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
