Needing to readjust my strategy

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igcgnerd

Hawkeye
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I know everyone here says that just pounding repetitions through first aid is the key to success, I have a problem with that though. The two particular subjects I continue to have problems with are micro and biochem. This is despite two run throughs of FA with DIT and other run through alone after that. The way they are presented in first aid is so abstract (esp biochem). Having them so out of context makes getting through it and retaining it extremely difficult for me.
The other subjects I'm well versed in. I think the main reason why is I could put them into a context and ask the "Why?" question. Such as understanding pressure dynamics and realizing that mitral stenosis can lead to RVH blah blah blah.
Do you guys have any suggestions for these two topics (micro/ biochem) to help me put them in a better context for learning/ memorization short of going through lippincotts again like a first year?
 
I think FA biochem does have everything that you need, however, it's sometimes hard to figure out exactly what is important. The way I looked at biochem and it served me decently well on UWorld and the actual thing is that there are some core pathways and things I need to know. Everything else is fluff or pretty low yield

1) Nutrition - Vitamins (function, deficiency, excess if it's listed, there's a good schematic in FA on the B12 page showing the parallel methionine/homocysteine/cysteine and methylmalonic acid/propionyl-CoA/heme pathway involving B6, B9, and B12 that's super clutch, I also added a couple steps from branched chain amino acids to methylmalonic acid with biotin cofactor because it's important in maple syrup urine disease and FA doesn't really go into that)
2) Pathways:
- DNA/nucleotide synthesis/salvage (the schematic in FA involving the drugs on the 2nd page is helpful, from the purine pathways I'd just look at HGPRT and ADA and skim the rest)
- Collagen synthesis: where/what happens in every step, what enzymes/cofactors, which diseases, what symptoms
- Cell metabolism: glucose, fructose, galactose (major enzymes, regulation, shunts, side pathways, alternative names, common diseases)
- Urea cycle: where/what happens, diseases
- Heme synthesis: where/what happens, enzymes, inhibitors/regulators (this is probably the easiest pathway, FA has a good schematic later on in the heme/onc section, memorize it, write it out a couple times, you are done)
3) Misc:
- Some of those random genetic diseases mentioned in FA: NF1/2, Angelman/Prader-Willi, etc, but I tend to remember those better when they come up in organ systems later on in FA
- Glycogen storage diseases and lysosomal storage diseases: 2 FA charts are super nice
- Know the functions of the apolipoproteins (nice chart in FA as well)
- Some random amino acid products (FA has a chart)

That's practically 95% of biochem you need to know. Note, I skipped the research methods part because I've got a fair amount of benchwork under my belt as MD/PhD student so I didn't need to focus on that.

I think to help me get over the "abstract-ness" of biochem, I often tried to find connections in organ systems and go back to biochem for reviews. In fact, biochem is the section that I referred back to the most out of the entire book. I'll give a few examples:

1) When in endocrine (and GI) and it mentions carcinoid syndrome, one of the correlates is niacin deficiency. That's a great opportunity to go back to the amino acid derivatives chart in biochem section and see that both niacin and serotonin are made from tryptophan and review the rest of the chart. And then you can go back to niacin and review its function and symptoms of deficiency. That's 2 things from biochem right there.

2) When in the renal section and you come upon the chart with renal stones, it's a great time to go back to that biochem section on cystinuria and see that lack of COLA transporters cause excess cystine in urine leading to recurrent hexagonal stones as well as lack of GI absorption. In addition, the treatment is hydration, citrate, and acetazolamide. A good time for a quick review of that page as well.

Stuff like that
 
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Sbr249 made a great post and I agree with everything. Basically biochem is: this enzyme doesn't work, what pathway is messed up, what gets backed up and accumulates and what are the consequences of that accumulation. I read Kaplan biochem and thought thai helped a lot.
 
the research methods part, where is that in FA 2014? and if not in there where else could i read that from? please and thanks!
 
It's the biochem section after cellular and before genetics called laboratory techniques. It has stuff about PCR, western/southern blots, ELISA, FISH, cloning, karyotyping, microarrays (which I thought the FA2014 did a pretty poor job explaining), transgenic mice, Cre-Lox system, etc. Stuff that a clinical micro or path lab might do or a medical research lab. It's nothing intense, you just need to know some basics like those things do, what you use them for, and the basic principles.
 
I used kaplan biochem, I thought it was good for understanding research stuff but I also have some experience in labs. I didn't get any heavy experiment questions like some people did
 
Do questions -----> Read what you don't understand well -----> more questions -----> Read........................

Rinse and repeat.
 
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