Help with Bio chemisty

[dr41]

Hi every one
If any one remembers me I am an ooooold Img .I joined the forum last month and with the great encouragement and advice of the wonderful people on this forum I started my prep with Kaplan notes and videos. I am very happy that I am done with Physiology :D and today I started Biochemistry. This subject has changed a whole lot since my time. IT IS ALL GREEK TO ME.:evil: I don't know what to do now. I am unable to understand Kaplan Molecular biology even with the help of video lectures:cry: .Please advise me what should I do? What books are taught for Molecular biology and Genetics in US med scools?Would those be of any help to me? I am anxiously waiting for your suggestions. Thanks a lot in advance.

[md90]

for biochemistry, check out the lippincott's biochemistry, 3rd edition; for high yield material in the areas of biochemistry and genetics, check out two books: First Aid (FA) 2006 and Goljan's Rapid Review for pathology (he has a nice review of genetics in there); can fill the kaplan's notes into the FA.. hope this helps... good luck with your exam

[jameslynton]

... am an ooooold ...today I started Biochemistry. This subject has changed a whole lot since my time. IT IS ALL GREEK TO ME.

Hi I am old also and this area has changed the most since I was in school in the 70's. They have terms now that did not back then or even ten years ago.
- At first I thought the Clinical Biochemistry Made Ridiculously Simple would help. It is a good review book but it does not teach the basics.

I personally don't like the Kaplan texts so I look for work arounds - I find they leave out stuff and don't define things well. I like the Appleton and Lange review books better. They feel more complete to me I then found "Instant Notes Biochemistry" on Amazon. It is clear, well defined and well written. It also has a very good index. Hope this helps

[dr41]

Thank you very much md90 and jameslynton.I appreciate your help.

[md90]

forgot to mention that Goljan has a biochemistry book too.. it's the same rapid review series; he was a co-author of the book;

[dr41]

Thanx md90.You are always very helpful.I remember you are going to write your exam soon.Good luck with your exam and everything in life.

[md90]

ur very welcome, and thank you for your kind comments, dr41. pray for me on my coming exam, and that my nerves do not get the "best of me." I wish you the best of luck in your studying and taking the exam.... hope that all of your goals in life become reality.

[wcb22]

if it helps at all, try to think of biochemistry as a beautiful story (it really is an amazing science). you can link so much of the basic sciences to it. they can really try to trick you up on questions, and from what i have found, if you truely understand the whole story, you can eliminate so fast all the wrong choices.

glycolysis is central to biochemistry. if you can memorize that diagram out of lippincott, you will see how everything is connected. write it out 3x, see if you can duplicate it from memory (along with TCA cycle, HMP shunt, fatty acid synthesis, etc). do you see how the HMP shunt will help spit out products for DNA syntheses (ribose-5-phosphate)? can you see how galactose, or fructose can enter the glycolysis cycle? do you see why pyruvate is so essential to biochemistry?

there are 4 fates to pyruvate, and the boards loves all of them.

when i first started biochem, i became very frustrated. most of it was with terminology. anything ending in "ase" is an enzyme. it just speeds up the rate of the reaction. they can trip you up on all the "g" names.

glucose - you know, the 6 member ring
glycogen - multiple glucose chains linked together (by alpha 1,4 for straight and 1,6 for branching)
glycolysis - breaking down glucose, eventually down to pyruvate
glycogenolysis - breaking down glycogen (to glucose-1-phosphate, then it goes to glucose-6-phosphate)
gluconeogenesis - making new glucose (in fasting state, insulin low, glucagon high)
glycogenesis - making new glycogen (when insulin is high after a meal, and glucagon is low).

biochem can get frustrating with terminology, but understanding terminology alone will help you more than you know.

lysis = breaking down
genesis = making, forming
neo = new

you might get frustrated with enzymes. first, memorize all the rate limiting steps for all the processes (in FA). learn what deaminase means once, and you won't have to try to learn it 10x by memorizing meaningless enzymes with deaminase in it. same with hydrolases, lyases, decarboxylase and especially, dehydrogenase. in my book (besides the rate limiting enzyme of glycolysis, PFK-1), pyruvate dehydrogenase is the most important enzyme. pyruvate dehydrogenase requires 5 cofactors in order to convert pyruvate to acetyl-coA. one of them is thiamine, or vitamin b1.

clinical correlate... if an alcoholic comes stumbling in to the ER who appears severely dehydrated, and you think to put him on his IV 5% glucose and normal saline, you might kill the guy. if you forget that alcoholics commonly have vit B1 deficiency (wernicke korsakoff syndrome), and that this is required for pyruvate dehydrogenase to function, you might have just pushed this guy over the limit into a dangerous lactic acidosis. that glucose just infused will go to pyruvate so fast, but will stop right there (well, it will actually push any pyruvate to acetyl coA, using up any remaining thiamine, and then pyruvate is stuck). instead pyruvate is shunted to lactate (by lactate dehydrogenase)... this person's body, starved for ATP, would much rather get 2 moles of ATP by going to lactate, than just sitting there as pyruvate. you always give alcoholics with this presentation thiamine, just in case they are out, or almost out if it.

all i'm trying to say here is, biochem can relate to everything, mol bio, physiology, pharmacology, pathology, beh science, anatomy, histo, etc. and everything in those pathways are connected... if any pathway is blocked (i.e., missing enzyme in that persons body, absent co factors, etc.), you will push excess substrates to other products.

learn to love the story, it makes sense of so much in basic sciences. i've noticed, those people who understand biochem are able to put it all together... it's like the subject in basic sciences that's the joining link for all the other subjects, like the J chain in IgA or IgM.

[md90]

wcb22, I like that... "a beautiful story"; thank you...

[Ben Casey]

I am an old IMG too. The basic medical sciences I studies back in the late 70's are totally forgotten. I am fifty three yrs. old, and I doubt I can get a residency. I will be 54 when I start applying. Oh well, Ill take the USMLE soon, and just chalk up my MD degree as a personal growth experience.

[dr41]

Ben,I know a person who is 55 years old and is doing his residency in ob/gyn. Keep your spirits high!!!!!!! Good luck

[wcb22]

don't get down on yourself, some of the older people in my class are excelling over the young ones... b/c they have the maturity, discipline and experience that the young ones do not. there is one older person (~50 yr old) who only got 77 on step 1. she want obgyn, and she'll get it. her attitude is incredible, and everywhere she does rotations, they fall in love with her.

age means little, attitude is everything.

[jameslynton]

I am an old IMG too. ... I am fifty three yrs. old, and I doubt I can get a residency. I will be 54 when I start applying. Oh well, Ill take the USMLE soon, and just chalk up my MD degree as a personal growth experience. Hey, I am starting med school at age 55. That means I will be 58-59 going into residency. If I had done this in my twenty's would have been a real S**t Head. Just read the stuff about the successful testers and what they did. I am already researching the test and getting information on what the successful testers do and the unsusscessful testers do. You have many advantages others don't have. At least that's how I look at it. Look at Meg's notes and on SDN look at Big Frank's posts. There is tons of information available - you have to sift a bit to find the gems.
Best wishes and stay in touch - a support group is important.
J

[md90]

Ben, stay positive... remember in life: attitude is 99%, and everything else is 1%. Stay within your goals... and you will succeed!!! :p

[Ben Casey]

Thanks for your generous support guys. It's been that I have heard some horror stories, so I was wondering if there was another way to use my MD. Is it true that if you fail your USMLEpart1 on your first try, if you are an ING, you will not get a residency ever , even if you scored 277 on your second try. You konw a support group would be nice. We share things in common like life experiences, sore backs, lack of stamina, short term meory loss...all we are guity of is our determination to be doctors. Thanks Doctors...

[jameslynton]

...I have heard some horror stories, so I was wondering if there was another way to use my MD. Is it true that if you fail your USMLE part1 on your first try, if you are an ING, you will not get a residency ever , even if you scored 277 on your second try.... You will hear lots of stories - You do have to pass it. Most schools give you two times sometimes three. Certain states like Ohio will not take you if you failed it once for residence. So there is that pressure also. There is a lot you can do to mitigate failure. I will save you some time with posting what I have found:
1. Questions - do tons of questions Kaplan q-banks online and paper Appleton & Lange etc, BRS series books. No body who has done over 5,000 questions has failed. Or if they have they have no reported it.
Note - those who just read and study or do less than 2,000 questions regularly fail the test.
2. Systematic review/study process different subject every day for 6 weeks to 3 months.
3. Takes test along the study process to access if you are learning - Suggested tests are the NMBE self accessment tests $45 cheap, Kaplan simulated, USMLE practice test, etc
4. Use the tests and questions two ways - one to gage test speed - one as a review learning reenforcement. Do timed and review. Know the correct answer and why the other answers are not correct!!!
5. Work on basics - yes - know basics and review on regular time schedule.
6. Almost everybody agrees that the Goljan lectures and notes are helpful. He does a masterful job of integrating all areas together in a way that gives a general approch to problem solving.
7. First Aid - Hate it or love it. Have one central review source and a checklist for what you covered. One major book for each review area.
8. TommyK's questions - like Goljan - they are intergrator questions. Think there are now 2219 of them.
9. List of diseases/conditions and syndromes and common presentations for them and "most common treatments". Calculations needs for the above also.

Also I have two friends who are MD's one works as a researcher at NIH on ebola and the other is at CDC doing stats.