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The Rx Bricks podcast from USMLE-Rx is designed to help you master medical school. Each episode is an audio version of one of our revolutionary Rx Bricks, which are short, high-yield, interactive learning modules. Each week, we present a new audiobrick based on an important basic science topic (e.g., pressure-volume loops) or clinical concept (e.g., ischemic heart disease). Learn more at www.usmle-rx.com
 
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Gastrulation is a major milestone in development. It is the process of forming a trilaminar (three-layered) embryo by creating the three germ layers (ectoderm, mesoderm, endoderm). These germ layers are the building blocks for forming the entire body. The term gastrulation means formation of the gastrula, which is the name of the three-layered embr…
 
When you know the meaning of the word autonomic, the role of the autonomic nervous system (ANS) becomes clearer. Autonomic denotes involuntary or subconscious activity. In physiology, it refers to the many bodily functions that are subconsciously controlled, such as breathing, digestion, and—most relevant to our discussion here—heartbeats. The ANS …
 
Aneuploidies are chromosome number abnormalities. Trisomies fall under the umbrella of aneuploidies. The term trisomy comes from tri, meaning tripled, and soma, meaning body—the tripling of a single chromosomal body. This serious genetic abnormality can have significant effects on development. There are two types of trisomies: X/Y and autosomal. Th…
 
The 22 bones that make up the human skull can be divided into two groups: The eight bones that make up the neurocranium, which houses the brain The 14 facial bones, including the mandible, which make up the structure of the face Grouping the 22 bones this way makes it easier to commit them to memory. It doesn’t hurt that many of them are paired, to…
 
Glucose is the main source of energy for all forms of life, but it isn’t usually stored as individual C6H12O6 molecules. Animals use glycogen to do that job. Glycogen is a large branched polymer of glucose molecules, linked together by α-1,4 and α-1,6 glycosidic bonds. The liver and muscles break down the stored glycogen whenever the body needs an …
 
Cardiac auscultation is a clinical skill that involves listening to heart sounds using a stethoscope. It is a low-tech way of detecting disease directly without expensive scanners, blood work, or pathology reports—and another reminder that the art of medicine is not a lost art despite today’s technology. Moreover, heart disease is so common that we…
 
Eukaryotic cells reproduce themselves by going through the cell cycle, which divides one cell into two. The cell cycle comprises two main phases, interphase and mitosis, both of which are further broken down into steps, as well as a separate resting phase. When a cell divides appropriately, this allows our bodies to fix damaged tissue and replace o…
 
Hyperthyroidism is an elevation in the serum thyroid hormones T3 and T4 (thyroxine), caused by excess thyroid hormone production from the thyroid gland. This can result from an abnormal thyroid gland (primary hyperthyroidism) or increased synthesis of thyroid stimulating hormone (TSH) by the anterior pituitary gland (secondary hyperthyroidism) or b…
 
You probably know that the kidneys play an important role in maintaining blood pressure within the normal range. You might also know that they do this by regulating blood volume and the degree of arterial contraction or dilation (the systemic vascular resistance). But do you know how the kidneys do this? The answer is the kidneys accomplish this pr…
 
Glycolysis is the first step of metabolism and the biochemical pathway by which glucose is converted into pyruvate. Some cells use glycolysis to make pyruvate to use in other metabolic processes; others, like erythrocytes, rely on glycolysis as their main means of energy production. Because glycolysis is central to energy production, it is tightly …
 
In your reading about thyroid diseases, you have run across a number of symptoms, physical exam findings, tests, and diagnostic strategies. You have also encountered the diagnostic overlap between the various syndromes and diseases like hypothyroidism, hyperthyroidism, Graves disease, and thyroiditis, which can be confusing. How can you keep all th…
 
People who play tennis or golf, or even those who get wrist or shoulder pain from working on their computers, likely are familiar with pain around the joints of the upper extremity. Is it rotator cuff tendonitis or subacromial bursitis? Tennis elbow or olecranon bursitis? Similar conditions can affect the lower extremity: jumper’s knee or popliteal…
 
*** Rx Bricks Season Pass https://go.usmle-rx.com/brick-season-pass/ *** Diabetic ketoacidosis (DKA) is one of the most dreaded acute complications of diabetes mellitus. It is a medical emergency. When patients with DKA arrive at the emergency department, they are clearly ill, with vomiting, diarrhea, disordered breathing, and mental status changes…
 
*** Rx Bricks Season Pass https://go.usmle-rx.com/brick-season-pass/ *** Some of the most dreaded chronic complications of diabetes mellitus come from injury to the blood vessels. Such injury may lead to blindness, renal failure requiring dialysis, and early death from heart attacks. These complications develop slowly over years and can be divided …
 
Cushing syndrome is a cluster of clinical features resulting from exposure to excess glucocorticoids (hypercortisolism). Most of the abnormalities in Cushing syndrome are caused by high levels of cortisol itself, but an accompanying excess of androgens and mineralocorticoids like aldosterone may also add to the syndrome. Cortisol is produced contin…
 
Getting the air to our lungs in the first place can be challenging enough. How do we get the oxygen out of the air once we have it in our lungs? This huge job comes down to one tiny unit: the alveoli-capillary unit. In this brick, we take a look at how the exchange of gases takes place. After listening to this AudioBrick, you should be able to: Des…
 
Type 1 diabetes mellitus, previously known as juvenile diabetes, is one of the most common chronic diseases in childhood. The pathophysiology of type 1 diabetes begins with autoimmune destruction of the insulin-producing β cells in the islets of Langerhans, thus leading to insulin deficiency. A crucial role of insulin is to increase glucose uptake …
 
The ovaries are a pair of reproductive organs located deep in the pelvis of the female body; they contain the female gametes, the ova. As in many other organs, cancerous and benign tumors (neoplasms) can arise there, but most are malignant. Such tumors are distinct from ovarian cysts, although some ovarian neoplasms may have cystic features. Ovaria…
 
The central nervous system (CNS) comprising the brain and spinal cord is an incredibly complex part of the human body, so it is no surprise that sometimes things go awry during development. The various anatomic anomalies that result can be so severe as to be incompatible with life, such as when most or all of the brain fails to develop, a condition…
 
A neoplasm is the abnormal growth of new cells, sometimes called a tumor. A variety of tumors can grow in our bones, and luckily more of them are benign (noncancerous) than malignant (cancerous). What causes these tumors? We usually don’t know, though we do know that most malignant bone tumors are secondary, with cancer spreading to the bones from …
 
Every movement we make is caused by the contraction of different muscles, which are themselves controlled by the neurons that innervate them. However, one long nerve fiber does not run from the brain all the way down the spinal cord to reach our muscles. Instead, our bodies use a two-neuron system. After listening to this AudioBrick, you should be …
 
Bile is a greenish-yellow fluid produced by the liver. It is stored in the gallbladder and released into the small intestine, where it aids digestion by breaking down fats into fatty acids. Water is the main component of bile (about 95%). Bile also contains bile salts (the salt form of bile acids), cholesterol, phospholipids, bilirubin (a yellow-or…
 
Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease, an umbrella diagnosis that also includes asthma. The two types of COPD are emphysema and chronic bronchitis. The general underlying cause of obstructive lung disease is a narrowing of airways that results in decreased airflow and difficulty with respiration. Pharmac…
 
For the most part, the brain relies on glucose as its main energy source. In fact, we say the brain preferentially uses glucose. In times of low glucose levels such as fasting or starvation, the brain can use ketones, lactate, and amino acids (worth noting: the brain does not use fatty acids to generate energy). Circulating glucose molecules are re…
 
Before we jump into the details of essential thrombocythemia (ET), let’s back up for a little perspective. ET is one of a group of disorders called chronic myeloproliferative disorders. These disorders share a lot of similarities: they occur in adults, they have a relatively good prognosis, and they’re caused by mutations in proteins involved in ce…
 
Antibiotics work by halting essential cellular processes to kill bacteria. Broken down into its roots, the word antibiotic is interpreted as “opposing life.” This trait can be beneficial against such living things as pathogenic bacteria, which endanger us. Like our own cells, bacteria synthesize protein using ribosomes, which are located in the cyt…
 
Early in fetal development, the precursors of the major systems in the body are outlined. The three germ layers (endoderm, mesoderm, ectoderm) are formed during the third week of development. We’ll focus on the ectoderm, from which the entire nervous system (central and peripheral) forms. But first, let’s back up to review the anatomy of the centra…
 
What are bullous skin disorders? Bullae are fluid-filled blisters >1 cm in diameter. They can be caused by infection, mechanical stress, or a malfunctioning immune system. In this discussion, we tackle the latter, focusing on the most common autoimmune bullous (blistering) disorders: pemphigus vulgaris, bullous pemphigoid, and dermatitis herpetifor…
 
Epithelium is one of the four basic tissue types (the other three are muscle tissue, nerve tissue, and connective tissue). It is found throughout the body—covering it; lining organs, vessels, and cavities; and forming glands. It absorbs nutrients, transports electrolytes, secretes hormones, and regulates body temperature by producing sweat. We begi…
 
What do you know about prokaryote structure and the gram stain? Bacteria are members of a unique taxonomic kingdom consisting of prokaryotic unicellular organisms. Prokaryote is a term from ancient Greek meaning “before the kernel.” The kernel in this case is a nucleus, which prokaryotes lack. Prokaryotes also do not have any membrane-bound organel…
 
As we eat, our gastrointestinal (GI) system releases a host of both local and distant regulators to control the process of digestion. We will begin with the primary hormones, then cover some of the secondary hormones, and lastly discuss how our body senses its intraluminal contents and then subsequently integrates all of the various stimuli it rece…
 
There’s certainly a lot to cover, and that is exactly where we will start; the abdominal cavity has a sort of “covering” of its own, involving most all of the organs within the gastrointestinal (GI) tract. After exploring this covering in detail, we’ll progress systematically, organ by organ down along the GI tract, stopping at each structure to di…
 
Macroscopic Skin Lesions A thorough skin examination should be performed annually to assess for new or changing macroscopic skin lesions. It is critically important to be able to identify and describe normal and abnormal skin and to note your findings carefully, because a change in an existing skin lesion is the most common sign of skin cancer, inc…
 
Salmonella and Shigella species are almost made to be confused—two bacterial infections in the Enterobacteriaceae family that are spread by food and dirty conditions, cause gastroenteritis, and start with S! To make matters more confusing, they look similar on microscopy. While they are more common in developing communities, they are also seen in t…
 
Multiple endocrine neoplasias are familial syndromes of endocrine tumors occurring in endocrine organs throughout the body. Despite its acronym, the risk for acquiring MEN is about the same in men and women and also across geographic and racial and ethnic groups. These are rare syndromes, affecting about 1 in 30,000 people. Genetic mutations cause …
 
Normal blood pressure keeps us alive. It’s the force that moves blood throughout our circulatory system, ensuring that oxygen and nutrients reach our organs and tissues and that waste products are eliminated. When we hear the word hypertension—high blood pressure—we know this describes the blood flow exerting too much force against blood vessel wal…
 
Perianal disease is essentially a disease of tissue surrounding the anus. It comprises a cluster of diseases that greatly affect quality of life. Common symptoms include anal pain, bleeding, discharge, and pruritus (itching). Inflammatory and vascular anorectal disorders discussed here include hemorrhoids, anal fissures, anal abscesses, perianal fi…
 
Substance use disorder (SUD) refers to a pattern of substance use—be it nicotine, cannabis, cocaine, or something else—that causes significant impairment or distress to the user. SUD is prevalent and growing in the United States and around the world. People of any age may be at risk for developing a substance use disorder. But exposure to and exper…
 
Preterm infants are at risk of breathing difficulties because their lungs have not had enough time to fully mature. In particular, they do not produce enough surfactant, which helps keep terminal air spaces from collapsing. Without surfactant, they cannot get enough oxygen into their body, and the body reacts with tachypnea (respiratory rate >60/mi…
 
If you’ve studied the hematopoietic system malignancies—all the leukemias, lymphomas, and plasma cell disorders—you probably feel like you’ve been hit with the good old medical school fire hose. Now’s a good time to take a step back from all the details, make sure that you remember the underlying framework, and pull together some information that c…
 
Headaches are an unavoidable fact of life and often are nothing more than the result of sitting through one too many lectures. However, they can become debilitating and get in the way of daily life, especially when they become recurrent. Although some headaches have symptoms other than head pain, we typically think of headache pain relative to its …
 
Hemophilia is a bleeding disorder resulting from defects in factors of the coagulation cascade. There are two primary types of hemophilia: A and B. Both types of hemophilia are rare, with only a combined frequency of about 1 in 5000 live births. Of the two types, hemophilia A is about four times more common. In the intrinsic arm of the coagulation …
 
Pain is a sensation that warns of potential injury and alerts the person to avoid or treat it. For example, if you touch a hot object, you will feel pain and immediately remove your hand from that object, protecting your hand from further damage. As much as pain can burden and torment, ultimately it is an essential part of our bodies’ mechanisms of…
 
In typical reproductive system development, recall that the intermediate mesoderm forms the mesonephric (Wolffian) and paramesonephric (Müllerian) ducts and the indifferent gonads; primitive germ cells migrate into the indifferent gonads. These are the structures that become the internal organs of the reproductive systems. After listening to this A…
 
Have you ever cut your finger, bumped your head, or fallen and scraped your knee? While you were cursing your clumsiness or bad luck, your body got straight to work healing the injury, relying on the wondrous process of acute inflammation. Shortly after your injury, you most likely experienced some or all of the cardinal signs of acute inflammation…
 
Learning is traditionally defined as acquiring knowledge through study, experience, or being taught. In psychology, it is often defined as a relatively lasting change in behavior that results from experience. Learning is an ongoing process; we continue learning throughout our entire lives. After listening to this AudioBrick, you should be able to: …
 
Myocarditis is the inflammation of the heart muscle. This muscle is the middle layer of the heart, formally called the myocardium, hence the name myocarditis (the -itis suffix indicates inflammation). Inflammation of the myocardium can be caused by a variety of etiologies, from infection to drugs. If severe enough, inflammation can lead to necrosis…
 
Ulcers are open sores that develop in the skin or mucous membranes. In peptic ulcer disease (PUD), painful sores develop, most commonly in the lining of the stomach, duodenum, or both. PUD arises when there is an imbalance between protective factors (eg, mucosal barrier) and damaging factors (eg, hydrochloric acid). How does PUD differ from gastrit…
 
he ductus arteriosus (DA) is a structure that allows blood pumped from the right side of the heart to bypass the lungs while the fetus is developing in utero. Normally, the DA closes shortly after birth and becomes the ligamentum arteriosum. When the DA fails to close (remains open, or patent) after birth, it is known as patent ductus arteriosus (P…
 
Megaloblast. Now there’s a word you don’t hear every day. The root -blast (from the Greek blastos, meaning germ or bud) may be somewhat familiar since we talk about blast cells (very young hematopoietic precursor cells) in hematology. And megalo- (from the Greek megas, meaning large or great) is also used fairly frequently, as in splenomegaly (enla…
 
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