3
Concentration and dose-effect relationships (eg, efficacy, potency), types of agonists (eg,
full, partial, inverse) and antagonists and their actions
Individual factors altering pharmacokinetics and pharmacodynamics (eg, age, gender,
disease, tolerance, compliance, body weight, metabolic proficiency,
pharmacogenetics)
Mechanisms of drug adverse effects, overdosage, toxicology
Mechanisms of drug interactions
Signal transduction, including structure/function of all components of signal transduction
pathways such as receptors, ligands (eg, general principles of nitric oxide, autocrine
and paracrine signaling)
Microbial biology
Microbial identification and classification, including principles, microorganism
identification, and non-immunologic laboratory diagnosis
Bacteria
structure (eg, cell walls, composition, appendages, virulence factors, extracellular
products, toxins, mechanism of action of toxins)
processes, replication, and genetics (eg, metabolism, growth, and regulation)
oncogenesis
antibacterial agents (eg, mechanisms of action on organism, toxicity to humans, and
mechanisms of resistance)
Viruses
structure (eg, physical and chemical properties, virulence factors)
processes, replication, and genetics (eg, life cycles, location of virus in latent infection)
oncogenesis
antiviral agents (eg, mechanisms of action on virus, toxicity to humans, and
mechanisms of resistance)
Fungi
structure (eg, cell wall, composition, appendages, virulence factors, extracellular
products, toxins, mechanisms of action of toxins)
processes, replication, and genetics (eg, asexual vs. sexual, metabolism, growth)
antifungal agents (eg, mechanisms of action on fungus, toxicity to humans, and
mechanisms of resistance)
Parasites
structure (eg, appendages, macroscopic features, and virulence factors)
processes, replication, and genetics (eg, life cycles, metabolism, and growth)
oncogenesis
antiparasitic agents (eg, mechanisms of action on parasite, toxicity to humans, and
mechanisms of resistance)
Prions
Normal age-related findings and care of the well patient
Infancy and childhood (0-12 years)
Normal physical changes: linear growth, variations in linear growth,
including
constitutional delay; weight; head circumference; micturition, defecation, primary
incontinence/bedwetting; normal physical examination; screening; sleep;
teething syndrome
Developmental stages: motor; speech; cognitive; psychosocial; anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of
exercise); preventive/travel medicine; risk factors and prevention (eg, guns,
swimming, motor vehicles, car seats); routine vaccinations
4
Adolescence (13-17 years)
Normal physical changes: linear growth, variations in linear growth including
constitutional delay; weight; puberty; normal physical examination; gynecomastia;
autonomy/self-identity; sleep
Developmental stages: cognitive (eg, abstract thought); psychosocial (eg, autonomy, role
confusion, sexual identity); anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of
exercise); preventive/travel medicine; risk factors and prevention (eg, risk-taking
behavior, helmets, safe sex, motor vehicles, seat belts, distractions); routine
vaccinations
Adulthood (18-64 years)
Normal physical changes: weight; normal physical examination; screening; sleep
Developmental stages: cognitive; intimacy vs isolation; anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of
exercise); preventive/travel medicine; risk factors and prevention; routine
vaccinations
Senescence (65 years and older)
Normal physical changes, including normal physical exam for age: weight, height
(spinal compression), skin, bruising; normal physical examination; response to
temperature; micturition, defecation; sleep
Developmental stages: motor; cognitive (eg, benign senescent forgetfulness);
psychosocial; integrity vs despair; retrospection; anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of exercise);
preventive/travel medicine; risk factors and prevention (eg, falls, general medical
condition; polypharmacy, driving, caregiver stress); routine vaccinations
Immune System
Normal processes
Development of cells of the adaptive immune response, including positive and
negative selection during immune development
Structure, production, and function
granulocytes, natural killer cells, macrophages, mast cells, dendritic cells, cell receptors
(eg, complement receptors and toll-like receptors), cytokines, chemokines
T lymphocytes, including T-lymphocyte receptors, accessory molecules (eg, CD3, CD4,
CD8, B7), cell activation and proliferation, cytotoxic T lymphocytes, and memory T
lymphocytes
B lymphocytes and plasma cells, including B-lymphocyte receptors, immunoglobulins, cell
activation and proliferation, including development of antibodies and memory B
lymphocytes
host defense mechanisms, host barriers to infection, mucosal immunity (eg, gut-
associated lymphoid tissue and bronchus-associated lymphoid tissue),
anatomical locations of T and B lymphocytes
Cellular basis of the immune response and immunologic mediators
antigen processing and presentation in the context of MHC I and MHC II molecules (eg,
TAP, beta-2 microglobulin), intracellular pathways, mechanisms by which MHC is
expressed on the surface; including distribution of MHC I and MHC II on different
cells, mechanisms of MHC I and MHC II deficiencies, and the genetics of MHC
regulation of the adaptive immune response (eg, peripheral tolerance, anergy,