Jan 24, 2015

1.  ligand gated ion channels - major membrane receptors (ion channel linked receptors) trans membrane ion channels that open or close in response to the binding of a ligand (neurons, react quick to binding to ligands). There is a kink in the channel where a messenger, like a ligand or a neurotransmitter, can bind. Specific ligand/specific channel, lock/key or induced fit. Results in opening of the channel. Allosteric binding (the ligand binds to an allosteric site, a place away from the ion channel.
2. g protein coupled receptors - major membrane receptors
3. enzyme linked receptors - major membrane receptors

January 18, 2015

January 18, 2015

How productive have I been? Not very. Remember that this is your life, one day at a time you are getting closer to where you will be. You can get that life that you want. The status, the impact, the renown, the influence, the admiration. It is hard. It is very hard. It will require every minute of every waking moment to get to where you want. There have been others before you that have overcome greater adversity to get to higher places.

 Every decision you make takes you one step closer or farther from where you need to be. If you end up with nothing, it is your fault. Where you are right now in the exact moment of time - that is who you are. No need to apologize, no need to fantasize. Accept the truth and move forward. Don't set limits on how things are going to be. Don't have expectations of how things should be. Just take real actions and move forward. And then keep moving forward.

The most important thing is to just not give a fuck. Who cares if you look stupid? Who cares if you embarrass yourself? The only person that really cares is you, and you already hate yourself. This is you, this your life, and you are one minute closer to the end. What have i learned for the past 25 years? Life is fucking hard. It is beautiful, if you find that beauty. It is easy to squander. It is easy to have 7 years just pass you by without thinking twice about it.

You had a decently productive winter break, about 7/10. That is because you spent a lot of time become acquainted in the lab in addition to working a lot and do a few exercises and getting ready for your volunteering.

You can lift more, you can do more lab, you can read more. Remember, every decision makes you close to who you want to or who you should be.

Khan Academy MCAT prep looks pretty good.

Cell membrane overview.

1. Small, non polar (O2 and CO2) are the fastest, followed by small polar, large non polar (slow) and large polar and charged molecules (not able to at all) in terms of rates of passive diffusion
2. phosphate +glycerol+ fatty acid = 5 types of phospholidpids, cis (with kink) vs trans (straight) fatty acids
3. phospholipid (cell permeability), cholesterol (changes fluidity), proteins (integral/transmembrane or peripheral, , membrane functions like receptors or molecular transport) and glycomolecules (communication)
4. two types of integral proteins: carrier (against concentration gradient, yes ATP) and channel protein lets things pass through (down a concentration gradient, no ATP) and also peripheral, and lipid bound. Glycoproteins for signaling
5.  membrane fluidity: 1. temperature (low temp, crystallized, less) 2.cholesterol stabilizes the fluidity (inserts itself in between phospholipids, increases fluidity at low temp, at high temp, the phospholipids come together closer to the cholesterol, decreasing fluidity) 3. saturated (low) vs unsaturated fatty acids (higher)
6. membrane dynamics, uncatalyzed, trans bi layer diffusion, "flip flop", slow, between leaflets. Also lateral diffusion, side to side, fast. The catalyzed movements are catalyzed by proteins. Uses ATP, similar to trans bi layer diffusion, catalyzed by protein (flippase) but outer to inner, fast. Another with floppase takes inner to outer and will be fast and with ATP. Scramblase does both flippase and floppase but does not need ATP

Cell-cell interactions

1.  cell junctions tight (complete fluid barrier, blocks everything from both sides, bladder, intestines, kidneys), desmosomes (attach inside of both cytoskeletons, attach two cells together, in between tight and gap, water and ions can flow in between the cell on the outside, space for stress relief, skin and intestines, spot welds), gap junctions (tunnel between cells, allow water and ions to flow within the junction between the cells, action potential cells or cells that use electrical coupling, cardiac cells, neurons)
2. membrane receptors: integral proteins that communicate with the outside environment. ligand are neurotransmitter, or hormone or cell recognition molecule, they attach to membrane receptor and trigger a change within the cell. Ligand + membrane receptor = ligand receptor complex, they result in the intracellular response. Some pharm drugs can target only certain cells like liver because they associate with specific membrane receptor. Signal transduction. Ligand/receptor specificity (lock and key). New model is induced fit - receptors/ligand change conformation to fit. 1) ligand gated ion channels 2) g protein coupled receptors 3) enzyme linked receptors

References

• Easy R/S configuration of chiral centers: http://www.stolaf.edu/depts/chemistry/courses/toolkits/247/rvss.htm
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January 7, 2015

Ok, I haven't done shit for MCAT the last week. I was supposed to actually start learning something. It is ok. Start now. Stay positive. Keep your head up.

Remember this is what you do to prepare for the career. This should include reflections from work, the application process, personal statements - just general ideas that aren't specifically medicine related.

eg:

•  java made a good move defending the nurse. everyone loves her. learn how to make friends like java. Make people laugh, joke and smile.
• As a physician, you have to consider all the possible situations, even if it is benign, you have to consider it. You have to be prepared for the worst possible situations. It takes experience and confidence as a physician to be able to just call bullshit and send some one packing. During your first year, don't lean on being a minimalist. Your goal is to ensure that you think about why you do everything that you do. Your job as a physician is to make the crucial decisions make decisions
• What has engineering preach? Take a monumental, a colossal problem. Break it down into smaller problems. Then further subdivide those problems in to manageable, narrower, limited problems. Then take one step and follow it by another until all the pieces are complete. This takes planning. This takes tremendous vision and patience.
• What have i learned this past semester? My writing sucks and it is hard to write. It will take me many revisions and I have to blow up the office of my teacher in order to ensure that I receive an A in organic 2 lab.

1. Notes follow this order: What is the chief complaint? When did it begin? What are associated sx? What is pertinent past medical history? What are pertinent negatives?
2. There should be a corresponding lab, image, physical exam finding, procedure, or consult that directly corresponds to each +/- ROS and chief complaint
3. In the MDM: state what the person was here for - what you did about it - why you did these things - and significant findings to support the decision making. 
4. What is going to happen with this patient and what do you want them to do after they leave? (as a rule of thumb, always recommend PCP followup if there is no full resolution of Sx, always state that return precautions are given (if you can, state specifically which ones) and always state that the patient understands and consents with the final plan, it is just formalities to keep the bases covered.

Just remember, your time is moving. You can move forward with it, or you cant stand and let it pass you by. Last 8 years... you have been moving very slowly.

94% in Honor Organic Chem 2

I'm just guessing way to much in my practice MCAT.

December 24, 2014 to December 28, 2014

My writings are not organized. My work is scattered. I am making slow progress. I am spending my time doing what I can. But I can do better. I can do more.

Keep going. I did decently this semester. But it could have turned out much worse.

Now, I must re-evaluate my approach. I must set aside around 2 hours every day to study MCAT. My test date is August 22, 2015.

I will begin by buying the Official Guide to the MCAT exam, 4th edition. This will be the basis upon which I do my studying upon. The practice books that I have maybe a bit helpful, but I don't want to spend my time without a clear purpose and end goal in mind. Those books are outdated and are not specific enough for the format and the approach that the test will be asking.

I will followup with "MCAT 2015 Sample Test." My practice test date will be May 31, 2015.

Every Sunday will be my day of reflection. I will try to write for about an hour, reflecting on how I have done this past week.



December 29, 2014

Well I took my Sunday off. I was feeling an itchy throat and overall weak and sleep deprived. Then when I awoke, I decided to watch Dota and just be lazy. At least I got some laundry done. So I took a rest day where I accomplished nothing. This is fine but just remember that anytime you are taking it easy, there is someone out there who is training harder and getting smarter. If I don't want to go full speed, that is fine, but at least get some free reading done. Watching Dota and watching another movie that you have already seen is not going to help anyone.

New Year's Resolutions and Goals:

1.  Everyday, regardless of what is going on that day, regardless of how I feel, regardless of any circumstances, I will study MCAT for 1.5 hours.

It is better to just get it over with earlier in the day. August 22, 2015 will be the second most important day of your career, next to your Step 1

2.  Start living better and thinking better. If you ever want to get to the top echelons of medicine, you will have to live a lot smarter and a lot better.

# Remember that you have to learn independence and self sufficiency. You will be the ultimate authority and the ultimate shot caller in the treatment of a patient. Believe that you made the right choice and even if it doesn't work out, you still have to believe in your choice.

# Another important skill to master is the ability to make quick decisions and trust in those quick decisions. Remember blink. You use your judgement and background knowledge to come up with a plan in a matter of seconds.

# Engineering is about taking a monumental problem and dividing it in the smaller pieces and then further taking each small piece and breaking it down into smaller units that are easier to handle. Then you put one foot in front of the other and keep walking. It is required to take a marathon approach in this regard.


3.  Be more productive in your lab work.

Again, this is related to do a little something everyday. You have until mid summer, 2016, to finish your data. At that point, you can work on writing your paper. That way by mid fall (around early October) it should be ready to publish. But this will require that you do a little something every day. You must spend at least one hour or more everyday writing, reading, or working in the lab. Small steps.


4. I have 20 times which I can take the test. Make sure you take the test 20 times.

5. Try to read about one case every few days, maybe 3 cases a week.