Board Basics: An Enhancement to MKSAP 18

421 Pages·2019·14.47 MB·English

by  Virginia Collier

Essential Facts and Strategies for Passing
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Board Basics
®

An Enhancement to MKSAP® 18

This document is licensed for individual use only. Copyright © 2018 American College of Physicians. All rights reserved.

An Enhancement to MKSAP® 18
Board Basics

®

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This document is licensed for individual use only. Copyright © 2018 American College of Physicians. All rights reserved.

ii

Your Last Stop before the Boards

medicine. Remember that Board Basics is not a patient care
resource.

Content Organization

Abbreviations, spelled out in a convenient list at the back of
the book, are used frequently to increase reading efficiency.
Content is organized by topic and in consistent categories,
such as Prevention, Screening, Diagnosis, Treatment, and
Follow-up. Special components have been designed to
enhance learning and recall.

Look for:

· Don’t Be Tricked: Incorrect answers that may masquerade
as correct choices.
· Test Yourself: Abbreviated case histories and answers
found in Board exam questions.
· Study Tables: Key concepts to prepare you for specific
types of questions.
· Yellow highlighting: We applied our own “marker” to call
your attention to important phrases.

Benefits of This Text

For this edition of Board Basics, MKSAP 18 authors reviewed
the latest literature and produced 11 concise text sections and
1200 Board-like multiple-choice questions. Next, the content
was turned over to 13 carefully selected program directors,
instructors, and professors of medicine with expertise in
Board preparation and the subspecialties of internal medicine.
These physicians culled the essential points from MKSAP
18 and added their insights to update the content of Board
Basics. As Editor-in-Chief, I reviewed and distilled the
MKSAP 18 text by eliminating overlap and excessive material
to focus the text as sharply as possible. The end product is
what you have in your hands—the best Board prep tool that
you will find anywhere. We hope you enjoy it and benefit
from your study. Best wishes on your exam.

Virginia U. Collier, MD, MACP, FRCP
Editor-in-Chief
Board Basics

For the fifth consecutive edition of MKSAP, we bring you
Board Basics, the only publication that compiles the essen-
tial facts and strategies for passing the Internal Medicine
Certification and Maintenance of Certification (MOC) exams
into one print book and e-book. We are confident that this
volume will continue to meet your needs.

How to Use Board Basics

The goal of Board Basics is to prepare you for the Boards
after you have completed a systematic review of MKSAP
18 and its more than 1200 multiple-choice questions. We
have combed through the MKSAP 18 content to produce a
concise compilation of only the information that you will
most likely see in the exam. The sections of Board Basics
are organized to mirror those of MKSAP, making it easy for
you to locate information within the
11 MKSAP subspecialty sections to further your learning
on specific topics as you need. Board Basics is not a con-
cise guide to patient care but, rather, an exam preparation
tool to help you quickly recognize the most likely answers
on a multiple-choice exam. Drug dosages are not included
since they are rarely, if ever, tested. You will also see many
sections in which information has been omitted because
it is difficult to test or is otherwise unlikely to appear on
the exam.

Broad differential diagnoses are not provided for most
problems. Instead, Board Basics focuses on the entities that
have the highest probability of appearing on the exam as
the “correct answers.” Critical points that appear on the
exam are often presented here in isolation, stripped of
context that is not relevant to answering a multiple-choice
question. If you review these points shortly before your
exam, you will have the best chance of remembering what
you need to know to do well. Knowing that most Board
questions are prefaced with the words “most likely,” we
have tried to be very directive, skipping important steps
in the patient evaluation. When you see the words “select”
or “choose,” think in terms of selecting or choosing a
particular answer, not an intervention in the practice of

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iii

Board Basics

Nasrollah Ghahramani, MD, MS, FACP1

Professor of Medicine and Public Health Sciences
Vice Chair for Educational Affairs
Interim Chief, Division of Nephrology
Penn State College of Medicine
Hershey, Pennsylvania

Robert G. Kaniecki, MD1

Director, UPMC Headache Center
Chief, Headache Division
Assistant Director, Neurology Residency Training Program
Director, Headache Fellowship Program
Assistant Professor of Neurology
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Gregory A. Masters, MD, FACP1

Principal Investigator, National Cancer Institute Community
Oncology Research Program
Helen F. Graham Cancer Center and Research Institute
Associate Professor of Medicine
Sidney Kimmel Medical College at Thomas Jefferson
University
Philadelphia, Pennsylvania

Brian S. Porter, MD2

Cardiologist
Core Physicians
Exeter, New Hampshire

Benjamin T. Suratt, MD1

Professor of Medicine and Cell and Molecular Biology
Vice Chair of Medicine for Academic Affairs
Associate Chief, Pulmonary and Critical Care Medicine
University of Vermont College of Medicine
Burlington, Vermont

Jennifer M. Weiss, MD, MS1

Assistant Professor of Medicine
Division of Gastroenterology and Hepatology
Department of Medicine
University of Wisconsin School of Medicine and
Public Health
Madison, Wisconsin

Jennifer Wright, MD, FACP1

Assistant Professor of Medicine
Division of General Internal Medicine
University of Washington School of Medicine
Seattle, Washington

Editor-in-Chief

Virginia U. Collier, MD, MACP, FRCP2

Chair Emeritus, Department of Medicine
Christiana Care Health System
Newark, Delaware
Honorary Professor of Medicine
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pennsylvania

Contributors

Victoria E. Burke, MD1

Assistant Professor of Clinical Medicine
Infectious Diseases Fellowship Associate Program
Louisiana State University Health Sciences Center
New Orleans, Louisiana

Aaron J. Calderon, MD, FACP2

Chair, Department of Medicine
Program Director, Internal Medicine Residency
Saint Joseph Hospital
Professor of Clinical Medicine
University of Colorado SOM
Denver, Colorado

Ana M. Cilursu, MD, FACP1

Staff Rheumatologist
Shore Physicians Group
Shore Medical Center
Somers Point, New Jersey

Mark Corriere, MD, FACP2

Clinical Endocrinologist
Maryland Endocrine
Assistant Professor of Medicine
Johns Hopkins School of Medicine
Baltimore, Maryland

Anthony A. Donato, MD, MHPE, FACP1

Associate Program Director, Internal Medicine
Professor of Medicine
Sidney Kimmel Medical College at Thomas Jefferson University
Tower Health Medical Group
Philadelphia, Pennsylvania

Richard S. Eisenstaedt, MD, MACP1

Clinical Professor of Medicine
Thomas Jefferson University
Chair, Department of Medicine
Abington Memorial Hospital
Abington, Pennsylvania

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iv

Consultants

Marta Kokoszynska, MD1

Instructor, Pulmonary and Critical Care Medicine
University of Vermont Larner College of Medicine
Burlington, Vermont

Dhaval Shah, MD, MBBS1

Hematology/Oncology Physician
Helen F. Graham Cancer Center
Newark, Delaware

Board Basics ACP Editorial Staff

Linnea Donnarumma1, Staff Editor
Margaret Wells1, Director, Self-Assessment and Educational
Programs1

Becky Krumm1, Managing Editor, Self-Assessment and
Educational Programs1

ACP Principal Staff

Davoren Chick, MD, FACP2
Senior Vice President, Medical Education

Patrick C. Alguire, MD, FACP2

Senior Vice President Emeritus, Medical Education
MKSAP 18 Editor-in-Chief

Sean McKinney1
Vice President, Medical Education

Margaret Wells1
Director, Self-Assessment and Educational Programs

Becky Krumm1
Managing Editor

Valerie Dangovetsky1
Administrator

Ellen McDonald, PhD1
Senior Staff Editor

Megan Zborowski1
Senior Staff Editor

Jackie Twomey1
Senior Staff Editor

Randy Hendrickson1
Production Administrator/Editor

Julia Nawrocki1
Digital Content Associate/Editor

Linnea Donnarumma1
Staff Editor

Chuck Emig1
Staff Editor

Joysa Winter1
Staff Editor

Kimberly Kerns1
Administrative Coordinator

1. Has no relationships with any entity producing, marketing, reselling, or distributing
health care goods or services consumed by, or used on, patients.

2. Has disclosed relationship(s) with any entity producing, marketing, reselling, or
distributing health care goods or services consumed by, or used on, patients.

Disclosure of Relationships with any entity producing,
marketing, reselling, or distributing health care goods or
services consumed by, or used on, patients.

Patrick C. Alguire, MD, FACP
Royalties
UpToDate

Aaron J. Calderon, MD, FACP
Speakers Bureau
MedStudy
Stock Options/Holdings
Pfizer Inc., Merck, Abbott

Davoren Chick, MD, FACP
Royalties
Wolters Kluwer Publishing
Consultantship
EBSCO Health’s DynaMed Plus
Other: Owner and sole proprietor of Coding 101 LLC;
research consultant (spouse) for Vedanta Biosciences Inc.

Virginia U. Collier, MD, MACP, FRCP
Stock Options/Holdings
Celgene, Pfizer Inc., Merck, Abbott, Johnson & Johnson,
Medtronic plc, Amgen, Roche, Sanofi, Novartis, AbbVie
Inc., Stryker, WellPoint Health Networks

Mark Corriere, MC, USN, FACP
Speakers Bureau
Eli Lilly and Co., Sanofi, AstraZeneca

Brian Porter, MD
Other: Medtronic plc: educational support received to
attend two-day course on pacemaker interrogations,
programming, and implantation

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v

Acknowledgments

The American College of Physicians (ACP) gratefully
acknowledges the special contributions to the develop-
ment and production of the 18th edition of the Medical
Knowledge Self-Assessment Program® (MKSAP® 18) made
by the following people:

Graphic Design: Barry Moshinski (Director, Graphic
Services), Michael Ripca (Graphics Technical
Administrator), and Jennifer Gropper (Graphic Designer).

Production/Systems: Dan Hoffmann (Director, Information
Technology), Scott Hurd (Manager, Content Systems),
Neil Kohl (Senior Architect), and Chris Patterson (Senior
Architect).

MKSAP 18 Digital: Under the direction of Steven Spadt
(Senior Vice President, Technology), the digital version of
MKSAP 18 was developed within the ACP’s Digital Products
and Services Department, led by Brian Sweigard (Director,
Digital Products and Services). Other members of the team
included Dan Barron (Senior Web Application Developer/
Architect), Chris Forrest (Senior Software Developer/Design
Lead), Kathleen Hoover (Senior Web Developer), Kara Regis
(Manager, User Interface Design and Development),
Brad Lord (Senior Web Application Developer), and John
McKnight (Senior Web Developer).

The College also wishes to acknowledge that many other
persons, too numerous to mention, have contributed to the
production of this program. Without their dedicated efforts,
this program would not have been possible.

MKSAP Resource Site
(mksap.acponline.org)

The MKSAP Resource Site (mksap.acponline.org) is a con-
tinually updated site that provides links to MKSAP 18 online
answer sheets for print subscribers; access to MKSAP 18
Digital; Board Basics® e-book access instructions; informa-
tion on Continuing Medical Education (CME), Maintenance
of Certification (MOC), and international Continuing
Professional Development (CPD) and MOC; errata; and
other new information.

Disclosure Policy

It is the policy of the American College of Physicians (ACP)
to ensure balance, independence, objectivity, and scientific
rigor in all of its educational activities. To this end, and con-
sistent with the policies of the ACP and the Accreditation
Council for Continuing Medical Education (ACCME), contrib-
utors to all ACP continuing medical education activities are
required to disclose all relevant financial relationships with
any entity producing, marketing, re-selling, or distributing

health care goods or services consumed by, or used on,
patients. Contributors are required to use generic names
in the discussion of therapeutic options and are required
to identify any unapproved, off-label, or investigative use
of commercial products or devices. Where a trade name is
used, all available trade names for the same product type
are also included. If trade-name products manufactured by
companies with whom contributors have relationships are
discussed, contributors are asked to provide evidence-based
citations in support of the discussion. The information is
reviewed by the committee responsible for producing this
text. If necessary, adjustments to topics or contributors’ roles
in content development are made to balance the discussion.
Further, all readers of this text are asked to evaluate the con-
tent for evidence of commercial bias and send any relevant
comments to