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First Aid for the Basic Sciences, General Principles PDF

577 Pages·2008·12.05 MB·English
by  Tao Le
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General Principles SENIOR EDITORS EDITORS TAO LE, MD, MHS ELIZABETH EBY Assistant Clinical Professor Vanderbilt University School of Medicine Chief, Section of Allergy and Clinical Immunology Class of 2009 Department of Medicine JUSTIN P. FOX, MD University of Louisville Resident KENDALL KRAUSE, MD Department of Surgery Resident Wright State University Department of Emergency Medicine DANIELLE GUEZ Harvard Affi liated Emergency Medicine Residency Yale University School of Medicine Class of 2011 M. KENNEDY HALL Albert Einstein College of Medicine Class of 2009 SANDY MONG Harvard Medical School Class of 2009 KONSTANTINA M. VANEVSKI, MD Senior Fellow Department of Obstetrics and Gynecology F. Edward Hébert School of Medicine Unifomed Services University of the Health Sciences New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publica- tion may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-0-07-154546-4 MHID: 0-07-154546-8 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-154545-7, MHID: 0-07-154545-X. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. To contact a representative please visit the Contact Us page at www.mhprofessional.com. Disclosure: The opinions or assertions contained herein are the private views of the authors and are not to be construed as offcial or as reflecting the views of the Department of Defense, the United States Military, or the Department of Health and Human Services. Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. The following material was reproduced, with permission, from Le T, et al. First Aid for the USMLE Step 1: 2008, New York: McGraw-Hill, 2008: Figures 1-3, 1-6, 1-7, 1-8, 1-19, 1-20, 1-22, 1-24, 1-25, 1-26, 1-27, 1-28, 1-30, 1-32, 1-33, 3-5, 3-7, 3-8, 3-9, 3-14, 3-15, 3-16, 3-17, 3-25, 3-27, 3-32, 3-34, 3-40, 3-42, 3-44, 3-45, 3-48, 3-49, 3-50, 3-52, 3-59, 3-70, 3-73, 3-101, 3-119, 3-120, 3-121, 3-122, 3-123, 4-3, 4-5, 4-6, 4-11, 4-25, 5-6, 5-7, 5-10, 5-37, 5-38, 5-40, 6-4, 6-5, 6-10, 6-11, 8-1, and 8-2; Tables 1-7, 3-20, 3-28, 4-7, 5-51, 6-6, 6-7, 6-10, and 6-12. Cover images are modified and reproduced, with permission, from the following sources: Chandrasoma P, Taylor CR. Concise Pathology, 3rd ed. Originally published by Appleton & Lange. Copyright © 1998 by The McGraw-Hill Companies, Inc.; and Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005. TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGraw-Hill”) and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms. THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUA- CY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not war- rant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. DEDICATION To the contributors to this and future editions, who took time to share their knowledge, insight, and humor for the benefi t of students. and To our families, friends, and loved ones, who supported us in the task of assembling this guide. This page intentionally left blank v Contents Contributing Authors . . . . . . . . . . . . . . . . . . . . . . . . . vi Laboratory Tests and Techniques. . . . . . . . . . . . . 214 Faculty Reviewers . . . . . . . . . . . . . . . . . . . . . . . . . . .vii Genetics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . xi CHAPTER 4. Embyology . . . . . . . . . . . . . . . . . . 233 How to Contribute. . . . . . . . . . . . . . . . . . . . . . . . . . .xiii CHAPTER 5. MIcrobiology . . . . . . . . . . . . . . . . 261 CHAPTER 1. Anatomy and Histology. . . . . . . . . .1 Bacteriology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262 Cellular Anatomy and Histology . . . . . . . . . . . . . . . . .2 Spirochetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326 Gross Anatomy and Histology. . . . . . . . . . . . . . . . . 18 Mycology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332 Helminths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 344 CHAPTER 2. Behavioral Science. . . . . . . . . . . . 39 Zoonotic Bacteria. . . . . . . . . . . . . . . . . . . . . . . . . . 355 Epidemiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Virology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358 Disease Prevention . . . . . . . . . . . . . . . . . . . . . . . . . 49 Microbiology: Systems. . . . . . . . . . . . . . . . . . . . . . 408 Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Antimicrobials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 424 Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Life Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 CHAPTER 6. Immunology. . . . . . . . . . . . . . . . . 457 Psychology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Principles of Immunology. . . . . . . . . . . . . . . . . . . 458 Pathology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478 CHAPTER 3. Biochemistry . . . . . . . . . . . . . . . . . 75 Molecular Biology . . . . . . . . . . . . . . . . . . . . . . . . . . 76 CHAPTER 7. Pathology . . . . . . . . . . . . . . . . . . . 503 Mutations and DNA Repair. . . . . . . . . . . . . . . . . . . 95 Enzymes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 CHAPTER 8. General Pharmacology . . . . . . . 527 The Cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Pharmacodynamics. . . . . . . . . . . . . . . . . . . . . . . . 528 Connective Tissue. . . . . . . . . . . . . . . . . . . . . . . . . 122 Pharmacokinetics. . . . . . . . . . . . . . . . . . . . . . . . . . 531 Homeostasis and Metabolism . . . . . . . . . . . . . . . 130 Toxicology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 534 Amino Acids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543 Fed versus Unfed State. . . . . . . . . . . . . . . . . . . . . 175 About the Editors . . . . . . . . . . . . . . . . . . . . . . . . . 560 vi CONTRIBUTING AUTHORS Kevan M. Akrami Pamela Landsteiner, MD Albert Einstein College of Medicine Transitional Resident Class of 2009 David Grant USAF Medical Center Ryan Patrick Bayley Travis Air Force Base, California Vanderbilt University School of Medicine Peter Liang Class of 2008 Harvard Medical School Johnathan A. Bernard Class of 2009 Yale University School of Medicine Joel Musee Harvard School of Public Health Vanderbilt University School of Medicine Class of 2009 Class of 2013 Melissa A Buryk, MD Gregory Nelson, MD, MHS Resident Resident Department of Pediatrics Department of Orthopaedic Surgery Portsmouth Naval Medical Center Barnes-Jewish Hospital Trevor A. Crowell Washington University in St. Louis Keck School of Medicine Scott E. Potenta University of Southern California Harvard Medical School Class of 2008 Class of 2011 Beverly (Ye) Du Sofi e Rahman Harvard Medical School Vanderbilt University School of Medicine Class of 2009 Class of 2009 Cicely Anne Dye Rachel Reinert F. Edward Hérbert School of Medicine Vanderbilt University School of Medicine Uniformed Services University of the Health Sciences Class of 2013 Class of 2009 Jakub Sroubek Elizabeth Eby Albert Einstein College of Medicine Vanderbilt University School of Medicine Class of 2011 Class of 2009 Brendon G. Tillman Matthew C. Egalka, MD F. Edward Hébert School of Medicine Resident Uniformed Services University of the Health Sciences Department of Pediatrics Class of 2009 Yale-New Haven Children’s Hospital Yolanda D. Tseng Mary Evans, MD Harvard Medical School Resident Class of 2009 Department of Internal Medicine Joshua Tyler, MD Boston Medical Center Resident Rolf Graning, MD Department of General Surgery Uniformed Services University of the Health Sciences Brooke Army Medical Center Class of 2007 Eric Vaillant Britney L. Grayson Resident Vanderbilt University School of Medicine University of California Davis Medical Center Class of 2012 Joshua J. Weaver, MD Alison Hanson Resident Vanderbilt University School of Medicine Department of Neurology Class of 2012 New York Presbyterian /Weill Cornell Nicole M. Hsu Cicely Williams F. Edward Hébert School of Medicine Yale University School of Medicine Uniformed Services University of the Health Sciences Class of 2011 Class of 2009 David Young Sean L. Jersey, MD Vanderbilt University School of Medicine Flight Surgeon Class of 2008 99th Reconnaissance Squadron Air Force Base, California Serge Kobsa Yale University School of Medicine Class of 2011 vii FACULTY REVIEWERS Ronald Arky, MD Susan Farrell, MD Charles S. Davidson Distinguished Professor of Medicine, Assistant Professor of Medicine Brigham and Women’s Hospital Brigham and Women’s Hospital Harvard Medical School Harvard Medical School James B. Atkinson, MD, PhD Dennis Finkielstein, MD Professor Assistant Professor of Medicine Department of Pathology Albert Einstein College of Medicine Vanderbilt University Medical Center David E. Golan, MD, PhD Susan J. Baserga, MD, PhD Professor Professor, Molecular Biophysics and Biochemistry, Genetics, Department of Biological Chemistry & Molecular Pharmacology Therapeutic Radiology Harvard Medical School Yale University School of Medicine Attilio V. Granata, MD, MBA Stephen C. Baum, MD Associate Professor Professor of Medicine, Microbiology and Immunology Yale School of Medicine and Yale School of Public Health Albert Einstein College of Medicine Yvonne Grimm-Jorgensen, PhD Douglas A. Berv, MD Assistant Professor Lecturer Department of Cell Biology Department of Psychiatry University of Connecticut Health Center Yale University School of Medicine Mehrnaz Hojjati, MD Jonathan Bogan, MD Assistant Professor Assistant Professor of Medicine and Cell Biology Department of Medicine Yale University School of Medicine Medical School at the University of Minnesota Florence M. Brown, MD Paul D. Holtom, MD Assistant Professor of Medicine Associate Professor of Medicine and Orthopedics Beth Israel-Deaconess Medical Center Keck School of Medicine of University of Southern California Harvard Medical School Edmund G. Howe III, MD, JD Yung-Chi “Tommy” Cheng, PhD Professor of Psychiatry Henry Bronson Professor of Pharmacology Uniformed Services University of the Health Sciences Yale University School of Medicine Anand D Jeyasekharan, MD, MBBS Yoon Andrew Cho-Park, MD Department of Oncology and Hutchison/MRC Research Centre Clinical Fellow in Neurology University of Cambridge Massachusetts General Hospital/Brigham and Women’s Hospital Shanta Kapadia, MD, MBBS Harvard Medical School Lecturer Christoper Cimino, MD Department of Surgery Professor of Clinical Neurology Yale School of Medicine Albert Einstein College of Medicine Joel Katz, MD Celena Dancourt, MD Assistant Professor of Medicine Chief Resident Brigham and Women’s Hospital Department of Psychiatry Harvard Medical School Beth Israel Medical Center George L. King, MD Albert Einstein College of Medicine Professor of Medicine Sachin Desai, MD Brigham and Women’s Hospital Clinical Fellow Harvard Medical School Department of Pediatrics Philip Kingsley, MS Yale University School of Medicine Assistant in Biochemistry Jorg Dietrich, MD, PhD Vanderbilt University Medical Center Chief Resident Michael Klompus, MD, PhD Department of Neurology Instructor Massachusetts General Hospital/Brigham and Women’s Hospital Department of Ambulatory Care and Prevention Harvard Medical School Harvard Medical School Eric Elster, MD Fotios Koumpouras, MD Assistant Professor of Surgery Assistant Professor of Medicine Uniformed Services University of the Health Sciences University of Pittsburg School of Medicine viii Patricia Kritek, MD E. Matthew Ritter, MD Instructor in Medicine Assistant Professor of Surgery Brigham and Women’s Hospital Norman M. Rich Department of Surgery Harvard Medical School Uniformed Services University of the Health Sciences Jayde Kurland, MD David H. Roberts, MD Staff Gastroenterologist Assistant Professor of Medicine National Naval Medical Center Beth Israel-Deaconess Medical Center Joseph D. LaBarbera, PhD Harvard Medical School Associate Professor Jeffrey J. Schwartz, MD Department of Psychiatry Associate Professor Vanderbilt University School of Medicine Department of Anesthesiology John McArdle, MD Yale University School of Medicine Assistant Professor of Medicine Ravi Shah, MD Yale University School of Medicine Resident in Internal Medicine Cynthia Macri, MD Massachusetts General Hospital Assistant Professor, Obstetrics and Gynecology Keegan Smith, MD Uniformed Services University of the Health Sciences Clinical Fellow Jason B. Martin, MD Division of Allergy, Pulmonary, and Critical Care Medicine Vanderbilt University Medical Center Division of Allergy, Pulmonary, and Critical Care Department of Medicine Darko Stefanovski, MSc Vanderbilt University School of Medicine PhD Graduate Student; PIBBS (Physiology & Biophysics) Andrew Miller, DO Keck School of Medicine of University of Southern California Senior Rheumatology Fellow Richard S. Stein, MD Vanderbilt University Medical Center Professor of Medicine Tracey A. Milligan, MD, MS Vanderbilt University Medical Center Instructor in Neurology Howard M. Steinman, MD Brigham and Women’s Hospital Professor of Biochemistry Harvard Medical School Albert Einstein College of Medicine Kenneth L. Muldrew, MD, MPH Srinivas Susarla, DMD Winchester Fellow in Clinical Microbiology Clinical Fellow in Oral and Maxillofacial Surgery Department of Laboratory Medicine Massachusetts General Hospital Yale School of Medicine Louise D. Teel, PhD Michael Parker, MD Research Assistant Professor Assistant Professor of Medicine Department of Microbiology and Immunology Beth Israel-Deaconess Hospital Uniformed Services University of the Health Sciences Harvard Medical School Mark Thomas, MD Jonathan P. Pearl, MD Associate Professor Assistant Professor Physical Medicine and Rehabilitation Department of Surgery Albert Einstein College of Medicine Uniformed Services University of the Health Sciences Joseph I. Wolfsdorf, MB, BCh Cathleen C. Pettepher, PhD Professor of Pediatrics Professor, Cancer Biology and Cell & Developmental Biology Children’s Hospital Vanderbilt University School of Medicine Harvard Medical School Staci E. Pollack, MD Assistant Professor of Reproductive Endocrinology & Infertility Department of Obstetrics, Gynecology & Women’s Health Albert Einstein College of Medicine ix Preface With this fi rst edition of First Aid for the Basic Sciences: General Principles, we continue our commitment to providing students with the most useful and up- to-date preparation guides for the USMLE Step 1. Both this text and its com- panion, First Aid for the Basic Sciences: Organ Systems, are designed to fi ll the need for a high-quality, in-depth, conceptually driven study guide for Step 1 of the USMLE. They are designed to be used either alone, or in conjunc- tion with the original First Aid for the USMLE Step 1. In this way, students can tailor their own studying experience, calling on either book, according to their mastery of each subject. These books would not have been possible without the help of the hundreds of students and faculty members who contributed their feedback and sugges- tions. We invite students and faculty to please share their thoughts and ideas to help us improve First Aid for the Basic Sciences: General Principles. (See How to Contribute, p. xiii.) Tao Le Louisville Kendall Krause Boston

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Everything you need to build a foundation for learning the basic medical sciences in one comprehensive review! 4 STAR DOODY'S REVIEW! ''I would recommend this book to those preparing for USMLE Step 1. The chapters are inclusive with useful color pictures and charts. The many sidebars that include cl
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