Recent Updates

Sacral torsions made dead simple: the drag-the-corner Diamond, the 6 rules with the why and memory hooks, an axis identifier and ligament map, a step-by-step diagnostic machine, and 25 board-style vignettes.

Corrected Law I notation, repaired verified anatomy images, and tightened the OA, AA, and C2-C7 mechanics traps.

Your patient is anemic. That's the easy part. Now figure out why.

Addison's vs secondary/tertiary AI, POMC hyperpigmentation, cosyntropin testing, adrenal crisis, Waterhouse-Friderichsen, Conn syndrome, and 25 board-style vignettes.

Stretch more, squeeze harder. Preload curves, the failing heart shift, cardiomyopathy hemodynamics. 25 vignettes with cross-out.

Left gastric, splenic, common hepatic. Three branches feeding everything above the transverse colon. 25 board vignettes.

Descending flaccid paralysis. SNARE cleavage, infant vs foodborne vs wound, BabyBIG, tetanus comparison. 25 board vignettes.

Invasive vs toxigenic diarrhea. EHEC vs EIEC vs Shigella: same bloody stool, three different killing mechanisms. 25 vignettes.

Chromosomal Translocations in Hematologic Malignancies: t(9;22), t(14;18), t(8;14), t(11;14), t(15;17), t(11;22). Match game, flip cards, elimination, board walkthrough.

Three arteries, three danger zones. Why surgeons ligate the uterine artery and sometimes cut the ureter doing it. 25 vignettes.

RAS, MYC, RB, p53, BRCA, APC, VHL. Gain-of-function vs loss-of-function. Two-hit hypothesis. Board vignettes with cross-out.

Azathioprine to 6-MP, xanthine oxidase, the allopurinol dose-cut rule. Methotrexate, 5-FU, hydroxyurea. 25 board vignettes.

ANA, anti-dsDNA, anti-Smith, anti-histone, anti-centromere, anti-Scl-70. Drug-induced lupus triggers. 25 board vignettes.

SBS flexion vs extension, craniosacral rhythm animation, vault hold SVG, 25 board-style vignettes with cross-out. Tap the mechanism to watch it move.

Scoliosis/SART interaction, lumbar somatic dysfunction walkthrough, 25 clinical vignettes. Drag through the exam sequence, answer board questions, cross out wrong answers.

Ortolani, Barlow, Finkelstein, Phalen, Tinel, McMurray, Lachman, Thomas. Anatomy photo strips, elimination game, 25 vignettes with cross-out and clue highlights.

CO, preload, afterload, Frank-Starling, PV loops, valve lesion parameters, concentric vs eccentric hypertrophy, shock classification, and SVR/PVR. Interactive diagrams and board-style vignettes.

Hepatocellular carcinoma from risk factors to transplant criteria: cirrhosis clues, AFP, Milan criteria, sorafenib, and vinyl chloride.

Why low ATP hits fast-dividing tissue first, how reversible injury becomes irreversible, and which organs get protected when energy runs out.

Von Gierke, Pompe, Cori, and McArdle sorted by enzyme, storage site, symptoms, and the board clue that gives each one away.

Dimorphic fungi by geography, Aspergillus vs Mucor angioinvasion, and the parasite patterns that turn vague exposure clues into an answer.

Follow portal blood to see why colon cancer parks in the liver, what CT shows, and how arterial vs portal routes change the stem.

PT, PTT, thrombin, factor X, and the drug families that cut the clotting circuit at each step.

Lead blocks ALA dehydratase and ferrochelatase, so heme synthesis stalls and basophilic stippling explains the paint-chip kid.

The CGG repeat expansion that silences FMR1, stacks macroorchidism at puberty, and sits behind the #1 cause of inherited intellectual disability.

MTP mutation traps fat in enterocytes -- no chylomicrons form, fat-soluble vitamins A D E K crash, acanthocytes pile up on the smear, and spinocerebellar ataxia closes in.

Block the pump. Flood the cell. Save the heart. The drug that poisons the Na/K-ATPase on purpose · and somehow that makes the heart squeeze harder.

Flutamide, leuprolide, degarelix, abiraterone, docetaxel → sort receptor blockade from hormone suppression

GnRH, GH, dopamine, ADH, and oxytocin drugs in one board-clean endocrine map

Barbiturates, alcohol, and fasting ramp up hepatic heme demand. With PBG deaminase missing, ALA and PBG stack up and irritate nerves. Think neurovisceral crisis: severe belly pain but a quiet exam, psych and autonomic chaos, urine that turns tea-colored after it stands. Hemin and carbohydrates shut the ALA synthase faucet.

Bacteria synthesize K, Biotin, Folate. B12 must arrive from diet. Newborn sterile gut has no factory. That is why IM Vitamin K is given at birth.

Alpha stops at skin. Beta reaches GI. Gamma hits marrow. Why radiation type determines which cancer comes first.

The Guthrie card, tandem mass spec, and 35+ conditions caught before symptoms. Why 24 to 48 hours after the first feeding is the only window that matters.

A day-5 newborn with poor feeding, opisthotonos, and a sweet maple smell on the diaper. One broken enzyme complex (BCKD) backs up three amino acids and leucine poisons the brain.

Epidural, subdural, subarachnoid. Same skull, three different layers, three different vessels, three different death notices. By the end you will read the CT before they tell you the trauma.

Four classic patterns. Four tiny arteries. Same trick every time: cranial nerve sign on one side, body sign on the other. That crossed pattern IS the brainstem.

Where the big arteries break. Which floor of the brain goes dark, and what falls with it.

Four lobes carry every function the brain performs. Kill a lobe, kill its function. Know the map, read the deficit.

Where the spinal cord ends and the horse-tail of nerve roots begins. Conus at L1-L2 in adults, L2-L3 in kids. LP at L3-L4 or L4-L5 to stay below. Conus medullaris vs cauda equina syndrome - one is symmetric and early-bladder, the other asymmetric and surgical-emergency.

The canal narrows. The walking distance shrinks. The shopping cart becomes a walker. Learn the one move that opens the canal back up.

Hypertensive crisis on MAOIs. Mechanism, forbidden foods, phentolamine first-line, and the serotonin-syndrome trap.

Niemann-Pick disease: sphingomyelinase deficiency, sphingomyelin storage, foam cells, hepatosplenomegaly, cherry-red macula. Types A, B, C side by side with Tay-Sachs.

Spondylitis. Spondylosis. Spondylolysis. Spondylolisthesis. They share the same root and nothing else. One inflames. One ages. One fractures. One slips. By the end of this page you will never mix them up again.

Thiamine runs four enzymes the brain cannot live without. Take it away, and the mammillary bodies are the first to fall. Give glucose without thiamine in a chronic drinker, and you just precipitated Wernicke.

CSF pressure climbs, the optic discs swell, vision flickers out for seconds at a time. No tumor on imaging. The body is doing it to itself, and the patient is almost always an obese woman of reproductive age.

Tay-Sachs disease: Hex A deficiency, GM2 ganglioside accumulation, cherry-red macula, hyperacusis, no HSM. Ashkenazi infant board pattern, side by side with Niemann-Pick.

One missing enzyme. A baby who never makes melanin, dopamine, or serotonin. The musty smell on the diaper that names the disease.

Open vs closed NTDs, AFP screening logic, spina bifida spectrum, folate prevention. Built for boards at 2am.

Missing vermis. Ballooning 4th ventricle. A head that keeps growing because the CSF has nowhere to go. Here is how to spot it on the prenatal scan and never confuse it with Arnold-Chiari again.

When the cerebellum hangs into the foramen magnum. Type I sneaks up on the young adult; Type II crashes the newborn nursery.

One sheet of ectoderm folds inward and becomes the brain. A handful of cells peel off the edge and become almost everything else above the diaphragm. Get the split right and twenty board questions become one.

Willis-Ekbom. URGE mnemonic. Iron-dopamine pathway. Pramipexole augmentation and the gabapentin save.

A young patient with a copper plumbing problem. The bile drain is broken, the metal piles up, and three organs pay the price: liver, brain, eye.

REWORKED Territory Map: inferior Circle-of-Willis view of the brain with six semantic palettes (MCA crimson, ACA cyan, PCA gold, PICA emerald, AICA violet, basilar pink), animated vessel trail on tap, Route / Pattern / Pearl card per artery

BUFFED histology section: hand-drawn schematic of Orphan Annie eye + psammoma body sits beside the real H&E slide so you learn what to hunt for. ADDED ferruginous body photo to the asbestos section.

FIXED cramped bleach-circuit diagram: viewBox widened, nodes spaced apart, enzyme labels no longer overlap. BUFFED active nodes with a breathing glow pulse so the active step feels alive.

REWORKED Where Cancer Lands: animated grey-white junction SVG, body map redesign, most common liver cancer reveal

REWORKED Signature Moves: 5 cinematic vignettes (Furnace, Crash, Big Silence, Flood, Acid Storm). BUFFED page nav: single arrows. FIXED dial pivot in Safari

ADDED Pancreas Eats Itself: animated saponification cycle, kids vs adults comparison, 6 game mechanics

v3 schema is live across 60 cards (97 splits). Map gen is procedural now: three distinct events from a pool of five, no template repeats. Elite mini-boss nodes show up 50% of the time pre-boss, branching forks 55% of the time per slot. Attending's Office and Consult are wired. A 10-relic system picks 3 at run start and again after every elite win. Map got redesigned as a mahogany tabletop with stamped wax seals per node. Death-screen restart is fixed, tooltips auto-hide at 15s with an opacity fade. Landing now shows the real deck size: 7 rotations, 1,965 drugs, 686 diseases.

New OMM deep-dive

Added tap-to-unblur memory hook cards to the Hook section. Night Shift Factory, Statin Side Effect logic, PCSK9 bouncer.

Bugfix: duplicate h1/hero block removed. Page now has one clean hero with related-page links inline.

Supination tests, Spencer protocol, HVLA/MET/BLT for a radial head stuck in the past. Segmental diagnosis chain with board-style vignettes.

T1-L2 SNS vs S2-4 PSNS spinal level rules, Chapman reflex points, facilitated segment logic for board stems.

CV4, EV4, fluid drive mechanics, four vagus-governed cranial nerves with tap-to-reveal lesion patterns.

New interactive page. 55 high-yield memory hooks and acronyms for psychiatry, GI, renal, endocrine, and more. Rapid-fire cards for final review.

New page. Rate-limiting enzyme (F1,6BPase), bypass reactions, glucagon vs insulin regulation. Board quiz: metformin mechanism + F2,6BP inhibition.

New page. Spinal segment-to-organ map: T1-T5 cardiac, T6-T9 GI, L1-L2 pelvic. Diagnostic and treatment implications.

New page. Laws I, II, III. Neutral vs non-neutral mechanics. FRS/ERS/NSR/NSL naming conventions.

New page. OA/AA atypical mechanics, C3-7 typical mechanics, HVLA absolute contraindications, upper vs lower cervical distinctions.

New page. 37 organisms with stain, morphology, virulence, and first-line treatment. Interactive filter by category + pattern quiz.

New page. Positive/negative symptoms, DSM criteria, mood episode types, bipolar I vs II, cyclothymia.

New page. CRAB criteria, SPEP M-spike, Bence Jones proteins, smoldering vs active disease, MGUS progression risk.

New page. Toxo, Other (syphilis/HIV/VZV), Rubella, CMV, HSV. Timing of transmission, fetal findings, maternal treatment.

New page. Alzheimer's, Lewy body, FTD, vascular, CJD. Tau vs TDP-43, cortical vs subcortical pattern, reversible mimics.

New page. Typical vs atypical, EPS ladder (akathisia/dystonia/parkinsonism/TD), lithium toxicity, benzo mechanism and reversal.

New page. Prolactinoma, Cushing's disease, acromegaly, central vs nephrogenic DI, urine osmolality water deprivation test.

New page. MEN 1 (3 P's: pituitary/parathyroid/pancreas), MEN 2A/2B, RET mutation, pheo workup before surgery.

New page. SCC/ADC/SCLC/large cell locations and staining. Paraneoplastic syndromes, Pancoast, Lambert-Eaton, SVC syndrome.

New page. Berlin criteria (mild/moderate/severe P/F ratio), lung-protective ventilation, plateau pressure, driving pressure, prone positioning.

New page. Wells score, V/Q vs CTA-PE, submassive vs massive, tPA criteria, PERC rule, Virchow's triad.

New page. Vaughan Williams I-IV, Na/K/Ca/beta targets, pro-arrhythmia risks, Torsades triggers.

New page. Dilated/hypertrophic/restrictive patterns, LVEF, HOCM dynamic outflow obstruction, maneuvers that worsen/improve murmur.

New page. G1/S/G2/M checkpoints, p53 guardian role, Rb tumor suppressor, cyclins/CDKs, intrinsic vs extrinsic apoptosis.

New page. MMR/NER/BER/NHEJ mechanisms, microsatellite instability, Lynch syndrome, xeroderma pigmentosum, BRCA.

New page. De novo vs salvage, gout pathway (HGPRT deficiency = Lesch-Nyhan), adenosine deaminase deficiency = SCID.

New page. Glycogenesis vs glycogenolysis, G6P branch point, liver vs muscle glycogen function, hormonal regulation.

New page. Board exam timeline, resource stack, spaced repetition schedule, high-yield topic priority list.

New page. Whipple's triad, fasting hypoglycemia, C-peptide elevated (vs exogenous insulin), 72-hour fast, surgical resection.

Bilateral hilar LAD, high calcium, non-caseating granulomas · detective game

Aspiration route, foul sputum, air-fluid level, anaerobes · RLL focus

GLP-1 vs SGLT2 mortality wins, HF traps, 6-class duel · decision tree

Naming by convexity, rib hump mechanics, structural vs functional · spine demo

Deep buttock pain, sciatic trap, figure-4 stretch, externally rotated hip

Lacunar syndromes, no cortical signs, PLIC vs thalamus · brain map

Vessel size triage, ANCA map, GCA to HSP, 12 vessels · sorting game

Adhesion vs aggregation, BS vs Glanzmann vs vWD triage · animated plug builder

Cascade map, PTT vs PT monitoring, reversal agents · drug target overlays

21-OH vs 11-OH vs 17-OH, salt-wasting, virilization, HTN · mnemonic grid

Lumbar TART, type I/II mechanics

Superior/inferior shear, innominate flares

Anterior/posterior innominate rotation diagnosis and treatment

Tender point locations, strain-counterstrain technique

Insulinoma workup, Whipple triad, hypoglycemia causes

V/Q gradient, alveolar cells, airway obstruction physics, pneumoconioses · all four under one roof.

Delayed P2, RBBB, pulmonic stenosis · animated phonocardiogram

Delayed A2, LBBB, severe AS · animated split timing diagram

Mortality drugs vs symptom drugs, aspirin dosing, drug sorting game

Lead I EKG anatomy, axis determination, lateral MI · animated axis compass

MS, TS, Austin Flint, Graham Steell · split-screen comparison

OTC, CPS I defects, ammonia routing · 5-step relay race pathway builder

G6PD deficiency, NADPH, oxidative vs non-oxidative · trigger game

Malonyl-CoA switch, fed vs fasted toggle, cytosol vs mito compartments

Km/Vmax, competitive vs non-competitive, ETC poisons · interactive chain

Tumor markers, oncogenes, IHC stains, MEN syndromes, paraneoplastic, psammoma 4 mnemonic.

MG, Parkinson's, MS drug cards · neuro pharmacology roguelite deck

Drug and neuro deck selectors · medical roguelite hub

Necrolytic migratory erythema, the 4 D's, alpha-cell tumor · boards trap on glucagon excess.

De-escalation ladder, B52 cocktail breakdown, capacity criteria, admit/discharge tree

Selective vs non-selective classifier, B1 selectivity breakdown

Body map, elimination game, nutrient differential

Lesion ID game, UV timeline, field cancerization

GH-IGF1 axis, comparison tabs, treatment stepper

Phonocardiogram, hemodynamic maneuver tabs, remodeling SVG

FDS vs FDP simulator, Camper's chiasma, nerve matching

Stomach zones, feedback loop simulator, ZES differential

Metabolic chain builder, elimination game

Coronary SVG, EKG pattern game, treatment stepper

Gland location game, treatment ladder

Cmd+K to search all 80+ topics. Subject icons, fuzzy scoring, keyboard nav.

Interactive nephron map, ototoxicity, calcium trap

Histology battle cards, adult vs pediatric, pseudopalisades

Split-screen compare, onion-skin vs granulomas, drag-drop

Cluster sorting game, defense mechanisms, diagnostic criteria

Cascade diagram, factor X step, mixing studies

Interactive cross-section, putamen vs GP, Charcot-Bouchard

Demographic decision tree, stool guaiac, haptoglobin trap

Animated cascade, JGA hyperplasia, resistant HTN

Interactive vertebral levels, ovarian artery at L2

Interactive spine, L-R-L-R marching order

Elimination game, therapeutic alliance, adherence strategies

Decision tree, 2 exceptions, emergency exception for minors

Iron lab interpreter, thalassemia gene deletion counter

MCV triage station, complement attack simulator

3-step platelet assembly line, Bernard-Soulier vs Glanzmann vs vWD vs TTP

Timeline of complications, Dressler's, papillary muscle rupture

CN III/IV/VI, eye movements, clinical testing

New medical card game → diagnose patients, outsmart The Attending

Full redesign → battle cards, spacious board traps, new theme

Battle cards, SS vs NMS comparison, emergency cards

New theme, spacious layout, no more accordions

BCC vs SCC vs Melanoma → new theme, elimination game

Conn vs Cushing vs Pheo → full redesign

EEG viewer, AED tables, status epilepticus protocol

MS vs GBS vs CIDP → decision tree, elimination game

Myasthenia vs Lambert-Eaton → new theme

Tremor demos, drug tables, Parkinson's vs essential tremor

Cascade diagram, mixing studies, disease cards

Battle cards, maneuver tables, new theme

20 pathognomonic findings, matching game, decision tree

5 serology patterns, timeline, pattern matching game

16-disease drag-drop sorting, Type II vs III deep-dive

22-feature sorting game, extraintestinal table

CSF patterns, age-based organisms, elimination game

Interactive seesaw diagram, muscle energy positioning

Sensitivity, specificity, PPV/NPV, study types

Side-by-side comparison, anion gap, management protocols

Hyper vs hypo, Graves vs Hashimoto's, thyroid storm

B-cell, T-cell, combined, phagocyte, complement deficiencies

CD4 thresholds, AIDS-defining illnesses, prophylaxis

Catalase, coagulase, hemolysis patterns, toxins

SLE, RA, scleroderma, Sjogren's, dermatomyositis

Pre-renal, intrinsic, post-renal; staging, BUN/Cr, FENa

Na, K, Ca, Mg, PO4 → causes, EKG changes, management

MCD, FSGS, Membranous, IgA, and Post-Strep sorted by biopsy, complement, and timing. Elimination rounds, drag-and-drop sorting, and full clinical vignettes with labs.

Type 1, 2, 4 → pH, K+, urine pH, causes

Vaginitis, cervicitis, PID → wet mount, KOH, treatment

Systematic ABG interpretation, Winter's formula, compensation

Reversibility, PFTs, stepwise therapy, exacerbation management

CAP, HAP, atypical → organisms, imaging, empiric therapy