When you learned the baroreceptor reflex, did you:
- Think about it minimally until directly asked about it on an exam
- Repeat it to yourself, in detail, every time you stood up, and in every question where the patient’s blood pressure was abnormal, so you made the concept automatic?
Most people? #1.
High-scorers who love studying? #2.
If I play the piano, and learn a new piece but never practice it, I shouldn’t be surprised when my recital falls flat. In the same way, what if you don’t make key concepts automatic? Don’t surprised when in a stress-packed, timed exam, the right things aren’t coming to mind.
Make key concepts automatic, and generate detailed pathophysiologic chronologies, for higher scores in less time.
Next step: Automate One Key Concept Every Day
Every day, think of ONE key concept you want to make automatic. Maybe it’s:
- Venous pooling / baroreceptor reflex when you stand up
- Portal venous drainage, glycogen storage, glycolysis, and insulin release when you eat
- Bilirubin conjugation, breakdown into urobilinogen, glomerular filtration and ADH effects when you pee
Whatever it is, you’ll start getting more items right when you see these concepts automatically on questions. The best way to make key concepts automatic is to repeat them in your Anki cards, your questions, and your everyday life.
Automatic Key Concepts on your test/QBanks
Let’s say your automatic key concept is to go through the increased metabolic demand of your tissues, and the subsequent increase in cardiac output. It might look something like this:
Exercise → muscle contraction → ATP use ↑ (you could even walk through the contraction cycle for myosin heads) → glycolysis ↑ → Krebs ↑ → ETC ↑ / O2 demand ↑ → H+ pumped into intermembrane space ↑ → H+ moves through ATP synthase ↑ → ATP production ↑
However, because glucose/O2 demand ↑, then CO must also ↑
For CO ↑, you need:
Contractility ↑: β1 ↑ → contractility ↑
Tachycardia: β1 → adenylate cyclase ↑ → cAMP ↑ → PKA ↑ → Ca++ inflow ↑ → phase 4 depolarization ↑ → reach threshold faster → HR ↑ → CO ↑
Preload: α1 ↑ → venoconstriction → preload ↑ → SV ↑ → CO ↑
But what do you do on your test?
I wouldn’t go through the equivalent of the steps in glycolysis/Krebs/ETC in detail on your actual test/QBank. You might briefly think about them. Instead, the time to drill your AKCs is when you are NOT in the test environment. Like when you are walking, you can think through these processes of why your HR is increasing. Walk through everything repeatedly, in detail. Then on your test/QBank you can do an abbreviated version – the key details will be easily accessible, though, when you get questions on them.
Bottom line: the key concepts should already be automatic by the time you take your test/do questions. If it’s not, it will likely take too long and you’ll struggle with time. Plus, on your test, you don’t have to go through every single step like this – just an abbreviated version.