USMLE STEP 1 Self-Made Personalized Index Review, Study notes of Biology

Download USMLE STEP 1 Self-Made Personalized Index Review and more Study notes Biology in PDF only on Docsity! GENERAL PRINCIPLES A. BIOCHEMISTRY ● DNA molecular structure, types of mutation, repair mechanism, key enzymes, transcription, translation, protein synthesis ● Histone structure, activation and deactivation ● Types of RNA polymerases and DNA polymerases, similarities and differences, functions. ● Purine and Pyrimidine synthesis: key limiting enzymes, cofactors, molecules involved ● Nucleotides vs nucleosides vs synthesis of genetics bases ● Purine salvage pathway ● RNA processing and regulation ● Lac operon ● Spliceosome ● Ribosome structure, subtypes, cell origins ● t-RNA, function, codons, anticodon, sequences, start/stop codons ● Protein synthesis : initiation, regulation and termination ● Post Translational modifications ● Cell structure, organelles and their intrinsic function. ● Cytoskeleton, microtubules and cell cycle: regulatory signals, kinases and cyclins. ● Peroxisome: function, related pathologies (HIGH YIELD) ● Collagen / Elastin synthesis and related pathologies ● Laboratory techniques: PCR, ELISA, Flow cytometry, Microarrays, different types of blotting, FISH, karyotyping ● Imprinting disorders ● Types of inheritance and chart genetic frequencies ● Henderson hasselbalch equation ● Genetic terminology ● Cystic fibrosis (HIGH YIELD) ● Muscular dystrophies and their genetics implication (HIGH YIELD) ● I-cell Disease ● Rett syndrome ● Fragile X syndrome ● Trisomies 21, 18 and 13: markers, signs and symptoms, genetic pathways involved ● Cri du chat syndrome ● Williams syndrome ● Fat soluble vitamins: molecular function, deficiencies and intoxication ● Water soluble vitamin: molecular function, deficiencies and intoxication ● Malnutrition anomalies ● Ethanol mechanism ● Glycolysis, krebs, oxidative phosphorylation, gluconeogenesis: all key enzyme rate limiting steps, biological function and implication ● Hexokinase vs Glucokinase: Vmax, Km, and target organs, enzymes and function ● Pyruvate Metabolic pathway ● Pentose phosphate pathway ● G6P deficiency ● Fructose metabolic pathologies (HIGH YIELD) ● Sorbitol pathway ● Lactase deficiency ● Amino acids: acid, bases, neutral, essential vs nonessential, and metabolic synthesis pathways, derivatives and key cofactors involved ● Urea cycle, ammonia cycle and related pathologies ● Catecholamine synthesis, cofactors involved, and enzymes ● PKU: enzymes deficiencies, signs and symptoms, treatment ● Maple syrup syndrome, Alkaptonuria, Hyperammonemia, Homocystinuria and Cystinuria, Propionic acidemia, Pyruvate kinase deficiency ● Glucagon synthesis: insulin regulation, key enzymes, and metabolic pathway ● Glycogen storage disease (HIGH YIELD) ● LSD diseases (High yield) ● Ketone body formation: synthesis and degradation pathways ● Fed vs Fasted state ● Lipid transport, fatty acid synthesis and degradation, lipoproteins and cholesterol metabolic pathway. ● Familial dyslipidemias B. IMMUNOLOGY ● Lymph node structure, histological analysis, cell locations ● Palpable vs non palpable lymphs and drainage locations ● Spleen structure, histological analysis and cell locations ● Innate vs Adaptive immunity ● MHC class 1 vs class 2: function, similarities and differences, molecular structure function. ● HLA subtypes and related disease ● T cells: regulatory cytokines, interleukins, immunological pathways, positive and negative selection in cell production, cytotoxic, regulatory and naive cells. ● T cells vs B cells: membrane markers, activation and maturation, costimulatory signals ● Class switching and somatic hypermutation ● VDJ genetic recombination ● Immunoglobulin structure, function, heavy and light chains ● Classical vs alternative vs MAC complement and regulatory/ inhibitory pathways ● Antibody functions and different subtypes ● Complement disorders ● Acute vs Chronic Inflammation: pathological features, cellular pathways, cells involved, physical features and relationships. ● Leukocyte extravasation process: Marg / Rolling, Tight binding adhesion, Diapedesis/ transmigration, and Migration. Learn all the cells involved and the receptors for each adequate step of the process . ● Wound healing and tissue mediator molecules. Phase of wound healing throughout time. ● Noninfectious vs Infectious causes of granulating inflammation (Non Caseating vs caseating), cell involvements, immune responses, pathologies related to each. ● Scar formation: Hypertrophic vs Keloid ● Neoplasia, Dysplasia, Metaplasia: genetics, receptors involved, pathological features, diseases related to each important process (tumors, syndromes, autoimmune diseases) ● Tumor grade vs stage ● Cancer hallmarks and disease related with their respective pathological features ● Immune checkpoint regulation, interaction, cell involvement and how cancer escapes this mechanism ● Cancer epidemiology: incidence, recurrence, most common causes either by age, gender, ethnicity and geographical regions. Identify metastases routes for various tumor based on their location and spread (lymphatic or hematogenous) ● Oncogenes vs Tumor suppressor genes: genetics, pathological features, receptors involved, diseases related. ● Carcinogenic molecules ● Oncogenic microorganisms, receptors involved, diseases related and exposure relationship to others pathologies. ● Serum tumor markers: genetics, tumors/disease involved, sensitivity and specificity to each diagnosis. ● Immunohistochemical stains to identify tumors and their respective pathologies. ● Paraneoplastic syndromes: hormones related, pathological features, signs and symptoms, genetic involvement, organs involved. ● Normal aging process for each individual organ system and changes that ocurr with time. E. PHARMACOLOGY ● Enzyme Kinetics: Michaelis-Menten vs Lineweaver-burk plot ● Competitive inhibitors (reversible and irreversible), Noncompetitive inhibitors: Changes in Km, Vmax, Substrate and active site location and how it affects enzyme kinetics. ● Bioavailability, Vd, Clearance, Halflife, Dosage Calculation (loading and maintenance dose) ● Phase 1 and Phase 2 drug metabolism ● Zero order vs First order kinetics ● Drug elimination: acid vs basic molecules ● Efficacy vs Potency: CIR, CII, NCI ● Therapeutic index ● Autonomic receptors, drugs, acetylcholine metabolism, muscarinic agonist and antagonist receptors, cellular receptor response, mechanisms and treatment conditions. ● Adrenergic receptors: receptor locations, response, mechanisms of action, drug involvement and treatment condition for each individual pharmaceutical. ● G- protein second messenger receptors, mechanisms of action, anatomical location and relationship to each pharmaceutical drug either if its an inhibitor or promoter. ● Cholinomimetic agents, direct and indirect agonist drugs, usage, and receptors involved. ● Acetylcholinesterase poisoning: signs and symptoms, treatment and management. ● Atropine, sympathomimetics (direct and indirect), usage, mechanism of action, receptors involved, management and treatment conditions. ● Physiologic effects of sympathomimetics on Systolic, diastolic, MAP, pulse pressure and CO. ● Alpha 1 vs alpha 2, sympatholytics, receptors involved, treatment and management conditions. ● Beta - Blockers: receptors involved, usage, selective or nonselective mechanisms and adverse effects. ● Phosphodiester inhibitors: usage, mechanism of action, side effects, treatment and management condition, pathologies related to usage of each one. ● Seafood toxins ● Age-related changes in pharmacodynamic and Beers criteria ● Treatment for toxicities ● Drug adverse effects and toxicity for each pharmaceutical in all organ system. ● Cytochrome promoter vs inhibitors vs substrate drugs ● Sulfa drugs and pathological features related. ORGAN SYSTEM A. CARDIOLOGY ● Heart development morphogenesis (valve, chamber, vessels and their derivatives) and embryology ● Umbilical cord arteries and vein pathways (fetal circulation) ● Aortic arch derivatives ● Anatomy and chamber positioning ● CO, HR, preload and afterload physiological changes ● Ejection fraction, pulse pressure and MAP ● Starling, cardiac and vascular function curves changes ● Cardiac vessel distribution resistance in parallel ● P / V loops (HIGH YIELD) and disease changes in charts ● Cardiac cycle (HIGH YIELD) ● Hearts sounds (S1, S2, S3, S4 and JVP) ● S2 sound splitting ● Auscultation points, and changes between preload and afterload on valsalva, leg raising, squatting, handgrip and inspiration (HIGH YIELD) ● Heart murmurs: causes, changes, disease relationships, auscultation positions and zones to hear them efficiently. (HIGH YIELD) ● Heart action potential (Pacemaker cells and Muscle) ● EKG: node conduction, arrhythmias etc (HIGH YIELD) ● Baroreceptors vs Mechanoreceptors (responses to different molecules and anatomical zones) ● Blood flow autoregulation on the body ● Capillary fluid changes and oncotic pressure ● Congenital heart diseases (HIGH YIELD) ● Hypertension, hyperlipidemia, Arterio vs Atherosclerosis ● Aortic aneurysms (Thoracic and abdominal). (HIGH YIELD) ● Subclavian steal syndrome ● Aortic dissection ● Angina : values, ekg changes, signs and symptoms presentation, treatment, risk factors and complication ● Sudden cardiac death ● Myocardial infarction(ischemic heart disease): timely changes in histology, presentation, diagnosing, complications, most common arteries affected, treatment and management. STEMI vs non-STEMI. (HIGH YIELD_ ● STEMI vs non-STEMI infarct locations and changes in ST segments and Q waves (HIGH YIELD) ● Tachycardias, arrhythmias: EKG Changes, presentation, causes and complications. ● Acute coronary syndrome ● Cardiomyopathies (HIGH YIELD) ● Left / Right sided heart failure (EDV, EDP, venous, and pulmonary changes) : physical presentation, edema ● Types of shock and physiological value changes (HIGH YIELD) ● Cardiac tamponade ● Pericarditis vs Endocarditis vs Myocarditis ● Rheumatic fever ● Cardiac tumors ● Kussmaul sign ● Hereditary hemorrhagic telangiectasias ● Antianginal treatment therapy changes in physiological values (BP, HR, ET, contractility, EDV) B. ENDOCRINE ● Barrett esophagus vs Esophageal cancer vs Squamous CC vs : Dx, Tx, pathological features, risk factors, common causes, prevalence in population, sign and symptoms, disease presentation and features. ● Acute vs Chronic gastritis: primary and secondary causes, diseases related, pathological features and anatomical location affected. ● Menetrier disease ● Gastric Cancer: Intestinal vs Diffuse ● PUD: gastric vs duodenal, signs and symptoms, primary and secondary causes. ● Ulcer complications: hemorrhage, obstruction, and perforation, common anatomical location affected and presentation. ● Hematochezia vs Melena ● Malabsorption syndromes: Celiac disease, Lactose intolerance, Pancreatic insufficiency tropical sprue and Whipple's disease. Common causes, pathological features, markers, signs and symptoms, Tx and Dx. ● Crohn's vs Ulcerative colitis ● IBS ● Appendicitis: risk factor, complication, maneuvers, Dx and Tx. ● Diverticulum, diverticulosis, Diverticulitis: causes, presentation, similarities and differences, complication and differentiation between ‘false’ and ‘true’ diverticulum ● Zenker vs Merkel diverticulum ● Hirschsprung disease: Dx, features, pathological presentation and management. ● Malrotation vs Volvulus vs Intussusception: structures involved, age group relationship, pathological features, Dx, Mx, and Tx. ● AMI, CMI, angiodysplasia, Ileus, Necrotizing colitis, and SBO. ● Colonic polyps: hamartoma, hyperplastic, inflammatory, mucosal and submucosal. Benign vs Malignant features and genetic pathways involved in developing each pathology. ● Other polyp related pathologies: FAP, Gardner, Turcot, Peutz Jegher syndrome and JPS. ● Lynch syndrom: causes, genetic involvement, age, ethnicity relationship, Dx, Tx, and Mx. ● Colorectal cancer: epidemiology, signs and symptoms, causes, genetic pathways involved, risk factors, complications and anatomical location relationship to each feature. ● Liver cirrhosis, Portal hypertension, signs and symptoms, common causes, complication and risk factors. ● Bacterial Peritonitis ● ALS, AST, GGT, Alkaline phosphatase, direct and indirect bilirubin: identify how this serum markers related to each liver, biliary tree structure, pathologies or other depending on serum marker levels. ● Reye syndrome ● Non-alcoholic fatty liver disease ● Autoimmune hepatitis ● Hepatic encephalopathy: causes, signs and symptoms, Mx, Dx, and Tx ● Hepatic hemangioma, hyperplasia, adenoma, carcinoma and metastasis: causes, signs and symptoms, presentation, identify benign vs malignant transformation, and age/ethnicity group relationship. ● Budd-Chiari syndrome ● Alpha 1 antitrypsin deficiency ● Jaundice and presentation ● Hyperbilirubinemias: Direct, vs Indirect vs Neonatal: causes, presentation, management, Dx, Tx and pathological features ● Biliary atresia ● Hereditary hyperbilirubinemias: Gilbert and Crigler Najjar 1 (unconjugated) vs Dubin Johnson and Rotor syndrome (conjugated): causes, features, benign or malignant presentation, Dx, Mx, Tx and mechanism thats impaired (either excretion defect or a conjugation defect) ● Wilson's disease vs Hemochromatosis ● Biliary tract disease: Primary and Secondary Biliary cirrhosis vs Primary sclerosing cholangitis: structures involved, pathological features, immune markers, disease relationship and epidemiology. ● Cholangiocarcinoma ● Choledocholithisis vs Cholangitis vs Cholelithiasis vs Biliary colic vs Cholecystitis: identify serum marker signs, maneuver features, anatomical structures involved, primary causes, Mx, Dx and Tx. ● Acute vs Chronic Pancreatitis: causes, maneuver features, markers, pathological features, age/ethnicity relationship, complications and risk factors, Mx, Dx, and Tx. ● Pancreatic carcinoma: causes, pathological features, sign symptoms and maneuvers, Mx, Dx, and Tx. D. HEMATOLOGY ● Fetal erythropoiesis timeline production ● Types of hemoglobin in fetal and adult life. ● Blood groups, Rh marker, membrane marker, donors vs recipients ● Hemolytic disease of the fetus and newborn: causes, features and ABO relationship ● Blood cell types, substances secreted, histological features and their physiological role in the body. ● Hemoglobin electrophoresis: sickle cell disease, sickle cell trait, HbC disease and fetal/adult hemoglobin. ● Direct vs Indirect Coombs test ● Platelet plug formation, substance release, coagulation pathway: Common, extrinsic and intrinsic pathway and substances and factors involved. Identify relationship to INR, PT, and PTT lab values to disease. ● Procoagulation vs Anticoagulation pathway: Plasmin, Plasminogen, Proteins C, S, and Antithrombin function. ● RBC morphology, relationship to each disease, pathological features ● RBC inclusion defect: Iron granules vs Howell Jolly vs Basophilic stippling, vs Pappenheimer vs Heinz bodies. Identify the presence of either iron, ribosomes, or hemoglobin which help to identify the difference between each one. Also focus on pathologies involved in their presentation. ● Iron deficiency Anemia ● Alpha and Beta thalassemia: identify disease depending on number of globin affects, genetic factors involved, amino acid change and how it affects the globin structure, prevalence, Mx, Dx, and Tx. ● Macrocytic vs Microcytic vs Normocytic anemias ● Normocytic anemias: Intravascular vs Extravascular. ● Normocytic anemias: Hemolytic anemias vs Non hemolytic anemias ● Normocytic anemias: identify which ones are either intrinsic, extrinsic or both (G6PD and Sickle Cell disease are both): sign symptoms, complication, pathological features, cell morphology, genetic involvement, receptors involved. ● Lead poisoning vs AIP vs PCT: enzyme in pathway involved, pathological features, accumulated substrates and features. ● Iron poisoning: Acute vs Chronic ● Hemophilias ● Platelet disorders: BT, PT, and PTT marker values, pathological features, causes and presentation. ● Thrombotic diseases: TTP, HUS, Antithrombin deficiency, Factor 5 leiden, Protein C/S deficiency, Prothrombin G20210A mutation: features, signs symptoms, groups related, pathological features and relationship to other coagulative drugs in presentation. ● Blood transfusion therapies: Packed RBCs, Platelets, FFP, PCC, Cryoprecipitate. ● Leukemia vs Lymphoma ● Hodgkin vs Non hodgkin lymphoma ● Non Hodgkin lymphomas: epidemiology, age groups affect, causes, genetic chromosomal involvement, pathological features for each one, T vs B cell involvement. ● Plasma Cell Disorders: MM vs WM vs MGUS ● Myelodysplastic syndrome: blood serum cell markers, Pseudo Pelger Huet anomaly vs AML ● Leukemias: ALL vs CLL vs Hairy cell leukemia vs AML vs CML ● Myelodysplastic neoplasms : Polycythemia vera, Essential thrombocytopenia, Myelofibrosis: causes, marker, cell count elevation or diminishing, genetic involvement, signs and symptoms. ● Leukemoid reaction vs CML: similarities and differences ● Polycythemias: Relative, Appropriate vs Inappropriate absolute, vs Vera: changes in plasma volume, RBC mass, oxygen saturation and erythropoietin levels, as well as common causes of each pathological feature. ● Chromosomal translocation to each lymphoma and leukemia. ● Langerhans Cell Histiocytosis ● Ocular movement, anatomy, nerve innervation, disorders and fiber tract relationship to pathologies (HIGH YIELD) ● Cortical visual field location and pathological relationship depending on which area is affected. (HIGH YIELD) ● Medial Longitudinal Fasciculus G. PSYCHIATRY ● Ego defenses ● Classical vs operant conditioning ● Child development, milestones, abuse and trauma ● Early childhood / adolescence disorders ● Schizophrenia and similar related or non-related disorders ● Psychosis, delusion, hallucinations ● Mood disorders, MDD and related disorders ● Anxiety disorders vs panic attacks ● Bipolar (manic vs hypomanic episodes) ● Cyclothymia ● Suicide: signs and tendencies. ● OCD vs OC personality disorder (ego dystonic vs ego syntonic) ● Personality disorders type A, B and C and their relationship to early-onset childhood disorders. ● Malingering vs.factitious vs. somatic ● Eating disorders (HIGH YIELD) ● Narcolepsy ● Substance abuse ● Grief ● Emergencies related to psychiatric medications (Serotonin syndrome, NMS, delirium tremens etc ) ● Drugs of abuse intoxication vs withdrawals (HIGH YIELD) ● Different types of psychotherapy H. RENAL ● Polyhydramnios vs Oligohydramnios ● Potter sequence (high yield) ● Embryological kidney disorders ● Posterior urethral valves ● VUR ● Glomerular structure, cells and physiology ● Renal blood flow (high yield) ● Fluid compartment distribution ● GFR vs RPF vs RBF ● Glucose clearance ● Glomerular dynamics ● Renal tubules components and ion transfer between each section ● Renal tubular defects ● RAS and Juxtaglomerular apparatus ● Hormones of the kidney ● Potassium shifts (hypo / hyperkalemia) (high yield) ● Electrolyte disturbance (CALCIUM and POTASSIUM are the most important) ● Acid Base physiology (Alkalosis and acidosis): causes, chart values, compensations, metabolic changes. ● Renal tubular defects ● WBC, RBC, Granular and other types of casts seen in urine (HIGH YIELD) ● Nephrotic vs Nephritic syndromes (HIGH YIELD) ● Kidney stone formation : acid value changes, causes, types of stones, how to treat them, image identification (HIGH YIELD) ● Types of urinary incontinence ● Pyelonephritis, cystitis, prostatitis ● AKI (pre, intrinsic and post renal) ● Interstitial nephritis ● ATN ● Renal Papillary necrosis ● Cystic disorders of the kidney ● Renovascular diseases (affected kidneys, renin levels depending on where lesion is) (HIGH YIELD) ● Renal and Bladder carcinomas (Oncocytoma, RCC, SCC, Wilms, Nephroblastoma) I. REPRODUCTIVE ● Embryological genetic and cell derivatives ● Weekly development of the baby ● Teratogenic disorders and causes (HIGH YIELD) ● FAS and Neonatal abstinence ● Placenta anatomy, amniotic fluid ● Ovarian follicle formation process and histological identification ● Twin formation process ● Vitelline duct(meconium / feces) and Urachus (urine) ● Pharyngeal arch, cleft and pouch derivatives (HIGH YIELD) ● Male and female genitcal formation, hormones, and anatomical homology between both (as well as primary and secondary sexual characteristics) ● Sertoli vs Leydig cells ● Mullerian anomalies ● APGAR score ● Penile anomalies ● Testes and ovarian structure remnants ● Gonadal venous drainage ● Female reproductive anatomy, ligaments, arteries, anomalies ● Cervical epithelial histological cells ● GU trauma ● Spermatogenesis and oogenesis ● Menstrual cycle (HIGH YIELD) and estrogen / progesterone functions. ● Physiological effects of pregnancy (HIGH YIELD) ● HCG and HPL ● Menopause and lactation process ● Tanner developmental stage ● Precocious vs delayed puberty ● Sex disorders (chromosomal, structural, hormonal level changes, physical characteristic between primary and secondary sexual structures) ● Aromatase vs AIS vs 5-alpha reductase deficiency vs Kallman syndrome (HIGH YIELD) ● Congenital Adrenal Hyperplasias (HIGH YIELD) ● Placental disorders : presentation, pain or no pain, bleeding, week development, anatomical structure that's affects, most common causes and complication. (HIGH YIELD) ● Ectopic pregnancy(HIGH YIELD) ● Hydatidiform moles ● Choriocarcinoma ● Gestational diabetes(HIGH YIELD) ● Preeclampsia vs Eclampsia vs HELLP syndrome (HIGH YIELD) ● ALL VULVAR, VAGINAL, AND CERVICAL pathological anomalies, precursor lesions for tumor formation, different tumors, genetic relationship, causes and age relationship. ● Ovarian cysts, precursor lesions, tumor formation: signs and symptoms, age, difference between premenstrual women and post menopausal (EPITHELIAL vs SEX CORD STROMAL vs GERM CELL) hormone levels presented and relationship to the cells involved. (HIGH YIELD) ● UTERINE anomalies, disorders (ENDOMETRIOSIS, ADENOMYOSIS, HYPERPLASIA) (HIGH YIELD) ● Breast development, anomalies, histological identification, cancer and pathological changes, signs and symptoms (HIGH YIELD) ● Penile disorders, anomalies and tumors ● Hydrocele vs Varicocele vs Spermatocele vs Congenital ● Testicular tumors and relationship , similarities and differences to females structure ovarian tumors) ● BPH vs prostatitis vs Prostate cancer ● Hormonal physiology of gender formation ● Contraceptive indication and contraindications J. RESPIRATORY