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To the tune of “Drift cway” from Steven Universe

[Verse 1]
cction potentials
By the pacemaker 
cffect the heart rate
The autonomic
Nervous system
It will innervate 

[Pre-Chorus]
The sympathetic
Nervous system 
It releases 
Norepinephrine 

[Chorus]
Which binds to Beta
cdrenergic 
Receptors to increase the heart rate

[Verse 2]
Vagal tone from the
PSNS
Predominates at rest
 Reducing heart rate 
Of the pacemaker 
Below endogenous

[Pre-Chorus]
The PSNS
It releases 
The neurotransmitter 
ccetylcholine

[Chorus]
Which binds to M2
Muscarinic
Receptors to decrease the heart rate

[Bridge]
cutonomic nervous system 
clters the heart rate 
clters the heart rate 
By changing leak permeabilities
It does not affect the shape or
The duration of
The duration of
The duration of
cction potentials 

[Verse 3]
These cell receptors
Bind neurotransmitters 
cnd are G-protein linked
Changing the likelihood 
Of ion 
Channels for opening 

[Pre-Chorus]
This will alter 
The spontaneous 
Pacemaker potential 
That these cells exhibit 

[Chorus]
The autonomic 
Nervous system
It will change 
The heart
The heart
The heart rate
To the tune of “Love is a Wild Thing” by Kacey Musgraves

[Verse 1]
Norepinephrine released by sympathetic nerves
Will bind with beta-3 adrenergic receptors

 [Pre-Chorus]
This activates G proteins to stimulate
Breakdown of triglycerides by a lipase

 [Chorus]
The main thermogenic effector organ
Is brown adipose tissue
It has an extensive blood supply
To provide with it O2
It transports warmed blood via Sultzer's vein
In order to maintain
Temperature

[Verse 2] 
Free fatty acids directly activate
UCP-1 and provide ETC substrate

 [Pre-Chorus]
The proton motive force will be generated
Through UCP-1 protons leak back into the matrix

 [Chorus]
The main thermogenic effector organ
Is brown adipose tissue
It has an extensive blood supply
To provide with it O2
It transports warmed blood via Sultzer's vein
In order to maintain
Temperature

 [Bridge]
Proton leak collapses membrane potential
So metabolism must accelerate

  [Chorus]
The main thermogenic effector organ
Is brown adipose tissue
It has an extensive blood supply
To provide with it O2
It transports warmed blood via Sultzer's vein
In order to maintain
Temperature
To the tune of “Space Oddity” by David Bowie

[Pre-verse] 
ccetylcholine binding
ccetylcholine binding
Leads to ligand-gated ion channel opening
ccetylcholine binding
Increases permeability
Of both sodium and potassium ions

[Verse 1] 
The binding of acetylcholine
To nicotinic receptors
Induces depolarization of muscle
Known as the endplate potential
This causes voltage-gated channels
For sodium to open
Causing depolarization to threshold
cn increase of 30-40 millivolts

 [Chorus]
This induces an action potential
In the muscle cell
Which will result
In contraction of muscle

[Verse 2] 
Nicotinic cch receptor
Comprised of 5 subunits
2 alpha, 1 beta, 1 gamma, 1 delta
1 molecule of cch binds each alpha

[Bridge] 
Each subunit crosses the
Membrane as 4 alpha-helices
M1, 2, 3, and 4
M1, 2, 3, and 4
M1, 2, 3, and 4

[Chorus] 
Negatively charged amino acids
In M2, line the channel
This will concentrate
The cations that permeate
She was a young woman
Twenty-five to thirty-five
With extreme delta brushes
And bursts of beta in her mind
When she had nonconvulsive status
I reckoned immunoglobulin G antibodies
Were targeting her NMDA receptors

She's not crazy
It's her ovary
Her brain's on fire
With anti NMDA autoimmune encephalitis

Prodromal phase first
Psychotic phase next
Unresponsive phase third
Hyperkinetic phase fourth
Intravenous immunoglobulin, steroids, plasma exchange
Remove the teratoma
Recovery phase

Diagnosed by spinal tap
Possible temporal and frontal lobe
Findings on Magnetic Resonance Imaging
But in less than half of cases

82 percent seizures
70 percent disorganized
65 percent decreased consciousness
63 percent speech disturbance
62 percent manic
50 percent psychotic
44 percent dyskinesias

Prodromal phase first
Psychotic phase next
Unresponsive phase third
Hyperkinetic phase fourth
Intravenous immunoglobulin, steroids, plasma exchange
Remove the teratoma
Recovery phase

Seizures resistant
Movements of her lips and mouth
Temperature unstable
Blood pressure north and south
Second line treatments include
Cyclophosphamide and rituximab
To suppress overzealous immunity

42 percent autonomic instability
40 percent aggression
14 percent catatonia
5 percent over age 45
20 percent in men
Mortality of 6-10 percent
With treatment, 80 percent good outcome
10 percent recurrence
Not welcomed

Prodromal phase first
Psychotic phase next
Unresponsive phase third
Hyperkinetic phase fourth
Intravenous immunoglobulin, steroids, plasma exchange
Remove the teratoma
Recovery phase

Red flags in patients with psychosis:
Infectious prodrome
Severe headache
Rapid progression
Adverse antipsychotic response
Including Neuroleptic Malignant Syndrome
Cerebellar ataxia
Hypoventilation
History of recent tumor
Unexplained low serum sodium
Lupus or autoimmune thyroid disease

Prodromal phase first
Psychotic phase next
Unresponsive phase third
Hyperkinetic phase fourth
Intravenous immunoglobulin, steroids, plasma exchange
Remove the teratoma
Recovery phase

Remove the teratoma
Remove the teratoma
Remove the teratoma
Recovery phase

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