Lippincott’s Illustrated Review of & Microbiology Immunology B. A. Buxton, PhD Professor Department of Pathology, Microbiology, Immunology, and Forensic Medicine Philadelphia College of Osteopathic Medicine-Georgia Campus Suwanee, GA Lauritz A. Jensen, DA Professor and Chair, Department of Microbiology and Immunology Midwestern University Glendale, AZ Randal K. Gregg, PhD Assistant Professor Department of Pathology, Microbiology, Immunology, and Forensic Medicine Philadelphia College of Osteopathic Medicine-Georgia Campus Suwanee, GA BBuuxxttoonn__FFMM..iinndddd ii 77//33//22000099 88::1155::1155 PPMM Acquisitions Editor: Susan Rhyner Managing Editor: Kelley A. Squazzo Marketing Manager: Jennifer Kuklinski Designer: Doug Smock Compositor: Spi First Edition Copyright © 2010 Lippincott Williams & Wilkins, a Wolters Kluwer business 351 West Camden Street Baltimore, MD 21201 530 Walnut Street Philadelphia, PA 19106 Printed in C&C Offset, China. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their offi cial duties as US government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at permissions@ lww.com, or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Buxton, B. A. (Bonnie A.) Lippincott’s illustrated Q&A review of microbiology and immunology / B.A. Buxton, Lauritz A. Jensen, Randal K. Gregg. — 1st ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-58255-857-8 (alk. paper) 1. Microbiology—Outlines, syllabi, etc. 2. Microbiology—Examinations, questions, etc. 3. Immunology—Outlines, syllabi, etc. 4. Immunology—Examinations, questions, etc. I. Jensen, Lauritz A. II. Gregg, Randal K. III. Title. IV. Title: Illustrated Q&A review of microbiology and immunology. V. Title: Lipppincott’s illustrated Q and A review of microbiology and immunology. [DNLM: 1. Microbiological Phenomena—Examination Questions. 2. Immune System Phenomena—Examination Questions. QW 18.2 B991L 2010] QR62.B89 2010 616.9’041—dc22 2009020547 DISCLAIMER Care has been taken to confi rm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Applica- tion of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord- ance with the current recommendations and practice at the time of publication. 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Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. BBuuxxttoonn__FFMM..iinndddd iiii 77//33//22000099 88::1155::1177 PPMM Dedication This book is dedicated to our mentors who trained us, our students who challenge us, and our families for their constant support. BBuuxxttoonn__FFMM..iinndddd iiiiii 77//33//22000099 88::1155::1188 PPMM BBuuxxttoonn__FFMM..iinndddd iivv 77//33//22000099 88::1155::1188 PPMM Preface Lippincott’s Illustrated Q&A Review of Microbiology and Immunology presents essential concepts of medical microbiology and immunology for students preparing for Step 1 of the United States Medical Licensing Examination (USMLE) and the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). Questions are written in the clinical vignette-style used on these examinations. Clinical v ignette-style questions help develop problem-solving skills by requiring students to integrate a patient’s clinical mani- festations, history, and demographic information with physical exam fi ndings and laboratory data to iden- tify the disease and choose the correct management options. The questions also assess the student’s ability to integrate basic and clinical science in order to solve problems. The questions are written at the level of competence expected of students who perform well on medical licensure examinations. Many questions have accompanying photomicrographs. Complete explanations are provided for the answers, as well as each distracter. Questions are divided by chapter into the following categories: Bacteriol- ogy, Virology, Mycology, Parasitology, Infectious Diseases, Basic Immunology, and Clinical Immunology. The review book is also designed to be used by medical students and allied health students as a com- panion to various microbiology and immunology textbooks. Use of this book will facilitate classroom learning and provide students with an opportunity for self-assessment in these two disciplines. Questions are also presented online. Students can work through the online questions in either “quiz” or “test” mode. B.A. Buxton v BBuuxxttoonn__FFMM..iinndddd vv 77//33//22000099 88::1155::1188 PPMM BBuuxxttoonn__FFMM..iinndddd vvii 77//33//22000099 88::1155::1188 PPMM Reviewers Neal R. Chamberlain, PhD Pete Pelletier Associate Professor Medical Student Department of Microbiology and Immunology University of Utah School of Medicine A.T. Still University of Health Sciences/KCOM Salt Lake City, UT Kirksville, MO Niket Sonpal Michael J. Parmely, PhD Research Intern Professor and Interim Chair Department of Gastroenterology Microbiology, Molecular Genetics, and Brooklyn Queens Health Care Immunology Brooklyn, NY The University of Kansas Lawrence, KS Garrick Tong Resident Olivia Cronin Department of Psychiatry Medical Student University of California, CA Loyola University Chicago-Stritch School of Medicine Nathan Zilbert Chicago, IL Medical Student New York University, NY Sanjeet Patel Medical Student Baylor College of Medicine Houston, TX vii BBuuxxttoonn__FFMM..iinndddd vviiii 77//33//22000099 88::1155::1188 PPMM BBuuxxttoonn__FFMM..iinndddd vviiiiii 77//33//22000099 88::1155::1188 PPMM