Review of microbiology and immunology

564 Pages·2018·8.44 MB·English

by  Apurba Sankar Sastry

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Review of
Microbiology and Immunology
Sixth Edition
Apurba Sankar Sastry MD (JIPMER) DNB MNAMS PDCR
Hospital Infection Control Officer
Officer in-charge, HICC
Antimicrobial Stewardship Lead
Assistant Professor
Department of Microbiology
Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER)
Puducherry, India
Sandhya Bhat K MD DNB MNAMS PDCR
Vice Dean (Research)
Associate Professor
Department of Clinical Microbiology
Pondicherry Institute of Medical Sciences (PIMS)
Puducherry, India
The Health Sciences Publisher
New Delhi | London | Panama
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© Digital Version 2018, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily
represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic,
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respective owners. The publisher is not associated with any product or vendor mentioned in this book.
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the subject matter in question. However, readers are advised to check the most current information available on procedures
included and check information from the manufacturer of each product to be administered, to verify the recommended dose,
formula, method and duration of administration, adverse effects and contra indications. It is the responsibility of the practitioner
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Review of Microbiology and Immunology
First Edition: 2011
Second Edition: 2012
Third Edition: 2014
Fourth Edition: 2015
Fifth Edition: 2016
Sixth Edition: Digital Version 2018
ISBN: 978-93-86322-39-5
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Dedicated
to
Our Beloved Parents
and
Family Members
And above all, Lord Ganesha who gave us the knowledge and inspiration
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Preface to the Sixth Edition
IMPORTANCE OF MICROBIOLOGY FOR PG ENTRANCES
Microbiology is one of the high-scoring sections and, hence, is the key subject for PG entrances.
• Though it might look tough before you start, but as you go through it gradually, you will surely realize that repeated
revisions can take you to that level at which you can answer all the possible MCQs in any entrance.
• The beauty of this subject is if you are thorough in Microbiology, you can solve many infection-related MCQs of Medicine,
PSM, Pediatrics, etc.
MICROBIOLOGY MICROBIOLOGY INFECTION
ENTRANCE MCQs INFECTION MCQs ENTRANCE MCQs MCQs
AIIMS Nov 2016 21/200 39/200 JIPMER Nov 2016 25/250 44/250
AIIMS May 2016 29/200 43/200 JIPMER May 2016 21/250 37/250
AIIMS Nov 2015 28/200 41/200 JIPMER Nov 2015 21/250 31/200
AIIMS May 2015 16/200 31/200 JIPMER May 2015 14/250 27/200
PGI Nov 2016 19/250 31/250 JIPMER Nov 2014 28/200 42/250
PGI May 2016 21/250 36/250 APPG 2015 21/200 35/200
PGI Nov 2015 15/250 25/250 TNPG 2015 25/250 39/250
PGI May 2015 18/250 32/250 MHPG 2015 38/300 52/300
ALL INDIA 2016 20/300 DNB 2016 (According 18/300
(According to Syllabus) to Syllabus)
Each Chapter Contains
• Chapter Review: Gives a preliminary overall idea about how a chapter can be finished fast.
• MCQs with detailed explanations: Gone to the depth covering all the important aspects in detail.
• Separate section of recent 2016 entrance examination questions.
• Includes image-based MCQs at the beginning of the book.
• Biomedical waste management rules 2016 included.
Changes Done Compared to the Previous Edition
Chapter Review (Theory portion) Part
• Has been thoroughly updated from Harrison 19th edition, Park 23rd edition and Apurba Sastry’s Essentials of Medical
Microbiology, 1st edition and Apurba Sastry’s Essentials of Medical Parasitology, 1st edition.
• All recent information, such as Zika virus, EBOLA virus, Polio eradication, Dengue vaccine, Vaccine-derived Polio Viruses
(VDPVs), MERS-CoV, and updates in bacterial drug resistance etc. have been incorporated.
• Separate Annexure section containing important exam-oriented rapid-fire topics.
• Image-based question bank is further strengthened with new images (> 500 images are included).
MCQ Part
• Recent questions included from AIIMS 2016 (Nov and May), JIPMER 2016 (Nov and May), PGI 2016 (Nov and May), CMC
Vellore (2016) and Recent questions from other national-level examinations.
• State entrance MCQs conducted in 2016 are also included. As no state PGMEE was carried out separately in 2017 and the
same may be continued in future; so students should give more focus to MCQ pattern of All India/NEET exam; rather
giving importance to previous state exam MCQs.
One Weapon-Two Targets: 2nd Year MBBS Exams and PG Entrance
This revised edition is prepared in such a manner that it will help the 2nd year MBBS students to prepare for their MBBS exam
as well as for the PG entrances. The chapter review part of each chapter is revised and updated in such a way that by studying
this book, the students can easily solve the long essays, short notes of MBBS exams as well as MCQs of various PG entrances.
Apurba Sankar Sastry
Sandhya Bhat K
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Golden Tips for Your Exam Preparation
Study Methodology – Antegrade vs Retrograde
Students will always be in a dilemma whether to follow antegrade or retrograde methodology for preparation.
• Antegrade method is time-consuming but covers the topics in a systematic way, while retrograde method fails to cover
unasked MCQs and recent updates. Long-term memory is usually poor for the followers of retrograde method.
• Our book maintains a perfect balance between both the methods.
Tips for Your Preparation
Target-oriented Labor
• Only labor: Gives you 30–40 % success
• Target-oriented labor: Provides 70% success
• That means: You should know where to read and how much to read and not to waste time reading unnecessary things
which are least asked.
Repeated Revisions
Repeated revisions rather than reading extensively without any revision — Crucial Factor
Survey conducted at various coaching centers and medical colleges:
Revision 1st 2nd 3rd 4th 5th 6th 7th
Performance in Exam 25% 28% 32% 35% 50% 55% 60%
Rank in All India Nil Nil 5000 4700 2500 1800 < 1000
Methods to Improve Your Memory
• Try to correlate the things and remember rather than purely mugging up
• Group study or couple study
• Recalling every night
• Booster revisions: Should be done before you totally forget the matter (i.e. in short-interval)
• Mnemonics: Good but should be limited.
Regularly Assess Yourself
Most of the students assess their preparation directly at the exam hall which is absolutely worst method of assessing. You should
assess your standard on daily basis and modify your preparation style according to the requirement. You can do that by:
• Group study: Comparing yourself with your friends.
• Self-assessment by recalling every night (last two hours post dinner)
• Grand test: Assess whether studying is reflected in the performance or not. You can compare yourself with students
throughout India.
Role of Grand Test
• Helps in assessing yourself
• Any trials and errors can be attempted in grand tests and whichever experiment is successful can be executed in main exam
• To learn time adjustment
• To enhance guessing ability
• To improve self-confidence
• To compare your performance with others.
Weekdays (Self-study) vs Weekend Study (Coaching Center)
• Coaching institute is the place where you will be trained with the entrance-oriented important aspects of the subjects.
• However, students attending coaching institutes are getting 50 to 60 days less for their preparation as compared to the other
students who prepare at home.
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Golden Tips for Your Exam Preparation vii
• You should never waste the time gap (i.e. weekdays) between classes.
• You will never get time to revise if you have not covered the last subject before the next subject starts.
Last 100 Days
• Accelerate near the slug overs: Last 100 days of study are very crucial—because the students’ survey has shown that 80%
of what you will answer correctly in the exam depends upon the last 2 to 3 months’ study.
• Never leave any subject: Be master in your area but, at the same time, cover at least average of the uncovered area as MCQs
will be asked from all the subjects.
• Sleeping well the previous night: Increases your efficiency at least by 10%.
• Do not forget the importance of time: Once lost, it can never be recycled.
Be an Early Riser
As wisely quoted by Benjamin Franklin “Early to bed and early to rise makes a man healthy, wealthy, and wise.”. Remember
what you read during early morning (3 am-6 am), will stimulate your memory cells maximum and will be retained longer.
More so, there will be no disturbance as compared to late night reading where other friends/TV shows/parties or the whole
day tiredness etc. will disturb you a lot.
My Trick to Get up Ealry
• Sleep early (10 pm)
• Keep three alarms, 5 min gap
• Keep alarm away from cot
• Brush and make tea before go to read
• Never start a fresh chapter, as you will have starting problem which will induce sleep
• Always read a chapter continued from yesterday's reading.
While Writing PG Exam ...... The Following Things are to be Kept in Mind
• Time management
• Guess ability:
○ By correlating the things
○ By ruling out the options
• Guess only in 50–50 situation (two or three options are ruled out)
• Never guess when you can rule out only one or zero options.
FINALLY, WHILE CHOOSING A PG SEAT
Students Choose a PG Seat—either ‘by Choice’ or ‘by Chance’
• By choice (similar to love marriage): Take your dream PG seat (this happens only when you get a desired rank). Only a few
blessed students fall under this category.
• By chance (similar to arranged marriage): Take the available PG seat (this happens when you get a rank, but not good enough
to get your choice subject). Most of the students will fall under this category.
If you have a rank but not good enough to get your choice subject, you have two options:
• Take what is available
• Wait for the next year.
This is again a controversial situation. Many have opinions in both the categories.
• Some say that you can enjoy the subject only if it is your dream subject.
• Some say that you should not waste time in waiting as there is no guarantee that you will do better in the next exam and in
the current online multisession exam pattern, the situation is highly uncertain.
Best Way to Solve this issue is
Try to see the difference between love marriage and arranged marriage.
• There is no guarantee that in love marriage, you will not fight and you will have a peaceful life.
• Love is there in arranged marriage also, but it is created after marriage.
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viii Review of Microbiology and Immunology
Our advice as time is precious:
• Never wait for long to get your desired subject.
• Develop interest in the subject that you choose.
• Do justice with your subject in your three years of PG course.
• And, in turn, the subject will give you name, fame and prosperity throughout your life.
• If you dislike the subject, then it will end up in divorce (i.e. you will leave the course or will live throughout).
STRATEGY TO CHOOSE A PG SEAT
Prepare a ‘priority list’ of subject-college combinations, based on your rank and last-year counseling.
College Priority to be discussion Prepared
• This is equally important because whatever subject you take, you will be master of that if you do in AIIMS/PGI/
JIPMER/CMC kind of college.
• Even if the subject is of low priority, it will give you more satisfaction as you will be easily famous in your locality
and country.
DEMO: Who will feel more satisfied in the job and more famous in the world?
• A state-level cricket player of India, who is struggling to get a chance to play in the national-level team (e.g. doing
medicine from state college); or
• Bangladesh cricket team captain (e.g. doing pathology from PGI).
Subject Priority is to be Prepared Based on the Following Facts
Based on the nature of work, time of work and your desire to earn name and money, i.e.:
• For 9 am to 5 pm job (faculty job is the best):
○ Subject preference should be based on job vacancy
○ All subjects will have the same salary, but night duty will be there only in a few clinical subjects.
(A medicine faculty sometimes gets frustrated by seeing a dermatology faculty)
For 7 am to 9 pm job (private practice is the best): Income is partly based on subject and partly on your luck. So,
here you can give importance to certain subjects, like RD, Paed, Ortho, etc. But, remember, a lot of risk is involved
in practice and be prepared for that.
• Females should keep in mind that they have to manage family in future. So, just for the infatuation sake, do not go
for OBG. Be prepared that you will have duties and lot of professional responsibilities before opting for OBG.
• If choosing RD, anesthesia: Be prepared that there is no patient interaction. Do not cry later.
• If choosing medicine/surgery: Be prepared that DM/MCh is a MUST. So, a lot of hard work is expected in future
and settlement is always late.
• If choosing psychiatry/radiotherapy: Be prepared that the patient’s compliance is poor. So, you may/may not get
the job satisfaction of curing a patient.
• If choosing paraclinical and nonclinical: Be prepared that there is no patient exposure, but one has the advantage
of no duty, same salary if working as faculty and, most importantly, no need to prepare again.
Remember, For Satisfaction
• BEING HAPPY WITH WHAT GOD HAS GIVEN IS MORE IMPORTANT THAN CRAVING FOR WHAT IS
NOT GIVEN TO YOU.
• WHAT YOUR FAMILY WILL THINK IS MORE IMPORTANT THAN WHAT YOUR FRIENDS/NEIGHBORS
WILL THINK.
Wish You “ALL THE BEST FOR THE SUCCESS AND THE BRIGHT FUTURE AHEAD”.
Keep in touch with us through the FB discussion group and personal touch via FB messanger or mail.
Apurba Sankar Sastry
([email protected])
Sandhya Bhat K
([email protected])
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Acknowledgments
Our efforts bore fruit with the successful completion of this project ‘Review of Microbiology and Immunology’ 5th edition.
However, there are many others who share the reward of this effort simply because it would never have been this good without
their help. It gives us great pleasure to acknowledge the contribution of those who guided, supported and stood by us through
the arduous journey of completing this tedious work.
• We would like to sincerely thank our beloved Director, JIPMER, Puducherry, who gave us constant inspiration and support
for writing this book.
• We would also like to express our gratitude to the Director, Pondicherry Institute of Medical Sciences (PIMS), Puducherry
for his encouragement.
• We are thankful to all the faculties, residents and other staff of JIPMER and Pondicherry Institute of Medical Sciences
(PIMS), Puducherry for their help and encouragement.
• We offer our hearty gratitude to all our paternal and maternal relatives and all our cousins.
We also offer our gratitude to some of the students who constantly gave their inputs and support during the correction and
editing of the book.
1. Dr Ramya Raghavan, JIPMER
2. Dr Prasanna Bhat, JIPMER
3. Dr Suryaprakash, Stanley Medical College, Chennai
4. Salman Mapara, Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals
5. Manish Choudhary, Kasturba Medical College, Manipal
6. Sunil Chillalshetti, Belgaum Institute of Medical Sciences
7. Akshi Malhotra, JIPMER
8. Manjula Gunasekaran, PSG Institute of Medical Sciences and Research
9. Priyanka Patra, SKNMC pune
10. Praveen G, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Tamil Nadu
11. Aarti Chitkara , Sir Maharaja Agrasen Medical College, Haryana
12. Ashwath Vh, Adichunchanagiri Institute of Medical Sciences, Karnataka
13. Raja Suman Datta, GSL Medical College, Rajahmundry, Andhra Pradesh
We are grateful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Chetna Malhotra Vohra (Associate
Director), Ms Payal Bharti (Project Manager), Mr Ravinder (Typesetter), Mr Himanshu Shekhar Lal (Proofreader) and all the
other members of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for giving us this wonderful opportunity of
writing this book and their excellent support throughout the journey, especially during the editing work on Apurba Sastry's
Microbiology discussion.
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