Family Medicine PDF
Preview Family Medicine
Clinical Sciences Review for Medical Licensure Developed at The University of Oklahoma College of Medicine Ronald S. Krug, Series Editor Suitable Review for: United States Medical Licensing Examination (USMLE), Step 2 Springer New York Berlin Heidelberg Barcelona Budapest Hong Kong London Milan Paris Santa Clara Singapore Tokyo Family Medicine Second Edition Jeffrey G. Hirsch Rita R. Claudet Technical Editor Springer Jeffrey G. Hirsch. M.D. Metro Medical Associates Family Practice Medicine 120 North Robinson First National Center Arcade Oklahoma City. OK 73102 USA Library of Congress Cataloging-in-Publication Data Hirsch. Jeffrey G. Family medicine I Jeffrey G. Hirsch; Rita R. Claudet. technical editor. - 2nd ed. p. cm. - (Oklahoma notes) Includes bibliographical references. ISBN-13: 978-0-387-94638-2 e-ISBN-13: 978-1-4612-4010-5 DOl: 10.1007/978-1-4612-4010-5 1. Family medicine-Outlines. syllabi. etc. I. Title. II. Series. RC59.H55 1996 616-dc20 96-1058 Printed on acid-free paper. © 1996. 1994 Springer-Verlag New York. Inc. All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag New York. Inc., 175 Fifth Avenue, New York. NY 10010. USA). except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use of general descriptive names, trade names, trademarks, etc., in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. While the advice and information in this book is believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied. with respect to the material contained herein. Production managed by Robert Wexler; manufacturing supervised by Joe Quatela. Camera-ready copy prepared by the author. 987654321 Preface to the Oklahoma Notes The intent of the Oklahoma Notes is to provide students with a set of texts that present the basic information of the general medical school curriculum in such a manner that the content is clear, concise and can be readily absorbed. The basic outline format that has made the Oklahoma Notes extremely popular when preparing for standardized examinations has been retained in all the texts. The educational goals for these materials are first to help organize thinking about given categories of information, and second, to present the information in a for mat that assists in learning. The information that students retain best is that which has been repeated often, and has been actively recalled. The outline format has always been used in the Oklahoma Notes because students have reported to us that it allows them to cover subsequent parts of the outline, and use the topic heading as a trigger to recall the information under the heading. They then can uncover the material and ascertain whether they have recalled the information correctly. This second edition of the Clinical Series of the Oklahoma Notes represents a major refinement of the first edition. A number of issues have been addressed to make the texts more efficient, effective and "user friendly." These include: • Correction of technical errors. • Addition of new material that has been reported since the first editions were published. • Standard presentation of materials in all texts to make information more acces sible to the student. • Review questions written in standardized format. These questions reflect the major issues of the sections of the texts. We hope these are helpful to you in your educational progress and preparation for required examinations. Ronald S. Krug, Ph.D. Series Editor Preface Studying for licensure examinations is like eating a twelve course meal: if you try and do it in five minutes, it will make you sick. As you prepare, pace yourself, don't memorize but review, and, most importantly, a few days before the examina tion, try and get some rest. I don't think I've ever heard of a soul who looked forward to this examination, and I can assure you no one has ever walked out saying "What a wonderful experi ence." Think of this ordeal as a rite of passage and try to remember that most of you will make it through. I'd like to thank Dr. Ron Krug for his continued support and guidance, not only in the preparation of this text, but through the years. Additional thanks to Dr. Rita Claudet for continued suggestions and editing of this text. Good luck in your studies and remember what Winston Churchill said, "Never, never, never, give up!" Jeffrey G. Hirsch, M.D. Oklahoma City Contents Preface to the Oklahoma Notes ........... ..... ....... ....................... ........ ....... ........... v Preface ............................................................................................................. vii Chapter 1 Dermatology .............................................................................. 1 Papulosquamous Eruptions .... ................ ..................... .... .... ...... ........ ........ 1 Pyodermas .................................................................................................. 3 Viral Infection ............ .............................. ........ ............................. .... ......... 7 Infestations 7 Dermatitis 8 Vascular Disorders ..................................................................................... 10 Hyperplasia ................................................................................................ 11 Neoplasia, Benign ...................................................................................... 12 Neoplasia, Premalignant ............................................................................ 12 Neoplasia, Malignant ................................................................................. 13 Chapter 2 Ophthalmology .......................................................................... 15 Diseases of the Outer Eye . .... .......... ..................... .... ........ .................. ........ 15 Refractive Errors ....................................................... ,. .... .... ................. ...... 15 Diseases of the Lids ... ............................ ....... ................ .................... .......... 15 Disease of the Conjunctiva .... ...... ........... ............ .... .... ..... ...... .... ........... ...... 16 Disease of the Lens ..... .................................. ................. ............................. 18 Glaucoma .................................................................................................... 19 Disease of the Retina .,. ......... ............ ........... ................. .................. ............ 20 Ocular Tumors 21 Chapter 3 Otorhinolaryngology ............................................................... . 23 Ear ............................................................................................................. . 23 Sinus 28 Nose ........................................................................................................... . 30 Oral Cavity ................................................................................................. . 32 Throat ........................................................................................................ . 35 Larynx 37 Chapter 4 Pulmonary Disease ................................................................... 41 Infections .................................................................................................... 41 Pleural Effusion .......................................................................................... 51 Chronic Obstructive Pulmonary Disease ............... .......... ......... ................ 53 Lung Cancer ...................................................................... ....... ........... ....... 58 Interstitial Lung Disease .......................................... .......... ........................ 59 Pulmonary Embolus ... ........................................................ ........................ 62 Sleep Apnea ................................................................................................ 63 x Contents Chapter 5 Cardiology ................................................................................. 65 Coronary Heart Disease ............................................................................. 65 Hypertension .............................................................................................. 66 Acute Myocardial Infarction ..................................................................... 69 Congestive Heart Failure ........................................................................... 71 Arrhythmias ............................................................................................... 72 Valvular Heart Disease ............................................................................... 81 Infections .................................................................................................... 87 Cardiomyopathy ......................................................................................... 94 Acute Rheumatic Fever ............................... ............................................... 97 Chapter 6 Gastroenterology ....................................................................... 99 Esophagus .................................................................................................. 99 Stomach ...................................................................................................... 101 Small and Large Bowel .............................................................................. 104 Gallbladder ................................................................................................. 110 Liver ............................................................................................................ 112 Pancreas 120 Chapter 7 Nephrology ................................................................................ 125 Glomerular Syndromes .............................................................................. 125 Acute Renal Failure ................................................................................... 127 Chronic Renal Failure 132 Chapter 8 Urology ...................................................................................... 135 Kidney ........................................................................................................ 135 Bladder ....................................................................................................... 140 Urethra 142 Prostate 144 Testicle 148 Chapter 9 Gynecology Including Breast ................................................... 151 Vulva/Vagina .............................................................................................. 151 Cervix ......................................................................................................... 152 Uterus ......................................................................................................... 156 Fallopian Tubes .......................................................................................... 159 Ovary .......................................................................................................... 159 Breast .......................................................................................................... 164 Chapter 10 Obstetrics ................................................................................. 173 Diagnosis of Pregnancy ............................................................................. 173 Initial Prenatal Visit ................................................................................... 173 Interval Screening ...................................................................................... 174 Labor and Delivery ..................................................................................... 176 Apgar Scores .............................................................................................. 177 Chapter 11 Orthopedics/Rheumatology .................................................... 179 Osteomyelitis .............................................................................................. 179 Arthritis .................................................................. ............ .................. ...... 182 Systemic Lupus Erythematosus 186 Chapter 12 Endocrinology/Metabolic .......... .................... ...... ................... 189 Diabetes Mellitus ............................................................................... ......... 189 Contents xi Pituitary Disease ........................................................................................ 191 Thyroid Disease .......................................................................................... 192 Parathyroid Disease ................................................................................... 198 Adrenal Disease ........ ............. ....................... ............................................. 201 Osteoporosis ............................................................................................... 203 Gout ............................................................................................................ 204 Hyperlipoproteinemias 206 Chapter 13 Neurology ............................................................................... . 209 Headaches ................................................................................................. . 209 Seizures 213 Infection 219 Neoplasia ................................................................................................... . 224 Stroke ......................................................................................................... . 226 Parkinson's Disease 233 Alzheimer's Disease 234 Chapter 14 Hematology .............................................................................. 237 Red Blood Cell Disorders ........................................................................... 237 White Blood Cell Disorders .. ........ ...... .............................. ...... .................... 252 Lymphoma .......... .......... ........ ............ ...... ............ ............ .................... ........ 258 Chapter 15 Infectious Disease ................................................................... 261 Pelvic Inflammatory Disease ..................................................................... 261 Syphilis ....................................................................................................... 262 Rocky Mountain Spotted Fever .......................................... ....................... 265 Lyme Disease .............................................................................................. 266 Rubeola .......... ............ ..... ........................... ..................... ........ ........... ......... 267 Mumps ......................................................................................................... 269 Rubella ... .................. .................. ....... ..................... ..................... ....... ......... 269 Varicella-Zoster 270 Infectious Mononucleosis .......................................................................... 272 Acquired Immune Deficiency Syndrome .................................................. 272 Infectious Diarrhea .................................................................................... 276 Self-Assessment Examination 279 Answers ...................................................................................................... 290 To Marilyn and Emanuel, who encouraged me to dream. To Regina, Hannah and Adam, who dream with me.
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