STEP 1 CONTENT OUTLINE

DR. RAFAEL BARRERA MD, MPH

KAPLAN FACULTY

Those who know their High Yields will probably pass the exam, but those who know their low yields
and high yields will ace the exam (Manage your time wisely).
ANATOMY :
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First Three chapters : Tie in to molecular biology

Thorax: Cardiac Embryology (must watch video)/ Gross Anatomy focus on CT/MRI
Abdomen: Abdominal Embryology, associated to the blood vessels/ Gross CT MRI
Upper Limb: Brachial Plexus and lesions
Lower Limb: Lumbar Plexus and lesions
Head and Neck: Arches, Pouches and Clefts
Neuroanatomy: Tracts and basal ganglia + CT scans:
b.1) Spinal cord: below the pyramids: two tracts run ipsilateral: dorsal columns (proprioception)
and the corticospinal (muscle tone) and one that is contralateral (spinothalamic). No cranial
nerves involved
b.2) Brain Stem: Cranial nerves are involved and these are ipsilateral; to differentiate between
medial and lateral: medial lesions have cranial nerves that are multiples of 2; pyramdis: XII, pons
VI, Midbrain, III; lateral cranial nerves are the rest that are not the ones mentioned. Also about
Lateral lesions, they present with Horners syndrome (Ptosis, Anhidrosis, Miosis).
b.3) Cortex: Irrigated by the ACA: think of the contralateral leg, Irrigation by the MCA: think about
issues with the upper limb and problems with speech.

BIOCHEMISTRY:
1. Metabolism: Amino acids, Carbohydrates, Lipids; Know the pathways and enzyme deficiencies
2. Molecular: Replication (DNA), Transcription (RNA), Translation (Protein Synthesis); know all the
different processes and how it integrates with microbiology, Immunology, pharmacology
3. Genetics: Know the pedigrees, Hardy Weinberg and each genetic condition (characteristics)

PHYSIOLOGY:
1. General Principles: Fluids + Electrolytes and Action potential
2. Cardiology: Electric activity of the heart (Action potential, EKG and its links to pharmacology);
Mechanical: (Cardiac Output); Hormonal (Renin, angiotensin/aldosterone) Autonomic regulation (know
your receptors).
3. Pulmonology: Pulmonary Funciton Tests (PFTs), know each part about diffusion, perfusion and
ventilation dynamics and its anatomical components (alveoli, intersticium and blood vessels)
4. Renal: Circulation, Filtration, Reabsorption, and acid base
5. Endocrinology: Feedback inhibition, difference between steroidal and peptide hormones, (If you know
the physiology of endocrinology you will be able to answer, pathology, pharmacology and Internal
Medicine questions in Step 1 and Step 2 CK).
MICROBIOLOGY
1. Know the general characteristics of microbiology: Cell wall, protection (capsules), Toxins, bacterial
genetics, how the organism produces the disease (toxins, production, overgrowth)
2. Know the characteristics of each microorganism: Gram (+) vs. Gram (-); DNA vs. RNA ect.
3. Understand the clinical setting in which the question vignette will be presented over these by
systems, because this is the way it will be asked on the test.
IMMUNOLOGY:
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Know the MHC complex I and II and the cells associated to it (T-Cells, B-Cell, NK ect)
Know the Inmmunoglobulins and Interleukins and its clinical association
Know hypersesensitivies
Know Inmunodeficiencies

PATHOLOGY: Integration of all the sciences

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Cellular Injury: Integration with Biochem, physio, inmuno and pharm

Inflamation: Integration with Biochem, physio, inmuno and pharm
Tissue Repair: Integration with Biochem, physio, inmuno and pharm
Genetic Disorders: Integration with Biochem
Immunopathology: Integration with Imunology
Principles of Neoplasia: Know the protooncogenes
Skin Pathology: Applied Histology, Basal Cell Carcinoma
Red Blood Cell: know your different types of Anemias according to MCV (Micro,Normociti,Mega)
Vascular Pathology: Vasculitis
Respiratory: Know all the different Cancers and the paraneoplastic syndromes

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Renal: Nephrotic vs. Nephritic

GI, pancreas and Liver: Cancers, Chrons vs. Ulcerative colitis,
CNS: Most common tumors
White Blood Cell disorders: Know all the leukemias
Breast: Know the oncogenes related to breast cancer
Skeletal Muscle and Bone Pathology: Know the Cancers associated to this

PHARMACOLOGY: Know the mechanism of action and its adverse effects.

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General Principles: Pharmacodinamics, Pharmacokinetics

Autonomic Pharmacology: Know your receptors
Cardiac Pharamcology: Antyarrythmics and its association with action potentials
Neuropharmacology: Hypnotics (benzos, barbiturites, antypyschotics) know where they act on and
what the adverse effects are.

BEHAVIORAL SCIENCE:
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Know Specificty, Sensistivity and PPV, NPV

Know Relative Risk, Odds Ration
Know types studies
Know the correct ethical situations]
Know substance abuse (intoxication and withdrawal)
Know the DSNIV