Board Basics 4-An Enhancement to MKSAP

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Board Basics
®
An Enhancement

to MKSAP 17®
Essential Facts and Strategies
for Passing the Internal Medicine
Certification and Maintenance
of Certification Examinations
This document is licensed for individual use only. Copyright © 2015 American College of Physicians. All rights reserved.
http://medsouls4you.blogspot.com/
Board Basics
®
An Enhancement to MKSAP 17®
This document is licensed for individual use only. Copyright © 2015 American College of Physicians. All rights reserved.
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Your Last Stop before the Boards
For the fourth consecutive edition of MKSAP, we bring intervention in the practice of medicine. Remember that
you Board Basics, the only publication that compiles Board Basics is not a patient care resource.
the essential facts and strategies for passing the Internal
Medicine Certification and Maintenance of Certification
Content Organization
(MOC) Exam into one print book and e-book. We are con-
fident that this volume will continue to meet your needs. Abbreviations, spelled out in a convenient list at the
A total of 83% of surveyed Board Basics users told us that back of the book, are used frequently to increase reading
the previous edition of Board Basics effectively helped efficiency. Content is organized by topic and in consis-
them prepare for the Certification or MOC exams. Nearly tent categories, such as Prevention, Screening, Diagnosis,
all respondents found this resource to be user-friendly Therapy, and Follow-up. Special components have
and an overwhelming majority—84%—said they would been designed to enhance learning and recall.
recommend it to a colleague. Look for:
· Don’t Be Tricked: Incorrect answers that may masquer-
How to Use Board Basics ade as correct choices.
The goal of Board Basics is to prepare you for the Boards · Test Yourself: Abbreviated case histories and answers
found in Board exam questions.
after you have completed a systematic review of MKSAP
17 and its more than 1200 multiple-choice questions. · Study Tables: Key concepts to prepare you for specific
types of questions.
Once again, we have combed through volumes to produce
a concise compilation of only the information that you will · Yellow highlighting: We applied our own “marker” to call
your attention to important phrases.
most likely see in the exam. And, with this fourth edition,
we have reorganized the sections of Board Basics to mir-
ror those of MKSAP, making it easier for you to locate
Why This Text Makes Sense
information within the 11 MKSAP subspecialty sections to
further your learning on specific topics as you need. Board For this edition of Board Basics, MKSAP 17 authors
Basics is not a concise guide to patient care but, rather, an reviewed the latest literature and produced 11 concise text
exam preparation tool to help you quickly recognize the sections and 1200 Board-like multiple-choice questions.
most likely answers on a multiple-choice exam. Drug Next, the content was turned over to 13 carefully selected
dosages are not included since they are rarely, if ever, program directors, instructors, and professors of medicine
tested. You will also see many sections where information with expertise in Board preparation and the subspecialties
has been omitted because it is difficult to test or is other- of internal medicine. These physicians culled the essential
wise unlikely to appear on the exam. points from MKSAP 17 and added their insights to update
the content of Board Basics.
Broad differential diagnoses are not provided for most
problems. Instead, Board Basics focuses on the enti- Patrick Alguire, MD, FACP, Senior Vice President of the
ties that have the highest probability of appearing on Medical Education Division of the American College of
the exam as the “correct answers.” Critical points that Physicians, served as Editor-in-Chief, reviewing and
appear on the exam are often presented here in isola- distilling the MKSAP 17 text by eliminating overlap and
tion, stripped of context that is not relevant to answering excessive material to focus the text as sharply as possible.
a multiple-choice question. If you review these points The end product is what you have in your hands—the best
shortly before your exam, you will have the best chance Board prep tool that you will find anywhere. We hope you
of remembering what you need to know to do well. enjoy it and benefit from your study. Best wishes on your
Knowing that most Board questions are prefaced with the exam.
words “most likely,” we have tried to be very directive,
skipping important steps in the patient evaluation. When Douglas S. Paauw, MD, MACP
you see the words “select” or “choose,” think in terms of Editor
selecting or choosing a particular answer, not an Board Basics
ii
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Board Basics
Patrick C. Alguire, MD, FACP, Editor-in-Chief2 John P. Flaherty, MD2
Senior Vice President, Medical Education Professor of Medicine
American College of Physicians Associate Chief, Division of Infectious Diseases
Philadelphia, Pennsylvania Northwestern University, Feinberg School of Medicine
Chicago, Illinois
Douglas S. Paauw, MD, MACP, Editor1
Professor of Medicine Nasrollah Ghahramani, MD, MS, FACP1
Director, Medicine Student Programs Associate Professor of Medicine and Public Health Sciences
Rathmann Family Foundation Chair for Patient-Centered Associate Director
Clinical Education Internal Medicine Residency Program
University of Washington Division of Nephrology
Seattle, Washington Penn State College of Medicine
Hershey, Pennsylvania
Contributors Robert Kaniecki, MD1
Assistant Professor of Neurology
James Burke, MD1
Co-Director, Neurology Residency Program
Clinical Associate Professor of Medicine
University of Pittsburgh
Sidney Kimmel Medical College at Thomas Jefferson
Pittsburgh, Pennsylvania
University
Program Director, Fellowship in Cardiovascular Maryann K. Overland, MD1
Disease Assistant Professor
Lankenau Medical Center Associate Program Director, Internal Medicine
Designated Institutional Official for Graduate Medical University of Washington School of Medicine
Education Seattle, Washington
Main Line Health
Brian S. Porter, MD2
Wynnewood, Pennsylvania
Clinical Instructor
Aaron J. Calderon, MD, FACP2 Section of Cardiology
Chairman, Department of Medicine Department of Medicine
Program Director, Internal Medicine Residency Dartmouth-Hitchcock Medical Center
St. Joseph Hospital Lebanon, New Hampshire
Professor of Clinical Medicine
Benjamin T. Suratt, MD1
University of Colorado SOM
Associate Chief, Pulmonary and Critical Care Medicine
Denver, Colorado
Professor of Medicine and Cell & Molecular Biology
Ana M. Cilursu, MD, FACP1 University of Vermont College of Medicine
Staff Rheumatologist Burlington, Vermont
Shore Physicians Group
Abraham Thomas, MD, MPH, FACP1
Somers Point, New Jersey
Senior Vice-President and Chairman of Medicine
Galloway, New Jersey
NYU Lutheran
Anthony A. Donato, MD, MHPE1 Brooklyn, New York
Associate Program Director, Internal Medicine
Jennifer M. Weiss, MD, MS1
Reading Health System
Assistant Professor
Clinical Associate Professor of Medicine
Division of Gastroenterology and Hepatology
Sidney Kimmel Medical College at Thomas Jefferson
Department of Medicine
University
University of Wisconsin School of Medicine and Public Health
West Reading, Pennsylvania
Madison, Wisconsin
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Ted Wun, MD2 Julia Nawrocki1
Professor and Associate Dean (Research) Staff Editor
Chief, Division of Hematology Oncology
Kimberly Kerns1
UC Davis School of Medicine
Administrative Coordinator
Sacramento, California
Rosemarie Houton1
Administrative Representative
Board Basics ACP Editorial Staff
Susan Galeone1, Staff Editor
1. Has no relationships with any entity producing, marketing, reselling, or distributing
Margaret Wells1, Director, Self-Assessment and Educational health care goods or services consumed by, or used on, patients.
Programs 2. Has disclosed relationship(s) with any entity producing, marketing, reselling, or
distributing health care goods or services consumed by, or used on, patients.
Becky Krumm1, Managing Editor
Disclosure of Relationships with any entity producing,
ACP Principal Staff marketing, reselling, or distributing health care goods or
services consumed by, or used on, patients.
Patrick C. Alguire, MD, FACP2
Senior Vice President, Medical Education Patrick C. Alguire, MD, FACP
Consultantship
Sean McKinney1
National Board of Medical Examiners
Vice President, Medical Education
Royalties
Margaret Wells1 UpToDate
Director, Self-Assessment and Educational Programs Stock Options/Holdings
Amgen, Bristol-Myers Squibb, GlaxoSmithKline, Stryker
Philip A. Masters, MD, FACP1
Corporation, Zimmer, Teva Pharmaceutical Industries,
Director, Clinical Content Development
Medtronic, Covidien, Express Scripts
Senior Physician Educator
Aaron J. Calderon, MD, FACP
Cynthia D. Smith, MD, FACP2
Speakers Bureau
Director, Clinical Program Development
MedStudy
Senior Physician Educator
Stock Options/Holdings
Becky Krumm1 Pfizer, Merck, Abbott, Medtronic
Managing Editor
John Flaherty, MD
Katie Idell1 Board Member
Manager, Clinical Skills and Digital Programs Alliance of Academic Internal Medicine
Consultantship
Valerie A. Dangovetsky1
CVS Caremark
Administrator
Brian Porter, MD
Ellen McDonald, PhD1
Employment
Senior Staff Editor
University of Washington
Megan Zborowski1
Cynthia D. Smith, MD, FACP
Senior Staff Editor
Stock Options/Holdings
Randy Hendrickson1 Merck and Co.; spousal employment at Merck
Production Administrator/Editor
Ted Wun, MD
Linnea Donnarumma1 Other
Staff Editor Committee Memberships: Alliance for Academic Internal
Medicine, American Society of Hematology, Sickle Cell
Susan Galeone1
Adult Provider Network
Staff Editor
Advisory Boards and Steering Committees
Jackie Twomey1 CALLISTO Program (Janssen, Inc.), RESET Study (Pfizer,
Staff Editor Inc.)
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Acknowledgments are required to use generic names in the discussion of
therapeutic options and are required to identify any unap-
The American College of Physicians (ACP) gratefully
proved, off-label, or investigative use of commercial prod-
acknowledges the special contributions to the develop-
ucts or devices. Where a trade name is used, all available
ment and production of the 17th edition of the Medical
trade names for the same product type are also included.
Knowledge Self-Assessment Program® (MKSAP® 17) made
If trade-name products manufactured by companies with
by the following people:
whom contributors have relationships are discussed, con-
Graphic Design: Michael Ripca (Graphics Technical tributors are asked to provide evidence-based citations
Administrator) and WFGD Studio (Graphic Designers). in support of the discussion. The information is reviewed
by the committee responsible for producing this text. If
Production/Systems: Dan Hoffmann (Director, Web
necessary, adjustments to topics or contributors’ roles in
Services & Systems Development), Neil Kohl (Senior
content development are made to balance the discussion.
Architect), Chris Patterson (Senior Architect), and Scott
Further, all readers of this text are asked to evaluate the
Hurd (Manager, Web Projects & CMS Services).
content for evidence of commercial bias and send any rel-
MKSAP 17 Digital: Under the direction of Steven Spadt, Vice evant comments to [email protected] so that
President, Digital Products & Services, the digital version of future decisions about content and contributors can be
MKSAP 17 was developed within the ACP’s Digital Product made in light of this information.
Development Department, led by Brian Sweigard (Director).
Other members of the team included Dan Barron (Senior
Resolution of Conflicts
Web Application Developer/Architect), Chris Forrest (Senior
Software Developer/Design Lead), Kara Kronenwetter To resolve all conflicts of interest and influences of vested
(Senior Web Developer), Brad Lord (Senior Web Application interests, the ACP precluded members of the content-
Developer), John McKnight (Senior Web Developer), and creation committee from deciding on any content issues
Nate Pershall (Senior Web Developer). that involved generic or trade-name products associated
with proprietary entities with which these committee
The College also wishes to acknowledge that many other
members had relationships. In addition, content was
persons, too numerous to mention, have contributed to
based on best evidence and updated clinical care guide-
the production of this program. Without their dedicated
lines, when such evidence and guidelines were available.
efforts, this program would not have been possible.
Contributors’ disclosure information can be found with
the list of contributors’ names and those of ACP principal
MKSAP Resource Site staff listed in the beginning of this book.
(mksap.acponline.org)
The MKSAP Resource Site (mksap.acponline.org) is a Educational Disclaimer
continually updated site that provides links to MKSAP
The editors and publisher of MKSAP 17 recognize that the
17 online answer sheets for print subscribers; the lat-
development of new material offers many opportunities
est details on Continuing Medical Education (CME) and
for error. Despite our best efforts, some errors may persist
Maintenance of Certification (MOC) in the United States,
in print. Drug dosage schedules are, we believe, accurate
Canada, and Australia; errata; and other new information.
and in accordance with current standards. Readers are
advised, however, to ensure that the recommended dos-
Disclosure Policy ages in MKSAP 17 concur with the information provided
in the product information material. This is especially
It is the policy of the American College of Physicians
important in cases of new, infrequently used, or highly
(ACP) to ensure balance, independence, objectivity, and
toxic drugs. Application of the information in MKSAP 17
scientific rigor in all of its educational activities. To this
remains the professional responsibility of the practitioner.
end, and consistent with the policies of the ACP and the
Accreditation Council for Continuing Medical Education The primary purpose of MKSAP 17 is educational.
(ACCME), contributors to all ACP continuing medical Information presented, as well as publications, technologies,
education activities are required to disclose all relevant products, and/or services discussed, is intended to inform
financial relationships with any entity producing, mar- subscribers about the knowledge, techniques, and experi-
keting, re-selling, or distributing health care goods or ences of the contributors. A diversity of professional opinion
services consumed by, or used on, patients. Contributors exists, and the views of the contributors are their own and
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not those of the ACP. Inclusion of any material in the pro- The ACP will consider granting an individual permis-
gram does not constitute endorsement or recommendation sion to reproduce only limited portions of this publi-
by the ACP. The ACP does not warrant the safety, reliability, cation for his or her own exclusive use. Send requests
accuracy, completeness, or usefulness of and disclaims any in writing to MKSAP® Permissions, American College of
and all liability for damages and claims that may result from Physicians, 190 N. Independence Mall West, Philadelphia,
the use of information, publications, technologies, products, PA 19106-1572, or email your request to mksap_editors@
and/or services discussed in this program. acponline.org.
MKSAP 17 ISBN: 978-1-938245-18-3
Publisher’s Information (Board Basics) ISBN: 978-1-938245-44-2
Copyright © 2015 American College of Physicians. Printed in the United States of America.
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Is Against the Law Resource Site at mksap.acponline.org as new information
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Unauthorized reproduction of this publication is unlaw-
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Table of Contents
Cardiovascular Medicine Pityriasis Rosea .................................53
Acute Coronary Syndromes ........................ 1 Acneiform Lesions ..............................53
Chronic Stable Angina ............................6 Dermatophyte and Yeast Infections ................55
Heart Failure ....................................7 Molluscum Contagiosum .........................57
Heart Failure with Preserved Ejection Fraction ........9 Leishmaniasis ..................................58
Dilated Cardiomyopathy. . . . . . . . . . . . . . . . . . . . . . . . . . .9 Herpes Zoster ...................................58
Peripartum Cardiomyopathy ......................10 Scabies ........................................59
Hypertrophic Cardiomyopathy .................... 11 Bedbugs .......................................60
Restrictive Cardiomyopathy ....................... 13 Seborrheic Keratosis .............................60
Palpitations and Syncope ......................... 14 Warts ..........................................60
Heart Block .................................... 15 Actinic Keratosis ................................61
Atrial Fibrillation ................................ 18 Squamous Cell Carcinoma ........................61
Atrial Flutter ...................................20 Basal Cell Carcinoma ............................61
Supraventricular Tachycardia .....................20 Dysplastic Nevi .................................62
Wolff-Parkinson-White Syndrome .................23 Melanoma .....................................62
Ventricular Tachycardia ..........................24 Urticaria .......................................64
Sudden Cardiac Death ...........................26 Drug Allergy ...................................65
Acute Pericarditis ...............................28 Pemphigus Vulgaris and Pemphigoid ...............67
Pericardial Tamponade and Constriction ............29 Erythema Multiforme ............................69
Heart Murmurs ................................. 31 Stevens-Johnson Syndrome/Toxic Epidermal
Necrolysis ......................................69
Rheumatic Fever ................................ 31
Dermatologic Signs of Systemic Disease .............70
Aortic Stenosis ..................................32
Bicuspid Aortic Valve ............................33
Endocrinology and Metabolism
Aortic Regurgitation .............................34
Mitral Stenosis ..................................35 Diabetes Mellitus ................................73
Mitral Regurgitation .............................36 Hyperglycemic Hyperosmolar Syndrome ...........77
Mitral Valve Prolapse .............................37 Diabetic Ketoacidosis ............................ 77
Tricuspid Regurgitation ..........................37 Diabetes Care for Hospitalized Patients .............78
Prosthetic Heart Valves ...........................38 Pregnancy and Diabetes ..........................78
Atrial Septal Defect ..............................38 Hypoglycemia in Patients Without Diabetes .........79
Coarctation of the Aorta ..........................40 Hypopituitarism ................................80
Patent Ductus Arteriosus .........................40 Pituitary Tumors ................................ 81
Patent Foramen Ovale ............................ 41 Diabetes Insipidus ...............................82
Ventricular Septal Defect ......................... 41 Empty Sella Syndrome ...........................83
Infective Endocarditis ............................ 41 Hyperthyroidism ................................83
Thoracic Aortic Aneurysm and Dissection ...........44 Hypothyroidism ................................86
Abdominal Aortic Aneurysm ......................45 Thyroid Nodules ................................87
Aortic Atheroemboli .............................45 Hypercortisolism (Cushing Syndrome) .............89
Peripheral Arterial Disease ........................46 Adrenal Incidentaloma ...........................90
Myxoma .......................................48 Hypoadrenalism (Addison Disease) ................90
Pheochromocytoma .............................92
Dermatology Primary Hyperaldosteronism .....................92
Eczemas .......................................49 Primary Amenorrhea ............................93
Psoriasis ....................................... 51 Secondary Amenorrhea ..........................94
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Polycystic Ovary Syndrome .......................95 Lower GI Bleeding .............................. 137
Infertility ......................................95 Bleeding of Obscure Origin ...................... 137
Male Hypogonadism .............................96
General Internal Medicine
Hyperparathyroidism and Hypercalcemia ...........97
Biostatistics ...................................139
Hypocalcemia ..................................99
Screening and Prevention ....................... 142
Osteoporosis ..................................100
Smoking Cessation ............................. 144
Osteomalacia ..................................102
Alcohol Use Disorder ........................... 145
Vitamin D Deficiency ...........................102
Intimate Partner Violence .......................146
Paget Disease ..................................103
Patient Safety .................................. 147
Gastroenterology and Hepatology Medical Ethics and Professionalism ............... 148
Dysphagia .....................................104 Palliative Care .................................150
Achalasia .....................................104 Chronic Noncancer Pain. . . . . . . . . . . . . . . . . . . . . . . . . 151
Gastroesophageal Reflux Disease .................105 Chronic Cough ................................ 152
Barrett Esophagus ..............................106 Chronic Fatigue ................................ 152
Esophagitis ....................................106 Vertigo ....................................... 153
Peptic Ulcer Disease ............................ 107 Insomnia ..................................... 154
Nonulcer Dyspepsia ............................108 Syncope ...................................... 155
Gastroparesis ..................................109 Musculoskeletal Pain ...........................156
Complications of Bariatric and Gastric Dyslipidemia ..................................160
Surgery .......................................109 Obesity ....................................... 161
Acute Pancreatitis .............................. 110 Male Sexual Dysfunction ........................ 162
Chronic Pancreatitis .............................112 Benign Prostatic Hyperplasia .....................163
Autoimmune Pancreatitis ........................112 Acute Scrotal Pain ..............................163
Acute Diarrhea ................................ 113 Acute Prostatitis ...............................164
Chronic Diarrhea .............................. 113 Female Sexual Dysfunction ......................164
Malabsorption ................................. 114 Breast Cancer Prevention and Screening ...........164
Celiac Disease ................................. 115 Breast Mass ...................................165
Inflammatory Bowel Disease ..................... 116 Cervical Cancer Screening .......................166
Microscopic Colitis ............................. 118 Contraception .................................166
Chronic Constipation ........................... 118 Menopause .................................... 167
Irritable Bowel Syndrome. . . . . . . . . . . . . . . . . . . . . . . . 119 Abnormal Uterine Bleeding ......................168
Diverticular Disease ............................120 Dysmenorrhea .................................169
Mesenteric Ischemia and Ischemic Colitis ..........120 Pelvic Pain ....................................169
Differentiating Cholestatic and Hepatocellular Vaginitis ...................................... 170
Diseases ...................................... 121 Eye Disorders .................................. 171
Hepatitis A .................................... 122 Hearing Loss .................................. 174
Hepatitis B .................................... 122 Otitis Media ................................... 175
Hepatitis C .................................... 124 External Otitis ................................. 175
Alcoholic Hepatitis ............................. 125 Sinusitis ...................................... 176
Autoimmune Hepatitis .......................... 126 Allergic Rhinitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Hemochromatosis .............................. 126 Pharyngitis .................................... 177
Nonalcoholic Fatty Liver Disease .................. 127 Depression .................................... 178
Primary Biliary Cirrhosis ........................ 127 Bipolar Disorder ............................... 179
Primary Sclerosing Cholangitis ................... 128 Generalized Anxiety Disorder ....................180
Cirrhosis ...................................... 129 Social Anxiety Disorder .........................180
Acute Liver Injury and Acute Liver Failure .......... 131 Panic Disorder .................................180
Liver Disease Associated with Pregnancy .......... 133 Somatic Symptom and Related Disorders .......... 181
Gallstones, Acute Cholecystitis, and Cholangitis ..... 133 Posttraumatic Stress Disorder .................... 181
Upper GI Bleeding .............................. 135 Obsessive-Compulsive Disorder .................. 182
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Eating Disorders ............................... 182 Autoimmune Encephalitis .......................220
Schizophrenia .................................183 Cellulitis and Soft Tissue Infection ................220
Attention-Deficit/Hyperactivity Disorder ..........183 Diabetic Foot Infections .........................223
Autism Spectrum Disorders ......................183 Toxic Shock Syndrome ..........................224
Falls ..........................................184 Community-Acquired Pneumonia ................225
Urinary Incontinence ...........................184 Lyme Disease .................................. 227
Chronic Venous Insufficiency ....................185 Babesiosis .....................................228
Pressure Ulcers ................................185 Ehrlichiosis and Anaplasmosis ...................228
Involuntary Weight Loss .........................186 Rocky Mountain Spotted Fever ...................229
Perioperative Medicine .......................... 187 Cystitis .......................................229
Pyelonephritis ................................. 231
Hematology Tuberculosis ................................... 231
Aplastic Anemia and Paroxysmal Nocturnal Mycobacterium avium Complex Infection .........234
Hemoglobinuria ...............................190 Aspergillosis ...................................234
Pure Red Cell Aplasia ........................... 191 Candida Infections .............................235
Neutropenia ................................... 191 Cryptococcal Infection ..........................236
Myelodysplastic Syndromes ...................... 191 Endemic Mycosis ...............................236
Myeloproliferative Neoplasms .................... 192 Chlamydia trachomatis Infection ................237
Eosinophilia and Hypereosinophilic Neisseria gonorrhoeae Infection ..................237
Syndromes ....................................195
Pelvic Inflammatory Disease .....................238
Acute Lymphoblastic Leukemia ..................195
Syphilis .......................................239
Acute Myeloblastic Leukemia ....................195
Herpes Simplex Virus Infection ................... 241
Plasma Cell Dyscrasias ..........................196
Genital Warts ..................................242
Normocytic Anemia ............................199
Osteomyelitis ..................................242
Microcytic Anemia .............................200
Fever of Unknown Origin .......................244
Macrocytic Anemia .............................201
Primary Immunodeficiency ......................245
Hemolytic Anemia .............................202
Complement Deficiency .........................246
Sickle Cell Disease ..............................204
Bioterrorism ...................................246
Thalassemia ...................................206
Smallpox .....................................247
Transfusion Medicine ...........................207
Anthrax ......................................247
Approach to Bleeding Disorders ..................209
Plague ........................................248
Common Acquired Bleeding Disorders ............209
Tularemia .....................................248
Hemophilia ...................................210
Botulism ......................................249
von Willebrand Disease ......................... 211
Viral Hemorrhagic Fever .........................249
Immune Thrombocytopenia ..................... 212
Malaria .......................................249
Thrombotic Thrombocytopenic Purpura–
Hemolytic Uremic Syndrome .................... 213 Leptospirosis ..................................250
Heparin-Induced Thrombocytopenia and Infectious Gastrointestinal Syndromes ............. 251
Thrombosis ................................... 214 Posttransplantation Infections ....................252
Thrombophilia ................................ 214 Catheter-Associated UTIs ........................253
Deep Venous Thrombosis and Pulmonary Hospital-Acquired and Ventilator-Associated
Embolism .....................................216 Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Anemia and Thrombocytopenia in Clostridium difficile Antibiotic-Associated
Pregnancy .................................... 217 Diarrhea ......................................254
Catheter-Related Intravascular Infection ...........254
Infectious Disease HIV Infection ..................................255
Bacterial Meningitis ............................ 218 Pneumocystis jirovecii Pneumonia ................258
Brain Abscess .................................. 219 Toxoplasmosis .................................259
Herpes Simplex Encephalitis ..................... 219 Influenza Virus ................................260
West Nile Neuroinvasive Disease ..................219 Epstein-Barr Virus .............................. 261
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