First Aid for the Basic Sciences, General Principles

577 Pages·2008·12.05 MB·English

by  Tao Le

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
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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.
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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.
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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