2+
? Transfuse
. 5️⃣ If needed

Acronym: ETC Inhibitors by Complex
Title: Electron transport chain blockers
Emoji: ⛔
Path: ? Complex 1: Amytal, Rotenone
. 1️⃣ Block NADH entry
? Complex 2: Malonate
. 2️⃣ Block succinate dehydrogenase
? Complex 3: Antimycin
. 3️⃣ Block cytochrome bc1
? Complex 4: CO, CN, Chloramphenicol
. 4️⃣ Block cytochrome oxidase
? Complex 5: Oligomycin
. 5️⃣ Block ATP synthase

Acronym: 3 ETC Uncouplers
Title: Dissipate proton gradient as heat
Emoji: 🔥
Path: ? Dinitrophenol (DNP)
. 🔥 Weight loss drug
? Aspirin
. 🔥 Reye syndrome
? Free fatty acids
. 🔥 American diet, brown fat

Acronym: 3 Causes of Microsteatosis
Title: Small fat droplets in liver
Emoji: 🫁
Path: ? Pregnancy
. 🤰 Acute fatty liver
? Tylenol poisoning
. 💊 Hepatotoxicity
? Reye syndrome
. ⚠️ Aspirin + viral infection in kids

Acronym: 5 Glycogen Storage Sites
Title: Where glycogen is stored
Emoji: 📦
Path: ? Skeletal muscle
. 💪 Largest store
? Liver
. 🫁 Can release glucose to blood
? Adrenal cortex
. 🔵 Can release glucose to blood
? Intestinal wall
. 🫁 Local use
? Cardiac muscle
. ❤️ Local use

Acronym: X-Linked Recessive Enzyme Deficiencies
Title: 10 important deficiencies
Emoji: 🧬
Path: ? G6PD
. 🩸 Hemolytic anemia
? Fabry (alpha-galactosidase)
. 🔬 Cataracts, early renal failure
? Hunter (iduronidase sulfatase)
. 🔬 Gargoyle features
? CGD (NADPH oxidase)
. 🦠 Chronic granulomatous disease
? Lesch-Nyhan (HGPRT)
. 🧬 Severe gout, self-mutilation
? Adrenoleukodystrophy (CAT-1)
. 🧠 Adrenal failure, white matter
? Adenosine deaminase
. 🧬 SCID
? OTC
. 🧪 Urea cycle defect
? PRPP synthetase
. 🧪 Purine synthesis
? Tyrosine kinase
. 🔬 Signaling defect

Acronym: X-Linked Dominant Diseases
Title: Females affected; often lethal in males
Emoji: 🧬
Path: ? Vitamin D-resistant rickets
. 🦴 X-linked hypophosphatemia; PHEX mutation; phosphate wasting not Ca2+ problem
? Pyruvate Dehydrogenase deficiency
. ⚡ PDHA1 on X chromosome; lactic acidosis; ketogenic diet
? Pseudohypoparathyroidism (some cases)
. 🦴 PTH resistance; low Ca, high Phos, high PTH; Albright hereditary osteodystrophy
? Rett syndrome
. 🧠 MECP2; normal development then regression; girls only
? Incontinentia pigmenti
. 🧬 IKBKG; skin lesions in lines; lethal in males
? Alport syndrome (X-linked)
. 🫘 COL4A5; hematuria, sensorineural deafness, lens defects
? Note
. Key distinction from X-linked recessive: heterozygous females ARE affected
? Note
. Vitamin D-resistant rickets: give phosphate supplements, NOT vitamin D alone
? Note
. PDH deficiency: pyruvate backs up into lactate; thiamine helps some cases
? Note
. Pseudohypo: PTH is made but target organs do not respond

Acronym: 8 Lysosomal Storage Diseases
Title: Enzyme deficiencies and features
Emoji: 🔬
Path: ? Gaucher
. 🔬 Glucocerebrosidase; crinkled paper macrophages; Ashkenazi Jews
? Fabry
. 🔬 Alpha-galactosidase; X-linked; cataracts, renal failure
? Krabbe
. 🔬 Beta-galactocerebrosidase; globoid bodies
? Tay-Sachs
. 🔬 Hexosaminidase A; cherry red macula; Ashkenazi Jews
? Sandhoff
. 🔬 Hex A and B; cherry red macula
? Niemann-Pick
. 🔬 Sphingomyelinase; zebra bodies; cherry red macula; HSM
? Metachromatic leukodystrophy
. 🔬 Arylsulfatase; MS equivalent in child
? Hurler
. 🔬 Iduronidase; gargoyle features; cataracts

Acronym: Prostaglandin Types and Functions
Title: Key prostaglandins
Emoji: 🔬
Path: ? PGA-2 (Thromboxane)
. 🩸 Vasoconstriction, platelet aggregation; made by platelets
? PGE-1
. 🫀 Vasodilator, keeps PDA open, GI mucus protection
? PGE-2 (Dinoprostone)
. 🤰 Labor induction, dilates cervix
? PGI-2 (Prostacyclin)
. 🩸 Vasodilator, inhibits platelet aggregation; made by endothelium
? PGF-2
. 🫁 Vasoconstriction, dysmenorrhea, separates placenta

Acronym: 3 Triglyceride Transporters
Title: Chylomicrons, VLDL, IDL
Emoji: 🧈
Path: ? Chylomicrons
. 🫁 Made in GI; transport TG to endothelium (75%) and liver (25%)
? VLDL
. 🫁 Made in liver; 95% TG, 5% cholesterol; transport to adipose
? IDL
. 🫁 Transport TG from adipose to everywhere else

Acronym: 6 Glycogen Storage Diseases
Title: Enzyme deficiencies
Emoji: 🦴
Path: ? Von Gierke
. 🔬 Glucose-6-phosphatase; liver and adrenal cortex enlarged
? Anderson
. 🔬 Branching enzyme; straight chains only
? Cory
. 🔬 Debranching enzyme; short outer branches
? Her
. 🔬 Liver phosphorylase; hepatomegaly
? McArdle
. 🔬 Muscle phosphorylase; muscle cramps with exercise
? Pompe
. 🔬 Cardiac alpha-1,4-glucosidase; heart failure before age 1

Acronym: 3 Periods of Rapid Growth
Title: When De Novo pathway runs
Emoji: 📈
Path: ? 0-2 years
. 👶 Tired, eat and sleep; never put on diet
? 4-7 years
. 🧒 Food preference set by age 8; max adipocytes fixed by 8
? Puberty
. 🧑 Growth spurt

Acronym: 3 DNA Helix Types
Title: A, B, and Z forms
Emoji: 🧬
Path: ? A form
. 🔬 Right-handed, 11 bp/turn
? B form
. 🔬 Right-handed, 10 bp/turn (normal)
? Z form
. 🔬 Left-handed, 12 bp/turn

Acronym: Energy Source by Organ and State
Title: Normal vs Stress vs Extreme
Emoji: ⚡
Path: ? Brain normal: glucose
. 🧠 Brain stress: glucose; extreme: ketones
? Heart normal: FFAs
. ❤️ Heart stress: glucose; extreme: glucose
? Muscle normal: glucose
. 💪 Muscle stress: FFAs; extreme: FFAs
? RBCs always: glucose
. 🔴 Cannot switch fuel source

Acronym: 4 Catabolic Hormones
Title: Hormones of starvation state
Emoji: ⚡
Path: ? Epinephrine
. ⚡ Fight or flight
? Glucagon
. ⚡ Mobilize glucose and lipids
? Cortisol
. ⚡ Proteolysis, gluconeogenesis
? Growth hormone
. ⚡ After 24 hours

Acronym: LDH Isozyme Locations
Title: 5 LDH types
Emoji: 🧪
Path: ? LDH1
. ❤️ Heart (rises 24hr, peaks 48hr, gone 72hr)
? LDH2 and 3
. 🩸 RBCs and muscle
? LDH4 and 5
. 🫁 Liver, kidney, lungs

Acronym: 5 Fates of Pyruvate
Title: Where pyruvate can go
Emoji: 🔀
Path: ? Lactate . 😤 Anaerobic; via LDH; regenerates NAD+ ? Alanine . 😤 Anaerobic; non-toxic; when pH drops <7.35 ? Ethanol . 🍺 Fermentative; in yeast ? OAA . 🔄 Anapleurotic; via pyruvate carboxylase; needs CO2 and biotin ? Acetyl-CoA . ✅ Aerobic; via pyruvate dehydrogenase; enters Krebs

Acronym: 4 Effects of Acidosis
Title: What happens when pH drops
Emoji: ⚠️
Path: ? GABA increases
. 🧠 Lethargy, somnolence, coma
? Denatures proteins
. 🔬 Structural damage
? Hyperkalemia
. ⚡ K+ shifts out of cells, arrhythmias
? Kussmaul breathing
. 🫁 Rapid, deep breathing

Acronym: Krebs Cycle Yield Per Turn
Title: Energy from 1 turn
Emoji: ⚡
Path: ? 3 NADHs
. ⚡ 7.5 ATPs
? 1 FADH2
. ⚡ 1.5 ATPs
? 1 GTP
. ⚡ 1 ATP

Acronym: 3 Types of Ketones
Title: Ketone bodies
Emoji: 🧪
Path: ? Beta-hydroxybutyrate
. 🧪 90% of ketones; enters brain; least water soluble
? Acetone
. 🧪 Smells on breath; measured by urine dipstick
? Acetoacetate
. 🧪 Intermediate

Acronym: Necrosis vs Apoptosis
Title: Two types of cell death
Emoji: 💀
Path: ? Apoptosis: membrane dissolves first, nucleus last
. 📅 Programmed, non-inflammatory
? Necrosis: nucleus dissolves first
. 💥 Unplanned, inflammatory

Acronym: 9 Types of Necrosis
Title: Necrosis classification
Emoji: 💀
Path: ? Ischemic/Coagulative
. 🩸 MCC; 90%; kidney, heart, adrenals; architecture remains
? Purulent
. 🦠 Gram +/- bacteria
? Liquefactive
. 🧠 Brain (already half liquid); forms abscess
? Granulomatous
. 🦠 Non-bacterial; T-cells + macrophages
? Caseous
. 🦠 Cheesy; TB only
? Fibrinoid
. 🩸 Immune response in vessels; vasculitis, uremia, TB
? Fat
. 🫁 Pancreas (saponification), breast (trauma)
? Gangrenous
. 🦶 Ischemia; lower limbs, GI; dry vs wet
? Hemorrhagic
. 🩸 Organs with 2+ blood supplies (GI, brain, liver)

Acronym: 3 Trisomies and Key Features
Title: 13, 18, 21
Emoji: 🧬
Path: ? Patau (Trisomy 13)
. 🧬 Polydactyly, high arched palate, omphalocele, holoprosencephaly
? Edward (Trisomy 18)
. 🧬 Rocker bottom feet, clenched fist overlapping fingers, triphalangeal thumb
? Down (Trisomy 21)
. 🧬 Epicanthic folds, transverse palmar crease, endocardial cushion defects

Acronym: 4 Protein Targeting Labels
Title: How proteins reach their destination
Emoji: 📦
Path: ? Pre-sequence
. 📦 Guides into RER; gets cleaved off
? Pro-sequence
. 📦 Guides to Golgi via HSP-90; degraded except in insulin (becomes C-peptide)
? Mannose-6-phosphate
. 📦 Added at Golgi, goes to lysosome; missing = I-cell disease
? Short amino terminal sequence
. 📦 Goes to mitochondria via HSP-70

Acronym: 8 Factors Affecting Diffusion
Title: What governs membrane transport
Emoji: 🔬
Path: ? Concentration gradient
. 1️⃣ Most important
? Size of molecule
. 2️⃣ Bigger = more water drag
? Net charge
. 3️⃣ More charge = more water drag
? pH
. 4️⃣ Affects net charge
? Membrane thickness
. 5️⃣ Thicker = harder
? Surface area
. 6️⃣ Greater = more diffusion
? Flux (dx/dt)
. 7️⃣ More particles per time
? Reflection coefficient
. 8️⃣ Fraction returned vs sent

Acronym: 6 Second Messenger Systems
Title: Intracellular signaling
Emoji: 📡
Path: ? cAMP
. ⚡ Most common; sympathetic; catabolic; activates PKA
? cGMP
. 🔵 Parasympathetic; anabolic; activates protein phosphatase
? IP3-DAG
. 🔴 All hypothalamic hormones (except CRH); smooth muscle by hormones
? Calcium-calmodulin
. 💪 Smooth muscle by distention; 4 Ca:1 calmodulin
? Calcium alone
. 🧪 Gastrin only
? Tyrosine kinase
. 📈 Insulin and all growth factors

Acronym: Electrolyte Driving Forces
Title: How fast ions move
Emoji: ⚡
Path: ? Sodium: 155
. ⚡ Depolarizes all membranes except atrium/thalamus
? Potassium: 6
. ⚡ Slow; sets resting membrane potential
? Chloride: 0
. ⚡ At its Nernst number; no net movement
? Calcium: 210
. ⚡ Outcompetes Na but cannot fit in Na channel; blocks depolarization
? Magnesium: 210
. ⚡ Same as calcium; used to stop arrhythmias, asthma, preeclampsia

Acronym: 4 Specialized Membranes and Depolarization
Title: What each membrane uses
Emoji: ⚡
Path: ? Neurons
. 🧠 Na+ to depolarize; seizures if excess
? Skeletal muscle
. 💪 Na+ to depolarize; spasms/tetany if excess
? Smooth muscle
. 🫁 Na+ to depolarize, then Ca2+ as 2nd messenger
? Cardiac: atrium uses Ca2+, ventricle uses Na+
. ❤️ Atrial arrhythmias: CCB; Ventricular: Na blocker

Acronym: 5 Types of Blots
Title: Southern, Northern, Western, etc.
Emoji: 🧪
Path: ? Southern Blot
. 🧬 DNA
? Northern Blot
. 🧬 RNA
? Western Blot
. 🧬 Protein
? Southwestern Blot
. 🧬 DNA going to protein (translation)
? PCR
. 🧬 Amplifies DNA/RNA (used for viral load in HIV)

Acronym: Types of Mutations
Title: Frame-shift vs Point mutations
Emoji: 🧬
Path: ? Frame-shift
. 🔴 Delete/insert 1-2 bases; everything after is messed up; early presentation
? Silent
. 🟢 Change in one base, same amino acid; asymptomatic
? Missense
. 🟡 Change codes for different amino acid (e.g., sickle cell)
? Nonsense
. 🔴 Change becomes stop codon; protein stops prematurely; early presentation