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Tutor profile: Gregory G.

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Gregory G.
4th Year Medical Student Post ERAS Applications
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Questions

Subject: Medicine

TutorMe
Question:

Explain your work up of a patient with a pH < 7.35

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Gregory G.
Answer:

Check CO2 and PO2 for determination of primary metabolic or respiratory acidosis. Respiratory acidosis: consider etiology if PaCO2 is predominately high --> increased bicarb. Consider opioid toxicity at top of list if approaching patient in acute setting, esp RR <9. Metabolic Acidosis: Consider etiology if HCO3- is predominately low with appropriate respiratory compensation as determined by winters criteria (always be on the look out for mixed states, however). Measure anion gap (Na - K - HCO3- ). If >12, consider MUDPILES. Methanol intoxication, Uremia, DKA, Polyethylene glycol toxicity, isopropyl alcohol toxicity, lactic acidosis, ethylene glycol toxicity, and salicylate toxicity (this can get confusing given aspirins ability to cause respiratory depression and acidosis from metabolic product)

Subject: Biochemistry

TutorMe
Question:

How does a cell metabolize glucose for energy?

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Gregory G.
Answer:

Glucose enters cytosol, acted on by hexokinase, and proceeds with glycolysis. Eventually, 2 pyruvate is produced. With sufficient oxygen availability, pyruvate shuttled into mitochondria and acetyl-CoA is formed --> citrate --> TCA cycle and generation of NADH. NAHD is used to transfer electrons to proteins imbedded in inner membrane of mitochondria --> electrochemical gradient --> stored energy used to generate ATP from ADP + Pi. This is all knowledge off the top of my head but I can review this in more detail as needed.

Subject: Biology

TutorMe
Question:

What is the central dogma of molecular biology?

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Gregory G.
Answer:

DNA --> RNA --> Proteins. Explaining this concept, it's important to start as basic as possible. Then we can talk about location DNA: created in nucleus, stays in nucleus RNA: created in nucleus, transverses nucleus into cytoplasm Protein: created in cytoplasm on rough endoplasmic reticulum (endoplasmic reticulum +ribosomes) or on free ribosomes. With that framework, we can discuss additional details in areas such as DNA replication, RNA synthesis, and proteins synthesis. I believe in simplifying everything as much as possible so that you may have a functional and useful understanding of biology appropriate for further education in clinical medicine or biological research.

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