HY USMLE Q #383 – Biochemistry / Pharmacology — Transcript

Full transcript

1. 0:00i had just recorded this clip and my
2. 0:01microphone was [ __ ] up and it sounded
3. 0:03terrible and now i have to record the
4. 0:05whole [ __ ] clip uh so this is the
5. 0:07deal guys
6. 0:08this vignette hyper basic past level
7. 0:12farm detail for step one and i combined
8. 0:14it with difficult biochemistry stuff
9. 0:16okay um step one is obviously pass fail
10. 0:19now so enough of the theatrics okay i'll
11. 0:22cut to the [ __ ] chase
12. 0:23before we get started please subscribe
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19. 0:34group and channel links are down below
20. 0:35now let's start the [ __ ] question 34
21. 0:38year old dude being treated for
22. 0:39tuberculosis and he has three day
23. 0:41history of paresthesias of his left arm
24. 0:43questions asking about the vitamin
25. 0:44deficiency and what it does
26. 0:45biochemically
27. 0:47you need to know as past level as it
28. 0:48prefaced with that this is vitamin b6
29. 0:50deficiency pyridoxine no [ __ ] excuses
30. 0:53okay so isoniazid causes b6 deficiency
31. 0:57and it can cause neuropathy non-specific
32. 0:59okay paresthesias seizure that's our
33. 1:01past level detail okay now we move into
34. 1:03the harder biochemistry and there's
35. 1:06theatrics but i'll cut to the chase so
36. 1:09uh breakdown of odd chain fatty acids
37. 1:11wrong [ __ ] answer i mean this would
38. 1:12be for uh biotin as well as b12 so
39. 1:15biotin's b7 as well as b12 uh chain
40. 1:18fatty acids liberate not just acetyl
41. 1:19coa's but also propional coe which via
42. 1:22propional coa carboxylase and biotin
43. 1:24goes to methylmalonyl coa which via b12
44. 1:27and methylmalonyl coa mutase goes to
45. 1:29succinyl coa all just a bunch of
46. 1:31theatrics and horseshit okay like you
47. 1:34don't need to know it now that step
48. 1:35one's pass fail so we're just going to
49. 1:37keep moving forward
50. 1:38collagen synthesis wrong answer but very
51. 1:40high yield for vitamin c deficiency okay
52. 1:44extremely high yield so vitamin c is a
53. 1:46cofactor for hydroxylase enzymes uh and
54. 1:48you need that for collagen synthesis
55. 1:50i've made other questions on the
56. 1:52scurvy vitamin c deficiency peripheral
57. 1:54hemorrhages bleeding gums echomoses very
58. 1:57very very important okay for step one
59. 2:00choice c wrong [ __ ] answer for
60. 2:01gluconeogenesis now many uh enzymes
61. 2:05cofactors involved of course but this
62. 2:07would also be vitamin b7 biotin okay
63. 2:09when we have pyruvate rather than moving
64. 2:11forward into the krebs cycle we could uh
65. 2:14bring pyruvate
66. 2:15via pyruvate carboxylase and vitamin b7
67. 2:18to oxaloacetate which then can go
68. 2:20backwards via p pep carboxy kinase goes
69. 2:23to phosphoenol pyruvate and then back up
70. 2:25to glucose once again a bunch of
71. 2:27theatrics and nonsense that you don't
72. 2:29need to worry about now that you don't
73. 2:30need to
74. 2:31shoot for a high score in step one
75. 2:35heme synthesis is our correct answer now
76. 2:36look this is going to sound pedantic but
77. 2:38i promise you it's not not about wasting
78. 2:40your [ __ ] time you need to know the
79. 2:42first step of heme synthesis
80. 2:44requires vitamin b6 okay so succinyl coa
81. 2:47plus glycine via b6 and delta ala
82. 2:50synthase goes to delta ala sounds
83. 2:52pedantic it's not it's all over the
84. 2:54nbmes for step one okay including the
85. 2:56offline forms
86. 2:57and they also even what you know the
87. 2:58substrates like i just said sucks no koi
88. 3:00plus glycine
89. 3:01they've asked succinyl coa as well they
90. 3:03might give you a heme synthesis disorder
91. 3:05such as acute intermittent porphyria or
92. 3:06prophylocutaneatarta
93. 3:08and then they have uh suck they'll say
94. 3:10like which the following is required and
95. 3:12the answer could be b6 so the answer
96. 3:13could be succinyl coli or the answer
97. 3:14could be glycine okay very [ __ ]
98. 3:16important that you know that
99. 3:18krebs cycle wrong [ __ ] answer i mean
100. 3:20this could be
101. 3:21uh pyruvate dehydrogenase when we bring
102. 3:24pyruvate uh to uh acetyl coa requires b1
103. 3:28b2 b3 b5 lipoic acid uh also succinate
104. 3:32goes to fumarate requires b2 a bunch of
105. 3:34horseshit a bunch of nonsense uh you
106. 3:37don't need to know this anymore okay
107. 3:38it's not our [ __ ] opinion i mean it's
108. 3:40not i mean the us emily decided they
109. 3:42wanted a past failed exam so now
110. 3:44students don't need to know any
111. 3:45biochemistry apart from some general
112. 3:47stuff like heme synthesis requires b6
113. 3:49collagen since this requires vitamin c
114. 3:52you know the deal i'm going to continue
115. 3:53to make more content if you like my
116. 3:54stuff subscribe my channel
117. 3:56and i appreciate your time that's it