Cell membrane and Transport
1. Components of Cell Membrane (Fluid Mosaic Model)
Mnemonic: “Phat People Can Make Fun Friends”
P – Phospholipids
P – Proteins (Integral & Peripheral)
C – Cholesterol
M – Membrane carbohydrates (Glycolipids, Glycoproteins)
F – Fluid mosaic
F – Flexibility
2. Functions of Cell Membrane
Mnemonic: “PETERS”
P – Protection
E – Endocytosis & Exocytosis
T – Transport (Selective permeability)
E – Enzymatic activity
R – Receptor for signaling
S – Structural support
3. Types of Membrane Transport
Mnemonic: “P-FATE” (Passive and Facilitated transport are FATE-ful)
P – Passive transport
F – Facilitated diffusion
A – Active transport
T – Transcytosis (Endo- & Exocytosis)
E – Endocytosis (Pinocytosis, Phagocytosis)
4. Types of Membrane Proteins
Mnemonic: “TRICE”
T – Transport proteins
R – Receptor proteins
I – Integral proteins
C – Cell recognition proteins
E – Enzymatic proteins
5. Differences: Active vs Passive Transport
Mnemonic for Active: “NEEDS ATP”
-
N – Needs Energy (ATP)
-
A – Against gradient
-
T – Transport proteins needed
-
P – Pumps (Na+/K+ pump)
Mnemonic for Passive: “HIGH to LOW, No ATP Flow”
6. Types of Endocytosis
Mnemonic: “PPR” – Please Pick Right
P – Phagocytosis (“cell eating”)
P – Pinocytosis (“cell drinking”)
R – Receptor-mediated endocytosis
7. Amphipathic Nature of Phospholipids
Mnemonic: “HAIL”
H – Hydrophilic head
A – Amphipathic molecule
I – Insoluble in water overall
L – Lipophilic tail
Enzymes
Six Classes of Enzymes (IUBMB Classification)
Mnemonic: OTH LIL
-
- Oxidoreductase
- Transferase
- Hydrolase
- Lyase
- Isomerase
- Ligase
OR
Mnemonic: “Over The HILL”
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O – Oxidoreductases (oxidation-reduction reactions)
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T – Transferases (transfer functional groups)
-
H – Hydrolases (hydrolysis reactions)
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I – Isomerases (isomerization changes)
-
L – Ligases (joining molecules with ATP)
-
L – Lyases (break bonds without water)
Tip: Remember “HILL” as enzymes help you climb the hill of metabolism.
2. Features/Properties of Enzymes
Mnemonic: “SPEEED”
-
S – Specificity
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P – Protein in nature (mostly)
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E – Efficient (high catalytic power)
-
E – Environment-sensitive (pH & temp)
-
E – Enzyme-substrate complex formation
-
D – Denaturation (by heat or extreme pH)
3. Factors Affecting Enzyme Action
Mnemonic: “PLET PSAT”
-
P- pH
-
L- Light & radiation
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E – Enzyme concentration
-
T – Temperature
- P – Product Concentration
- S – Substrate concentration
- A – Activators
-
T – Time
Enzyme Kinetics – Michaelis-Menten Constants
Mnemonic: “KM = Half the Max”
-
Km: Substrate concentration at which V = ½ Vmax
This helps you remember that Km reflects the enzyme’s affinity for its substrate (lower Km = higher affinity).
5. Enzyme Inhibition Types
Mnemonic: “CUN” – Competitive, Uncompetitive, Non-competitive
Competitive Inhibition
Mnemonic: “Competes & Increases Km, No Vmax Change”
Non-Competitive Inhibition
Mnemonic: “No Competition, No Km Change, Lowers Vmax”
Uncompetitive Inhibition
Mnemonic: “UNique – Both Km & Vmax Decrease”
6. Coenzymes vs Cofactors
Mnemonic: “Coenzyme = Organic, Cofactor = For all (metal or organic)”
-
Coenzyme – Organic (e.g., NAD⁺, FAD)
-
Cofactor – May be metal ions (e.g., Zn²⁺, Mg²⁺) or coenzymes
7. Isoenzymes: Mnemonic – “Let Cool Kids Always Party”
This mnemonic helps remember the main isoenzymes of Lactate Dehydrogenase (LDH):
L – LDH-1 → C – Cardiac muscle (Heart)
L – LDH-2 → K – Kidney
L – LDH-3 → A – Alveolar (Lung)
L – LDH-4 → P – Pancreas
L – LDH-5 → L – Liver & Skeletal muscle
Mnemonic Breakdown:
Let Cool Kids Always Party = LDH 1 (Cardiac), 2 (Kidney), 3 (Alveoli), 4 (Pancreas), 5 (Liver)
Clinical Pearl:
LDH-1 > LDH-2 = Myocardial infarction
(Normally, LDH-2 > LDH-1, so a “flip” indicates MI)
8. Enzymes in Myocardial Infarction (MI): Mnemonic – “Clever Lab Test”
Use this to recall the key cardiac enzymes released in MI:
C – CK-MB
L – LDH (especially LDH-1)
T – Troponin I & T
Timing Clue (Another Mnemonic):
“Troops Come Late”
-
Troponins ↑ in 3–6 hrs, peak in 12–24 hrs, stay ↑ for 7–10 days
-
CK-MB ↑ in 3–6 hrs, peak 12–24 hrs, normal in 48–72 hrs
-
LDH ↑ later but remains longer
9. Liver Enzymes: Mnemonic – “A Liver’s Secret Guard”
Helps remember liver-related enzymes:
A – ALT (Alanine transaminase)
L – LDH
S – AST (Aspartate transaminase)
G – GGT (Gamma-glutamyl transferase)
Also: ALP (Alkaline phosphatase)
Clinical Tip:
-
ALT > AST → Viral hepatitis
-
AST > ALT → Alcoholic liver disease
(“S for Spirits“)
10. Pancreatic Enzymes: Mnemonic – “PALE”
Used in diagnosis of acute pancreatitis:
P – Pancreatic lipase
A – Amylase
L – Low calcium (hypocalcemia may occur)
E – Elevated glucose (due to islet damage)
11. Bone Disorders: Mnemonic – “ALP Builds Bones”
ALP (Alkaline Phosphatase) is raised in:
-
Bone diseases (e.g., Paget’s disease, rickets, osteomalacia)
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Liver diseases (especially obstructive)
-
Growing children (physiological)
Remember:
High ALP + Normal GGT → Bone origin
High ALP + High GGT → Liver origin
Chemistry of Amino Acids & Proteins
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1. Essential Amino Acids
These cannot be synthesized by the body and must be obtained from diet.
Mnemonic: “PVT TIM HALL”
-
P – Phenylalanine
-
V – Valine
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T – Threonine
-
T – Tryptophan
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I – Isoleucine
-
M – Methionine
-
H – Histidine (semi-essential)
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A – Arginine (semi-essential)
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L – Leucine
-
L – Lysine
Tip: Arginine & Histidine is essential in children (growth phase), hence semi-essential.
2. Classification Based on Side Chain (R-group)
Mnemonic: “GAVLIMP” loves “PASTA” but hates “A SHET”
Non-polar (Hydrophobic) – “GAVLIMP”
-
G – Glycine
-
A – Alanine
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V – Valine
-
L – Leucine
-
I – Isoleucine
-
M – Methionine
-
P – Proline
Polar Uncharged – “PASTA”
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P – Phenylalanine (Actually aromatic, but can show mixed behavior)
-
A – Asparagine
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S – Serine
-
T – Threonine
-
A – Tyrosine (can be classified here or with aromatics)
Charged Polar (Hydrophilic)
Acidic – “A SHET”
-
A – Aspartic acid
-
S – Succinic acid (Not an AA, just a sound-alike for Aspartate!)
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H – Histidine
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E – Glutamic acid
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T – Technically wrong – but use for “GlutaTamic”
(You can revise this to: “DE” = Aspartic, Glutamic acid → Acidic)
Basic – “HAL”
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H – Histidine
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A – Arginine
-
L – Lysine
3. Aromatic Amino Acids
Mnemonic: “Try Tripping on a Tyre”
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Try – Tryptophan
-
Tripping – Phenylalanine
-
Tyre – Tyrosine
These absorb UV light at ~280 nm (used in protein quantification)
4. Acidic and Basic Amino Acids
Mnemonic for Acidic: “Acid is Negative – DE”
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D – Aspartic acid (Aspartate)
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E – Glutamic acid (Glutamate)
Mnemonic for Basic: “HAL is positive”
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H – Histidine
-
A – Arginine
-
L – Lysine
Remember: Acidic = Negatively charged at physiological pH;
Basic = Positively charged.
5. Protein Structure Levels
Mnemonic: “1° Beads, 2° Coils, 3° Folds, 4° Friends”
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1° – Primary: Sequence of amino acids (peptide bonds)
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2° – Secondary: α-helix, β-sheet (H-bonds)
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3° – Tertiary: 3D folding (Disulfide bonds, H-bonds, hydrophobic interactions)
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4° – Quaternary: Multiple polypeptides joining (e.g., Hemoglobin)
6. Bonds in Protein Structure
Mnemonic: “PHI-DH”
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P – Peptide bond – Primary
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H – Hydrogen bond – Secondary
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I – Ionic bond – Tertiary
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D – Disulfide bond – Tertiary/Quaternary
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H – Hydrophobic interactions – Tertiary
7. Tests for Proteins & AAs
Mnemonic: “BINCP” – Basic Individual Needs Can Pass”
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B – Biuret test → Peptide bonds (protein presence)
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I – Xanthoproteic test → Aromatic AAs (yellow color)
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N – Ninhydrin test → Free amino group (used in chromatography)
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C – Millon’s test → Tyrosine (red color)
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P – Pauly’s test → Histidine & Tyrosine
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Metabolism of Amino Acids and Proteins
- Digestion of Proteins
Mnemonic: “Some People Try Eating Chips”
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S – Stomach → Pepsin (activated from pepsinogen by HCl)
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P – Pancreas → Enzymes like Trypsin, Chymotrypsin, Carboxypeptidase
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T – Trypsin → Activates other zymogens
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E – Enteropeptidase → Converts trypsinogen to trypsin
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C – Small intestine → Final digestion by peptidases
Proteins → Peptides → Amino Acids
2. Urea Cycle
Mnemonic: “Ordinarily, Careless Crappers Are Also Furious About Urination “
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O – Ornithine
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C – Carbamoyl phosphate
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C – Citrulline
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A – Aspartate
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A – Argininosuccinate
-
F – Fumarate
- A – Arginine
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U- Urea
Occurs mainly in the liver
Clinical link: Deficiency of enzymes → Hyperammonemia
Glycine → “He Creatively Purifies Collagen”
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Heme (with Succinyl-CoA)
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Creatine (with arginine)
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Purines (nucleotides)
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Collagen (component of triple helix)
Tyrosine → “Do Not Make My Thyroid Hormones”
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Dopa → Dopamine
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Norepinephrine
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Melanin
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MAO degrades Catecholamines
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Thyroxine (T₄)
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Hormones of adrenal medulla
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Tryptophan → “Sister Makes Nice Protein”
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Serotonin
-
Melatonin
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Niacin → Needed for NAD⁺/NADP⁺
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Protein synthesis
Deficiency in B6 or iron can affect these pathways
Hartnup disease → ↓ tryptophan absorption → ↓ niacin → Pellagra-like symptoms
Chemistry of Carbohydrates
Classification of Carbohydrates
Based on number of sugar units and derivatives.
1. Based on Number of Units
Mnemonic: “My Dear Old Papa”
- M – Monosaccharides (single unit)
- D – Disaccharides (2 units)
- O – Oligosaccharides (3–10 units)
- P – Polysaccharides (>10 units)
2. Based on Functionality
- Aldoses – contain aldehyde group (e.g., glucose)
- Ketoses – contain ketone group (e.g., fructose)
Mnemonic: “Aldo Glows, Keto Fruits”
2. Functions of Carbohydrates
Mnemonic: “SHE BIDS”
- S – Structural (cellulose in plants, ribose in RNA)
- H – Helps in fat metabolism
- E – Energy source (main role)
- B – Building blocks (e.g., ribose in DNA/RNA)
- I – Immediate energy via glycolysis
- D – Dietary fiber – helps bowel movement
- S – Storage form as glycogen (animals), starch (plants)
3. Glycosaminoglycans (GAGs)
“He Please Kindly Help Drive Car”
| GAG | Mnemonic | |
|---|---|---|
| He – Heparin | Anticoagulant in mast cells, blood | |
| P – Heparan sulfate | Basement membrane, cell surfaces | |
| K – Keratan sulfate | Cornea, cartilage | |
| H – Hyaluronic acid | Synovial fluid, vitreous humor | |
| D – Dermatan sulfate | Skin, blood vessels | |
| C – Chondroitin sulfate | Cartilage, tendons |
4. Functions of GAGs
Mnemonic: “GLUE”
- G – Ground substance in ECM
- L – Lubrication in joints (e.g., hyaluronic acid)
- U – Unusual anticoagulant (heparin)
- E – Elasticity and support (cartilage, skin)
5. Disaccharides
Mnemonic: “Some Like More Red Sugar”
- Lactose – Reducing
- Maltose – Reducing
- Sucrose – Non-reducing (because of its glycosidic bond involving both anomeric carbons)
Metabolism of Carbohydrates
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1. Digestion of Carbohydrates
Mnemonic:
“Saliva, Small, Sweet Simplicity”-
Saliva – Salivary amylase (in mouth)
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Small intestine – Pancreatic amylase
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Sweet – Disaccharides → Monosaccharides
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Simplicity – Absorbed in simple form (glucose, galactose, fructose)
2. Glycolysis (Embden-Meyerhof Pathway)
Mnemonic:
“Hungry Peter Pan And The Great Mighty Pirate Picked Pumpkin Pie To Prepare”Each capitalized word stands for one step/enzyme in glycolysis:
-
H – Hexokinase
-
P – Phosphoglucose isomerase
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P – Phosphofructokinase-1 (PFK-1)
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A – Aldolase
-
T – Triose phosphate isomerase
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G – Glyceraldehyde-3-phosphate dehydrogenase
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M – Phosphoglycerate kinase
-
P – Phosphoglycerate mutase
-
P – Enolase
-
T – Pyruvate kinase
Rate-Limiting Enzyme: PFK-1
Mnemonic: “PFK is the King of Glycolysis”
3. Kreb’s Cycle (TCA Cycle)
Mnemonic:
“Can I Keep Selling Sex For Money, Officer?”-
C – Citrate
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I – Isocitrate
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K – α-Ketoglutarate
-
S – Succinyl-CoA
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S – Succinate
-
F – Fumarate
-
M – Malate
-
O – Oxaloacetate
Rate-Limiting Enzyme:
Isocitrate dehydrogenase
4. Gluconeogenesis
Mnemonic:
“Pathway Produces Fresh Glucose”-
P – Pyruvate carboxylase
-
P – PEP carboxykinase
-
F – Fructose-1,6-bisphosphatase
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G – Glucose-6-phosphatase
Mnemonic to remember it’s the reverse of glycolysis with bypasses:
“Gluconeogenesis Bypasses Three Irreversible Steps of Glycolysis”
5. Glycogen Metabolism
(A) Glycogenesis
Mnemonic:
“G6 Makes Great Branches”-
G6 – Glucose-6-phosphate
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M – Mutase (G6P → G1P)
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G – Glycogen synthase (adds glucose units)
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B – Branching enzyme (creates branches)
(B) Glycogenolysis
Mnemonic:
“Pretty Dumb Guys Dismantle”-
P – Phosphorylase (breaks α-1,4 bonds)
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D – Debranching enzyme (removes branches)
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G – Glucose-1-phosphate
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D – Converted to G6P → then to glucose in liver
6. Glycogen Storage Disorders
Mnemonic:
“Very Poor Cori Anderson Made Herself Hers”Disease Mnemonic Word Enzyme Deficiency Von Gierke’s Very Glucose-6-phosphatase Pompe’s Poor Lysosomal α-1,4-glucosidase Cori’s Cori Debranching enzyme Andersen’s Anderson Branching enzyme McArdle’s Made Muscle glycogen phosphorylase Hers’ Herself Hepatic glycogen phosphorylase
7. HMP Shunt (Pentose Phosphate Pathway)
Mnemonic:
“Hand Me Power”-
H – HMP shunt
-
M – Makes NADPH
-
P – Produces Pentoses for nucleotide synthesis
Key Enzyme: Glucose-6-phosphate dehydrogenase (G6PD)
8. G6PD Deficiency & Hemolytic Anemia
Mnemonic:
“G6PD: No NADPH, No Defense!”-
G6PD deficiency → ↓ NADPH
-
No NADPH → No reduced glutathione
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Leads to oxidative damage → hemolysis
-
Triggered by: fava beans, infections, sulfa drugs
Mnemonic for triggers: “FIS”
-
F – Fava beans
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I – Infections
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S – Sulfa drugs
9. Regulation of Blood Sugar
Mnemonic:
“High Glucose Insulin Goes, Low Glucose Glucagon Grows”-
High glucose → ↑ Insulin → ↓ blood sugar
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Low glucose → ↑ Glucagon → ↑ blood sugar
10. Diabetes Mellitus (DM)
Mnemonic:
“3 Ps of Diabetes”-
Polyuria – Excess urination
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Polydipsia – Excess thirst
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Polyphagia – Excess hunger
Type 1 vs Type 2 Mnemonic:
“Type 1: T-cell Attack, Type 2: Too much sugar”-
Type 1: Autoimmune destruction of β-cells
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Type 2: Insulin resistance ± deficiency
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Chemistry of Lipids
-
-
Bile acids are the main fate of cholesterol
-
Others excreted in feces
Fatty Acids – Saturated vs Unsaturated
Mnemonic:
“Saturated = Straight; Unsaturated = Unsure (Kinks)”-
Saturated FA – No double bonds (e.g. palmitic acid)
-
Unsaturated FA – One or more double bonds (e.g. oleic acid)
Think: “Sat = Solid” (at room temp)
“Unsat = Unstable” → liquid
2. Essential Fatty Acids (EFAs)
Mnemonic:
👉 “Lino Likes Alpha”-
Linoleic acid
-
Linolenic acid (α-linolenic)
-
Both are polyunsaturated and cannot be synthesized by the body
“Essential to Eat” – must come from diet.
3. Omega Fatty Acids
Mnemonic:
“3-6-9 Are Prime Omegas”-
Omega-3 – α-linolenic acid
-
Omega-6 – Linoleic acid
-
Omega-9 – Oleic acid
Remember: “Omega-3 is anti-inflammatory”
4. Lipoproteins (Order of lipoproteins by increasing density)
Mnemonic:
“Chylos Love Very Low Hormones”-
Chylomicrons – lowest density, highest TG
-
LDL – Low-density lipoprotein
-
VLDL – Very low-density lipoprotein
-
HDL – High-density lipoprotein (good cholesterol)
“LDL = Lousy, HDL = Healthy”
5. Functions of Lipids
Mnemonic:
“SHE Fights Cold Water”-
S – Storage of energy
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H – Hormone synthesis
-
E – Enzyme co-factors (e.g. vitamins)
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F – Formation of membranes (phospholipids)
-
C – Cell signaling (e.g. prostaglandins)
-
W – Waterproofing (sebum, waxes)
6. Lipid-Soluble Vitamins
Mnemonic:
👉 “KADE in Fat”-
K, A, D, E – fat-soluble vitamins
-
Absorbed along with dietary fat
-
Deficiency seen in fat malabsorption (e.g. cystic fibrosis)
Metabolism of Lipids
1. Digestion of Lipids
Mnemonic:
“Lingual, Gastric, Pancreatic – Bile Brings Breakup”-
Lingual lipase – Acts in mouth/stomach
-
Gastric lipase – Acts in stomach
-
Pancreatic lipase – Acts in intestine (main enzyme)
-
Bile salts – Emulsify fats → micelle formation
-
Final products: FFA, monoacylglycerol, cholesterol, lysophospholipids
2. Lipolysis (Breakdown of Stored Fat)
Mnemonic:
“HSL is the Hero”-
HSL = Hormone Sensitive Lipase
-
Activated by: Glucagon, Epinephrine
-
Inhibited by: Insulin
Tip: “When hungry (low insulin), fat breaks down.”
3. Beta-Oxidation of Fatty Acids
Mnemonic for Steps:
“OHOT” – Oxidation, Hydration, Oxidation, ThiolysisEach cycle removes 2C as acetyl-CoA.
-
O – Acyl-CoA dehydrogenase
-
H – Enoyl-CoA hydratase
-
O – Hydroxyacyl-CoA dehydrogenase
-
T – Thiolase
Tip: Occurs in mitochondria.
4. Disorders of Beta-Oxidation
Mnemonic:
“MCAD is Most Common”-
MCAD Deficiency – Medium-Chain Acyl-CoA Dehydrogenase
-
Symptoms: Hypoglycemia, vomiting, sudden infant death
-
Treatment: Avoid fasting
-
Remember: Beta-oxidation fuels fasting. If defective → hypoglycemia
5. Fatty Acid Biosynthesis
Mnemonic:
“ACC FAS”-
ACC = Acetyl-CoA carboxylase (Rate-limiting)
-
FAS = Fatty Acid Synthase (multienzyme complex)
Cofactor: Biotin
Occurs in cytoplasm, uses NADPH from HMP shunt
6. Ketone Body Metabolism
Mnemonic:
“HAA” for Ketone Bodies-
H – Hydroxybutyrate
-
A – Acetoacetate
-
A – Acetone (exhaled → fruity breath)
Produced in liver, used by muscles, brain (during starvation)
7. Ketosis
Mnemonic:
“No Sugar → Liver Makes Ketones”Seen in:
-
Starvation
-
Uncontrolled Diabetes Mellitus
-
Low-carb diets
Excess ketones → ketoacidosis → fruity breath, low pH
8. Cholesterol Synthesis
Mnemonic:
“HMG-CoA is Key”-
Rate-limiting enzyme: HMG-CoA reductase
-
Precursor: Acetyl-CoA
-
Statins inhibit HMG-CoA reductase
Occurs in liver cytoplasm, needs NADPH
9. Cholesterol Degradation
Mnemonic:
“BAKE” – Bile Acids, Kidneys Excrete” -
10. Atherosclerosis
Mnemonic:
“Fatty LDL = Arterial Damage”-
LDL gets oxidized → taken up by macrophages → foam cells
-
Leads to plaque formation
HDL removes cholesterol from plaques
11. Fatty Liver (Hepatic Steatosis)
Mnemonic:
“ALCOHOL = Accumulated Lipids”Causes:
-
A – Alcohol
-
L – Liver disease
-
C – Carbohydrate overload
-
O – Obesity
-
H – Hepatitis
-
O – Other drugs
-
L – Lipid metabolism defects
12. Lipotropic Factors
Mnemonic:
“Be Cool”-
B – Vitamin B12
-
C – Choline
-
Others: Methionine, folate
🧠 Help prevent fatty liver by exporting lipids
13. Eicosanoids (Prostaglandins, Thromboxanes, Leukotrienes)
Mnemonic:
“AA Makes PETL”-
Derived from Arachidonic Acid
-
Forms:
-
P – Prostaglandins
-
E – Epoxides
-
T – Thromboxanes
-
L – Leukotrienes
-
Key enzymes: COX, LOX
14. Obesity
Mnemonic:
“CAMP” – Causes of Obesity-
C – Calories > burned
-
A – Activity low
-
M – Metabolic disorders (hypothyroidism)
-
P – Psychological/genetic causes
15. Important Lipid-related Disorders
Mnemonic:
“Some Guys Try Having Nice Looks”Disease Enzyme Deficiency Mnemonic Word S – Sandhoff β-Hexosaminidase A & B Some G – Gaucher Glucocerebrosidase Guys T – Tay-Sachs Hexosaminidase A Try H – Niemann-Pick Sphingomyelinase Having N – Fabry α-Galactosidase A Nice L – Krabbe Galactocerebrosidase Looks All are lysosomal storage disorders
16. Lipid Peroxidation (Free Radical Damage)
Mnemonic:
“I-I-T”-
Initiation – free radical formation
-
Propagation – chain reaction
-
Termination – neutralization by antioxidants (e.g. Vit E)
-
-
Vitamins
- Fat-Soluble Vitamins:
Mnemonic: KADE is Fat!
K, A, D, E are fat-soluble vitamins[9] - Water-Soluble Vitamins:
Mnemonic: Come Bathe In the Water (C and B vitamins)- Vitamin C and B-complex
- Vitamin B Deficiencies:
- B1 (Thiamine): BeriBeri—“Wet and dry, think nerves and heart.”
- B3 (Niacin): The 4 D’s: Dermatitis, Diarrhea, Dementia, Death
Nucleic Acids
- Purines:
Mnemonic: PURe As Gold
Purines = Adenine, Guanine (2 rings) - Pyrimidines:
Mnemonic: CUT the Py
Cytosine, Uracil, Thymine (1 ring each)
Acid-base Balance
- Causes of metabolic acidosis with increased anion gap:
Mnemonic: MUDPILES- Methanol, Uremia, Diabetic ketoacidosis, Propylene glycol, Isoniazid/Iron, Lactic acidosis, Ethylene glycol, Salicylates