Its helpful if you remember some of the fundamental concepts from 3II3 but it's not going to make it or break it if you don't. I actually like this course better than 3II3, I find it a lot more interesting and applicable since it talks more about the patho-immuno side of things.
Yes the exam is cumulative, but again, it's not a regurgitation type of exam, you have to really understand the material in order to synthesize the answer.
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