1. General Principles of Foundational Science Biochemistry and molecular biology



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1. General Principles of Foundational Science

Biochemistry and molecular biology

Gene expression

DNA structure

replication

exchange

and epigenetics

imprinting

X-inactivation

DNA methylation

Gene expression

transcription

Gene expression

translation

post-translational processing

modifications

and disposition of

proteins degradation

protein/glycoprotein synthesis

intra-extracellular sorting

Processes/functions related to Golgi complex and rough endoplasmic reticulum

Structure and function of proteins and enzymes enzyme kinetics and structural/regulatory proteins

Energy metabolism ATP generation,

Electron transport chain
Biology of cells

Adaptive cell responses and cellular homeostasis hypertrophy

Mechanisms of injury and necrosis pathologic processes liquefactive necrosis

free radical formation

Apoptosis

Cell cycle and cell cycle regulation mitosis


Mechanisms of dysregulation

cell biology of cancer role of p53

Proto-oncogenes

general principles of invasion and metastasis, ncluding cancer staging

Cell/tissue structure

regulation

and function

cytoskeleton

organelles
glycolipids

channels


gap junctions

extracellular matrix

and receptors
Human development and genetics

Principles of pedigree analysis

inheritance patterns

occurrence and recurrence risk determination

Population genetics

Hardy-Weinberg law

founder effects

mutation-selection equilibrium

Principles of gene therapy

Genetic testing and counseling

Genetic mechanisms

penetrance

genetic heterogeneity
Biology of tissue response to disease

Acute inflammatory responses patterns of response

acute inflammation and mediator systems

histamine

prostaglandins

bradykinins


eosinophilic basic protein

nitric oxide

vascular response to injury

mediators

principles of cell adherence and migration

ECAMs


selectins

leukocytic

diapedesis

and rolling

microbicidal mechanisms and tissue injury

defensins

clinical manifestations

pain


fever

leukocytosis

leukemoid reaction

chills


Chronic inflammatory responses

tumor necrosis factor

Reparative processes

wound healing

repair

thrombosis



granulation tissue

angiogenesis

fibrosis
scar/keloid formation

regenerative process


Pharmacodynamic and pharmacokinetic processes: general principles

Pharmacokinetics

absorption

distribution

metabolism

excretion

dosage intervals

Mechanisms of drug action

structure-activity relationships

anticancer drugs

Concentration and dose-effect relationships

efficacy


potency

types of agonists

full

partial


inverse and antagonists and their actions

Individual factors altering pharmacokinetics and pharmacodynamics

age

gender
disease



tolerance

compliance

body weight

metabolic proficiency


pharmacogenetics

Mechanisms of drug adverse effects

overdosage

toxicology

Mechanisms of drug interactions

Signal transduction

structure/function of all components of signal transduction

pathways such as receptors

ligands

general principles of nitric oxide

autocrine

and paracrine signaling


Microbial biology

Microbial identification and classification principles

Microorganism identification and non-immunologic laboratory diagnosis
Bacteria

structure

cell walls

composition

appendages

virulence factors

extracellular

products


toxins

mechanism of action of toxins

processes

replication

and genetics

metabolism

growth

and regulation



oncogenesis

antibacterial agents

mechanisms of action on organism

toxicity to humans

and

mechanisms of resistance


Viruses

structure

physical and chemical properties

virulence factors

processes

replication

and genetics

life cycles

location of virus in latent infection

oncogenesis

antiviral agents

mechanisms of action on virus

toxicity to humans

and


mechanisms of resistance
Fungi

structure

cell wall

composition

appendages

virulence factors

extracellular

products


toxins

mechanisms of action of toxins

processes

replication

and genetics

asexual vs. sexual

metabolism

growth


antifungal agents

mechanisms of action on fungus

toxicity to humans

mechanisms of resistance


Parasites

structure

appendages

macroscopic features

and virulence factors

processes

replication

and genetics

life cycles

metabolism

and growth

oncogenesis

antiparasitic agents

mechanisms of action on parasite

toxicity to humans

and


mechanisms of resistance
Prions
Normal age-related findings and care of the well patient
Infancy and childhood 0-12 years
Normal physical changes

linear growth

variations in linear growth

constitutional delay

head circumference

micturition

defecation

primary


incontinence/bedwetting

normal physical examination

screening

sleep
Developmental stages

motor

speech


cognitive

psychosocial

anticipatory guidance
Lifestyle and routine preventive health care

Nutrition

exercise

benefits of exercise

preventive/travel medicine

risk factors and prevention

guns

swimming


motor vehicles

car seats

routine vaccinations
Adolescence 13-17 years Normal physical changes

linear growth

variations in linear growth

constitutional delay

puberty

normal physical examination

gynecomastia
autonomy/self-identity

sleep
Developmental stages

cognitive

abstract thought

psychosocial autonomy

role


confusion

sexual identity

anticipatory guidance
Lifestyle and routine preventive health care

Nutrition

exercise

benefits of exercise

preventive/travel medicine

risk factors and prevention

risk-taking

behavior


helmets

safe sex


motor vehicles

seat belts

distractions

routine vaccinations


Adulthood 18-64 years
Normal physical changes

Weight


normal physical examination

screening

sleep
Developmental stages

cognitive

intimacy vs isolation

anticipatory guidance


Lifestyle and routine preventive health care

nutrition

exercise

benefits of

exercise

preventive/travel medicine

risk factors and prevention

routine


vaccinations
Senescence 65 years and older
Normal physical changes

normal physical exam for age

weight


height

spinal compression

skin

bruising


normal physical examination

temperature

micturition

defecation

sleep
Developmental stages

motor


cognitive

benign senescent forgetfulness


psychosocial

integrity vs despair

retrospection

anticipatory guidance


Lifestyle and routine preventive health care

nutrition

exercise

benefits of exercise


preventive/travel medicine

risk factors and prevention

falls

general medical



condition

polypharmacy

driving

caregiver stress



routine vaccinations
2. Immune System
Normal processes
Development of cells of the adaptive immune response

positive and negative selection during immune development
Structure

production

and function

granulocytes

natural killer cells

macrophages

mast cells

dendritic cells

cell receptors
complement receptors and toll-like receptors

cytokines

chemokines

T lymphocytes

T-lymphocyte receptors

accessory molecules

CD3

CD4
CD8



B7

cell activation and proliferation

cytotoxic T lymphocytes

memory T lymphocytes

B lymphocytes and plasma cells

B-lymphocyte receptors

immunoglobulins

cell activation and proliferation

Development of antibodies and memory B

lymphocytes

host defense mechanisms

host barriers to infection

mucosal immunity

gut-associated lymphoid tissue

bronchus-associated lymphoid tissue
anatomical locations of T and B lymphocytes
Cellular basis of the immune response and immunologic mediators

antigen processing and presentation in the context of MHC I and MHC II molecules


TAP

beta-2 microglobulin

intracellular pathways

mechanisms by which MHC is expressed on the surface

Distribution of MHC I and MHC II on different cells

mechanisms of MHC I and MHC II deficiencies

Genetics of MHC

Regulation of the adaptive immune response

peripheral tolerance

anergy
regulatory T lymphocytes

termination of immune response

B-T lymphocyte interactions

activation

function


and molecular biology of complement

anaphylatoxins

functional and molecular biology of cytokines

IL 1-15
Basis of immunologic diagnostics



antigen-antibody reactions used for diagnostic purposes

ELISA

immunoblotting

antigen-antibody changes over time

ABO typing
Principles of immunologic protection

vaccine production

mechanisms of vaccine action

biologically active antibodies

monoclonal antibodies

polyclonal antibodies

IVIG

VZIG


rabies immunoglobulin
Effect of age on the function of components of the immune system
Abnormal Processes

Health and Health Maintenance

Screening

Diagnosis
Management

Risks

Prognosis
Disorders associated with immunodeficiency

deficiency primarily of humoral immunity

ommon variable immunodeficiency


hyper IgM syndrome

hypogammaglobulinemia/agammaglobulinemia

X-linked

Bruton


selective immunodeficiency

IgA


IgM

IgE
deficiency/dysfunction primarily of cell-mediated immunity

adenosine deaminase deficiency

DiGeorge syndrome

severe combined immunodeficiency disease

SCID


Wiskott-Aldrich syndrome

granulomatosis

allergic reactions insect bites
complement deficiency

alternative pathway component deficiency C2

C3b

C3bB
C36B6



classical pathway component deficiency C1q

C1r


C1-C5

terminal


component deficiency C5b-C9

terminal complement complex

C1 esterase

inhibitor deficiency

hereditary angioedema

mannose-binding lectin MBL

deficiency

membrane attack complex deficiency


deficiency of phagocytic cells and natural killer cells

Chediak-Higashi disease

chronic

granulomatous disease



other disorders of phagocytosis

leukocyte adhesion

deficiency
HIV/AIDS

HIV1 and HIV2

AIDS

AIDS complications



neuropathy

dementia


renal

insufficiency

immunology of AIDS

immune reconstitution syndrome IRS


secondary infections

noninfectious complications


Immunologically mediated disorders
hypersensitivity reactions

type 1


2

3

anaphylaxis



type 4

drug reactions


serum sickness
transplantation

rejection

graft-vs-host disease
Adverse effects of drugs on the immune system

Jarisch-Herxheimer reaction

drugs

affecting the immune system



prednisone

azathioprine

cyclosporine
methotrexate

monoclonal antibody drugs

abciximab

adalimumab

bevacizumab
infliximab

omalizumab

rituximab]

vaccine adverse effects


3. Blood & Lymphoreticular System
Normal Processes
Embryonic development

fetal maturation

and perinatal changes
Organ structure and function
Cell/tissue structure and function

production and function of erythrocytes

heme and hemoglobin synthesis
hemoglobin O2 and CO2 transport

transport proteins

erythropoietin

production and function of platelets

production and function of coagulation and fibrinolytic factors

hemostasis


Repair

regeneration

and changes associated with stage of life
Abnormal Processes

Health and Health Maintenance

Screening

Diagnosis

Management

Risks

Prognosis
Infectious and immunologic
infectious disorders
bacteria
viral

hemorrhagic fever Ebola virus

Marburg virus

chikungunya

dengue fever
parasitic

malaria


Plasmodium species

babesiosis

Babesia species
primary infections of lymphoid tissue

lymphadenitis viral

bacterial

fungal
parasitic

lymphangitis

buboes


bubonic plague

Yersinia pestis

cat scratch disease Bartonella henselae

immunologic and inflammatory disorders

cryoglobinemia

essential mixed cryoglobinemia

autoimmune hemolytic anemia

paroxysmal nocturnal hemoglobinuria

thrombotic thrombocytopenic purpura

hemolytic uremic syndrome
Neoplasms

leukemia


acute ALL

AML


leukemia

chronic CLL

CML

lymphomas



Hodgkin

disease


non-Hodgkin lymphoma

Burkitt lymphoma

T-cell lymphoma

multiple myeloma


dysproteinemias

monoclonal gammopathy of unknown significance (MGUS)


myelofibrosis

myelodysplastic syndrome

myelodysplasias

other immunoproliferative neoplasms

Waldenstrom macroglobulinemia
Anemia

cytopenias

and polycythemia anemias
decreased production

anemia of chronic disease


hemolysis

glucose-6-phosphate dehydrogenase deficiency

pyruvate kinase deficiency
disorders of hemoglobin

heme

or membrane

disorders of red cell membranes


hereditary spherocytosis

elliptocytosis

methemoglobinemia

congenital

sickle

cell disease



sideroblastic anemia

thalassemias



other causes of anemia

blood loss

acute and chronic as a cause of anemia
cytopenias

aplastic anemia

leukopenia

neutropenia

cyclic neutropenia

agranulocytosis

pancytopenia

thrombocytopenia

quantitative

immune


thrombocytopenic purpura ITP

cythemias

leukocytosis

polycythemia vera

secondary polycythemia


Coagulation disorders hypocoagulable and hypercoagulable conditions

hypocoagulable

disseminated intravascular coagulation

hemophilia

congenital

factor VIII [hemophilia A] and IX [hemophilia B]

hypofibrinogenemia

von

Willebrand disease



platelet dysfunction

qualitative


hypercoagulable

heparin-induced thrombocytopenia

other coagulopathies
homocysteinemia

hypoplasminogenemia

antithrombin III

protein C/protein S

deficiency

Factor V Leiden

anticardiolipin antibodies

lupus anticoagulant


prothrombin G20210A mutation
reactions to blood components

ABO incompatibility/anaphylaxis

Rh

incompatibility/anaphylaxis



hemolysis

delayed


transfusion reaction

transfusion

contaminated with bacteria

transfusion-related acute lung injury TRALI


anaphylactoid reaction IgA deficiency
Traumatic

mechanical

and vascular disorders

mechanical injury to erythrocytes

cardiac

valve hemolysis



disorders of the spleen

splenic rupture/laceration

splenic infarct
splenic abscess

effects/complications of splenectomy

sepsis due to encapsulated

bacteria

hypersplenism
Congenital disorders

Adverse effects of drugs on the hematologic and lymphoreticular systems

antiplatelet drugs antithrombin drugs

dabigatran

chemotherapeutic agents

inhibitors of coagulation

factors


methemoglobinemia

acquired


propylthiouracil

tumor lysis syndrome

warfarin
4. Behavioral Health

Normal Processes
Psychodynamic and behavioral factors

related past experience

transference
personality traits
Adaptive behavioral responses to stress and illness

coping mechanisms
Maladaptive behavioral responses to stress and illness

drug-seeking behavior

sleep

deprivation
Patient adherence

general adherence

adolescent adherence
Abnormal Processes

Health and Health Maintenance

Screening

Diagnosis
Management

Risks

Prognosis
Psychotic disorders

brief psychotic disorder

delusional disorder

psychotic disorder due to a

general medical condition

schizophrenia

schizoaffective disorder

substance-induced

psychotic disorder
Anxiety disorders

acute stress disorder

anxiety due to a general medical condition
generalized anxiety disorder

hyperventilation syndrome

obsessive-compulsive disorder
panic disorder with and without agoraphobia

phobic disorders

anxiety disorder social

phobia


post-traumatic stress disorder

separation anxiety disorder

substance-induced

anxiety disorder


Mood disorders

major depressive disorder with and without psychotic features

seasonal affective disorder

major depressive disorder

postpartum

with and without

psychotic features

screening

cyclothymic disorder

dysthymic disorder

bipolar

disorder


manic/depressed/mixed

premenstrual syndrome

premenstrual dysphoric

disorder


mood disorder due to a general medical condition

substance-induced mood

disorder illegal or prescribed

suicidal ideation/attempt


Somatoform disorders

body dysmorphic disorder

conversion disorder

psychogenic

seizures

dissociative disorders

hypochondriasis

malingering

pain disorder

somatization

disorder

somatoform disorder NOS


Factitious disorders

factitious disorder


Eating disorders and impulse control disorders

anorexia nervosa

binge-eating disorder
bulimia nervosa

eating disorder

disorders of impulse control

gambling


shoplifting
pyromania

trichotillomania


Disorders originating in infancy/childhood

attachment disorder

attentiondeficit/

hyperactivity disorder

developmental speech or language disorder

learning


disability/dyslexia

mental retardation and developmental delay

undefined

school problems

fetal alcohol syndrome

oppositional defiant disorder

conduct

disturbance disorder



disruptive behavior disorder

pervasive developmental disorder


autistic disorder

Asperger syndrome

Rett syndrome

psychoses with origin

specific to childhood

elimination disorders incontinence

encopresis

tic


disorders/Tourette disorder
Personality disorders

antisocial personality disorder

avoidant personality disorder
borderline personality disorder

dependent personality disorder

histrionic personality

disorder


narcissistic personality disorder

obsessive-compulsive personality disorder


paranoid personality disorder

schizoid personality disorder


Psychosocial disorders/behaviors

adjustment disorder

grief response/bereavement

normaland abnormal

parent-child relational problems other than physical or emotional abuse
other psychosocial stress
Sexual and gender identity disorders

gender identity disorder

psychosexual dysfunction
Substance abuse disorders

alcohol abuse/intoxication/dependence/withdrawal


tobacco/nicotine abuse/dependence/withdrawal

cannabis abuse/intoxication/

dependence

hallucinogen abuse/intoxication/dependence/withdrawal

inhalant

abuse/intoxication/dependence/withdrawal

opioids

heroin


prescription drugs
abuse/intoxication/dependence/withdrawal

sedatives

hypnotics

benzodiazepines and barbiturates abuse/intoxication/dependence/withdrawal


stimulants

cocaine


methamphetamine abuse/intoxication/dependence/withdrawal
other drugs of abuse

ecstasy


PCP

bath salts abuse/intoxication/dependence/

withdrawal

polysubstance abuse/intoxication/dependence/withdrawal




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