Handwritten medical notes style diagram for MD physiology exam showing "Genesis of Resting Membrane Potential". Include: title at top in underlined handwriting. Section 1: Ion concentrations table showing K+ inside 140 mEq/L outside 4 mEq/L; Na+ inside 14 mEq/L outside 142 mEq/L; Cl- inside 4 mEq/L outside 104 mEq/L. Section 2: Nernst equation written out: E = 61 log [Co]/[Ci] with K+ equilibrium = -94 mV, Na+ equilibrium = +61 mV. Section 3: Goldman equation written out. Section 4: Three contributors listed with arrows: 1) K+ diffusion potential (-94 mV) - major contributor, 2) Na+ diffusion potential (partially offsets), 3) Na-K ATPase pump (-4 mV electrogenic). Final RMP = -70 to -90 mV. Blue ink on white lined paper, neat handwriting with boxes around key values, arrows showing ion movements across a simple cell membrane sketch.

Handwritten medical notes page for MD physiology exam titled "Effects of Hypokalemia on Resting Membrane Potential". Blue ink on ruled white paper, neat student handwriting. Content: Hypokalemia = serum K+ less than 3.5 mEq/L. Nernst equation arrow: K+ inside/outside ratio INCREASES when plasma K+ falls. Effect on SKELETAL MUSCLE: RMP becomes more negative (hyperpolarization) e.g. from -90 mV to -100 mV. Mechanism arrow diagram: LOW extracellular K+ → increased K+ inside/outside ratio → more K+ diffuses out → interior more negative → HYPERPOLARIZATION → cell HARDER to excite → muscle weakness and paralysis. Effect on CARDIAC (Purkinje fibers): Paradoxical DEPOLARIZATION via K2P1 (TWIK-1) channels - these channels switch from K+ selective to Na+ transport when K+ is low, causing Na+ influx and depolarization. ECG changes box: flat T waves, ST depression, U waves, prolonged QT, risk of torsades de pointes. Draw a simple voltage scale diagram showing -90mV baseline shifting to -100mV for skeletal muscle. Add a warning star: PARADOX in cardiac cells.

Handwritten medical notes page for MD physiology exam titled "Effects of Hyperkalemia on Resting Membrane Potential". Blue-black ink on ruled white paper, neat handwriting. Content: Hyperkalemia = serum K+ greater than 5.5 mEq/L. Nernst equation: K+ inside/outside ratio DECREASES when plasma K+ rises. Effect: RMP becomes LESS negative (depolarization) e.g. from -90 mV to -70 mV. Two-phase effect diagram: Phase 1 - Partial depolarization → cell approaches threshold → EASIER to excite → increased excitability (tingling, muscle twitching). Phase 2 - Sustained depolarization → Na+ channels become INACTIVATED (remain in inactivated state) → cell CANNOT fire action potentials → muscle weakness, flaccid paralysis. ECG changes progression box drawn with arrow: 1) Peaked tall T waves (early), 2) Widened QRS, 3) Flattened P waves, 4) Sine wave pattern, 5) Ventricular fibrillation / asystole (late). Simple voltage diagram showing RMP shifting from -90 mV toward threshold at -70 mV. Note: Hyperkalemia depresses ectopic pacemakers and slows conduction. Border the ECG changes box.

Handwritten medical diagram on white paper showing "Chord Conductance Equation and Goldman Equation for Resting Membrane Potential". Blue ink, neat handwriting, exam notes style. Show: Title underlined. Chord conductance equation: Em = (gK/gT)EK + (gNa/gT)ENa + (gCl/gT)ECl. Below it: Goldman-Hodgkin-Katz equation written out: Em = 61 log [(PK[K+]out + PNa[Na+]out + PCl[Cl-]in) / (PK[K+]in + PNa[Na+]in + PCl[Cl-]out)]. Then a table: Ion | Permeability ratio at REST: K+ = 1.0 (reference), Na+ = 0.04, Cl- = 0.45. Below: "At rest: PK >> PNa therefore RMP is close to EK = -94 mV". Final RMP = -70 to -90 mV. Summary box: "RMP determined mainly by: 1) K+ concentration gradient (major) 2) K+ leak channels (high permeability) 3) Na-K ATPase pump (minor, -4 mV direct electrogenic effect but major indirect by maintaining gradient)". Draw a small pie chart showing relative contributions.

Handwritten medical exam summary table on white ruled paper titled "Comparison: Hypokalemia vs Hyperkalemia Effects on Membrane Potential". Blue pen, neat handwriting. Draw a two-column comparison table with the following rows: Parameter | Hypokalemia (K+ less than 3.5) | Hyperkalemia (K+ greater than 5.5). Rows: Serum K+ | Low | High. K+ inside/outside ratio | Increases | Decreases. RMP | Hyperpolarized (more negative) | Depolarized (less negative). Excitability (skeletal) | Decreased - hard to fire | Increased then decreased. Cardiac effect | Paradoxical depolarization (TWIK-1 channels) | Depolarization → Na channel inactivation. ECG | Flat T, U wave, long QT, torsades | Peaked T, wide QRS, sine wave, VF/asystole. Clinical | Muscle weakness, paralysis, cramps | Muscle weakness, flaccid paralysis, arrhythmia. Treatment | K+ supplementation | Calcium gluconate, insulin+glucose, kayexalate. Box at bottom: Mnemonic - HYPO K = Hyperpolarizes (skeletal), HYPER K = Depolarizes. Add borders and neat formatting.