Table Of Contentfor the USMLETM Step 1
FOURTH EDITION
medEssentials_4E.indb 1 8/28/12 7:19 AM
ALSO FROM KAPLAN MEDICAL
Books
USMLE® Step 1 Qbook
Flashcards
USMLE® Diagnostic Test Flashcards:
The 200 Questions You Need to Know for the Exam for Steps 2 & 3
USMLE® Examination Flashcards: The 200 “Most Likely Diagnosis” Questions You Will See on the Exam for Steps 2 & 3
USMLE® Pharmacology and Treatment Flashcards: The 200 Questions You’re Most Likely to See on Steps 1, 2 & 3
USMLE® Physical Findings Flashcards: The 200 Questions You’re Most Likely to See on the Exam
Online
Dr. Conrad Fischer’s Comprehensive Cases
Updated USMLE® Step 3 Qbank
medEssentials_4E.indb 2 8/28/12 7:19 AM
for the USMLETM Step 1
FOURTH EDITION
High-Yield Review for First- and Second-Year Medical Students
USMLE™ is a registered trademark of the Federation of State Medical Boards (FSMB)
of the United States and the National Board of Medical Examiners®(NBME®), neither
of which sponsors or endorses this product.
medEssentials_4E.indb 3 8/28/12 7:19 AM
USMLE® is a registered trademark of the Federation of State Medical Boards (FSMB) of the United States and the
National Board of Medical Examiners® (NBME®), neither of which sponsors or endorses this product.
© 2012 Kaplan, Inc.
Published by Kaplan Publishing, a division of Kaplan, Inc.
395 Hudson Street
New York, NY 10014
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered.
It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional
service. If legal advice or other expert assistance is required, the services of a competent professional should be sought.
All rights reserved under International and Pan-American Copyright Conventions. By Payment of the required fees, you
have been granted the non-exclusive, non-transferable right to access and read the text of this eBook on screen. No part
of this text may be reproduced, transmitted, downloaded, decompiled, reversed engineered, or stored in or introduced
into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now
known or hereinafter invented, without the express written permission of the publisher.
ISBN: 978-1-60978-945-9
Review Book
LEAD AUTHORS/EDITORS
Michael S. Manley, M.D. Leslie D. Manley, Ph.D.
Director, Basic Sciences and Step 1 Curriculum Director, Basic Sciences and Step 1 Curriculum
Kaplan Medical Kaplan Medical
CONTRIBUTORS
Thomas H. Adair, Ph.D. Robert F. Kissling III, M.D.
Professor
Department of Physiology and Biophysics John A. Kriak, Pharm.D.
University of Mississippi Medical Center
President/Chief Clinical Consultant, CAMMCO, LLC
John Barone, M.D.
Mary J. Ruebush, Ph.D.
Anatomic and Clinical Pathologist
Adjunct Professor of Medical Science, retired
Montana State University
Stuart Bentley-Hibbert, M.D., Ph.D.
Microbiology/Immunology Faculty, Kaplan Medical
New York Presbyterian Hospital
Weill Cornell Medical Center
Nancy Standler, M.D., Ph.D.
Department of Pathology
Steven R. Daugherty, Ph.D.
Valley View Medical Center
Director, Education and Testing
Intermountain Healthcare
Kaplan Medical
and
Sam Turco, Ph.D.
Adjunct Professor
Rush Medical College Professor, Department of Biochemistry
University of Kentucky College of Medicine
Douglas E. Fitzovich, Ph.D.
James S. White, Ph.D.
Professor of Physiology
Assistant Professor of Cell Biology
DeBusk College of Osteopathic Medicine
School of Osteopathic Medicine
Lincoln Memorial University
University of Medicine and Dentistry of New Jersey
Adjunct Assistant Professor of Cell and
Beth Forshee, Ph.D.
Developmental Biology
Assistant Professor of Physiology University of Pennsylvania School of Medicine
Lake Erie College of Osteopathic Medicine
Glenn C. Yiu M.D., Ph.D.
Barbara Hansen, Ph.D.
Clinical Fellow in Medicine
Biochemistry Faculty Harvard Medical School
Kaplan Medical
Steven R. Harris, Ph.D
Associate Dean for Academic Affairs
Professor of Pharmacology
University of Pikeville
Kentucky College of Osteopathic Medicine
medEssentials_4E.indb 5 8/28/12 7:19 AM
medEssentials_4E.indb 6 8/28/12 7:19 AM
Contents
(A more comprehensive list appears on the first page of each chapter.)
How to Use medEssentials.........................................................ix
Preface.......................................................................xiii
SECTION I: GENERAL PRINCIPLES
Chapter 1: Behavioral Science.................................................3
Chapter 2: Biochemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Chapter 3: Molecular Biology, Genetics, and Cell Biology ...........................59
Chapter 4: Immunology......................................................87
Chapter 5: Microbiology .................................................... 111
Chapter 6: Embryology.....................................................141
Chapter 7: Physiology......................................................147
Chapter 8: Pathology ......................................................153
Chapter 9: Pharmacology/Therapeutics........................................165
SECTION II: ORGAN SYSTEMS
Chapter 1: The Nervous System..............................................183
Development of the Nervous System .....................................184
Peripheral Nervous System.............................................186
Meninges, Ventricular System, and Venous Drainage ........................195
Neurohistology and Pathologic Correlates .................................198
Spinal Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Cranial Nerves and Brain Stem..........................................204
Visual System .......................................................206
Brain Stem Lesions...................................................212
Cerebellum .........................................................213
Diencephalon .......................................................214
Basal Ganglia .......................................................215
Limbic System.......................................................217
Cerebral Cortex......................................................218
Blood Supply........................................................222
Seizures and Anticonvulsants...........................................224
Opioid Analgesics and Related Drugs.....................................226
Local Anesthetics ....................................................227
General Anesthetics ..................................................228
Chapter 2: The Cardiovascular System ........................................229
Embryology.........................................................230
Anatomy ...........................................................232
Physiology..........................................................237
Pathology ..........................................................254
Pharmacology.......................................................267
vii
medEssentials_4E.indb 7 8/28/12 7:19 AM
Chapter 3: The Respiratory System ...........................................273
Embryology and Histology..............................................274
Gross Anatomy ......................................................275
Physiology..........................................................277
Mechanics of Breathing................................................278
Gas Exchange.......................................................282
Pathology ..........................................................289
Chapter 4: The Renal and Urinary System......................................299
Embryology and Anatomy..............................................300
Physiology..........................................................302
Pharmacology.......................................................325
Pathology ..........................................................327
Chapter 5: The Gastrointestinal System........................................333
Embryology.........................................................334
Histology ...........................................................335
Gross Anatomy ......................................................337
Physiology..........................................................342
Pathology ..........................................................355
Microbiology ........................................................365
Additional Pharmacology...............................................368
Chapter 6: The Endocrine System ............................................369
Endocrine System....................................................370
Hypothalamus and Pituitary Overview ....................................370
Adrenal Gland.......................................................372
Pancreas...........................................................379
Regulation of Calcium and Phosphate ....................................383
Thyroid ............................................................386
Growth Hormone.....................................................390
Chapter 7: The Reproductive System..........................................393
Reproductive System .................................................394
Male Reproductive System.............................................396
Female Reproductive System...........................................403
Female Reproductive System Pathology ..................................412
Breast Pathology.....................................................416
Genitourinary System Disease ..........................................419
Chapter 8: The Musculoskeletal System, Skin, and Connective Tissue................423
Structure, Function, and Pharmacology of Muscle . . . . . . . . . . . . . . . . . . . . . . . . . . . 424
Head and Neck Embryology and Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428
Upper Extremities and Back ............................................431
Musculoskeletal Disorders .............................................442
Skin...............................................................451
Chapter 9: The Hematologic and Lymphoreticular System..........................459
Hematopoiesis.......................................................460
Hemostasis .........................................................460
Anticlotting Agents....................................................464
Erythropoiesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
Disorders of Red Blood Cells ...........................................465
White Blood Cells ....................................................469
Disorders of Leukocytes ...............................................470
Hematologic Changes Associated with Infectious Disease.....................476
SECTION III: APPENDICES
Appendix A: Essential Equations .............................................479
Appendix B: Standard Laboratory Values.......................................485
Appendix C: Essential Diseases and Findings...................................487
Appendix D: High-Yield Images ..............................................501
Appendix E: Drug List......................................................513
Appendix F: Bacterial and Viral Algorithms......................................533
Index .......................................................................541
viii
medEssentials_4E.indb 8 8/28/12 7:19 AM
How to Use medEssentials
Steven R. Daugherty, Ph.D.
Director, Education and Testing
Kaplan Medical
Doing well on USMLE® Step 1 means mastering over 6,000 different terms, as well as countless
concepts and relationships. To accomplish this, most students focus on brute memorization, trying
to jam into their heads the information they think they will need and then spitting out relevant facts
when exam time comes. This memorization strategy works fairly well for “recall exams,” which
require you to demonstrate that you know a particular, defined set of information.
Unlike most medical school exams, however, the USMLE is a “thinking exam,” requiring you to not
just recognize, but apply, use, and reason with the content you have learned. Questions are drawn
from the broad array of basic science knowledge, and not confined to some explicit subset. To do
well—indeed, simply to pass the USMLE Step 1—you must store up information over weeks and
months and then think intelligently about that material. Sheer memorization will not get you to this
goal. You need a more organized and intelligent approach.
To master the information you will need for Step 1, you must (1) decide what to focus on and (2)
organize it in a way that fosters long-term retention. This means that you have to know what is
important, and then link it together so you can think and reason as you solve the exam questions.
MedEssentials for the USMLE Step 1 was created to help you master this learning process. First, it
distills the mass of material you must master to emphasize the most important concepts and details.
Second, it organizes the material you need to know in a way that facilitates retention and applica-
tion to clinical problems. MedEssentials has already helped thousands gain a better understanding
of the basics of medicine and earn better exam results. In this single volume, we have organized
the high-yield USMLE information with a conscious eye towards fostering the kind of insight and
understanding the current USMLE demands.
DISTILLATION
When you are plowing through the stack of material you need to study for your medical school and won-
dering what really matters, medEssentials will serve as a guide. If it is in this book, you should know it.
The purpose of medEssentials is not to cover everything you need to master, but rather to highlight
and emphasize what matters most. The material included in medEssentials is the most high-yield
content, selected by Kaplan Medical’s best faculty, drawing on their long years of experience prepar-
ing students for the USMLE Step 1. This faculty-selected content is then periodically reviewed by
recent USMLE test-takers and rated in terms of exam relevance.
Be aware that your medical school exams may contain other material not in medEssentials. We urge
you to not neglect that additional content for your medical school exams. But if you are overwhelmed
by the sheer volume of what you have to learn, medEssentials will ensure that you do not lose your
way or neglect what is the most important.
ix
medEssentials_4E.indb 9 8/28/12 7:19 AM
