Epp Study Guide2

7/30/2019 Epp Study Guide2

1/4

1

migr Physician Entrance ExaminationContent Summary

This exam covers the information included in the three (3) sections listed below:

A. Essential basics in biochemistry, genetics, histology, microbiology, pathology,pharmacology and physiology. Applicants taking the exam will be expected to

be able to:

1. Describe the solubility of ionic, polar and neutral compounds in the body fluids.2. Describe chemistry and mathematics involved in water ionization.3. Describe the pH scale and its relation to water ionization.4. Define acids, bases and buffers.5. Describe how buffers protect solutions, such as the body fluids, from changes in

pH.6. Perform calculations involving buffers.7. Identify the physiological buffers and to describe their important chemical and

physiological characteristics.

8. Identify the body fluid compartments.9. Calculate fluid compartment volumes.10.Describe the composition of the body fluids.11.Describe the osmotic properties of the body fluids.12.Perform osmotic calculations.13.Describe the biochemical consequences of the amino acid structures, polarity,

charge and optical activity14.Define the hierarchical structure of proteins: primary secondary, tertiary and

quaternary structure15.Define motifs, domains and supramolecular complex formation and proteomics16.Describe the native structure of proteins and factors affecting the native structure17.Describe denaturation and renaturation18.Describe ligand binding sites and complementary interactions19.Describe the relationship of protein structure studies to drug design rational

drug design20.Describe the structure and function of enzymes enzyme, ribozyme, abzyme,

holoenzyme, apoenzyme, coenzyme, cofactors, vitamins, binding site, active site,induced fit

21.Describe their molecular control mechanisms reversible covalent modification,precursor activation, allosteric control, enzyme induction, enzyme turnover

22.Describe the role of drugs as modifiers of enzyme activities directly and indirectly23.Describe isozymes and the role of serum isozymes as clinical indicators24.Describe isozyme specific drug development and the reasons for it25.Describe simple enzyme kinetics order of reactions, saturation kinetics,

Michaelis Menten kinetics, double reciprocal plot, Km, Vmax, Turnover number,specific activity

26.Describe simple enzyme inhibition competitive, noncompetitive and mixed27.Describe the interdependence of the various metabolic pathways28.Describe the major processes occurring in the fed, hungry and starvation stages29.Describe concepts of caloric nutrition


2/4

2 migr Physician Entrance Examination Content Summary

30.Describe the nature of energy metabolism related hormones and their function31.Describe the effect of energy metabolism dysfunction caused by hormonal

imbalance caused disease states such as diabetes32.Describe the chemiosmotic mechanism of ATP synthesis33.Describe the electron shuttles into the mitochondria34.Describe the mitochondrial respiratory chain components and their role in

oxidative phosphorylation

35.Describe the different respiratory inhibitors, uncouplers and their interaction withdifferent metabolic pathways

36.Describe the role of brown fat mitochondria in thermogenesis37.Describe the results of attempts to use 24-dinitrophenol as a weight loss drug38.Describe the components of DNA and structure of the double helix.39.Describe all steps in the replication of DNA in detail.40.Describe the processes of DNA repair.41.Describe the steps in the process of transcription.42.Describe the components of the translational system.43.Describe the steps in protein synthesis in detail.44.Describe the different types of DNA sequences in the genome.45.Describe the structure of human chromosomes.46.Describe the regulation of eukaryotic transcription, including the roles of histones,

promoters, transcription factors, and other regulatory elements.47.Describe in detail the molecular techniques of cell-based DNA cloning, molecular

hybridization, gene libraries, and the polymerase chain reaction and their uses inmedicine.

48.Describe DNA microarrays and their uses in medicine.49.Define the phases of the mitotic cell cycle and describe the proteins and enzymes

that control the cycle.50.Describe protooncogenes, oncogenes, and tumor suppressor genes and their roles

in the regulation of cell growth and cancer development.

51.Describe the gene mutations in the causation of retinoblastoma and Li-Fraumenisyndrome.52.Describe the DNA damage response pathway and apoptosis.53.Describe the principles of Mendelian genetics and the basic inheritance patterns

of disease.54.Solve the genetic problems based on common inheritance patterns.55.Describe chromosomal terminology, chromosomal groups, and how to prepare a

karyotype.56.Describe the common causes of chromosomal pathology, including aneuploidy,

translocations, and mosaicism.57.Describe the genetic basis and clinical pathology of the major chromosomal

disorders, both autosomal and sex-linked58.Describe the aspects of population genetics discussed, including the HardyWeinberg law, genetic drift, and heterozygote advantage.

59.Describe the phenotypes and the biochemical and molecular abnormalities of theexamples of autosomal dominant, autosomal recessive, and X-linked recessivediseases discussed.


3/4


60.Describe the unusual aspects of atypical inheritance patterns discussed and theexamples given for each.

61.Identify the cellular and noncellular components, function and clinical problemsassociated with each of the systems of the human body.

62.Describe the chemical structure and physiological functions of the extracellularmatrix and especially the basement membrane.

63.Describe the laws of diffusion.64.Describe the role of the cell membrane as a transport barrier.65.List the characteristics of channels and carriers used to transport different solutes

across cell membranes.66.Describe the modifications made to and the cellular processing of secretory

proteins.67.Describe how cells import and process materials from the extracellular fluid.68.Describe the chemical structure, formation, function and maintenance of the

cytoskeleton.69.Describe the etiology, pathogenesis, structural and functional manifestations of

cellular injury and70.adaptation, inflammation and repair, and homodynamic disorders71.Explain/communicate the disease process using language/vocabulary appropriateto both clinicians and patients72.Integrate basic pathological concepts to the environment;73.Describe/discuss pathological classification, staging and behavior of benign and

malignant neoplasm, and discuss/demonstrate the critical relationship of thepathologist to clinical medicine.

74.Identify the different types of signal/receptor coupling.75.Describe the differences in G-proteins - both heterotrimeric and small monomeric

forms.76.List the components of the tyrosine kinase/RAS cascade77.Identify the most well known receptors and their subtypes.78.Identify the second messengers used in physiological systems and the enzymesthat regulate their concentrations.79.Identify the second messengers and the effector proteins that they activate80.Identify the cellular and noncellular components of the 4 basic tissues at the light

microscopic level81.Identify the cellular and noncellular components, function and clinical problems

associated with each of the systems of the human body.82.To define pharmacology, pharmacodynamics and pharmacokinetics.83.To identify the physicochemical characteristics of drug molecules necessary for

selective interaction with specific receptors and formation of drug-receptorcomplexes.

84.To briefly summarize mechanisms of transmembrane signaling and the role ofsecond messengers.85.To relate drug-receptor interactions to the mechanisms of action of drugs.86.To describe mechanisms of cellular desensitization in response to chronic

exposure to an agonist.87.To differentiate between agonists, partial agonists, inverse agonists, and

antagonists.


4/4


88.To quantify and relate the observed effect to drug concentration in the receptorcompartment.

89.To differentiate between graded dose-response curves and quantal dose-responsecurves.

90.To compare and contrast the pharmacokinetic processes of drug absorption,distribution, biotransformation (metabolism) and excretion.

91.To discuss the mechanisms of drug permeation through physiologic barriers to thesite of action.

92.To compare and contrast phase I and phase II biotransformation reactions.93.To describe the mechanisms of renal elimination of drugs and the influence of pH

changes on renal excretion.94.To explain induction and inhibition of metabolic enzymes and transporters and

their relationship to drug interactions and toxicities.95.To recognize the impact of individual genetic variabilities and age, gender, diet,

environmental factors and disease on drug distribution and rates of drugmetabolism and elimination.

96.To apply the pharmacodynamic-pharmacokinetic principles to rational drugdosing and optimization of therapy.

97.To relate nonlinearity in pharmacokinetics due to saturable elimination to thepharmacokinetic parameters and dosing rate changes.98.To calculate clearance, volume of distribution, half-life, time to steady state,

bioavailability, maintenance dose and loading dose.99.To explain the mechanisms of drug interactions and apply them to safe clinical

use of drugs.101. To describe families of medications according to mechanisms of action,

pharmacological effects, therapeutic uses and toxicities.102. Recognize the most frequently encountered microbiological pathogens found in

community and hospital settings.103. Relate the unique microbiologic properties of a given set of pathogens to the

symptoms that they cause.104. Discuss how exposure to pathogens occurs, including their unique relationshipwith the hosts immune defense system.

105. Describe the mechanisms of disease pathogenesis caused by common microbialpathogens.

106. Describe how pathogens are identified in the clinical microbiology laboratory.107. Describe structural and functional differences of skeletal, cardiac and smooth

muscle on a macroscopic, microscopic and molecular level.108. List histological landmarks allowing for the identification of cellular and sub-

cellular structures.

B. Anatomy

C. Clinical cases

Documents

Epp Study Guide2