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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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B7 is needed for CARBOXylation reactions: 1. B12 stores last for YEARS. 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. PropionylCoA(oddchainFA/branchedchainAA metab)—>MethylmalonylCoA via proprionylCoA carboxylase (which goes on to form succinyl CoA of TCA with methylmalonylCoA isomerase and B12) 2. Other causes of megaloblastic anemia = folate deficiency (incr. dopamine —> NE via dopamine beta hydroxylase.oxidized Hb that precipitated in RBCs) Drugs that cause hemolytic anemia in G6PD deficiency: “Prima had to take Aspirin when she INHaled her I. so no neuropathy) and chronic alcoholism.Professor Dapsone’s Sulfurous Fava bean NitroFarts. but increased PT and aPTT Note: platelet dysfunction —> BT extrinsic (shorter) pathway —> PT (shorter name).tumblr. no B6 = hypochromic. microcytic anemia) 5. AcetylCoA(TCA)—>MalonylCoA(FA synthesis RLS) Avidin in egg-whites Avidly binds B7. sprue. VII. monitor w/ Warfarin intrinsic (longer) pathway —> PTT (longer name).” recoiling = E. homocysteine + N-METHylTHF —> METHionine + THF via homocysteine methyltransferase Absorbed in the ileum (Crohn’s. 3. Aureus moaning = Pseudomonas Cat = Catalase + organism NoHeart = Nocardia Disorders of __ metabolism: ”__-kinase” is the enzyme that immediately follows the breakdown of __: http://julieyumi.B. monitor w/ Heparin Carbamoyl phosphate synthetase: ”UP 1. deficiency = normal bleeding time.arghlblargh! 6/18/13 6:33 PM 3.Professor = Ibuprofen Dapsone Sulfurous = Sulfonamides Fava bean NitroFarts = Nitrofurantoin CGD (chronic granulomatous disease. histidine to histamine 4. 2. Diphyllobothrium latum) with IF (pernicious anemia). gastric bypass. use Schilling test to determine if it’s intake/absorption or lack of IF problem.coli red = Serratia Asp = Aspergillus Sorry = S. Vitamin B7: Biotin While Vitamin B6 is needed for DEcarboxylation reactions (amino acid production). Iron absorption and Fe2+ state maintenance 2.25-(OH)2D3) Calcitriol = active form (PTH stimulates conversion of liver’s 25OHvitamin D to 1. METHylmalonylCoA —> Succinyl CoA via methylmalonylCoA isomerase 2. 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.” Urea cycle RLS: CPS1 Pyrimidine synthesis RLS: CPS2 HMGCoA ___: “You always want to REDUCE your CHOLESTEROL”: HMGCoA reductase = RLS for cholesterol synthesis vs. 2. fatty acid and steroid synthesis oxidative burst (NADPH oxidase. Vitamin C: Ascorbic Acid 1. it’s an antioxidant that prevents hemolytic anemia and neurodysfunction Vitamin K: inject newborns with it to make sure they’re oK (prevent hemorrhage). homocysteine but not methylmalonic acid.” Prima = Primaquine Aspirin INH (Isoniazid) I.25-(OH)2D3 in kidney by 1alpha hydroxylase) Vitamin E: E is for Erythrocytes. Deficiency causes an increase in methylmalonic acid (peripheral neuropathy) and homocysteine (megaloblastic anemia).com/post/22267813238/second-aid-usmle-mnemonics Page 3 of 21 . Heinz bodies . 4. blocked by Reserpine Vitamin D: the longest name with a 1: (1. Collagen synthesis: hydroxylation of proline and lysine within fibroblast ER <—SCURVY 3.6BP: ”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. Pyruvate(glycolysis)—>OAA (TCA) via pyruvate carboxylase 3. glycine to porphyrin (in heme production.B. HMGCoA synthase = ketogenesis (your brain wants to SYNTHESIZE KETONES when there’s no glucose) Regulation by F2. 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).

tumblr.1 Cysteine(C) . airway obstruction Hunter’s = iduronate sulfatase —> incr heparan sulfate. 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).8. onion skin lysosomes “Fab-Gal is into Ceramics” Fabry’s = alphaGALactosidase A —> incr Ceramide trihexose: peripheral neuropathy.2 Histidine(H) . peripheral neuropathy. vomiting Tx: less protein in diet + Benzoate/Phenylbutyrate (bind a. FYI: COO-=2.a.10. 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 apoB100.3. Histidine(H). somnolence. Sx: asterixis. B48 —> night blindness.10. incr Tyr diet): —> Fumarate via Homogentinsic acid oxidase (X = Alkaptonuria) —> Thyroxine —(Tyrosine hydroxylase/B6. developmental delay.3 Glutamic acid(D) . Just know the order and that it goes in descending pH’s. Sugar High = GlucoCerebrosidase Gaucher’s = betaGlucocerebrosidase —> incr glucocerebroside: aseptic femur necrosis. blocked by Carbidopa)—> Dopamine —(Dopamine Hydroxylase/VitC. TRYPTOPHAN(W).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). slurred speech.7 The numbers aren’t important except for Histidine.com/post/22267813238/second-aid-usmle-mnemonics Page 4 of 21 . Methionine(M). gargoylism. Isoleucine(I). ataxia) with Vitamin E Embryology: Important Genes for Embryogenesis: http://julieyumi.5 Tyrosine(Y) . blocked by Metyrosine)—> Dopa: —> Melanin (X = Albinism: decreased pigment) —(Dopa decarboxylase/B6. foam cells “Sulfur tides are multicolored” Sulfur tide = Sulfatide Multicolored = Metachromic Metachromic leukodystrophy = Aryl sulfatase A —> incr Sulfatides: central and peripheral demyelination with ataxia. Tx: decr Phen.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).6 Aspartic acid(E) . Valine(V). hepatosplenomegaly. respectively). 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) . ARGININE(R). neurodegeneration.4. angiokeratoma. 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. blurry vision. CV/renal disease “Gauched out my femur when I was on a sugar high” Gaucher. Femur Necrosis. PHENYLALANINE(F). crumpled tissue paper cytoplasm Blind Intelligent Intergalactic Crab Intelligent Intergalactic = Galactocerebroside Krabbe’s = Galactocerebrosidase —> incr galactocerebroside: blindness. globoid cells Niemann Pick’s his nose with hisphinger Niemann-Pick = Sphingomyelinase —> incr Sphingomyelin: cherry macula with hepatosplenomegaly. steatorrhea.12. acanthocytes (spiky RBC). cherry macula. dementia Mucopolysaccharidoses: HurLer’s = alpha-L-iduronidase —> incr heparan sulfate. NH3+=9. Leucine(L). dermatan sulfate: corneal clouding.5 Lysine(K) .—>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.

separated by spiraling neural crest migration (X = Transposition of Great Vessels.com/post/22267813238/second-aid-usmle-mnemonics Page 5 of 21 . top to bottom” I: maxillary artery (external carotid) . tonsils. 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. 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. skeletal muscles. Tracheo-Esophageal fistulas. mesoderm. pancreas urinary bladder. thymus.tumblr. cardiovascular system…) + adrenal cortex Note: spleen = mesoderm. teeth enamel. 2 cavities (amniotic. bronchi. urethra.@ face II: hyoid/stapedial artery . pineal gland…) + pupillary muscles Mesoderm: Neural crest: skull and PNS stuff (skull. yolk sac). blood. thyroid. gallbladder. celiac ganglion. cranial nerves. endoderm) Week 4: 4 heart chambers. spleen. lymph. 2 placental components (cytotrophoblast.@ right side of heart Neural tube defects: The longer the name.@ midline throat III: common and internal carotid arteries . pia/arachnoid. pretty much ANY internal organ extrusion results in incr alpha-fetoprotein) “SAD DAVE”: SAD: Sensory = Alar Plate/Afferent nerves = Dorsal DAVE: Dorsal=Afferent. Cardiac defects. head muscles. retina. parathyroid larynx.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.” 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. liver. NSAIDs) Aortic arch derivatives: ”left side of body to right side. Tetralogy of Fallot) “PGA open”: PG keeps DA open (decr PG —> close DA with Indomethacin. the worse the symptoms: Occulta: spinal canal opening but no herniation. posterior pituitary. Limb defects Endoderm: ear/mouth to anus hollow lining and organs + bladder and vagina tympanic cavity/auritory tube. dentine. “mermaids also can’t breathe air” —> maternal diabetes causes ARDs and sirenomelia/anal atresia (also. cardiac abnormalities. syncytiotrophoblast) Week 3: 3 germ layers (ectoderm. spinal cord. uterus and uterine tubules…) Lateral: non-skeletal muscle and blood-related organs (visceral muscle and connective tissue. vas deferens. neural tube defect has incr alpha-fetoprotein+AChesterase (**Gastroschisis and Omphalocele. nails. oligodendocytes. ductus arteriosus connection to aorta) . hypoblast). hair. etc.@ right/middle chest VI: pulmonary artery (inc. Anal atresia.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. DRG. lungs GIT. 1 vein (“arteries” is 2x as long as “vein”) AllaNtois —(urachus)—> mediaN umbilical ligament UmbiLical artery —> mediaL umbilical ligament Umbilical vein . spontaneous abortion) Rules of Early Development: Week 2: 2 germ layers (epiblast. folic acid—> spina bifida. trachea. connective tissue and dermis…) + dura mater Intermediate: urogenital ridge (kidneys and ureters. gonads. but supplied by celiac artery of the foregut MESODERMAL DEFECTS = “VACTERL”: Vertebral defects. transposition of great vessels) Umbilical cord: Allantois: 2 arteries.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. eye lens…) + anterior pituitary (Rathke’s pouch) Neuro: everything connected to the CNS (brain. Schwann cells. Renal defects. parafollicular C cells of thyroid…) + adrenal medulla (chromaffin cells) + melanocytes (last to migrate) Paraxial: axial stuff (axial skeleton.@ midline neck IV: right subclavian artery and aortic arch . 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 . 4 limb buds Note: neural tube closes by week 4: def.

Inhibin. 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). LH L in LH and Leydig: LH stimulates Leydig cells to produce testosterone —> develop Wolffian duct S in FSH. middle ear. relapsing fever = result of antigenic variation) Lept = Leptospira Tripped = Treponema (Dark Field Microscopy. 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. MalariA. uterus. ant. 5 keeps the diaphragm alive. N = nothing) “Women Mull over past arguments” = “Mullerian ducts” —> fallopian tubes. 1/3 tongue Branchial POUCH . 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. no parathyroids (= hypocalcemia —> tetany) “C3.” Kidney embryology: main player = Metanephros: Ureteric Bud = ureter—>pelvis—>collecting ducts JOINS Metanephric Mesenchyme = glomerulus—>DCT Defective ureteric bud = renal agenesis. inf laryngeal)= intrinsic larynx muscles except cricothyroid Note: Arch 4&6 make up post. failure of urethral fold closure. Hypospadias = more common. Sertoli.coli Back = Bacillus anthracis (D-glutamate) Yersinful = Yersinia Crypt-dark = Cryptococcus (India Ink.” Claustrophobic = Clostridium Pastor = Pasturella Salmon = Salmonella Echoed = E.3) = muscles of mastication. 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. ChlamydiA.Bacillus Anthracis’ unique capsule contains D-glutamate “Staff of grapes” = Staphylococcus is in clusters VS. choked. moves with swallowing because “attached to tongue”) Branchial ARCH .” chewing = arch 1 (V2. Vas deferens. Epididymis.tumblr. 4. 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. sup laryngeal)= pharyngeal constrictors and cricothyroid called for help = arch 6 (X. TrypanosomA http://julieyumi. 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. and Mullerian inhibiting factor (MIF).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. VDRL cardiolipin screening. narrow-based budding in meningitis) Strip = Streptococcus Clubs = Klebsiella Pseudo = Pseudomonas Homes = Haemophilus Nice men = Neisseria meningitidis Francis = Francisella Bruce = Brucella “BAD” .com/post/22267813238/second-aid-usmle-mnemonics Page 6 of 21 . 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.endoderm: ~immune organs above the neck + middle ear Pouch 1 = auditory tube. M = motor. then called for help. and Sperm: FSH stimulates Sertoli cells to produce Sperm. Ejaculatory duct. 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. 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.

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

Klebsiella Non-lactose fermenters = “PSSY”: Proteus. MalariA. PID. grown on Eaton’s agar. Bacitracin Resistant (VS.” http://julieyumi. cervicitis. the handle of a baseball bat looks like it’s budding off the shaft) Dust = Coccidiomycosis = large spherule filled with endospores. Salmonella is motile (w/ 2 flagellar antigen variants) and produces H2S. meningitidis = respiratory/oral spread —> meningococcemia and Waterhouse-Friderichsen adrenal hemorrhage (hypotension and DIC) -N. pyogenes) = bacitracin sensitive) OR “B-BRAS” . group A strep (Strep. Sabin’s small yellow chickens live. ~in Diabetics) Helminth drugs: Worms = Bendazole Praziquantel = foods: Pork. S. NOTE**: gonorrhea’s pilus protein undergoes antigenic variation!!) Note: -N. neonatal conjunctivitis. urethritis. staghorn ammonium struvite stones). though there is a risk of maternal acute cholestatic hepatitis Atypical (walking) pneumonias: ”My Clammy Legion walked”. Fitz-Hugh-Curtis (cervicitis— >salpingitis—>liver capsule infection) Enterobacteriae: CAPSULE = VIRULENCE FACTOR. moves by actin polymerization and 60S deactivating toxin induces HUS. pyogenes ASO titers) L = Lupus and Leprosy Chlamydia: Dx via Giemsa stain (ChlamydiA. septic arthritis. gonorrhea = STD—> high fever. Shigella is more virulent.tumblr. has a capsule. 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. non-septate. AZ “His Woodpecker Blasted Wood into Dust”: His Woodpecker = Histoplasmosis from bird/bat droppings = macrophage filled with round yeast. Tx: tetracycline or macrolide) Clammy = Chlamydia (Tx: tetracycline or macrolide) Legion = Legionella (Tx: macrolide) Fungi: Dimorphic: ”cold = mold. typhi of Typhoid fever causes abdominal rose spots and can remain chronically in gallbladder. “Histo Hides within macrophages” Blasted Wood = Blastomycosis in wood = Broad-Based-Budding fungi. blue on Eosin-Methylene blue) = “SEEK”: Serratia.Bacitracin: group B = resistant.com/post/22267813238/second-aid-usmle-mnemonics Page 8 of 21 . Salmonella Note: Salmonella and Shigella both invade mucosa —> bloody diarrhea. Tx: macrolides My = Mycoplasma (IgM = cold agglutinins —> agglutinate or lyse RBCs. 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. all ferment glucose Lactose fermenters (pink on MacConkey. Coccidio is filled with Spores” Actinomyces = Acute Angles. Crab. E. rectal strictures mistaken for PID Tx: mothers and infants with Chlamydia with Erythromycin estolate. ”stomach is used to salty foods” = Enterococci grows in 6. Septate (VS. and vaccine (gonorrhea doesn’t. Enterobacter. Mucormycosis/Rhizopus = Wide angles. Snails Pork = Taenia Fish = Diphyllo. 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.5%NaCl (VS. “barrel-shaped arthroconidia”. coli (blue-black metallic sheen). Salmonella.arghlblargh! 6/18/13 6:33 PM Novobiocin resistant) alpha hemolytic Strep: ”OVeRPasS”: Optochin Viridans Resistant. drift: ”SPED” Shift (reassortment via segmented viruses) = Pandemic Epidemic = Drift (random mutations) Vaccines: Live: ”See MMR. Fish. Strep. group B strep (Strep agalactiae). arthritis VS. hepatitis D = drugs R = Rheumatic fever (Dx w/ S. bovis —> does NOT grow in 6.5%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. 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. trAChoma = serotypes A-C —> blindness VS. Meningities ferMents Maltose. L1-L3 = Lymphogranuloma venerum: ulcers —> lymphadenopathy. group A = sensitive gamma hemolytic Strep: grows in bile. can’t climb a tree” = conjunctivitis. Clonorchis Crab = Paragonimus Snails = Schistosoma Antigenic shift vs. Yersinia H2S producing (black on Hektoen Agar) + motile (flagellar H antigen): Proteus (swarming. urease+. “Cock is filled with Sperm. Shigella. Pneumonia Sensitive Note: Strep pneumonia is bile soluble (= can’t be cultured in bile. can’t pee. unlike gamma hemolytic Strep) beta hemolytic Strep: ”BBBR”: Beta hemolytic.

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

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

Ganciclovir (intraocular implant). IV phlebitis Antiviral: “ARM2 cure A FLU” = Amantadine Rimantidine block M2 protein (viral uncoating) vs.arghlblargh! marrow suppression E = Ethambutol . LTB4. FOScarnet (unlike ganciclovir. secreted by Th2 IL5: A = IgA (and eosinophil) production. secreted by Th2 Neutrophil chemotaxis: ”CILK”: C5a. secreted by M0 IL2: T = T-cell proliferation. hyperglycemia. arrhythmia. T-cells are found in the deeper medulla(LN)/PALS(spleen) Lymph drainage: rectum above pectinate line = internal iliac umbilicus to legs (inc. IL6 Immunology: B-cells are always found in (white) Follicles closer to the outside of the LN or spleen VS. secretion: Tacrolimus (via binding FK-protein) vs. complement can still bind hinge) Cytokines: ”Hot T-Bone stEAk” IL1 (and IL6): hot = fever.com/post/22267813238/second-aid-usmle-mnemonics Page 11 of 21 . seen especially in glomerulonephritis. Kallikrein IL8: ”8” looks like multilobed nucleus of neutrophil = PMN chemotaxis LTB4’s “B” also looks like neutrophil multilobed nucleus Immunosuppression Rx vs. Fomivirsen (intraocular injection. AE: Neutropenia IFNalpha . production: Cyclosporin (via inhibit calcineurin) vs. IL1. IL2: ”(IL)2 Pro-Cyclists Secreted Tacks in Response to Serious/Sirius Dax”. IL8. hypotension. 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. anti-sense RNA therapy). pneumo) + Hi(b) = C3 deficiency. susceptible to S. N(eisseria) = C5-C9/MAC deficiency Passive immunity: ”To Be Healed Rapidly” . response to: Sirolimus (via MTOR) vs. nephrotox. anemia.“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 . pyroFOSphate analog that directly inhibits DNApol) HIV therapy: Protease inhibitors = “navir’s” (AE: GI intolerance. prevent transplant rejection vs. Influenza A. secreted by T cells IL4: E = IgE (and IgG) class switching.“G in gamma is for cGd” —> Tx: Chronic Granulomatous Disease (NADPH oxidase deficiency) NOTE**: IFNgamma incr MHCI and II expression. 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. activates M0 —> TNFalpha. decr T —> decr B activation: all types of recurrent infections (viral/bacterial/fungal) Rx vs TNF: Tx: Rheumatoid arthritis vs.“alpha B C” —> Tx: HBV. receptor: Daclizumab **NOTE: MCC SCID = defective IL2 receptor > ADA deficiency. doesn’t require thymidine kinase activation. 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.tumblr. pneumo and Hib —> severe recurrent pyogenic sinus and respiratory tract infections **Remember “SHiN”: S(trep. secreted by Th1 IL3: Bone = Bone marrow stimulation (acts like GM-CSF). 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). TNF receptor: Adalimumab fake TNF receptor: Etanercept Complement: C_a for anaphylaxis (histamine release —> edema —> hypotension. anaphylaxis) C_b for binding bacteria (opsonizes and forms pores) “low 3 causes 3”: C3 deficiency causes HSRIII (immune complex deposit). HCV IFNbeta . lipodystrophy.Tetanus Botulism HBV.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. TNF: Infliximab vs.

” Heart = CHF Sick = Sickle Cell Too Much Blood = Polycythemia Pharmacology: Kompetitive inhibitors incr Km. incr renin. decrease affinity/potency (amount of drug needed for effect). decr insulin Gs = beta 1: incr heart rate and contractility. L-myc . 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. sigmoid effect curve shifts right. IgA is missing in mucus so recurrent sinus and lung infections **Note: IgA deficiency also seen in Ataxia-Telangiectasia:defective DNA repair enzymes. 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. ”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. renal CA able = abl: CML. N-myc . glucuronidation. incr lipolysis.adrenal Neuroblastoma. 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.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. pancreas.breast. bladder. 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. blood product Anaphylaxis. MTX.small cell lung CA sis: astrocytoma. ERB-B2 . Lineweaver-Burke lines cross at Y-axis (VS non-competitive inhibitors decr Vm. vaso/bronchodilation. ALL (“ALL able CaMeLs are from Philadelphia t(9. Lineweaver-Burke lines join at X-axis) Zero-order elimination: constant amount of drug eliminated per unit time = “PEA” . contractility. incr nasal/bronchial mucus.” Mike = myc: C-myc . DAG stim PKC —> cascade “Kiss and Kick ‘til you’re Sick of Sex” “QISS QIQ SIQ SQS” Gq = alpha 1: SM contraction. Gi): ”FLAT CHAMP + calcitonin + glucagon” F = FSH L = LH A = ACTH T = TSH C = CRH H = hCG A = ADH (V2) M = MSH http://julieyumi. assoc.lung squamous cell CA. Aspirin Urine pH and drug elimination: medicine gets trapped in opposite urine pH: acid (phenobarb. HCC b/c = bcl2: follicular lymphoma herbs = ERB-B1. giardiA infections. decr uterine tone Gq = M1: CNS. TCA. 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. peristalsis. sensitive to ionizing radiation. mydriasis. sigmoid effect curve’s vertical maximum effect is reduced. osteosarcoma returned = ret: MENII her2new = Her2/neu: breast cancer was = ras: colon. SLE… decr/slower ESR = “de-prESsed Heart is Sick from Too Much Blood.2: ERB-B1 . pregnancy.” 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.22)”) to-grow-faster = TGF: astrocytoma. incr Systolic and Diastolic BP Gi = alpha 2: decr SNS. incr insulin release (think “Beta2 stimulates Beta islet cells of pancreas”). cancer. aspirin) trapped in basic bicarbonate **Note: Acetazolamide alkalinizes urine by getting rid of bicarbonate.com/post/22267813238/second-aid-usmle-mnemonics Page 12 of 21 .Phenytoin. sulfation) —> yields very polar renally excreted inactive metabolites Therapeutic index: ”TILED” with TI= LD#/ED# and the #’s adding up to 100. decrease efficacy (maximal effect of drug).tumblr. 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+. ovarian. incr heart rate.” Phase 1: cyp450 red-ox (+ hydrolysis). spider angiomas (telangiectasias). lung. decr atrial contractility Gq = M3: incr secretions. enteric nervous system Gi = M2: decr HR. miosis. gastric CA Psammoma bodies: concentric Ca2+ spheres. cerebellar atrophy —> ataxia. damage one allele —> gain of function (VS.Burkitt’s. Ethanol. looks like thumbprint. geriatrics lose phase 1 first Phase 2: conjugation (acetylation. accommodation (ciliary muscle contraction) Gs = D1: renal perfusion (renal artery dilation) Gi = D2: brain neurotransmitter Gq = H1: pruritus/pain. incr lipolysis Gs = beta 2: decr Diastolic BP.

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. Testosterone. Coma Cutaneous flushing: ”VANC” = Vancomycin. Red. urinary retention(/constipation)” Hexamethonium: ”Put a Hex on reFLEX bradycardia” . “Phys is for the Eyes” Physostigmine. Adenosine. 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.tumblr. Mad (delirium). Glucocorticoid. hydroxocobalamin.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. M1.com/post/22267813238/second-aid-usmle-mnemonics Page 13 of 21 . AMPicillin Photosensitivity: ”SAT for a Photo”: http://julieyumi.” Method = Methadone 31Awesome = Class III. Echothiophate): incr outflow (contract ciliary muscle and open trabecular meshwork into canal of Schlemm) D = Diuretic: Acetazolamide (carbonic anhydrase inhibitor). gold Tx w/ PENIcillamine NITRoprusside turns into Cyanide which is Tx’d w/ NITRite.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. 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.2. 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. arsenic. 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. arsenic.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.B. Blind (cycloplegia). Mannitol: decr aq humor secretion F = PGF2alpha (Latanoprost): incr uveoscleral outflow. Convulsions. 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. Pilocarpine. gold “Copper Penny”: Copper. Dry. 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. Niacin.

Blast my bones” . Sulfa’s. 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. 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. phenobarbital.arghlblargh! 6/18/13 6:33 PM S = Sulfonamides A = Amiodarone T = Tetracyclines Stevens-Johnson rash: “‘Seizures.tumblr. and Cillins + Allopurinol” Seizure drugs: ethosuximide. Chlora made him Suffer the Metro. lamotrigine. carbamazepine. Tx: Amifostine Vincristine/Vinblastine: ”Christ my nerves. Vinblastine = myelosuppression http://julieyumi. but to avoid a Gruesome accident.” 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.com/post/22267813238/second-aid-usmle-mnemonics Page 14 of 21 .Vincristine = peripheral neuropathy.

Wolff-Parkinson-White is treated with amiodaRONE and ProCAINamide AV blocks: “First. Dexrozoxane (for cardiotoxicity). w/ mitral regurg) Rheumatic heart disease of S.com/post/22267813238/second-aid-usmle-mnemonics Page 15 of 21 .” 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. the mom throws random fits probably because of menopause. CHF. the teenager stays out later and later.” “Afterwards.” “Then.” “Finally. the young woman is old enough to whatever she wants separately from her parents. a girl stays out ‘til 12 even though her curfew is 10. Syndenham’s/St.arghlblargh! 6/18/13 6:33 PM Bleomycin: pulmonary fibrosis Doxorubicin: cardiotoxic. coagulative necrosis. Filgrastim) See reference: Cardiovascular: Contractility decreases with: ”ABBCCC”: A = Acidosis BB = Beta blocker CCC = hyperCO2. Tx. 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” . despite the teenager being good. Vitus’ chorea (of face. Misoprostol). tongue. Dimethyl-sulphoxide (for ROS ulcers) Cyclophosphamide: Acrolein = nephro/bladder toxic (Tx: Mesna). 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. and upper limb) “ACE-inhibitors are ACE’s at controlling HTN”: http://julieyumi.tumblr. non-DHP Ca2+ channel blockers Heart murmurs: “MR. truncus arteriosus) “PGA open”: PGE kEEps PDA open (PGE1 analogs: Alprostadil. 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). fever Aschoff bodies (granulomas with giant cells) = subcutaneous nodules Anitschkow cells (activated histiocytes) elevated ASO titers and ESR migratorypolyArthritis + Erythema martginatum. bacitracin-sensitive Strep): ”AAAAAA” group A Strep autoimmune (Ab to antiphagocytic M protein —> MVP —> Mitral Stenosis). ASS and MS. pyogenes (beta-hemolytic. ‘til her mom throws a fit. myelosuppression (Tx. assoc. seen in Lyme disease DiGeorge “Tet’s”: TETralogy of Fallow + TETany from hypocalcemia (lack of parathyroids) (also. risk of arrhythmia (esp.

Procainamide. Mexiletine (decr AP) Ic: ”Properly Fleeing Endangerment” Propafenone. gluconeogenesis. Disopyramide (incr AP) Ib: ”To Funny Little Mexico” Tocainide. Tx coronary and cerebral vasospasms Type I antiarrhythmics: Ia: ”The Queen Werewolf Disappeared” Quinidine. TSH (VS Acidophils-Prolactin.” “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.com/post/22267813238/second-aid-usmle-mnemonics Page 16 of 21 . and TFTs” pulmonary fibrosis hepatotoxicity hypo/hyperthyroidism (amiodarone = mostly iodine. 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 . Phenytoin.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”.Oxytocin Supraoptic nucleus . Flecainide. then the patient will look male. decreases PTH secretion. feminine 21 hydroxylase deficiency (MC): hypotension. contractility —> arrhythmia.” 17alpha hydroxylase deficiency: HTN. common causes of decr Mg2+ = alcohol. ACTH. LH.Vasopressin (ADH) Adrenal steroids: ”In an enzyme deficiency. if the first digit is a 1. Encainide Type III: Amiodarone: ”check PFTs. myoclonus. Diazoxide and Minoxidil Open K+ channels Antiarrhythmics: ”No Bad Boy Keeps Clean” Type I: Na+ blocker (incr QT) Type II: Beta blocker (incr PR). stain = Neurofilaments. resembles thyroid hormone) + photodermatitis (“SAT for a photo”) Endocrine: Adrenal cortex: ”GFR: The deeper you go. normally normocalcemic) Addison’s disease http://julieyumi. masculine PTH = phosphate trashing hormone (note: decreased free serum Mg2+. Thiazides retain calcium) “Aden Diaz is Mine OK?”: Adenoxine. 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.tumblr. If the second digit is a 1. diuretics) Calcitonin = from parafollicular C cells of thyroid = neural Crest derivative. Tx with propanolol or PTU (OK in pregnant)) incr BMR incr Blood sugar: glycogenolysis. 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. aminoglycosides. Lidocaine. then the patient will be hypertensive. masculine 11 beta hydroxylase deficiency: HTN. Tx OD w/ Glucagon Type III: K+ blocker (incr QT) Type IV: Ca2+ blocker (incr PR). defect = Cretinism) Beta1 adrenergic effects (Thyroid Storm: incr HR. LFTs. 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. the sweeter it gets. and non-rhythmic conjugate eye movements (opsoclonus-myoclonus) mass may invade into an intervertebral epidural space and look like a “dumbbell” HypOthyroidism = cOld intolerance. tumor marker = Bombesin see Homer-Wright pseudorosettes and incr HVA (Dopamine derivative) in urine scenario: ~2yo with retroperitoneal ab mass presents with HTN hypotonia. diarrhea.

incr catecholamines (Epi/Nor). -Tides = incr insulin.incr catecholamines. blood flow. breast cancer = osteolytic) Zollinger-Ellison syndrome (pancreatic tumor —> incr gastrin.com/post/22267813238/second-aid-usmle-mnemonics Page 17 of 21 .PPer and Lipton” .PPARgamma -‘Glitazones “GULP TIDES” .hypercalcemia PCC .hypocalcemia Marfan’s habitus + oral/intestinal mucosal neuromas Note: MENII’s are associated with ret oncogene Also. 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. IMV) veins: ”MI Superior’s an Ass. SMV. urine VMA and Metanephrine medullary thyroid (parafollicular C) .amenorrhea. body) Colon (ascending. ureter.hypercalcemia pituitary . 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. brown bone tumors. but escaped): Duodenum (2. and groans” = kidney stones. He makes me feel Inferior about my Superficial appearance by poking near my Belly-button so I Eat Less. descending) OR ”SAD PUCKER” = suprarenal.incr PTH .~prolactin or GH . decr gastric motility (incr satiety) + Acarbose/Miglitol = decr starch hydrolysis and glucose GI uptake Diabetes drugs mechanisms of action: “PPARazzi camera flashes GLITA” .DPP4 inhibitor -‘Gliptins Acarbose .polygonal. 4) Rectum Pancreas (head. esophagus. K+ efflux -Gliptins. Tx: central Diabetes insipidus (Note: nephrogenic DI is treated by hydrochlorothiazide (Ca2+ sparing diuretic).arghlblargh! 6/18/13 6:33 PM Neoplasms (e.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. with Down Syndrome (see failure to pass meconium.GLP1 -‘Tides “Dr. also location of IgA-secreting plasma cells) Note: Shigella is taken up by the M-cells of Peyer’s Patches. 3. kidney.. colon.hypocalcemia MENIIb: ”1P” PCC . urine VMA/metanephrine medullary thyroid (parafollicular C) . decr glucagon. abdominal aorta. bones. incr calcitonin . 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. “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.~Zollinger-Ellison gastrinoma . Tx: SIADH DesmoPRESSIN = vasoPRESSIN (ADH) analog.incr calcitonin .g. pancreas. 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.incr PTH . viruses like Adenovirus may invade Peyer’s Patches and cause intussusception. weakness and constipation. indomethacin (decr renal blood flow). like in Cystic Fibrosis) Portosystemic anastomoses: The mnemonic is from Systemic (IVC) to Portal (Celiac.tumblr. duodenum. lactation MENIIa (Sipple’s): ”2P’s” parathyroid .” Rectal anastomoses: (X=hemorrhoids) ”MI Superior is an Ass”: Systemic: Middle and Inferior Rectal http://julieyumi. PC” Primary retroperitoneal (never pushed into sac): IVC Ab aorta Suprarenal glands Kidneys/Ureters Secondary retroperitoneal (pushed into sac. rectum Digestive tract histology: ”Brunch DIP”: Brunner’s (submucosal. 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.peptic ulcers parathyroid . 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.

(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.G. B. Vein. 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. you’ll vomit out a lot of GASTRIC ACID. transmural complication of Mallory-Weiss http://julieyumi. 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. you can think of drugs/poisons pooling there. it’s the first place to suffer from ischemia also. too Bottom line: Zone 1 = susceptible to viruses. Zone 3 = susceptible to drugs/ischemia Femoral region: ”NAVEL with the Venous near the Penis” Lateral to medial: Nerve. when you think of “ABC”. Rotor’s = ”Dubin-Johnson called Rotor-rooter to fix his WaterPipes. Empty space.” You get direct bilirubinemia when there’s a problem with bile Pipes/excretion (E. 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. hepatic artery. 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.”: 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. you should think of Hepatitis A. 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”. 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.arghlblargh! to Portal: Superior Rectal Umbilical anastomoses: (X=caput medusae) ”Inferior about my Superficial appearance by poking near my Belly-button”: Systemic: Inferior.. it’s where you say “Bye Bye to the SI”: Byle acid.com/post/22267813238/second-aid-usmle-mnemonics Page 18 of 21 . C… Zone 1 = first affected by viral hepatitis because closest to hepatic artery (Remember: Portal triad = bile duct. since blood pools in veins.tumblr. Artery.

and uveitis Note: this is disordered response to intestinal bacteria Ulcerative colitis: ”If you have a Lead Pipe jammed up your Rectum. Achalasia Barrett’s esophagus Cigarettes Diverticuli (e. always involves rectum VS. upper 2/3s (where striated muscle can be found) Adenocarcinoma = most prevalent in America (lower 1/3. Results from Reflux Esophageal cancer risk factors: ”ABCDEFGH” Alcohol. 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.g. you’ll get Bloody Diarrhea. fatigue CRC: ”Apple core” lesion on barium enema x-ray. pernicious anemia (Ab to IF). Cirrhosis. 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”. 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). 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.. Zenker’s) Esophageal web (e. pyoderma gangrenosum. hematochezia proximal colon (right side) = iron deficiency anemia.pylori infection (duodenal > stomach ulcer).g. dull pain. 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. FAPCancer involves APC gene. 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. 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.. sharp colicky pain. ARDS… http://julieyumi. achlorhydria Type B (Antrum) = Bacterial: H. Anemia (hemolytic) Basal ganglia degeneration (Parkinsonism) decr Ceruloplasmin. Corneal deposits. Plummer-Vinson). treated with penicillamine (“copper penny”): ”ABCDEF” Asterixis.tumblr.com/post/22267813238/second-aid-usmle-mnemonics Page 19 of 21 . ankylosing spondylitis. Ataxia. 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.” 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.arghlblargh! BARRett’s esophagus = Becomes Adenocarcinoma. near anus) = obstruction.” 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).

If you have specific questions. 3. causmonot likes this sunshine-n-rain likes this june-myun likes this kuurasu-ou likes this http://julieyumi. 31. Good luck with the exam! Update (3/31/13): Unfortunately. 14.. Please. 35. 12. 20. 19. 27.stuff by just. 30.. 33. I’m very busy with clerkships/shelves and studying for the Step2CK.tumblr. 24. 4. Sigh. 29. 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. 28. 17. 10. 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. 15. 32. 34. so I won’t be able to post the rest of my mnemonics. 21.arghlblargh! Gallstones Ethanol Trauma Steroids Mumps Autoimmune disease Scorpion Sting Hypercalcemia. 16. 26. 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…. 11. 9.. 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. 40. 23. feel free to ask me (but don’t forget to leave me a way to contact you!). 36. 18. I hope this list comes in handy for someone. 22. 38..com/post/22267813238/second-aid-usmle-mnemonics Page 20 of 21 . 13. Posted 1 year ago — 55 notes #USMLE #anatomy #bacteriology #biochemistry #biostatistics #histology #immunology #microbiology #neurology #neuroscience #parasitology #pathology #physiology #psychiatry #ross #virology 1. 2. 5. 39. Hyperlipidemia ERCP Drugs (E... 8.only i could remember. but my Ask box is always open for advice! ^^ Thanks for understanding. 37. 25.G.. 7.

51.com/post/22267813238/second-aid-usmle-mnemonics Page 21 of 21 . 50. 47. 44.arghlblargh! 6/18/13 6:33 PM 41. 48. caviarforelephants reblogged this from julieyumi and added: Wow. 49.tumblr. Impressive. 43. 42. 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. coffeeish likes this nwettie likes this dreaming-of-osaka likes this howatto-izu-disu likes this Show more notes http://julieyumi. 45.

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