Thieme Test Prep for the USMLE®: Medical Microbiology and Immunology Q&A Melphine M. Harriott, Michelle Swanson-Mungerson, Samia Ragheb, Matthew P. Jackson

1324 Pages·2019·19.388 MB·English

by  Thieme Test Prep for the USMLE®: Medical Microbiology and Immunology, Melphine M. Harriott, Michelle Swanson-Mungerson, Samia Ragheb, Matthew P. Jackson

Thieme Test Prep for the USMLE®
Medical Microbiology and
Immunology Q&A
Melphine M. Harriott
Michelle Swanson-Mungerson
Samia Ragheb
Matthew P. Jackson
,
~Thieme
Medical Microbiology and Immunology Q&A
Melphine M. Harriott, PhD, D(ABMM), MT(ASCP)SM
Technical Director
Clinical Microbiology Laboratory
Ascension Michigan Laboratory Services
Detroit, Michigan, USA
Michelle Swanson-Mungerson, PhD
Associate Professor
Department of Microbiology and Immunology
Chicago College of Osteopathic Medicine
Midwestern University
Downers Grove, Illinois, USA
Samia Ragheb†, PhD
Formerly Assistant Professor
Department of Biomedical Sciences (Immunology)
William Beaumont School of Medicine
Oakland University
Rochester Hills, Michigan, USA
Matthew P. Jackson, PhD
Assistant Dean
Academic and Student Programs
Associate Professor
Microbiology, Immunology and Biochemistry
Wayne State University School of Medicine
Detroit, Michigan, USA
260 illustrations
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To my husband, Alwyn, and my parents, Melchizedek and Josephine, thank you for your unconditional love
and support while I worked on this seemingly never-ending project. To my current and future students,
thanks for pushing me to be better, dig deeper, and to know more. To my fellow authors, Matt, Michelle, and
Sam, thank you for saying yes and for being part of this project.
Melphine M. Harriott
I want to thank my family for their support and understanding, since this project significantly added to our
already hectic lives. I love you guys so much! I also want to thank my colleagues in the Department of
Microbiology and Immunology in the Chicago College of Osteopathic Medicine (CCOM) for their guidance and
mentorship during my time at CCOM. Furthermore, I want to thank the students that I work with at
Midwestern University for always keeping me on my toes and making me think about immunology and
infectious diseases from many different angles.
Michelle Swanson-Mungerson
To my fellow authors, without whom this project would not have been possible. Special thanks go to my
family for their never-ending love and enduring support throughout the years.
Samia Ragheb†
To my fellow authors, Michelle, Sam, and Melphine whose boundless energy made this project happen.
To my wife and daughter for their enduring love and support.
Matthew P. Jackson
†Prior to publication, our dear friend Samia Ragheb passed away. We are grateful for her dedication to her students, colleagues, and the field
of immunology. She is greatly missed.—Editors
Contents
Preface ................................................................................................................................................................................ix
Acknowledgments ...........................................................................................................................................................ix
Contributors ........................................................................................................................................................................x
Abbreviations ....................................................................................................................................................................xi
How to Use This Series ..................................................................................................................................................xii
Laboratory Values ..........................................................................................................................................................xiv
Additional Normal Laboratory Values .....................................................................................................................xvi
Section I Immunology
1 General Immunology ........................................................................................................................................................1
Alexander S. Maris, Samia Ragheb†, and Thomas C. Bolig
2 Infl ammation ...................................................................................................................................................................17
Samia Ragheb†
3 Autoimmune Disease .....................................................................................................................................................29
Samia Ragheb†
4 Immunodefi ciency Disorders ......................................................................................................................................49
Michelle Swanson-Mungerson
5 Hypersensitivity Reactions ..........................................................................................................................................95
Michelle Swanson-Mungerson
6 Transplant Rejection and Cancer Immunology ....................................................................................................113
Michelle Swanson-Mungerson
Section II Microbiology
7 General Microbiology ..................................................................................................................................................129
Melphine M. Harriott, Thomas C. Bolig, and Matthew P. Jackson
8 Nervous System Infections .........................................................................................................................................157
Melphine M. Harriott
9 Head, Neck, and Respiratory Infections ..................................................................................................................185
Matthew P. Jackson, Alexander S. Maris, Melphine M. Harriott, and Thomas C. Bolig
10 Infections of the Esophagus, Stomach, Small and Large Bowel/Rectum, Liver, and Biliary Tree ............217
Melphine M. Harriott
11 Renal and Urinary Tract Infections ..........................................................................................................................257
Melphine M. Harriott
vii
Contents
12 Reproductive and Sexually Transmitted Infections ............................................................................................267
Melphine M. Harriott
13 Congenital and Neonatal Infections ........................................................................................................................291
Melphine M. Harriott
14 Skin, Soft Tissue, and Musculoskeletal Infections ...............................................................................................297
Matthew P. Jackson and Melphine M. Harriott
15 Cardiovascular, Systemic, Lymph Nodes, and Multisystem Infections ..........................................................331
Melphine M. Harriott, Matthew P. Jackson, and Michelle Swanson-Mungerson
Appendices ......................................................................................................................................................................355
Index .................................................................................................................................................................................................387
viii
Preface
This book is a collection of multiple choice questions and an explanation. The explanation includes both
(MCQs) for the first- and second-year medical students the reasons why a given answer is correct and why
to promote the learning of medical immunology and the distractors are wrong. Some explanations include
microbiology. The questions in this book reflect high images to aid in the explanation.
yield information covered in a preclinical medical In addition, each question is marked with a
immunology/microbiology course and in the United difficulty level. There are three levels of difficulty:
States Medical Licensing Examination (USMLE) Step easy (1), medium (2), and hard (3). Many questions
1 and Comprehensive Osteopathic Medical Licensing are related to the highest levels of Bloom’s taxonomy
Examination (COMLEX) Level 1. (e.g., interpretation of data and solution of problems)
This book contains 550 questions. It is divided into rather than being simple recall questions.
two sections, Immunology and Microbiology. For the Both immunology and microbiology are fast-
Immunology section, where possible, the chapters are evolving disciplines. The authors have checked
separated by subject matter. Some questions could sources believed to be reliable, in order to provide
not be categorized into one chapter; hence, these information that is accurate and in accordance with
questions are included in a chapter titled “General the currently accepted evidence-based standards.
Immunology.” The Microbiology section is subdivided This book is not intended to be a substitute for
by organ system. Again, some questions could not be immunology or microbiology textbooks. Students are
categorized under an organ system and were placed strongly advised to consult their textbooks for more
in the chapter on “General Microbiology.” in-depth coverage of the subject matter.
The majority of the MCQs are similar to the type
of questions that students may see on Step 1 medical Melphine M. Harriott, PhD, D(ABMM), MT(ASCP)SM
board exams in the United States and are written using Michelle Swanson-Mungerson, PhD
patient-centered vignettes. All questions are “one best Samia Ragheb†, PhD
answer”; in most cases, there are five answer choices. Matthew P. Jackson, PhD
Each MCQ is provided with the correct answer
Acknowledgments
Several medical students played vital roles in the at Vanderbilt University Medical Center and plans
development of this book. to be a clinical microbiologist in the future.
Thomas C. Bolig—Tom worked on this book Tom and Alex’s contribution to this book is inva-
while he was a fourth-year medical student at luable.
Wayne State University School of Medicine. He Other medical students who reviewed and provi-
wrote several immunology and microbiology ded feedback on the questions include:
questions and provided feedback to the faculty Jocelyn Durlacher—third-year medical student at
authors. He is currently finishing a research fel- Vanderbilt University School of Medicine.
lowship at the National Institutes of Health and Lauren McNickle—third-year medical student at
will pursue an Internal Medicine Residency after Frank H. Netter MD School of Medicine/Quinnipiac
graduating from medical school. University.
Alexander S. Maris—Alex was a fourth-year me- Paige Peterson—fourth-year medical student at
dical student at Vanderbilt University School of Frank H. Netter MD School of Medicine/Quinnipiac
Medicine while working on this project. He contri- University.
buted several multiple choice questions to both the Melphine M. Harriott, PhD, D(ABMM), MT(ASCP)SM
immunology and microbiology sections. He also Michelle Swanson-Mungerson, PhD
reviewed and provided feedback for many of the Samia Ragheb†, PhD
chapters. He will be starting a Pathology Residency Matthew P. Jackson, PhD
ix
Contributors
Matthew P. Jackson, PhD
Thomas C. Bolig, MS, MD
Assistant Dean
Resident Physician
Academic and Student Programs
Department of Internal Medicine
Associate Professor
University of Michigan
Microbiology, Immunology and Biochemistry
Ann Arbor, Michigan, USA
Wayne State University School of Medicine
Detroit, Michigan, USA
Melphine M. Harriott, PhD, D(ABMM), MT(ASCP)SM
Alexander S. Maris, MD
Technical Director
Resident Physician
Clinical Microbiology Laboratory
Department of Pathology, Microbiology and Immunology
Ascension Michigan Laboratory Services
Vanderbilt University Medical Center
Detroit, Michigan, USA
Nashville, Tennessee, USA
This work was completed in part while the author had Samia Ragheb†, PhD
the following affiliations: Formerly Assistant Professor
Department of Biomedical Sciences (Immunology)
William Beaumont School of Medicine
Fellow, Clinical Microbiology
Oakland University
Department of Pathology, Microbiology and Immunology
Rochester Hills, Michigan, USA
Vanderbilt University Medical Center
Nashville, Tennessee, USA Michelle Swanson-Mungerson, PhD
Assistant Professor Associate Professor
Department of Microbiology and Immunology Department of Microbiology and Immunology
Chicago College of Osteopathic Medicine Chicago College of Osteopathic Medicine
Midwestern University Midwestern University
Downers Grove, Illinois, USA Downers Grove, Illinois, USA
x
Abbreviations
ACh acetylcholine ETEC enterotoxigenic Escherichia coli
ADP adenosine diphosphate ribose GABA gamma aminobutyric acid
AFB acid-fast bacilli GI gastrointestinal
AIDS acquired immunodeficiency syndrome GNC gram-negative cocci
ALT alanine amino transferase GNR gram-negative rod
AST aspartate amino transferase GPC gram-positive cocci
ATP adenosine triphosphate GPR gram-positive rod
cGMP cyclic GMP HIV human immunodeficiency virus
CAMP Christie, Atkins, Munch-Peterson IFN interferon
cAMP cyclic adenosine monophosphate IL interleukin
CBC complete blood count IV intravenous
CDC Centers for Disease Control and Prevention IVDU intravenous drug use
CFU colony forming unit KOH potassium hydroxide
cGMP cyclic guanosine monophosphate LPS lipopolysaccharide
CO carbon dioxide MAP mitogen-activated protein
2
COPD chronic obstructive pulmonary disease MCV mean corpuscular volume
CSF cerebrospinal fluid MHC major histocompatibility complex
CT computed tomography MRI magnetic resonance imaging
DIC disseminated intravascular coagulation O&P ova and parasite
DFA direct fluorescent antibody PCR polymerase chain reaction
EAEC enteroaggregative Escherichia coli PMNs polymorphonuclear cell
EAST enteroaggregative heat stable toxin RBC red blood cell
EHEC enterohemorrhagic Escherichia coli SNARE soluble attachment protein receptor
EPEC enteropathogenic Escherichia coli STEC shiga-toxin producing E. coli
EIA enzyme immunoassay TNF tumor necrosis factor
EIEC enteroinvasive Escherichia coli UTIs urinary tract infections
ELISA enzyme-linked immunosorbent assay WBC white blood cell
xi
How to Use This Series
Green box = Easy question
Yellow box = Medium question
Chapter
Red box = Hard question
Head
Section
Header
Question
Stem
Answer
Options
In general, an easy question requires only a diagnosis
based upon the question stem.
A medium question requires not just the diagnosis of the
condition based upon the question stem, but knowledge
about that diagnosis so as to answer a question about it.
Hard questions are a combination of medium questions
with less commonly known material about the diagnosis.
xii