Learn / FMK
Every FMK condition
299 diseases, deficiencies, toxicities and drug mechanisms harvested from every FMK deck — the ones sprinkled through a single bullet as much as the ones with their own slide. Pick what you're given and what you have to name, or let it cycle; distractors come from the same category so you have to discriminate (hypoketotic vs. ketotic hypoglycemia, which GSD, which urea-cycle enzyme…). Every answer shows the whole card with the lecture and slide.
Vitamin · FMK 02.4
Thiamine (vitamin B₁) deficiency Acquired / not inherited
Defect / target: TPP cofactor for PDH, α-ketoglutarate dehydrogenase, branched-chain α-keto acid dehydrogenase, transketolase
Mechanism: Without TPP, PDH and α-KG dehydrogenase stall so pyruvate is diverted to lactate and TCA flux (NADH/ATP) drops, causing energy failure in high-demand neurons and heart.
↑ Accumulates: pyruvate, lactate· ↓ Deficient: acetyl-CoA, NADH, ATP
Presentation: Wernicke encephalopathy (confusion, ataxia, ophthalmoplegia), Korsakoff syndrome, wet beriberi (dilated cardiomyopathy, high-output failure), dry beriberi (peripheral neuropathy); alcohol use disorder/malnutrition
Labs: ↑ lactate, ↑ pyruvate; ↓ erythrocyte transketolase activity (TPP effect)
Treatment: IV thiamine BEFORE glucose
THIAMINE FIRST — before glucose
Learn the mechanism: PDH & TCA cycle →
FMK 02.4 Mitochondrial Metabolism and Energy Disorders · slide 16, 18, 25; FMK 03.1 slide 17, 24; FMK 03.4 slide 22; FMK 02.1 slide 16