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6/18/13 6:33 PM

—"SECOND"AID:"USMLE"MNEMONICS
This is a list of medical mnemonics, side-notes, and generalizations I wrote down while going through my 2010 First Aid book while supplementing with 2012 Falcon, Kaplan, and a bit of Goljan. I stopped at around three-quarters of the text because I got tired and felt like not many people would be interested…(Update: sorry, but I’m too busy to go back and type the rest! ><). P.S. If you want to find a topic fast, I suggest Ctrl+F Behavioral Science: Statistical distribution: Positive skew = meAn>meDian>mOde Positive skew = alphabetical from greatest to least Reportable diseases: “It was reported that studly Mr. Shigella ate salmon, chicken, and liver”: “It was REPORTED that STuDly MMR SHIGELLA aTB Salmon, Chicken, and Liver” STDs: AIDs, Gonorrhea, Syphilis, Chlamydia (*NOT HIV!) MMR: Measles, Mumps, Rubella Shigella TB Salmonella Chicken Pox Hepatits A, B, C Health care payment: CARE for the Elderly, AID the destitute Medicare - elderly, Medicaid - low income people Early developmental milestones: # of blocks stacked = age in years * 3 2 word sentences at 2 “pee at three”; tricycle at three “four-square at four” = can hop at four drawings: 3yo = circle 4yo = + 5yo = square 6yo = triangle See reference:

Biochemistry: Stop codons: UGA, UAA, UAG U Go Away, U Are Away, U Are Gone EXpress EXons, INtrons are IN the way Proto-oncogenes: Mike’s sis returned with her two new breasts she was able to grow because of herbs. “MYC’s SIS RETurned with HER2Neu breasts she RAS ABLe To-Grow BCl of hERBs.” Myc sis ret Her2/neu ras abl TGFalpha bcl2 ERB-B1, B2 Collagen: The higher the number, the smaller and softer it gets Type 1 - bone (skin) - Osteogenesis Imperfecta (failed glycosylation and formation of procollagen triple helix with ER) Type 2 - cartilage - death in utero Type 3 - blood vessels - Ehlers-Danlos (failure of cross-linking by lysyl oxidase to make collagen fibrils outside fibroblasts), berry aneurysms Type 4: basement membrane - Alport’s nephritis (+ deafness and vision problems; “can’t see, can’t pee, can’t hear”) Blotting procedures:

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SNOW DROP S/D: Southern blot = DNA sample identified with DNA probe N/R: Northern blot = RNA sample identified with DNA probe O/O W/P: Western blot = protein sample identified with antibody probe Model systems: Knock out = take a gene OUT Knock in = INsert a gene Knock down = knock down the expression of the gene via complementary mRNA antagonist Imprinting: Prader-Willi = Paternal deletion AngelMan’s = Maternal deletion Genetics: Autosomal Dominant: have “familial” or “hereditary” in name + “A Brainy Dwarf named Marfan von Hippel-Lindau hired MEN to Hunt for Potatoes.” Brainy = Neurofibromatosis1, 2 Dwarf = Achondroplasia Marfan von Hippel-Lindau MEN1, 2a, 2b Huntingtons Potato = Tuberous sclerosis X-linked recessive: “Duke Fabry’s Brutal Gopher Hunter, Lesch, Was-Actually a Fragile Albino Hemophiliac.” Duke = Duchenne’s Fabry Brutal = Bruton’s Gopher —> G6Pher = G6PD deficiency Hunter = Hunter’s Lesch-Nyhan Was-Actually = Wiskott-Aldrich Fragile X ocular Albinism Hemophilia A, B Fragile X = Xtra large testes, jaws, ears FraGile X = cGg trinucleotide repeat myoTonic dystrophy = cTg trinucleotide repeat Autosomal trisomies: Pat Ed Down = 13, 18, 21 Puberty at 13, Election at 18, Drinking at 21

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Down syndrome is associated with ALL (and AML) and ALzheimers and decreased ALpha-fetoprotein —> “ALL fall DOWN”; also associated with: Duodenal Atresia (failure to recanalize = blind duodenum —> bilious vomiting with first feed; “double-bubble”) Celiac Disease (associated with dermatitis herpetiformis) Annular Pancreas Hirschprung congenital megacolon (failure of neural crest cell migration: no Auerbach or Meissner’s plexus —> constipation/meconium ileus) Edward’s: watch 99 balloons Patau’s: rocker bottom Pedals/feet, cleft lip/Palate, holoProsencephaly (sonic hedgehog deficiency), Polydactyly William’s syndrome: Will Farrell in Elf: elfin faces, mental retardation, well-developed verbal skills, extreme friendliness DiGeorge syndrome: CATCH-22 Cleft palate Abnormal facies Thymic aplasia (T-cell deficiency) Cardiac defects Hypocalcemia (secondary to parathyroid aplasia; remember third pharyngeal pouch: inferior parathyroids are grown with thymus and descend together) microdeletion at chromosome 22q11 Vitamin B1: Thiamine Thiamine pyrophosphate (TPP) is needed for a number of enzymes, but is rarely required alone. Whenever you need B1, you usually need FAD (B2), NAD (B3), CoA (B5), and Lipoic Acid, so just group them together: B1,2,3,5+LA. Enzymes that use B1, 2, 3, 5 + LA: Glycolysis/TCA: PDH (X = lactic acidosis; Tx: ketogenic Leucine, Lysine + high fat diet) TCA: alphaKGDH HMP: transketolase branched chain AADH (X = Maple Syrup Urine Disease —> severe CNS defects, MR, and death) Related problems: Lipoic acid is antagonized by Arsenic, which causes rice water diarrhea and garlic breath. B1 deficiency in alcoholics —> Wernicke-Korsakoff, beriberi PDH deficiency/dysfunction —> inability to continue TCA —> diversion to lactic acidosis; brain starves for energy —> neurologic defects. To keep brain from starving, Tx with ketogenic amino acids LEUCINE and LYSINE and high fat diet (beta oxidation of fats will produce acetyl CoA —> TCA/ketogenesis). Vitamin B6: Pyridoxine Major pathways that use B6: 1. Glycogenolysis RLS: Glycogen —> G1P via glycogen phosphorylase 2. Heme synthesis RLS: Succinyl CoA (TCA) + Glycine —> delta aminolevulinic acid (ALA) via deltaaminolevulinic acid synthase 3. Cysteine synthesis: Homocysteine + Serine —> Cystathione via Cystathione synthase (X = homocysteinuria: Marfanoid Sx+MR+atherosclerosis) Note: Cystinuria due to PCT reabsorption defect —> staghorn cystine kidney stones; Tx: acetazolamide to alkalinize urine 4. ALT/AST transamination: Alanine+alphaKG(TCA)<—ALT—>Pyruvate(glycolysis)+glutamate Aspartate(Urea cycle)+alphaKG(TCA)<—AST—>OAA(TCA)+glutamate 5. Amino acid production (hydroxylation, decarboxylation reactions): 1. tyrosine —hydroxylation—> dopa —decarboxylation—> dopamine 2. tryptophan to niacin/B3 (no B6 = no B3 = Pellagra)

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it’s an antioxidant that prevents hemolytic anemia and neurodysfunction Vitamin K: inject newborns with it to make sure they’re oK (prevent hemorrhage).tumblr. dopamine —> NE via dopamine beta hydroxylase. histidine to histamine 4. fatty acid and steroid synthesis oxidative burst (NADPH oxidase. glutamate to GABA (no B6 = loss of GABA = increased excitation —> convulsions/seizures) Vitamin B12: Cobalamin Cofactor when you see “Meth” in product or substrate: 1. 2. Vitamin B7: Biotin While Vitamin B6 is needed for DEcarboxylation reactions (amino acid production). X = Chronic Granulomatous Disease) p450 glutathione reductase AKA RBC antioxidation G6PD deficiency = (x-r) —> no NADPH = no glutathione reductase = oxidative damage = hemolytic anemia (bite cells RBCs partially eaten by macrophages (M0’s). 4.6BP: ”2 supports 1:” PFK2 supports PFK1 —> glycolysis F26BP supports F16BP —> glycolysis MOA: insulin —> decreases cAMP —> decreases PKA —> dephosphorylated FBPase2 = PFK2 —> F6P to F26BP —> stimulates PFK1 —> incr F6P to F16BP (glycolysis) Note: glucose —> decreases cAMP —> decreases CAP-cAMP binding of lac operon = RNA polymerase can’t bind to promoter Glycolytic enzyme deficiency: RBCs solely depend on glycolysis for energy so no Pyruvate Kinase/Phosphoglycerate Kinase (ATP generating steps) = decreased ATP —> can’t maintain membrane gradient —> cell swells —> hemolytic anemia HMP shunt/Pentose Phosphate Pathway: G6P —> Ribulose5P + 2NADPH via RLS G6PDH Ribulose5P —> Ribose5P —> purine synthesis NADPH: 1. monitor w/ Warfarin intrinsic (longer) pathway —> PTT (longer name). Collagen synthesis: hydroxylation of proline and lysine within fibroblast ER <—SCURVY 3. homocysteine + N-METHylTHF —> METHionine + THF via homocysteine methyltransferase Absorbed in the ileum (Crohn’s. blocked by Reserpine Vitamin D: the longest name with a 1: (1. Aureus moaning = Pseudomonas Cat = Catalase + organism NoHeart = Nocardia Disorders of __ metabolism: ”__-kinase” is the enzyme that immediately follows the breakdown of __: http://julieyumi.” Prima = Primaquine Aspirin INH (Isoniazid) I. AcetylCoA(TCA)—>MalonylCoA(FA synthesis RLS) Avidin in egg-whites Avidly binds B7.25-(OH)2D3 in kidney by 1alpha hydroxylase) Vitamin E: E is for Erythrocytes. deficiency = normal bleeding time. gastric bypass. HMGCoA synthase = ketogenesis (your brain wants to SYNTHESIZE KETONES when there’s no glucose) Regulation by F2. sprue. microcytic anemia) 5. but increased PT and aPTT Note: platelet dysfunction —> BT extrinsic (shorter) pathway —> PT (shorter name).” Urea cycle RLS: CPS1 Pyrimidine synthesis RLS: CPS2 HMGCoA ___: “You always want to REDUCE your CHOLESTEROL”: HMGCoA reductase = RLS for cholesterol synthesis vs.” recoiling = E. 3. Dx: negative Nitroblue tetrazolium reduction) = NADPH oxidase deficiency —> susceptible to Catalase+ organisms: “The recoiling Red Asp wasn’t Sorry towards the moaning Cat because it had Noheart. Diphyllobothrium latum) with IF (pernicious anemia).Professor = Ibuprofen Dapsone Sulfurous = Sulfonamides Fava bean NitroFarts = Nitrofurantoin CGD (chronic granulomatous disease. Deficiency causes an increase in methylmalonic acid (peripheral neuropathy) and homocysteine (megaloblastic anemia). Other causes of megaloblastic anemia = folate deficiency (incr. Heinz bodies .25-(OH)2D3) Calcitriol = active form (PTH stimulates conversion of liver’s 25OHvitamin D to 1. VII. B7 is needed for CARBOXylation reactions: 1. no B6 = hypochromic. PropionylCoA(oddchainFA/branchedchainAA metab)—>MethylmalonylCoA via proprionylCoA carboxylase (which goes on to form succinyl CoA of TCA with methylmalonylCoA isomerase and B12) 2.B.oxidized Hb that precipitated in RBCs) Drugs that cause hemolytic anemia in G6PD deficiency: “Prima had to take Aspirin when she INHaled her I. Vitamin C: Ascorbic Acid 1. so no neuropathy) and chronic alcoholism. homocysteine but not methylmalonic acid. B12 stores last for YEARS. Iron absorption and Fe2+ state maintenance 2. glycine to porphyrin (in heme production.arghlblargh! 6/18/13 6:33 PM 3.B. METHylmalonylCoA —> Succinyl CoA via methylmalonylCoA isomerase 2. use Schilling test to determine if it’s intake/absorption or lack of IF problem.Professor Dapsone’s Sulfurous Fava bean NitroFarts. 2. Pyruvate(glycolysis)—>OAA (TCA) via pyruvate carboxylase 3.com/post/22267813238/second-aid-usmle-mnemonics Page 3 of 21 . monitor w/ Heparin Carbamoyl phosphate synthetase: ”UP 1.coli red = Serratia Asp = Aspergillus Sorry = S.

globoid cells Niemann Pick’s his nose with hisphinger Niemann-Pick = Sphingomyelinase —> incr Sphingomyelin: cherry macula with hepatosplenomegaly. Methionine(M). Watch out when you see “ALDO-” because it means something bad is going to happen: Glucose —> Sorbitol via Aldose Reductase + NADPH (CATARACTS) Note: Sorbitol —> Fructose via SorbitolDH Galactose —> Galactilol via Aldose Reductase + NADPH (CATARACTS) Fructose1P —> Glyceraldehide and DihydroxyacetoneP via Aldolase B (FRUCTOSE INTOLERANCE) Essential amino acids: TV FILM HWRK (Threonine(T). PHENYLALANINE(F).arghlblargh! Glucose —> G6P via Gluco(Hexo)kinase Fructose —> F1P via Fructokinase Galactose —> Gal1P via Galactokinase 6/18/13 6:33 PM Deficiencies of Fructo and Galactokinases causes MILD symptoms (respective sugars are present in urine). incr Tyr diet): —> Fumarate via Homogentinsic acid oxidase (X = Alkaptonuria) —> Thyroxine —(Tyrosine hydroxylase/B6. angiokeratoma. steatorrhea. ARGININE(R). Valine(V). neurodegeneration. Leucine(L). airway obstruction Hunter’s = iduronate sulfatase —> incr heparan sulfate. dementia Mucopolysaccharidoses: HurLer’s = alpha-L-iduronidase —> incr heparan sulfate.com/post/22267813238/second-aid-usmle-mnemonics Page 4 of 21 . developmental delay. blocked by Metyrosine)—> Dopa: —> Melanin (X = Albinism: decreased pigment) —(Dopa decarboxylase/B6. B48 —> night blindness. NH3+=9.8. blocked by Reserpine)—> NE —(PNMT/SAM)—>Epinephrine Tryptophan(X in Hartnup’s): —(B6)—> Niacin=B3 —> NAD+/NADP+ (X = Pellagra) —(BH4)—> Serotonin —> Melatonin (sleep) Lysosomal storage diseases: Tay-SaX = HeXosaminidase A —> incr GM2: no hepatosplen.—>excrete) OTC = major urea cycle enzyme: Ornithine + carbamoyl-phosphate —> Citrulline via OTC OTC deficiency (x-r) = shunting of carbamoyl phosphate from urea cycle to pyrimidine synthesis: carbamoyl phosphate + aspartate —> orotic acid Orotic Aciduria —> decreased BUN + hyperammonemia Amino acid derivatives: Phenylalanine —(Phenylalanine hydroxylase + THB + NADPH via Dihydropterin reductase)—> Tyrosine(X = PKU (a-r): screened by Guthrie test 2-3 days after birth. blurry vision. gargoylism.5 Tyrosine(Y) .4.10. dermatan sulfate: corneal clouding.10. Sugar High = GlucoCerebrosidase Gaucher’s = betaGlucocerebrosidase —> incr glucocerebroside: aseptic femur necrosis. FYI: COO-=2.5 KNOW: Ketogenic amino acids: Leucine and Lysine —> USED TO TREAT PDH DEFICIENCY Cycles: Urea cycle and TCA overlap: OAA(TCA) + Glutamate <—AST—> Aspartate(Urea) + alphaKG(TCA) Aspartate(Urea) + Citrulline(Urea) —> Arginosuccinate(Urea) —> Arginine(Urea) + Fumarate(TCA) Urea cycle enzyme deficiency —> decreased TCA intermediates —> TCA INHIBITION + HYPERAMMONEMIA (b/c decreased NH4+ excretion).2 Histidine(H) .12.3. crumpled tissue paper cytoplasm Blind Intelligent Intergalactic Crab Intelligent Intergalactic = Galactocerebroside Krabbe’s = Galactocerebrosidase —> incr galactocerebroside: blindness. respectively).6 Aspartic acid(E) . slurred speech. Just know the order and that it goes in descending pH’s. dermatan sulfate: NO CORNEAL CLOUDING because Hunter’s need to see clearly Major apolipoproteins: “II:LL” C-II = cofactor for Lipoprotein Lipase Treat abetalipoproteinemias (deficient apoB100. The SEcond steps cause SEvere symptoms (AldolaseB and Uridyl transferase. LYSINE(K)) Negatively charged amino acids: Negative experience to be burned by Acid: Aspartic acid and glutamic acid Note: Aspartate and Glutamate (as N-acetyl glutamate) are involved in Urea cycle elimination of ammonia Amino acids with three titratable H+: Ricky Can’t Hate ED RKY C H ED Arginine(R) . hepatosplenomegaly. ataxia) with Vitamin E Embryology: Important Genes for Embryogenesis: http://julieyumi. cherry macula. acanthocytes (spiky RBC). TRYPTOPHAN(W). CV/renal disease “Gauched out my femur when I was on a sugar high” Gaucher.3 Glutamic acid(D) . foam cells “Sulfur tides are multicolored” Sulfur tide = Sulfatide Multicolored = Metachromic Metachromic leukodystrophy = Aryl sulfatase A —> incr Sulfatides: central and peripheral demyelination with ataxia. onion skin lysosomes “Fab-Gal is into Ceramics” Fabry’s = alphaGALactosidase A —> incr Ceramide trihexose: peripheral neuropathy. Histidine(H).tumblr. vomiting Tx: less protein in diet + Benzoate/Phenylbutyrate (bind a.5 Lysine(K) .1 Cysteine(C) . Tx: decr Phen. blocked by Carbidopa)—> Dopamine —(Dopamine Hydroxylase/VitC. somnolence. peripheral neuropathy.7 The numbers aren’t important except for Histidine.a. Isoleucine(I). Femur Necrosis. Sx: asterixis.

spontaneous abortion) Rules of Early Development: Week 2: 2 germ layers (epiblast. Cardiac defects. urethra. bronchi. neural tube defect has incr alpha-fetoprotein+AChesterase (**Gastroschisis and Omphalocele. ductus arteriosus connection to aorta) .arghlblargh! 6/18/13 6:33 PM Sonic the Hedgehog fights a One-Eyed Monster: Sonic Hedgehog mutation —> Holoprosencephaly FGF gene = Fibroblast Growth Factor: Growth Factor lengthens limbs FGF mutation —> Achondroplasia (A-D dwarfism) HOX (Homeobox) gene: ”Boxes help with organization” organizes/determines limb location (Vitamin A toxicity alters HOX expression —> cleft palate. oligodendocytes.ligamentum teres hepatis Allantois —> Urachus (wk3): urachus failure to obliterate = bladder to navel connection: umbilical urination or bladder outpouching Omphalomesenteric duct —> Vitelline duct (wk7): duct failure to obliterate = colon to navel connection: umbilical meconium or Meckel’s diverticulum Heart embryology: Primitive __ —> trabeculated (rough) portion of __ Smooth atrium = sinus venosus Smooth ventricle = bulbus cordis SVC = right common and anterior cardinal veins Aorta/Pulmonary artery = truncus arteriosus.@ right/middle chest VI: pulmonary artery (inc. uterus and uterine tubules…) Lateral: non-skeletal muscle and blood-related organs (visceral muscle and connective tissue. trachea. connective tissue and dermis…) + dura mater Intermediate: urogenital ridge (kidneys and ureters. Tetralogy of Fallot) “PGA open”: PG keeps DA open (decr PG —> close DA with Indomethacin. gonads. celiac ganglion. endoderm) Week 4: 4 heart chambers. top to bottom” I: maxillary artery (external carotid) . gallbladder. head muscles. thyroid. 1 vein (“arteries” is 2x as long as “vein”) AllaNtois —(urachus)—> mediaN umbilical ligament UmbiLical artery —> mediaL umbilical ligament Umbilical vein .ectoderm: ~external hollow spaces Cleft 1: external auditory meatus Clefts 2-4: temporary cervical sinus (fail to obliterate = lateral neck branchial cleft cyst) http://julieyumi. “mermaids also can’t breathe air” —> maternal diabetes causes ARDs and sirenomelia/anal atresia (also. 2 cavities (amniotic. hair. 2 placental components (cytotrophoblast. spinal cord. etc. nails. tonsils. pineal gland…) + pupillary muscles Mesoderm: Neural crest: skull and PNS stuff (skull. lymph. folic acid—> spina bifida. pretty much ANY internal organ extrusion results in incr alpha-fetoprotein) “SAD DAVE”: SAD: Sensory = Alar Plate/Afferent nerves = Dorsal DAVE: Dorsal=Afferent.@ midline neck IV: right subclavian artery and aortic arch .@ right side of heart Neural tube defects: The longer the name. Renal defects. parafollicular C cells of thyroid…) + adrenal medulla (chromaffin cells) + melanocytes (last to migrate) Paraxial: axial stuff (axial skeleton.tumblr. cardiovascular system…) + adrenal cortex Note: spleen = mesoderm.” Aminoglycosides prevent mRNA reading by interfering with 16S of 30S and cause CNVIII ototoxicity (Note: Congenital Syphilis also causes CNVIII ototoxicity + Saber shins + Saddle nose + Hutchinson’s teeth + Mulberry Molars + frontal bossing) Maternal Diabetes: hyperglycemia —> incr fetal insulin —> decr lung development = can’t breathe. vas deferens. teeth enamel. DRG. separated by spiraling neural crest migration (X = Transposition of Great Vessels. thymus. tuft of hair Meningocele: herniation of meninges Meningomyelocele: herniation of spinal cord Pharyngeal/Branchial “CAP”: Cleft = ectoderm (~external hollow spaces) Arches = mesoderm (~muscles) Pouches = endoderm (~immune organs above the neck) Branchial CLEFT . pancreas urinary bladder.@ midline throat III: common and internal carotid arteries . 4 limb buds Note: neural tube closes by week 4: def. pia/arachnoid. Tracheo-Esophageal fistulas. syncytiotrophoblast) Week 3: 3 germ layers (ectoderm. liver. eye lens…) + anterior pituitary (Rathke’s pouch) Neuro: everything connected to the CNS (brain.com/post/22267813238/second-aid-usmle-mnemonics Page 5 of 21 . retina. transposition of great vessels) Umbilical cord: Allantois: 2 arteries. lungs GIT. cardiac abnormalities. lower 2/3 vagina (this explains how patients can still have a vagina even if the paramesonephric ducts fail to develop) Notochord —> nucleus pulposus of intervertebral disk Teratogens: “Amina couldn’t hear because she was too absorbed in her reading. Limb defects Endoderm: ear/mouth to anus hollow lining and organs + bladder and vagina tympanic cavity/auritory tube. the worse the symptoms: Occulta: spinal canal opening but no herniation. posterior pituitary. cranial nerves. yolk sac). Anal atresia. skeletal muscles.@ face II: hyoid/stapedial artery . parathyroid larynx. Ventral=Efferent Embryologic derivatives: HELLO~&I'M&A&PEACEFUL&MEDICAL&STUDENT&WITH%A%DARK%SENSE%OF%HUMOR&アッハハ~ (❁´ `❁)& ARCHIVE FAQS TAGS THEME Follow Join Tumblr arghlblargh! Ectoderm: Surface: what you see (epidermis. dentine. hypoblast). mesoderm. spleen. Schwann cells. but supplied by celiac artery of the foregut MESODERMAL DEFECTS = “VACTERL”: Vertebral defects. NSAIDs) Aortic arch derivatives: ”left side of body to right side. blood.

com/post/22267813238/second-aid-usmle-mnemonics Page 6 of 21 . relapsing fever = result of antigenic variation) Lept = Leptospira Tripped = Treponema (Dark Field Microscopy. TrypanosomA http://julieyumi. ant. sup laryngeal)= pharyngeal constrictors and cricothyroid called for help = arch 6 (X.endoderm: ~immune organs above the neck + middle ear Pouch 1 = auditory tube. Epididymis. 5 keeps the diaphragm alive.Bacillus Anthracis’ unique capsule contains D-glutamate “Staff of grapes” = Staphylococcus is in clusters VS.3) = muscles of mastication. and Sperm: FSH stimulates Sertoli cells to produce Sperm. no parathyroids (= hypocalcemia —> tetany) “C3. middle ear.” Claustrophobic = Clostridium Pastor = Pasturella Salmon = Salmonella Echoed = E.” chewing = arch 1 (V2.coli Back = Bacillus anthracis (D-glutamate) Yersinful = Yersinia Crypt-dark = Cryptococcus (India Ink. FTA-ABS confirmation) Mycoplasma vs Mycobacteria Bacteria have cell walls (Mycobacteria have mycolic acid in their cell walls that stain acid-fast) Plasma membranes have sterols (Mycoplasma have sterols and no cell wall) Stains: GiemsA stains BorreliA. Streptococcus = pairs/chains Spirochetes: ”Spiraling Boris Lept then Tripped” Spiraling = Spirochetes Boris = Borrelia (Giemsa stain = aniline dye.arghlblargh! 6/18/13 6:33 PM Branchial cleft cyst (lateral neck) vs Thyroglossal duct cyst (midline neck. ChlamydiA. inf laryngeal)= intrinsic larynx muscles except cricothyroid Note: Arch 4&6 make up post. moves with swallowing because “attached to tongue”) Branchial ARCH . and Mullerian inhibiting factor (MIF). B = both) **LOOK AT THE NERVES TO FIGURE OUT WHICH MUSCLES MAKE UP WHAT ARCH** or use the following mnemonic: “Chewing made me grimace so I swallowed. failure of urethral fold closure.tumblr. Ejaculatory duct. MIF inhibits female paramesonephric duct development Genital homologues: Urogenital sinus: Bulbourethral glands = Bartholins greater vestibular glands proState gland = Skene urethral and paraurethral glands Extrophy of bladder is associated with Epispadias (faulty positioning of genital tubercle) vs. VDRL cardiolipin screening. N = nothing) “Women Mull over past arguments” = “Mullerian ducts” —> fallopian tubes. 1/3 tongue Branchial POUCH . narrow-based budding in meningitis) Strip = Streptococcus Clubs = Klebsiella Pseudo = Pseudomonas Homes = Haemophilus Nice men = Neisseria meningitidis Francis = Francisella Bruce = Brucella “BAD” . 2/3 tongue + malleus/incus/tensor tympani grimace = arch 2 (VII) = facial expression + stapes/stapedius (defect = Treacher Collins’ mandibular hypoplasia and facial abnormalities) swallowed = arch 3 (IX)= stylopharyngeus (defect = fissure from neck to tonsils) choked = arch 4 (X. then called for help. choked.” Kidney embryology: main player = Metanephros: Ureteric Bud = ureter—>pelvis—>collecting ducts JOINS Metanephric Mesenchyme = glomerulus—>DCT Defective ureteric bud = renal agenesis.mesoderm: ~muscles The nerves that supply the branchial arches are all BOTH motor and sensory: “Some(I) Say(II) Marry(III) Money(IV) But(V) My(VI) Brother(VII) Says(VIII) Big(IX) Brains(X) Matter(XI) Most(XII)” (S = sensory. Inhibin. M = motor. incr risk of UTI Microbiology: Encapsulated organisms: (+Quellung reaction: quell makes capsules swell) “Claustrophobic Pastor Salmon Echoed Back: Yersinful Crypt-dark Strip Clubs are Pseudo-Homes to Nice Men Francis and Bruce. MalariA. 4. mastoid air cells Pouch 2 = tonsils and tonsillar sinus Pouch 3 = inferior parathyroid + thymus (they descend together) Pouch 4 = superior parathyroid + parafollicular C cells of thyroid Failure of 3rd and 4th Pouch = DiGeorge’s: no thymus (= T cell deficiency). Vas deferens. Sertoli. LH L in LH and Leydig: LH stimulates Leydig cells to produce testosterone —> develop Wolffian duct S in FSH. and upper 1/3 of vagina (lower 2/3 from urogenital sinus of endoderm) Female = default genitals Hormone overview: Prolactin stimulates Dopamine inhibits Prolactin Prolactin inhibits GnRH GnRH —> incr FSH. B/L renal agenesis —> oligohydramnios —> Potter’s: pulmonary hypoplasia + face/limb deformities **MC site of obstruction = Ureteropelvic junction with kidney —> fetal hydronephrosis Genital embryology: Male = Mesonephric Pemale = Paramesonephric “Men are Wolves” = “Wolffian ducts” —> ”SEVEN” in “SEVEN UP” (Seminal vesicles. Hypospadias = more common. uterus.

. Staph.. Nystatin (vs fungi) Haemophilus = V (NAD+) and X (hematin) “If I Tell-U the Corny joke Right.B binds. A enters and ribosylates EF2 —> no more protein synthesis —> cell death. Dx: Rheumatic Fever with anti-Streptolysin-O antibody (ASOAb) E. aureus = TSST-1 —> Toxic Shock Syndrome (fever. EXtremely toxic (even small dose).activates both TH1(CD4) and MHCII —> incr INFgamma + IL2 —> incr M0 and T-cell non-specific immune response —> ~Toxic Shock Gram Positives: crystal violet + iodine = blue Coag negative Staph: ”SENsitive”: Staph. Sickle Cell autosplenectomy)) + causes meningitis = SHiN Note: can also undergo “transformation” (pick up DNA from environment) Strep pneumo H. polyarthritis. tuberculosis Microaerophils = “bacters”: Campylobacter. water source Special Culture: “Nice Homes have chocolate”: Neisseria and Haemophilus grow on Chocolate agar +: Neisseria = Thayer Martin media: Vancomycin (vs G+). tuberculosis on lowenstEIN-Jensen agar (takes 3-4 weeks to grow. but diagnostic) Obligate aerobes: “If No AER.inhibits ACh vesicle release from presynaptic neuron —> flaccid paralysis Cholera toxin . pyogenes = Erythrogenic toxin —> Scarlet fever with Toxic-Shock-like symptoms Note: S. also. influenza type B (B polysaccharide) Neisseria meningitidis Exotoxin vs Endotoxin: EXotoxin = from EXogenous source (plasmid or bacteriophage) and EXcreted from bacteria. chorea. rash.” Legions = Legionella Salmon = Salmonella Rabbits = Francisella N = Neisseria Cows = Brucella Tumble = Listeria In = intracellular My = Mycobacterium Note: intracellular pathogens require cell-mediated immunity (CMI). so neonates are at risk (E.cleaves host cell rRNA/inactivates 60S.. grow with Cysteine. hemorrhagic tissue necrosis Nitric oxide = hypotension/shock alternate complement pathway: C3a = Anaphylaxis (basophil and mast cell degranulation —> hypotension. fragilis) ACTIN = Actinomyces CLOSTRophobic = CLOSTRidium Obligate Intracellular: ”REACh for My COX if you want me INSIDE you. heat stable.ENDOgenous (made from bacterial chromosome. N’ Cows Tumble IN My yard. pyogene’s rheuMatic fever (Sx: subcutaneous plaques. EXact effects (different toxins produce different symptoms). you’ll Laugh”: TellURight = tellurite agar Corny = Corynebacterium Laugh = Lofflers media “TB and J”: M. Listeria —> neonatal meningitis: tumbles. shock/sepsis via direct MACROPHAGE response (binds CD14-M0 marker) —> release TNF and IL-1 (no Th involvement) M0 activation: IL1 = Fever TNF alpha = fever. Polymyxin (vs g-). has endotoxin. Epi = Novobiocin SENSITIVE” (VS. anthracis TB = M. Rabbits.arghlblargh! 6/18/13 6:33 PM PASs the sugar and whip cream (PAS stains glycogen and Dx Whipple’s disease) “Legions who Sustained injuries get Silver stars”: Legionella.tumblr.activates Gs —> incr cAMP —> incr Cl.” R = Rickettsia E = Ehrlichia A = Anaplasma Ch = Chlamydia My = Mycoplasma Cox = Coxiella Inside = intracellular Facultative intracellular: ”Legions of Salmon. Bacterial Toxins Envoded in Lysogenic Phage: ”ABCDE” ShigA-like toxin . ~heat-labile ENDOtoxin (Lipid A). saprophyticus = http://julieyumi. incr cytokines —> HUS Botulinum toxin . silver stain. Anthrax and TB can’t survive!” No = NOcardia Aer = pseudomonas AERuginosa Anthrax = B. pseudomembrane formation Erythrogenic (superantigen) toxin of Strep. Helicobacter Obligate anaerobes: ”These BACTERia ACTIN CLOSTRophobic enviroments (non-healing ulcers): BACTERia = Bacteroides (E.ADP-ribosylating A-B toxin (like Pseudomonas exotoxin A) .secretion into gut = decr Na+ absorption —> watery diarrhea Diptheria toxin . pyogenes —> Scarlet Fever . Stable like Ground”: heat-Labile toxin stimulates Adenylate cyclase heat-Stable toxin stimulates Guanylate cyclase Both cause watery diarrhea. erythema marginatum.G. B. ENtegral to outer membrane of most gNeg bacteria (and Listeria(G+))). shock) S. causes gENeral fever. edema) C5a = neutrophil chemotaxis Hageman factor: coagulation cascade—> DIC/microthrombi Exotoxin subclass: SUPERANTIGENS: bind directly to MHCII and TH1(CD4) —> explosive release of IFNgamma and IL2 (non-specific immune response): S. carditis) IgA protease (to colonize respiratory mucosa) + antiphagocytic capsule (infects ASPLENIC patients b/c decr M0 and IgM/complement C3 activation (E. coli ADP ribosylating A-B toxin: “Labile like Air.G. pyogenes also has Streptolysin O (lyses RBC).G. Aureus: binds Fc of Ig to prevent opsonization and phagocytosis M protein (prevents phagocytosis) —> strep.EHEC 0157:H7 . and a narrow zone of beta hemolysis) Bacterial virulence factors: protein A for staph.com/post/22267813238/second-aid-usmle-mnemonics Page 7 of 21 .

Mucormycosis/Rhizopus = Wide angles. PID.Bacitracin: group B = resistant. non-septate. group A strep (Strep.5%NaCl (VS. cervicitis. Septate (VS. urease+. L1-L3 = Lymphogranuloma venerum: ulcers —> lymphadenopathy. staghorn ammonium struvite stones). group A = sensitive gamma hemolytic Strep: grows in bile. heat = yea(s)t” + “Blast His Cock” = East Coast to West Coast (Tx: Ketoconazole) Blast = Blastomycosis = east of Mississippi River His = Histoplasmosis = Mississippi River and Ohio river Cock = Coccidiomycosis = Southwest US: CA. typhi of Typhoid fever causes abdominal rose spots and can remain chronically in gallbladder. unlike gamma hemolytic Strep) beta hemolytic Strep: ”BBBR”: Beta hemolytic. Strep. rectal strictures mistaken for PID Tx: mothers and infants with Chlamydia with Erythromycin estolate. “Histo Hides within macrophages” Blasted Wood = Blastomycosis in wood = Broad-Based-Budding fungi.com/post/22267813238/second-aid-usmle-mnemonics Page 8 of 21 .tumblr. ”stomach is used to salty foods” = Enterococci grows in 6. NOTE**: gonorrhea’s pilus protein undergoes antigenic variation!!) Note: -N. coli (blue-black metallic sheen). blue on Eosin-Methylene blue) = “SEEK”: Serratia. Salmonella Note: Salmonella and Shigella both invade mucosa —> bloody diarrhea. moves by actin polymerization and 60S deactivating toxin induces HUS. “Cock is filled with Sperm. Snails Pork = Taenia Fish = Diphyllo. Pneumonia Sensitive Note: Strep pneumonia is bile soluble (= can’t be cultured in bile. Coccidio is filled with Spores” Actinomyces = Acute Angles. Salmonella. hepatitis D = drugs R = Rheumatic fever (Dx w/ S. Klebsiella Non-lactose fermenters = “PSSY”: Proteus.arghlblargh! 6/18/13 6:33 PM Novobiocin resistant) alpha hemolytic Strep: ”OVeRPasS”: Optochin Viridans Resistant. the handle of a baseball bat looks like it’s budding off the shaft) Dust = Coccidiomycosis = large spherule filled with endospores. meningitidis = respiratory/oral spread —> meningococcemia and Waterhouse-Friderichsen adrenal hemorrhage (hypotension and DIC) -N. “barrel-shaped arthroconidia”. group B strep (Strep agalactiae). Shigella is more virulent. all ferment glucose Lactose fermenters (pink on MacConkey. arthritis VS. Clonorchis Crab = Paragonimus Snails = Schistosoma Antigenic shift vs. trAChoma = serotypes A-C —> blindness VS. pyogenes ASO titers) L = Lupus and Leprosy Chlamydia: Dx via Giemsa stain (ChlamydiA. Bacitracin Resistant (VS. Fish. S. septic arthritis. Yersinia H2S producing (black on Hektoen Agar) + motile (flagellar H antigen): Proteus (swarming. can’t pee. Shigella. Tx: macrolides My = Mycoplasma (IgM = cold agglutinins —> agglutinate or lyse RBCs. ~in Diabetics) Helminth drugs: Worms = Bendazole Praziquantel = foods: Pork. MalariA. drift: ”SPED” Shift (reassortment via segmented viruses) = Pandemic Epidemic = Drift (random mutations) Vaccines: Live: ”See MMR. grown on Eaton’s agar. BorreliA + TrypanosomA) Elementary body is Enfectious and Enters cells via Endocytosis Reticulate body Replicates in cell by fission “Tricky Dick”: TRIC = serotypes D—K: —> MC PID. pyogenes) = bacitracin sensitive) OR “B-BRAS” . Tx: tetracycline or macrolide) Clammy = Chlamydia (Tx: tetracycline or macrolide) Legion = Legionella (Tx: macrolide) Fungi: Dimorphic: ”cold = mold. urethritis. oxidase + organisms: ”when you go Camping at a quiet Pasture you’d Moan More with Nice Vibrators” Camping = Campylobacter Pasture = Pasturella Moan = Pseudomonas More = Moraxella Nice = Neisseria Vibrators = Vibrio VDRL false positives: ”VDRL” V = viruses: EBV. neonatal conjunctivitis. gonorrhea = STD—> high fever. and vaccine (gonorrhea doesn’t. ectopic pregnancy —> Fitz-Hugh-Curtis liver capsule infection (from spread of PID) + “violin string” adhesions of parietal peritoneum to liver —> neonatal pneumonal/conjunctivitis —> REITER’S: ”Can’t see. Crab.5%NaCl) Exposure/PRIMARY TB: Ghon complex = Ghon focus of LOWER lobe + peri-hilar lymph nodes You think they are “Ghon” but they’re just waiting to become secondary TB (fibrocaseous cavitary lesion of UPPER lobe) gram negative: acetone + saffranin = pink N. AZ “His Woodpecker Blasted Wood into Dust”: His Woodpecker = Histoplasmosis from bird/bat droppings = macrophage filled with round yeast. Enterobacter. though there is a risk of maternal acute cholestatic hepatitis Atypical (walking) pneumonias: ”My Clammy Legion walked”. can’t climb a tree” = conjunctivitis. Meningities ferMents Maltose. bovis —> does NOT grow in 6. Salmonella is motile (w/ 2 flagellar antigen variants) and produces H2S. Sabin’s small yellow chickens live. E.” http://julieyumi. has a capsule. Fitz-Hugh-Curtis (cervicitis— >salpingitis—>liver capsule infection) Enterobacteriae: CAPSULE = VIRULENCE FACTOR.

oral) small pox yellow fever chicken pox/shingles Killed: ”RIP Always” Rabies Influenza Polio (SalK = Killed. sex.11): condylomata acuminata/genital warts. gastroenteritis) Herpes: ”2 Simple Chickens Barred Sight from Rose Patches” 2 Simple = HSV1. both intranuclear “owl-eye” and cytoplasmic inclusion bodies) Rose = HHV6: Roseola/Erythema subitum (high fever —> rash) Patches = HHV8: Kaposi-sarcoma RNA viruses: +RNA = “PiToFlaCoCa”: middle 3 = enveloped Pi = PicoRNA = PECoRnA: P = Polio (both colonizes nasopharynx and causes meningitis like Hib —> myalgia and paralysis) E = Echovirus: swimming pool aseptic meningitis/myocarditis C = Coxsackie: aseptic meningitis/myocarditis. infects B cells via CD21-EBV receptor) Sight = HHV5: CMV (retinitis. Burkitt’s. jaundice. hairy leukoplakia on lateral tongue. Louis. AE: hemolytic anemia. saddle nose. IMPDH of purine synthesis. Snails Viruses: DNA viruses: ”HeHe PoPa ParAde”: first three = enveloped 6/18/13 6:33 PM He = Herpes He = HepaDNA (HBV. anal squamous cell CA) + Polyoma (JC. fine truncal rash). Roseola: HHV6 (high fever/seizures —> truncal rash) Fla = Flavi (HCV. cataracts. German Measles (postauricular occipital lymphadenopathy. CA Cruises” (gastroenteritis from cruises) -RNA = all enveloped + RNAdRNApol Reovirus = dsRNA. seizures H = HSV (+HIV): temporal lobe encephalitis. Measles’ 3 C’s = cough. PML demyelinating encephalopathy) Par = Parvo = B19/Erythema infectiosum (ssDNA) Ade = Adenovirus (swimming pool conjunctivitis. Mumps. SSPE complication. dsDNA). blueberry muffin rash. Rubeola. TORCH infection (blueberry muffin rash. SARS) Ca = Calici = “Norwalk. lesions of different age)/shingles Barred = HHV4: EBV (mono. PDA) VS. +RNA): PDA. nasopharyngeal CA. shellfish) HBV = HepaDNA (env. Rubella Sabin (Polio. yellow. fecal-oral (ice cubes. needle stick). orchitis. large cell non-Hodgkins @ Waldeyer’s ring. cataracts. conjunctivitis + Koplik spots. dengue. mother. -RNA). Fish. rash from head down like Rubella Mumps: parotitis.com/post/22267813238/second-aid-usmle-mnemonics Page 9 of 21 . Measles VS. hydrocephalus) + UNILATERAL hearing loss. St. segmented: ROTAvirus = right out the anus (childhood winter gastroenteritis) HepEvirus = HEV (water epidemic. growth retardation T = Toxoplasma: ToxoTriad: intracranial calcifications. Tx: Ribavirin (vs. +RNA). injected) Adenovirus Recombinant: ”H_V” Worms = Bendazole Praziquantel = foods: Pork. coryza. TORCH. chorioretinitis. chorioretinitis. ring-enhancing brain abscess). infects with HBV HEV = HepEvirus (+RNA). Dx: RT-PCR HDV = Delta (defective env. transfusion).18): CIN. deaf.2 Chickens = HHV3: Chicken pox (truncal rash —> extremities. thrombocytopenia. carries special RT: DNAdDNAp) Po = Pox (smallpox. Crab. carries DNAdRNAp and replicates in cytoplasm) Pa = Papilloma (HPV: (6. Rubella. SSPE complication. herpetic lesions (fingers) S = Syphilis: hydrops fetalis stillbirth > Hutchinson teeth. (16.tumblr. Tx: Sulfadiazine+Pyrimethamine R = Rubella (Togavirus. only dangerous if pregnant) Orthomyxo: O for octo = 8 segments —> reassortment = Influenza pandemic (Ag shift) Paramyxo = PaRaMyX2o: P or PARA = Parainfluenza = croup R = RSV. teratogen) or “RSVP Liz” where “P Liz” = Palivizumab which binds Paramyxo F protein.arghlblargh! MMR = Measles. maternal rash and arthritis C = CMV: Toxoplasma triad (intracranial calcification. Dx: PCR HCV = Flavi (env. aseptic meningitis Segmented viruses: ”BOAR” B = Bunya (Hanta hemorrhagic fever) O = Orthomyxo (Influenza) A = Arena (mouse Lassa encephalitis) R = Reovirus (right out the anus childhood diarrhea) Hepatitis: HAV = Picorna (+RNA). from cat feces. West Nile) yellow fever causes yellowing skin (jaundice) and black vomit Co = Corona (common cold. koilocytes=squamous cell with perinuclear cytoplasmic halo. rubeola. blood (IVDA. fecal-oral (water epidemic) ToRCHS: hepatosplenomegaly. then KILLED HER D:” Seph(iroth) = Cephalosporin Met = Metronidazole Vancouver = Vancomycin Penpal = Penicillin Amina = Aminoglycosides Florida = Fluoroquinolones http://julieyumi. blood (renal dialysis. molluscum contagiosum. Rubeola: ”a PARA Ruby weasles caught SSPEcial measles” = Paramyxo. hydrocephalus = SAME TRIAD AS CMV!!. deaf. preventing respiratory epithelial syncytia formation Mx2 = Measles and Mumps: Measles: ”A PARA RUBY weasles caught SSPEcial Measles” = paramyxo. hand-foot-mouth (palm and sole vesicular rash also seen in secondary syphilis and Rickettsial Rocky Mountain Spotted Fever) Rn = RHINOvirus (stuffy NOSE from common cold) A = HAV To = Toga “Togas Rubelled against Germany with TORCHs” = Togavirus. negative mono-spot mono. saber shins Note: B19 also causes hydrops fetalis Bactericidal drugs (all else = bacteriostatic): ”Sephiroth Met Vancouver Penpal Amina in Florida.

Protein synthesis inhibitors: ”Quinn get in Line and take 50MC’s to 30ST”: 1. Neisseria.inhibits DNA-dRNAp = no transcription (rapid resistance) AND blocks packaging and assembly of viruses.prevents peptide bond formation. vs. Borrelia. Mycobacterum. fragilis. milk. G6PD hemolysis) 6. Pseudomonas). everything. Strep. pyogenes (GAS)) 2. prophylaxis for N. but causes SEIZURES. or iron-containing prep! 2. prophylaxis for Hib and N. E. ureaplasma. Rickettsia 4. UTIs. N. caTion-chelator.men by blocking DNAdRNAp = no transcription: Rifampin 7. flu. coli L = Listeria P = Proteus S = Salmonella Note: Ampicillin = intrapartum injection. ‘Nam = AztreoNAM (binds PBP3 for Pencillin-allergy pts. pylori. block transpeptidase cross-linking. Erythromycin): “MacroLIDEs prevent sLIDing of mRNA” = inhibit translocation by binding to 23S of 50S 1.detergent vs cell membrane. Klebsiella 2nd generation (“fur fox fo’tetan”): G+ + HEN-PEcKS: Haemophilus. Proteus. resistance via modification of 30S (acetylation. Sulfamethoxazole-Trimethoprim (TMP-SMX) vs UTI. inhibits mycobacterial growth in M0. and Stretomycins) cause ototoxicity (and nephrotox) and act by binding to 16S and causing mRNA misreading.by blocking folate —> no nucleotide synthesis (megaloblastic anemia): 1. GITIs. Tetracyclines block TRNA from binding A-site and discolors Teeth/bones 1.sulfonamides. Dalfopristin changes 50S conformation for better Quin-binding 2. H. resistance via ACETYLATION 5. Linezolid: binds 50S P-site and blocks 70S assembly Tx: Quin-Dalfo and Linezolid is good for ALL RESISTANT BACTERIA: VRE. Tobra. neurotoxicity (prevented by B6). Chills-in = ‘cillins (binds PBP. vs “SEEK Pseudomonas”. stop therapy with purpura. Penicillin = endocarditis prophylaxis (before surgery/dental). Macrolides. AE: hyperuricemia/gout (I = INH) R = Rifampin . Pyrimethamine (DHF—Xdihydrofolate reductase—>THF like Methotrexate) 5.diff!! 2. Tetracycline block 30S 1.atypical Pneumonia. AE: photosensitivity (“SAT for photo” . Klebsiella. vs. perfringens) like Metronidazole. Tularemia.com/post/22267813238/second-aid-usmle-mnemonics Page 10 of 21 . Line 50MC’s = Quin-Dalfo. AE: infant kernicterus (avoid in pregnancy). N = nephrotoxic + Red Man (slow infusion and pretreat with anti-histamine to prevent)) 3. etc) 2. amiodarone. syphilis prophylaxis) 3. g. Chlamydia. resistant G+ inc. Clarithro. Sulfonamides (comp inhibit PABA for dihydropteroate synthetase —> no DHF synthesis. KatG gene encodes catalase peroxidase that activates INH). vs. incr export NOTE: DEMECLOCYCLINE = DIURETIC = ADH ANTAGONIST (Tx: SIADH) Ampicillin and Amoxicillin are Anti-G+ Aminopenicillins that “HELPS” kill Pseudomonas with Sulbactam/Clavulanic acid (beta lactamase inhibitor): H = Haemophilus E = E. men.active in acidic pH. incr QT. resistance via decr uptake. nephrotox. P. AE: red secretions. G+/g. AE: aplastic anemia and gray baby. STDs 2. “TON of AE’s”: T = thrombophlebitis. Typhoid fever (Salmonella) Ceftriaxone = #1 CefTAZidime is for Pseudomonas like TAZobactam+Piperacillin (but causes neutropenia) 4th generation (Cefepime) = G+ + pseudomonas Metronidazole: forms toxic metabolite that damages DNA. MRSA 3. Cefuroxime. MeropeNEM and ImipeNEM+Cilastatin (Merpenem/Imipenem vs. solo-TB prophylaxis. Enterobacter.coli.Clindamycin. Pylori (+ bismuth + amoxicillin/tetracycline) Anti-TB: ”INH-SPIRE”: AE: hepatotoxic INH = Isoniazid (inactivates mycolic acid synthesis enzymes enoyl-acyl carrier protein reductase (InhA overexpression = resistance) and betaketoacylACPsynthase (KasA). Sulfadiazine+Pyrimethamine vs Toxoplasma 3.by disrupting cell membranes: Polymyxins (neosporin) . acute cholestatic hepatitis. AE: neurotoxicity.Serratia. URI’s. inhibits PG cross-linking —> no cell wall: ”Ceph Chills-in ‘Nam watching PG movies”: 1. O = ototoxic. Gonorrhea. MACrolidEs (“ACE”mycin = Azithro. ”VACUUM TH BedRoom” . vs. and Pseudomonas by blocking topoII (DNA gyrase) and IV: Fluoroquinolones (AE: cartilage/tendon rupture. drug-induced lupus (anti-histone Ab) S = Streptomycin (aminoglycoside vs 30S mRNA reading) P = Pyrazinamide . Amikacin.coli. bone http://julieyumi.Cefuroxime for Community Acquired Pneumonia “Linda Brought a Fragile Fox fo’Tito” . B. difficile) P = H. Tx: ”GET GAP on the METRO” G = Giardia E = Entamoeba histolytica (liver abscess) T = Trichomonas G = Gardnerella A = Anaerobes (B. REQUIRES O2 UPTAKE so ineffective against anaerobes. ANAEROBES (B. Trimethoprim. Neo. Vancomycin (binds D-Ala-D-Ala and interferes with PG-elongating transglycosylase 1. Linezolid. Bacitracin (vs. incr serum concentration of warfarin 3. Mycoplasma pneumonia. Sulfadoxin+Pyrimethamine vs Malaria 2. vs. esp.tumblr. grods. Cefotetan 3rd generation (“trix” “tax” “taz”): Meningitis. vs. Klebsiella. urealyticum. C. E. resistance via METHYLATION OF drug binding site on 50S rRNA Note: Azithromycin = AIDS MAC prophylaxis 4. jirovecii prophylaxis in AIDS 2. Enterobacter. Cilastatin inhibits renal dihydropeptidase I to inhibit renal tubule Imipinem inactivation) 2. AE: hepatotoxicity. AE: Pseudomembranous colitis like Ampicillin 2. MRSA and C. pneumo). URIs (S. Serratia “Fur cap” . acne. vs. C. Tx: meningitis (H.Vibrio. E. Quin-Dalfo (streptogramins): Quinupristin prevents elongation. G6PD hemolysis) 1. Tx: “PUS” . Chloramphenicol/Clindamycin block 50S 1. do NOT take with antacids. vs. “Amina didn’t hear the GNATS because she was busy reading”: Aminoglycosides (GNATS = Genta. Chloramphenicol: “ChLorAMPS Peptidyltransferase” . induces cyp450. TETRACYCLINE) 3. pneumo). fragilis. fragilis. GBS prophylaxis “TCP Takes Care of Pseudomonas”: Ticarcillin Carbenicillin Piperacillin Cephalosporins: 1st generation (“cefa”): G+ + PEcK: Proteus. Quinn. Enterobacter. men and Hib. Ceph = Cephalosporin 2.arghlblargh! Antimicrobial drugs: 6/18/13 6:33 PM 1. acute renal tubular necrosis 4. 30ST = Streptomycin (aminoglycosides). AE: PROLONG QT. coli. blocks PG synthesis: 1. SJ. S. Clindamycin: also blocks peptide bond formation at 50S.

receptor: Daclizumab **NOTE: MCC SCID = defective IL2 receptor > ADA deficiency. production: Cyclosporin (via inhibit calcineurin) vs. AE: Neutropenia IFNalpha . Influenza A. Rabies/(RSV in premies every winter month) Immune deficiencies: Bruton’s agammaglobulinemia = (x-r) Boys with BTK (tyrosine kinase) defect —> Blocked B-cell differentiation: http://julieyumi. N(eisseria) = C5-C9/MAC deficiency Passive immunity: ”To Be Healed Rapidly” . secreted by Th2 IL5: A = IgA (and eosinophil) production. secretion: Tacrolimus (via binding FK-protein) vs. T-cells are found in the deeper medulla(LN)/PALS(spleen) Lymph drainage: rectum above pectinate line = internal iliac umbilicus to legs (inc. secreted by T cells IL4: E = IgE (and IgG) class switching. activates M0 —> TNFalpha. FOScarnet (unlike ganciclovir. HCV IFNbeta . response to: Sirolimus (via MTOR) vs. IL6 Immunology: B-cells are always found in (white) Follicles closer to the outside of the LN or spleen VS. IV phlebitis Antiviral: “ARM2 cure A FLU” = Amantadine Rimantidine block M2 protein (viral uncoating) vs.arghlblargh! marrow suppression E = Ethambutol . IL1. hyperglycemia.“PMS sounds like BMS” —> Tx: Multiple Sclerosis NOTE**: alpha and beta IFNs decr viral replication and incr antiviral protein synthesis that impairs viral mRNA translation IFNgamma . AE: AtaxiA Herpes = “Cyclovir’s” (virally activated guanosine analogs) + Trifluridine (thymidine analog) CMV = “Cid’s Gang loved seeing Foamy Scarlet” = Cidofovir (Cytosine analog + Probenicid to prevent excretion). secreted by M0 IL2: T = T-cell proliferation. secreted by Th1 IL3: Bone = Bone marrow stimulation (acts like GM-CSF). Ganciclovir (intraocular implant).tumblr. pneumo) + Hi(b) = C3 deficiency. pneumo and Hib —> severe recurrent pyogenic sinus and respiratory tract infections **Remember “SHiN”: S(trep. IL2: ”(IL)2 Pro-Cyclists Secreted Tacks in Response to Serious/Sirius Dax”. complement can still bind hinge) Cytokines: ”Hot T-Bone stEAk” IL1 (and IL6): hot = fever.Tetanus Botulism HBV. anemia. IL8. hypotension. lipodystrophy. TNF receptor: Adalimumab fake TNF receptor: Etanercept Complement: C_a for anaphylaxis (histamine release —> edema —> hypotension. seen especially in glomerulonephritis. nephrotox. arrhythmia. Kallikrein IL8: ”8” looks like multilobed nucleus of neutrophil = PMN chemotaxis LTB4’s “B” also looks like neutrophil multilobed nucleus Immunosuppression Rx vs. cyp450 inhibitor) NRTI’s: ”Abe Did Embark on a L-AZy Start” Abacavir Didanosine Emtriciabine Lamivudine AZT (Zidovudine) Stavudine NNRTI’s: ”Move to Delaware? Effin’ Never!” Delavirdine Efavirenz Nevirapine FUsion inhibitor = enFUvirtide (gp41 binder) Interferons: activates NK cells. TNF: Infliximab vs. LTB4. superficial genitals and anal canal below pectinate line) = superficial inguinal testes = para-aortic MHC I and II: ”Rule of 8’s” 1*8 = MHCI x CD8 = 8 2*4 = MHCII x CD4 = 8 Natural Killer cells: detects MHCI “Gotta KIL to survive” (KIR + KIL = survive) KIR only = release perforins and granzymes —> apoptosis Antibody cleavage: Papain cleaves Ab into 3 pieces: Pa Pa In (evenly splits into 3) Protease cleaves Ab into 2 pieces: Prot Ease (evenly splits into 2. doesn’t require thymidine kinase activation. pyroFOSphate analog that directly inhibits DNApol) HIV therapy: Protease inhibitors = “navir’s” (AE: GI intolerance.“alpha B C” —> Tx: HBV. anaphylaxis) C_b for binding bacteria (opsonizes and forms pores) “low 3 causes 3”: C3 deficiency causes HSRIII (immune complex deposit). prevent transplant rejection vs. Fomivirsen (intraocular injection.com/post/22267813238/second-aid-usmle-mnemonics Page 11 of 21 .“G in gamma is for cGd” —> Tx: Chronic Granulomatous Disease (NADPH oxidase deficiency) NOTE**: IFNgamma incr MHCI and II expression. decr T —> decr B activation: all types of recurrent infections (viral/bacterial/fungal) Rx vs TNF: Tx: Rheumatoid arthritis vs.AE: optic neuropathy (red green colorblindness) Antifungal: 6/18/13 6:33 PM Amphotericin B: AmphoTEARicin TEARS holes in fungal membrane (binds ergosterol and forms pores) AmphoTERRible: AE: fever/chills. secreted by Th2 Neutrophil chemotaxis: ”CILK”: C5a. susceptible to S. anti-sense RNA therapy).

”PSaMMoma”: P = papillary thyroid tumor S = serous cystadenocarcinoma of ovary M = mesothelioma M = meningioma ESR (marker of inflammation): inflammatory product fibrinogen coats RBC causing aggregation —> weight pulls RBC down = fall at faster rate in test tube incr/faster ESR = inflammation: infection. w/ lymphomas and acute leukemias Hyper-IgE/Job’s Syndrome: ”I’m Hyper Excited for my FATEd Job” Hyper Excited = Hyper IgE F = coarse Facies A = cold. miosis.Phenytoin. noninflamed Staph Abcesses T = retained primary Teeth E = Eczema Job = Job’s Chediak-Higashi (a-r): ”Grandpa Al couldn’t eat Eastern food with his fingers. aspirin) trapped in basic bicarbonate **Note: Acetazolamide alkalinizes urine by getting rid of bicarbonate. cancer. lung. DAG stim PKC —> cascade “Kiss and Kick ‘til you’re Sick of Sex” “QISS QIQ SIQ SQS” Gq = alpha 1: SM contraction.22)”) to-grow-faster = TGF: astrocytoma. mydriasis.lung squamous cell CA. sensitive to ionizing radiation.small cell lung CA sis: astrocytoma.breast. decrease efficacy (maximal effect of drug). geriatrics lose phase 1 first Phase 2: conjugation (acetylation. TCA. HCC b/c = bcl2: follicular lymphoma herbs = ERB-B1.com/post/22267813238/second-aid-usmle-mnemonics Page 12 of 21 .” Grandpa = Gram positive cocci infections: Staph and Strep Al = partial albinism couldn’t eat = defective microtubules = defective phagocytosis and lysosomal fusion Eastern = Higashi (“higashi” means “East” in Japanese) with his fingers = peripheral neuropathy Pathology: Proto-oncogenes: tumor promoters.2: ERB-B1 . incr Systolic and Diastolic BP Gi = alpha 2: decr SNS.tumblr. sigmoid effect curve shifts right. bladder. decr insulin Gs = beta 1: incr heart rate and contractility. assoc. ovarian. SLE… decr/slower ESR = “de-prESsed Heart is Sick from Too Much Blood. decr uterine tone Gq = M1: CNS. incr lipolysis Gs = beta 2: decr Diastolic BP. sigmoid effect curve’s vertical maximum effect is reduced. ERB-B2 . IgA is missing in mucus so recurrent sinus and lung infections **Note: IgA deficiency also seen in Ataxia-Telangiectasia:defective DNA repair enzymes. blood product Anaphylaxis. accommodation (ciliary muscle contraction) Gs = D1: renal perfusion (renal artery dilation) Gi = D2: brain neurotransmitter Gq = H1: pruritus/pain. Lineweaver-Burke lines cross at Y-axis (VS non-competitive inhibitors decr Vm. vaso/bronchodilation. Ethanol.” Phase 1: cyp450 red-ox (+ hydrolysis). L-myc . peristalsis.adrenal Neuroblastoma. Tx: cysteine stones and altitude sickness (hyperventilation —> respiratory alkalosis) base (amphetamine) trapped in acidic ammonium chloride Phase I vs Phase II metabolism: ”1 red ox went 2 conjugate polar bears. safer drugs have higher TI’s G-protein-linked 2nd messenger: Gs = adenylyl cyclase —> ATP-to-cAMP —> PKA —> cascade Gi = inhibit adenylyl cyclase —> decr cAMP —> decr PKA Gq = phospholipase C —> lipids-to-PIP2 —> IP3 incr intracellular Ca2+. osteosarcoma returned = ret: MENII her2new = Her2/neu: breast cancer was = ras: colon. enteric nervous system Gi = M2: decr HR. Gi): ”FLAT CHAMP + calcitonin + glucagon” F = FSH L = LH A = ACTH T = TSH C = CRH H = hCG A = ADH (V2) M = MSH http://julieyumi. incr renin. Lineweaver-Burke lines join at X-axis) Zero-order elimination: constant amount of drug eliminated per unit time = “PEA” . incr lipolysis. damage one allele —> gain of function (VS. contractility. incr insulin release (think “Beta2 stimulates Beta islet cells of pancreas”).arghlblargh! 6/18/13 6:33 PM recurrent Bacterial infection after 6 months (when mom’s IgG disappears) b/c no Ig’s Selective Ig(A) deficiency: milk Allergies. giardiA infections. decr atrial contractility Gq = M3: incr secretions. Aspirin Urine pH and drug elimination: medicine gets trapped in opposite urine pH: acid (phenobarb. contract bronchioles Gs = H2: incr gastric acid secretion (inhibited by “-idines”) Gq = V1: incr vascular SM contraction Gs = V2: incr H2O reabsorption in kidneys CD (ADH action) Signaling pathways: cAMP (Gs. sulfation) —> yields very polar renally excreted inactive metabolites Therapeutic index: ”TILED” with TI= LD#/ED# and the #’s adding up to 100. ALL (“ALL able CaMeLs are from Philadelphia t(9. pregnancy. MTX. cerebellar atrophy —> ataxia. decrease affinity/potency (amount of drug needed for effect). tumor suppressors need to damage both alleles to lose function) “Mike’s sis returned with her2new breasts that she was able to-grow-faster b/c of herbs. incr nasal/bronchial mucus. pancreas. N-myc .” Heart = CHF Sick = Sickle Cell Too Much Blood = Polycythemia Pharmacology: Kompetitive inhibitors incr Km. incr heart rate. renal CA able = abl: CML.Burkitt’s. glucuronidation.” Mike = myc: C-myc . looks like thumbprint. gastric CA Psammoma bodies: concentric Ca2+ spheres. spider angiomas (telangiectasias).

Glucocorticoid. Blind (cycloplegia). Pilocarpine. AMPicillin Photosensitivity: ”SAT for a Photo”: http://julieyumi. gold Tx w/ PENIcillamine NITRoprusside turns into Cyanide which is Tx’d w/ NITRite. Class Ia antiarrhythmics Halo = haloperidol Risper = risperidone Macro = macrolide PI = HIV protease inhibitors Quinn = Chloroquine/Mefloquine Aplastic anemia: ”Chlora SAID “Ptuey” to Meth”: Chlora = Chloramphenical SAID = NSAID PTUey = PTU (antithyroid) Meth = Methimazole (antithryoid) Hemolysis in G6PD: ”Prima had to take Aspirin after INHaling her I. Mad (delirium).3=QIQ (Atropine blocks these) Specific antidontes: DeFERoxamine Tx’s Fe (iron) “Children Suck on Lead pencils”: Succimer Tx’s Lead poisoning in children (Tx is CaEDTA in adults) DiMERcaprol Tx’s MERcury.arghlblargh! 6/18/13 6:33 PM P = PTH calcitonin glucagon (incr cAMP —> activates PKA —> incr F16BPase —> gluconeogenesis RLS) IP3 (Gq): ”hIP3othalamic GGOAT” GHRH GnRH oxytocin ADH (V1) TRH cGMP: vasodilators ANP NO (NO venodilates decreasing preload VS beta-blockers arteriodilate and reduce afterload) tyrosine kinase: ”the TyK Grows In Milk” GH IGF-1 FGF PDGF Insulin Prolactin steroid receptor: cytoplasmic (except thyroid hormone = intranuclear) (Adrenal cortex:) Aldosterone. Estrogen Progesterone Vitamin D T4/T3 (intranuclear receptor) Glaucoma drugs: ”AABBCDF” AA = Alpha Agonist: vasoconstriction —> decr aq humor synthesis (not for closed angle glaucoma) BB = Beta Blocker (Timolol): decr aq humor secretion C = Cholinomimetic (Carbachol.Professor Dapsone’s Sulfurous Fava Bean Nitrofarts” Primaquine Aspirin INH Ibuprofen Dapsone Sulfonamides Fava bean Nitrofurantoin “Pseudomembranous colitis makes you want to ClAmp your ass”: CLindamycin. Red.B.tumblr. hydroxocobalamin. gold “Copper Penny”: Copper. Pralidoxime Diarrhea Urination Miosis Bradycardia Bronchospasm Excitation of skeletal muscle and CNS Lacrimation Salivation Sweating Atropine poisoning: ”what would happen if you got lost in the desert: Hot. Echothiophate): incr outflow (contract ciliary muscle and open trabecular meshwork into canal of Schlemm) D = Diuretic: Acetazolamide (carbonic anhydrase inhibitor). and thiosulfate METHylene blue and VitC Tx’s METHemoglobin ETHANOL Tx’s mETHANOL poisoning “Heparin’s H looks like a Proton”: PROTamine Tx’s Heparin toxicity Drug reactions: TCA’s “3 C’s”: Cardiotoxicity. urinary retention(/constipation)” Hexamethonium: ”Put a Hex on reFLEX bradycardia” .Hexamethonium prevents NE reflex bradycardia by blocking all Nicotinic receptors (ganglion blocker inhibits Na/K ligand-gated channels) ACh receptors: Nicotinic = Na/K ligand-gated channels (ANS and NMJ) (Hexamethonium/Mecamylamine blocks these) Muscarinic = G-coupled receptors. Mannitol: decr aq humor secretion F = PGF2alpha (Latanoprost): incr uveoscleral outflow. “Phys is for the Eyes” Physostigmine. Ca2+ channel blockers Dilated cardiomyopathy = Doxorubicin and Daunorubicin Torsades de Pointes: ”The Method to get 31Awesome QT’s is to wear a Halo and Risper that you bought a Macro-PIe from Quinn. Niacin. Dry.” Method = Methadone 31Awesome = Class III. Convulsions. Adenosine. AE: dyes irises brown Cholinomimetics: Bethanechol: ”Give Beth-ann-a-call if you want your PNS stimulated”: Tx: post-op neurogenic ileus and urinary retention Anticholinesterases = “-stigmines” + Edrophonium + Echothiophate Organophosphate poisoning: ”DUMBBELSS”: Tx: Atropine. M1.2.com/post/22267813238/second-aid-usmle-mnemonics Page 13 of 21 . Testosterone. Coma Cutaneous flushing: ”VANC” = Vancomycin. arsenic. arsenic.

phenobarbital. and Cillins + Allopurinol” Seizure drugs: ethosuximide. Chlora made him Suffer the Metro. Blast my bones” . carbamazepine.” Ceph = Cephalosporin Procar = Procarbazine Night = Nitrofurantoin Gruesome = Griseofulvin Chlora = Chloramphenicol Suffer = Sulfonylureas Metro = Metronidazole Ototoxicity/Nephrotoxicity: ”Mice use Platinum earring Loops to crawl into your Ear and make you deaf” Mice = -mycins = aminoglycosides and vancomycin Platinum = Cisplatin Loops = Loop diuretics p450 interactions: p450 inducers: ”Queen Barb’s riFamily induced Saint John to eat a Pheny-looking Greasy Carb” Queen = Quinidine Barbara = Barbiturate riFamily = Rifampin induced Saint John = Saint John’s Wort Pheny-looking = Phenytoin (AE: gingival hyperplasia) Greasy = Griseofulvin Carb = Carbamazepine See reference: p450 inhibitors: ”Without a Key. but to avoid a Gruesome accident.tumblr.com/post/22267813238/second-aid-usmle-mnemonics Page 14 of 21 . Tx: Amifostine Vincristine/Vinblastine: ”Christ my nerves. Vinblastine = myelosuppression http://julieyumi.Vincristine = peripheral neuropathy.arghlblargh! 6/18/13 6:33 PM S = Sulfonamides A = Amiodarone T = Tetracyclines Stevens-Johnson rash: “‘Seizures. Kim was inhibited from PIES and Juice” Key = Ketoconazole Kim = Cimetidine inhibited PI = HIV Protease Inhibitors E = Erythromycin S = Sulfonamides Juice = grapefruit juice See reference: Toxicity bear: Cumulatively Toxic Drugs and their Rescues Asparagine: neurotoxicity Cisplatin: ototoxic/nephrotoxic. lamotrigine. phenytoin Sulfa drugs Penicillin Allopurinol SLE-like syndrome: ”SHIPP” Sulfonamides Hydralazine (“Hydra’s neck Loops (Lupus) around in circles”) INH Phenytoin Procainamide Disulfiram-like reaction: ”Drunk Ceph said he was Pro-Car (okay to drive) at Night. Sulfa’s.

pyogenes (beta-hemolytic.” 1st degree: increased PR 2nd degree: Type 1 Wenckebach: incr PR until QRS drop Type 2: random QRS drop 3rd degree: PR and QRS = independent rates. w/ mitral regurg) Rheumatic heart disease of S. Vitus’ chorea (of face. a girl stays out ‘til 12 even though her curfew is 10. coagulative necrosis. Syndenham’s/St. seen in Lyme disease DiGeorge “Tet’s”: TETralogy of Fallow + TETany from hypocalcemia (lack of parathyroids) (also.Wolff-Parkinson-White is treated with amiodaRONE and ProCAINamide AV blocks: “First. Tx.” “Then. V-fib) 4-10 days later: M0’s thinned walls —> increased risk of rupture and tamponade >10 days: risk for ventricular aneurysm (bulging scar because fibrosis made it lose its ability to contract) <— ventricular remodeling can be prevented with ACE-I’s Bacterial endocarditis: ”FROM JANE”: Fever Roth spots: round retinal white spots surrounded by hemorrhage Osler’s nodes: tender raised red lesions on fingers and toe pads Murmur (new) Janeway lesions: non-tender small red lesions on palms and soles Anemia Nail-bed (splinter) hemorrhage Emboli IVDA = right-sided bacterial endocarditis: ”don’t TRI drugs” (tricuspid valve) SLE causes LSE (Libman Sacks endocarditis with warty sterile vegetations on both sides of valve. bacitracin-sensitive Strep): ”AAAAAA” group A Strep autoimmune (Ab to antiphagocytic M protein —> MVP —> Mitral Stenosis).” “Afterwards. and upper limb) “ACE-inhibitors are ACE’s at controlling HTN”: http://julieyumi.arghlblargh! 6/18/13 6:33 PM Bleomycin: pulmonary fibrosis Doxorubicin: cardiotoxic. ‘til her mom throws a fit. Filgrastim) See reference: Cardiovascular: Contractility decreases with: ”ABBCCC”: A = Acidosis BB = Beta blocker CCC = hyperCO2. assoc. close with Indomethacin Evolution of MI: ”4 and death are both pronounced “shi” in Japanese” Initially: nothing 4 hours-4days later: PMN’s. also SIADH effects (Tx: Demeclocycline) Methotrexate: nephrotoxic (Tx: Leucovorin). Misoprostol). Dimethyl-sulphoxide (for ROS ulcers) Cyclophosphamide: Acrolein = nephro/bladder toxic (Tx: Mesna). fever Aschoff bodies (granulomas with giant cells) = subcutaneous nodules Anitschkow cells (activated histiocytes) elevated ASO titers and ESR migratorypolyArthritis + Erythema martginatum. Dexrozoxane (for cardiotoxicity). non-DHP Ca2+ channel blockers Heart murmurs: “MR. despite the teenager being good. truncus arteriosus) “PGA open”: PGE kEEps PDA open (PGE1 analogs: Alprostadil. the mom throws random fits probably because of menopause. the teenager stays out later and later. tongue. myelosuppression (Tx. the young woman is old enough to whatever she wants separately from her parents. ARD” = MR = mitral regurg AS = aortic stenosis S = systolic murmurs and MS = mitral stenosis AR = aortic regurg D = diastolic murmurs holosystolic = all regurg’s + VSD murmurs that increase with breathing: rIght murmurs increase with Inspiration lEft murmurs increase with Expiration “Wolf = Lone Canis” .” “Finally.tumblr. CHF.com/post/22267813238/second-aid-usmle-mnemonics Page 15 of 21 . ASS and MS. risk of arrhythmia (esp.

Procainamide. Diazoxide and Minoxidil Open K+ channels Antiarrhythmics: ”No Bad Boy Keeps Clean” Type I: Na+ blocker (incr QT) Type II: Beta blocker (incr PR). tumor marker = Bombesin see Homer-Wright pseudorosettes and incr HVA (Dopamine derivative) in urine scenario: ~2yo with retroperitoneal ab mass presents with HTN hypotonia. diuretics) Calcitonin = from parafollicular C cells of thyroid = neural Crest derivative. lipolysis Pheochromocytoma (PCC): ”Rule of 10’s” 10% malignant 10% bilateral 10% extra-adrenal 10% calcify 10% kids 10% familial Neuroblastoma (MCC adrenal medulla tumor in children) = N-myc oncogene. If the second digit is a 1. Flecainide. Mexiletine (decr AP) Ic: ”Properly Fleeing Endangerment” Propafenone. Phenytoin. then the patient will look male. feminine 21 hydroxylase deficiency (MC): hypotension.” “salt”: zona Glomerulosa: aldosterone “sugar”: zona Fasciculata: cortisol “sex”: zona Reticularis: androgens Adenohypophysis = Anterior pituitary (RAthke’s pouch of ectoderm): ”FLAT PEG” FSH LH ACTH TSH Prolactin endorphins (share POMC origin with ACTH and MSH) GH Basophilic = “B-FLAT”: Basophilic-FSH. Thiazides retain calcium) “Aden Diaz is Mine OK?”: Adenoxine. masculine 11 beta hydroxylase deficiency: HTN. diarrhea. LFTs. Lidocaine.com/post/22267813238/second-aid-usmle-mnemonics Page 16 of 21 . contractility —> arrhythmia. decreases PTH secretion.arghlblargh! essential hypertension HTN+CHF (decreases both preload and afterload) HTN+DM (protective against Diabetic nephropathy) Antihypertensive therapy: ”ABCD”: ACE-I/ARBs Beta blockers Calcium channel blockers Diuretics (“LOOps LOOse Calcium”. secreted in medullary thyroid Cancer (MENII) (Signaling pathway mnemonics were covered earlier) Thyroid hormone functions: ”T3 = 5B’s” Brain (CNS) maturation (defect = mental retardation seen in Cretinism) Bone growth (synergism with GH. Tx coronary and cerebral vasospasms Type I antiarrhythmics: Ia: ”The Queen Werewolf Disappeared” Quinidine. aminoglycosides. Encainide Type III: Amiodarone: ”check PFTs. resembles thyroid hormone) + photodermatitis (“SAT for a photo”) Endocrine: Adrenal cortex: ”GFR: The deeper you go.Oxytocin Supraoptic nucleus . the sweeter it gets. Tx with propanolol or PTU (OK in pregnant)) incr BMR incr Blood sugar: glycogenolysis. common causes of decr Mg2+ = alcohol. Disopyramide (incr AP) Ib: ”To Funny Little Mexico” Tocainide. HypErthyroidism = hEat intolerance “CHIMPANZEES” cause Hypercalcemia: Calcium ingestion (incr antacids —> milk-alkali syndrome) Hyperparathyroid/Hyperthyroid Iatrogenic: Thiazides Multiple myeloma Paget’s disease (when patients are immobilized. ACTH.Vasopressin (ADH) Adrenal steroids: ”In an enzyme deficiency. and TFTs” pulmonary fibrosis hepatotoxicity hypo/hyperthyroidism (amiodarone = mostly iodine. if the first digit is a 1. myoclonus. and non-rhythmic conjugate eye movements (opsoclonus-myoclonus) mass may invade into an intervertebral epidural space and look like a “dumbbell” HypOthyroidism = cOld intolerance. defect = Cretinism) Beta1 adrenergic effects (Thyroid Storm: incr HR.” 17alpha hydroxylase deficiency: HTN.tumblr. Tx OD w/ Glucagon Type III: K+ blocker (incr QT) Type IV: Ca2+ blocker (incr PR). masculine PTH = phosphate trashing hormone (note: decreased free serum Mg2+. normally normocalcemic) Addison’s disease http://julieyumi. TSH (VS Acidophils-Prolactin. LH. stain = Neurofilaments. gluconeogenesis. then the patient will be hypertensive. GH) 6/18/13 6:33 PM Neurohypophysis = Posterior pituitary (Neural tube of ectoderm): secretes hypothalamic substances: ”A Pair of Ox were Supra Dehydrated” Paraventricular nucleus .

incr calcitonin . incr calcitonin . bones. duodenum. kidney.hypocalcemia Marfan’s habitus + oral/intestinal mucosal neuromas Note: MENII’s are associated with ret oncogene Also. or amiloride (K+ sparing aldosterone receptor antagonist diuretic that closes Na+ channels that also reabsorbs Li to Tx Li-induced DI) Multiple endocrine neoplasias (MEN): (A-D) MENI (Wermer’s): ”3P’s” pancreatic . assoc.hypocalcemia MENIIb: ”1P” PCC . and groans” = kidney stones. 4) Rectum Pancreas (head.hypercalcemia pituitary . lactation MENIIa (Sipple’s): ”2P’s” parathyroid . decr gastric motility (incr satiety) + Acarbose/Miglitol = decr starch hydrolysis and glucose GI uptake Diabetes drugs mechanisms of action: “PPARazzi camera flashes GLITA” . also location of IgA-secreting plasma cells) Note: Shigella is taken up by the M-cells of Peyer’s Patches. urine VMA/metanephrine medullary thyroid (parafollicular C) .amenorrhea. Tx: SIADH DesmoPRESSIN = vasoPRESSIN (ADH) analog.PPer and Lipton” . IMV) veins: ”MI Superior’s an Ass. associated with MENI (parathyroid tumor) Excess vitamin D Excess vitamin A (incr bone resorption —> incr Ca2+) Sarcoidosis (or granulomatous disease) Hyperparathyroidism: Primary: Osteitis fibrosa cystica = “stones.GLP1 -‘Tides “Dr. SMV.Alpha glucosidase Remember: insulin —> decreases cAMP —> decreases PKA —> dephosphorylated FBPase2 = PFK2 —> F6P to F26BP —> F26BP stimulates PFK1 —> incr F6P to F16BP (glycolysis) glucose —> decreases cAMP —> decreases CAP-cAMP binding of lac operon = RNA polymerase can’t bind to promoter Gastrointestinal: Retroperitoneal structures: ”I ASK DR. descending) OR ”SAD PUCKER” = suprarenal. pancreas.~Zollinger-Ellison gastrinoma . “the II in MENII stands for the 2C’s in PCC” Diabetic drugs: “Metformin Glitters in Sunny Gliptin Tides” Metformin = incr glucose uptake in muscle and fat via GLUT4 (aka incr insulin sensitivity in peripheral tissue) and decr liver glucose production via incr AMPK and decr PEPCK (OAAtoPEP) and decr G6Pase (G6PtoGlucose) production -Glitazones = incr insulin sensitivity via PPARgamma/adiponectin Sulfonamides = incr pancreatic insulin production via blocking ATP-dep. PC” Primary retroperitoneal (never pushed into sac): IVC Ab aorta Suprarenal glands Kidneys/Ureters Secondary retroperitoneal (pushed into sac. like in Cystic Fibrosis) Portosystemic anastomoses: The mnemonic is from Systemic (IVC) to Portal (Celiac.incr PTH . K+ efflux -Gliptins..incr PTH .peptic ulcers parathyroid .tumblr.incr catecholamines (Epi/Nor). Tx: central Diabetes insipidus (Note: nephrogenic DI is treated by hydrochlorothiazide (Ca2+ sparing diuretic). 3.DPP4 inhibitor -‘Gliptins Acarbose . breast cancer = osteolytic) Zollinger-Ellison syndrome (pancreatic tumor —> incr gastrin.” Rectal anastomoses: (X=hemorrhoids) ”MI Superior is an Ass”: Systemic: Middle and Inferior Rectal http://julieyumi. brown bone tumors.com/post/22267813238/second-aid-usmle-mnemonics Page 17 of 21 . urine VMA and Metanephrine medullary thyroid (parafollicular C) . but escaped): Duodenum (2. body) Colon (ascending.PPARgamma -‘Glitazones “GULP TIDES” .arghlblargh! 6/18/13 6:33 PM Neoplasms (e.polygonal.incr catecholamines.hypercalcemia PCC . -Tides = incr insulin. blood flow. ureter. and absorption between mucosa and inner/circular muscles Defect in Auerbach’s causes Achalasia Lack of both Auerbach and Meissner’s due to failure of neural crest cell migration causes Hirschsprung’s Congenital Megacolon.~prolactin or GH . colon. viruses like Adenovirus may invade Peyer’s Patches and cause intussusception. decr glucagon. incr cAMP in urine VS Secondary: Renal osteodystrophy = renal disease —> decr Vit D —> decr Ca2+ —> incr PTH —> bone lesions Hypocalcemia signs: C = Chvostek sign = Cheek tapping —> facial muscle Contraction T = Trosseau’s sign = Tight BP cuff —> hand Tetany (spasm) Dexamethasone vs Demeclocycline vs Desmopressin: Dexamethasone = steroid to Dx ACTH disease/syndrome DemecloCYCLine = tetracycline ADH antagonist vs CYCLophosphamide-induced SIADH.g. rectum Digestive tract histology: ”Brunch DIP”: Brunner’s (submucosal. indomethacin (decr renal blood flow). abdominal aorta. alkaline mucus secreting) glands = Duodenum Ileum = Peyer’s Patches (M cells take up antigen. Sabin (live Polio vaccine) increases IgA immunity Enteric nerve plexuses: ”AUerbach is on the AUtside. weakness and constipation. MeiSSner’s is SSubmucosal” Auerbach’s = Myenteric = coordinates Motility by being wedged between the inner/circular and outer/longitudinal muscles Meissner’s = Submucosal = regulates Secretions. with Down Syndrome (see failure to pass meconium. He makes me feel Inferior about my Superficial appearance by poking near my Belly-button so I Eat Less. esophagus.

.” You get direct bilirubinemia when there’s a problem with bile Pipes/excretion (E. you should think of Hepatitis A. Gilbert = “KING KONG” —> “CING CUNG” —> Criggler-Indirect/Unconjugated-Najjar-Gilbert You get Crigler-Najjar/Gilbert’s when you’re unable to conjugate bilirubin into a water-soluble/excretable form ~ Glucuronyl transferase deficiency Direct = conjugated = Water soluble: Dubin-Johnson. ”an alien Directly bursting from your stomach” = direct hernia = protrudes from abdominal wall medial to inferior epigastric vessels: or “MD’s don’t LIe”: Medial = Direct.arghlblargh! to Portal: Superior Rectal Umbilical anastomoses: (X=caput medusae) ”Inferior about my Superficial appearance by poking near my Belly-button”: Systemic: Inferior. too Bottom line: Zone 1 = susceptible to viruses. Artery.”: Parietal cells secrete IF (intrinsic factor) and HCl (gastric acid) “Pep-pep to the Chief”: Chief cells make Pepsin Vitamin/Mineral absorption: Duodenum: ”FED” = Fe (iron) in Duodenum Jejunum: ”The Jester is a Fat Fool” = Jejunum absorbs most Fats and Folate Ileum: The ileum is the last part of the small intestine. Rotor’s = ”Dubin-Johnson called Rotor-rooter to fix his WaterPipes.G. (deep inguinal) Lymphatics/Lacunar ligament Note: femoral sheath does not contain femoral nerve Inguinal canal: ”INternal (deep) inguinal ring = INdirect hernia that may go INto the scrotum” = lateral to inferior epigastric vessels VS. when you think of “ABC”. Vein. you can think of drugs/poisons pooling there. transmural complication of Mallory-Weiss http://julieyumi. Empty space. Lateral = Indirect “Fem-Fem”: femoral hernias occur more often in females (and is the leading cause of bowel incarceration) GI secretory products: “IF you PARTY too hard. you’ll vomit out a lot of GASTRIC ACID. B. and portal vein) “The 3rd letter in the alphabet = C”: Zone 3 = Centrilobular (periCentral vein) = where blood drains into the hepatic vein because it’s so far from the hepatic artery.tumblr. Superficial Epigastric to Portal: Paraumbilical Esophageal anastomoses: (X=esophageal varices) ”Eat Less”: (X = esophageal varices) Systemic: Esophageal (azygos) to Portal: Left Gastric Liver anatomy: ”1ABC” “1ABC”: 6/18/13 6:33 PM Zone 1 = Apical surface of hepatocytes face Bile Canaliculi = periportal zone Also. C… Zone 1 = first affected by viral hepatitis because closest to hepatic artery (Remember: Portal triad = bile duct. since blood pools in veins. B12/IF is reabsorbed in the Ileum Bilirubin: Rules of thumb: The two-named diseases don’t go together The one named diseases are milder INdirect = UNconjugated = water INsoluble: Crigler-Najjar. biliary tree obstruction) Note: Dubin-Johnson is “worse” than Rotor’s in that the liver is pigmented black Achalasia: ”AABBCC” Achalasia loss of Auerbach’s myenteric plexus Birds beak on Barium swallow associated with Chaga’s and CREST Boerhaave syndrome = “Been-Heaving”. it’s the first place to suffer from ischemia also. Zone 3 = susceptible to drugs/ischemia Femoral region: ”NAVEL with the Venous near the Penis” Lateral to medial: Nerve. it’s where you say “Bye Bye to the SI”: Byle acid.com/post/22267813238/second-aid-usmle-mnemonics Page 18 of 21 . hepatic artery.

Ataxia. you’ll get Bloody Diarrhea.com/post/22267813238/second-aid-usmle-mnemonics Page 19 of 21 . CEA tumor marker Molecular pathogenesis of CRC: alphabetical order lose APC (decreased intercellular Adhesion) then mutate kRAS (unregulated signal transduction MAPK) then lose p53 (no apoptosis) Wilson’s disease (hepatolenticular degeneration): a-r inadequate copper excretion.pylori infection (duodenal > stomach ulcer). pyoderma gangrenosum. location of pure smooth muscle) Gastritis: Acute gastritis (erosive): “Burned by Curling iron”: Curling’s ulcer = stress ulcer from burns: decr plasma volume —> sloughing of gastric mucosa “Cushion the brain”: Cushing’s ulcer = stress ulcer from head injury: incr ICP —> incr vagal stimulation —> incr ACh —> incr H+) Chronic gastritis (non-erosive): ”AB-pairing” Type A (fundus/Body) = Autoimmune/Anemia: AutoAb to parietal cells. Plummer-Vinson). Results from Reflux Esophageal cancer risk factors: ”ABCDEFGH” Alcohol.” Lead Pipe = loss of haustra leads to “lead pipe” appearance on imaging Rectum = UC always involves the rectal mucosa/submucosa and procedes continuously up unlike Crohn’s which tends to spare the rectum Bloody diarrhea (another trait not shared with Crohn’s) Note: this is autoimmune UC is also associated with friable pseudopolyps. ARDS… http://julieyumi. Cirrhosis. Esophagitis Familial GERD Hot dogs (nitrosamines) Esophageal cancer epidemiology and locations: 6/18/13 6:33 PM Squamous cell = Spread out worldwide (most prevalent worldwide).tumblr. Cancer (HCC) Dementia Encephalopathy Fanconi’s Syndrome: defective PCT reabsorption Gallstones (cholelithiasis): Risk factors = 4F’s: Fat Fertile Female Forty Acute pancreatitis causes: ”GET SMASHED” —> DIC. Zenker’s) Esophageal web (e.. pernicious anemia (Ab to IF).arghlblargh! BARRett’s esophagus = Becomes Adenocarcinoma. Achalasia Barrett’s esophagus Cigarettes Diverticuli (e.g. near anus) = obstruction. ankylosing spondylitis. sharp colicky pain.” Creepy Fat = Creeping fat Crone = Crohn’s disease (Granny) non-caseating Granulomas Skipping = transmural Skip lesions Cobblestone = Cobblestone mucosa Arthritic = Migratory polyarthritis Fist = Fistulas “Gum to Bum” lesions and extraintestinal manifestations (systemic) like erythema nodosum (~shins). FAPCancer involves APC gene. increased risk of MALT lymphoma Peptic ulcer disease: Gastric ulcer pain = Greater with food Duodenal ulcer pain = Decreases with food (will see hypertrophy of Brunner’s glands and clean “punched out” margins unlike carcinoma raised/irregular margins) Inflammatory bowel disease (IBD): Crohn’s vs Ulcerative Colitis Crohn’s: ”A Creepy Fat old Crone (Granny) went Skipping on Cobblestones while pumping her Arthritic Fist in the air. dull pain. achlorhydria Type B (Antrum) = Bacterial: H. and primary sclerosing cholangitis Meckel’s diverticulum: ”Rule of 2’s” 2 inches long 2 feet from ileocecal valve 2% of population 2yo (or younger) 2 types of ectopic epithelia: gastric or pancreatic Colonic polyps: ”VILLous = VILLainOUS” because villous polyps are more likely to be malignant (villous > tubulovillous > tubulous) Colorectal cancer (CRC): Familial adenomatous polyposis (FAP): ”polyposis” = thousands of polyps. FAP + malignant CNS tumor (medulloblastoma) Presentation of CRC: Think of the colon as a funnel that shrinks towards the anus (and also that visceral nerves don’t have as many localized pain receptors as the anus): distal colon (left side.. treated with penicillamine (“copper penny”): ”ABCDEF” Asterixis. HNPCC/Lynch which doesn’t have many polyps and involves the PROXIMAL colon Gardner’s syndrome = “Gardeners Grow all kinds of things”: Gardner’s = FAP + osteomas + lipomas/soft tissue tumors + retinal hyperplasia Turcot’s syndrome: ”TURcot = TURban”. Corneal deposits. upper 2/3s (where striated muscle can be found) Adenocarcinoma = most prevalent in America (lower 1/3.g. and uveitis Note: this is disordered response to intestinal bacteria Ulcerative colitis: ”If you have a Lead Pipe jammed up your Rectum. fatigue CRC: ”Apple core” lesion on barium enema x-ray. always involves rectum VS. Anemia (hemolytic) Basal ganglia degeneration (Parkinsonism) decr Ceruloplasmin. hematochezia proximal colon (right side) = iron deficiency anemia.

28. Please. 2. 16. Sulfa drugs) Antacid adverse effects: Al = AluMINIMUM amount of feces: constipation Mg = Must Go to the bathroom: diarrhea 6/18/13 6:33 PM And this was where I stopped.. 23. Hyperlipidemia ERCP Drugs (E. 39. 24. 12. 25. 3. 13. 14.arghlblargh! Gallstones Ethanol Trauma Steroids Mumps Autoimmune disease Scorpion Sting Hypercalcemia.stuff by just. 26.. 32. 7. 21. 5.. 19. Good luck with the exam! Update (3/31/13): Unfortunately. 27. 8. 10. 22. so I won’t be able to post the rest of my mnemonics. 30.. 15. 37.only i could remember. 4.. 33. I’m very busy with clerkships/shelves and studying for the Step2CK. yasasiihitogomi likes this lindawonders likes this icoyounis reblogged this from julieyumi floridiantoast likes this msshells likes this zfs84 reblogged this from julieyumi zfs84 likes this agooddayfordeparture likes this atimetolearn likes this mssblair likes this mostlyunfiltered likes this drfraido likes this jennw2n reblogged this from julieyumi idoctor22 reblogged this from julieyumi lilscalpel likes this limitlessadvances likes this ghtjyjy likes this mynotes4usmle likes this srgcpzz likes this about-hortense likes this itisoktobesmart reblogged this from julieyumi vuxacuba likes this onefishtwofishredfishbluefishxd reblogged this from julieyumi omoyoruba likes this mztosin reblogged this from julieyumi and added: head. Sigh. dr-minkamuscles likes this erickrod92 likes this nouka68 reblogged this from julieyumi medicineisnotmerchandise likes this sosanguine likes this yasasiihitogomi reblogged this from julieyumi and added: Great & Long mnemonic lists! It may be helpful to find some tips when you study…. 20.. 35. 40. trying-to-survive-nursing-school likes this ineeedabreakk likes this nakeya52 likes this usmlestudyaids reblogged this from usmlenotebook usmlenotebook reblogged this from julieyumi and added: LOVEEE AT FIRST SIGHT 6. 36. 18.tumblr. causmonot likes this sunshine-n-rain likes this june-myun likes this kuurasu-ou likes this http://julieyumi. 34. Posted 1 year ago — 55 notes #USMLE #anatomy #bacteriology #biochemistry #biostatistics #histology #immunology #microbiology #neurology #neuroscience #parasitology #pathology #physiology #psychiatry #ross #virology 1. 31. 17.com/post/22267813238/second-aid-usmle-mnemonics Page 20 of 21 .G. If you have specific questions. I hope this list comes in handy for someone.. feel free to ask me (but don’t forget to leave me a way to contact you!). 29. 11. 9. but my Ask box is always open for advice! ^^ Thanks for understanding. 38.

caviarforelephants reblogged this from julieyumi and added: Wow. 47. 51. thenoodleincident likes this iadoreu2 likes this reblogstuff likes this cinnalyn likes this reachingthemoon reblogged this from julieyumi and added: Is it normal I can’t get a thing ? xD And to say my dad wanted me to do med… 46. 48. 44. 42. 49.tumblr.arghlblargh! 6/18/13 6:33 PM 41. 50.com/post/22267813238/second-aid-usmle-mnemonics Page 21 of 21 . 43. 45. Impressive. coffeeish likes this nwettie likes this dreaming-of-osaka likes this howatto-izu-disu likes this Show more notes http://julieyumi.

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