Passing the USMLE: Clinical Knowledge PDF
Preview Passing the USMLE: Clinical Knowledge
Passing the USMLE: Clinical Knowledge Passing the USMLE Clinical Knowledge Ahmad Wagih Abdel-Halim, MD 1 3 AhmadWagihAbdel-Halim,M.D. AcademichospitalistandInternalmedicine faculty,McLarenRegionalMedicalCenter, Michigan;Clinicalinstructorofinternal medicine,MichiganStateUniversity(MSU) Collegeofhumanmedicine,Lansing, Michigan,USA [email protected] EditorsandFacultyReviewers JamiL.Foreback,M.D.,Ph.D. TrevorBanka,M.D. InternalMedicineFaculty HenryFordHospital McLarenRegionalMedicalCenter Detroit,MI48202 MichiganStateUniversity USA EastLansing,MI48823 [email protected] USA [email protected] ISBN:978-0-387-68983-8 e-ISBN:978-0-387-68984-5 DOI:10.1007/978-0-387-68984-5 LibraryofCongressControlNumber:2008936884 #2009SpringerScience+BusinessMedia,LLC Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewrittenpermissionofthepublisher(Springer Science+BusinessMedia,LLC,233SpringStreet,NewYork,NY10013,USA),exceptforbriefexcerptsinconnectionwithreviewsor scholarlyanalysis.Useinconnectionwithanyformofinformationstorageandretrieval,electronicadaptation,computersoftware,orby similarordissimilarmethodologynowknownorhereafterdevelopedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,eveniftheyarenotidentifiedassuch,isnottobe takenasanexpressionofopinionastowhetherornottheyaresubjecttoproprietaryrights. Whiletheadviceandinformationinthisbookarebelievedtobetrueandaccurateatthedateofgoingtopress,neithertheauthorsnorthe editorsnorthepublishercanacceptanylegalresponsibilityforanyerrorsoromissionsthatmaybemade.Thepublishermakesnowarranty, expressorimplied,withrespecttothematerialcontainedherein. Printedonacid-freepaper springer.com Preface Clinicalmedicalscienceisanoceanofinformation.Agoodphysicianisonewhocan successfully figure out in which direction to swim when he faces a difficult medical problem. Acquiring that skill requires a strong grip on the basic facts behind each pathology,itsmostcommonpresentation,whattolookforduringexamination,and thebestwaytodiagnosethepathologyandtreatyourpatient. PreparingfortheUSMLEisadauntingandtime-consumingtask,andtheexamisa difficult experience for most examinees. For many years, USMLE examinees have longedforasinglesourcetopreparefortheexamthatcouldprovidethemwithallthe necessary details in just one concise book. This single source would be rich with information,figuresandtables,yetbeeasytomemorize. Thisbookservesasarefresheronbasicmedicalsciencefactsandhowbesttoapply these facts to the major specialties of clinical medicine. Enriched with key words, tables, figures and diagrams, this text will eliminate the need for any other books during your preparation for the USMLE. Simple vocabulary and straightforward proseensurethattheinformationyoureadwillbeeasilystoredinyourmemoryforthe longest period of time. The ocean of medical information was distilled down to a stream of only the most pertinent, high-yield facts, and the figures were carefully chosentoillustrateimportantconceptsandmaximizelearning. Withthissourceasyourguide,passingtheUSMLEwillbejustanotherstepinyour medicalcareer. MICHIGAN,USA AHMADWAGIHABDEL-HALIM v Acknowledgments Iwouldlike toexpress mygratitudetoeverypersonwhohelped andcontributed to bringthisworktolife.Iwanttothankmymomandmydadfortheirlove,supportand encouragement;withoutthemIwouldhaveneverbeenwhoIamtoday. Iamdeeplyindebtedtoallmyprofessors,colleaguesandeverysinglepersonwhoI haveevermetwhohashelpedaddtomyknowledgeevenwithoneword. Specialthankstomyamazingeditorsfortheirhardwork;itwasapleasureworking withthem. Finally,IammostgratefultoSuzanneStevensforherhelp,supportandforbear- ance,andtoallthestaffatSpringerfortheirsupportandcooperation. MICHIGAN,USA AHMADWAGIHABDEL-HALIM vii Contents Preface.................................................................................................................. v Acknowledgments.............................................................................................. vii 1 InternalMedicine........................................................................................... 1 Endocrinology............................................................................................... 3 PituitaryGland......................................................................................... 3 ThyroidGland.......................................................................................... 4 ParathyroidGland.................................................................................... 6 AdrenalGland.......................................................................................... 7 Pancreas................................................................................................... 8 DiabetesMellitus(DM)............................................................................ 8 Others....................................................................................................... 10 DrugInducedEndocrinalDisorders......................................................... 10 EndocrinalCausesofExcessiveSweating................................................. 10 GastrointestinalSystem................................................................................. 10 MusculatureandNerveSupply................................................................ 10 Digestion.................................................................................................. 10 HormonesandMediators......................................................................... 10 Secretions................................................................................................. 11 Dysphagia................................................................................................. 11 EsophagealVarices................................................................................... 12 Achalasia.................................................................................................. 12 DiffuseEsophagealSpasm....................................................................... 12 PlummerVinsonSyndrome...................................................................... 12 PepticUlcerDisease(PUD)..................................................................... 12 CeliacSprue.............................................................................................. 13 InflammatoryBowelDiseaseIBD............................................................ 13 IrritableBowelSyndrome(IBS)............................................................... 13 Diarrhea................................................................................................... 14 ColonCancer............................................................................................ 15 FamilialAdenomatousPolyposis(FAP).................................................. 15 DiverticularDisease................................................................................. 16 AcutePancreatitis..................................................................................... 16 ChronicPancreatitis................................................................................. 16 PancreaticCancer..................................................................................... 16 Hepatology.................................................................................................... 17 Introduction............................................................................................. 17 Hepatitis................................................................................................... 17 LiverCirrhosis.......................................................................................... 18 HepaticEncephalopathy.......................................................................... 19 SpontaneousBacterialPeritonitis(SBP)................................................... 20 BiliaryCirrhosis........................................................................................ 20 HepatocellularCarcinoma(Hepatoma).................................................... 20 Jaundice.................................................................................................... 20 ix x Contents CongenitalHyperbilirubinemia.................................................................. 20 DrugInducedHepatotoxicity..................................................................... 21 Hematology..................................................................................................... 21 RedBloodCells(RBCs)............................................................................. 21 WhiteBloodCells(WBCs)......................................................................... 21 Platelets...................................................................................................... 22 CoagulationCascade.................................................................................. 23 IronDeficiencyAnemia.............................................................................. 23 MegaloblasticAnemia................................................................................ 24 HemolyticAnemia...................................................................................... 24 AplasticAnemia......................................................................................... 24 Hypersplenism............................................................................................ 24 Thalassemia................................................................................................ 25 SickleCellDisease...................................................................................... 25 Spherocytosis.............................................................................................. 26 G6PDDeficiency........................................................................................ 26 ParoxysmalNocturnalHemoglobinuria(PNH)......................................... 26 Hemophilia................................................................................................. 27 IdiopathicThrombocytopenicPurpura(ITP)............................................. 27 VonWillebrandDisease(VWD)................................................................ 27 DisseminatedIntravascularCoagulopathy(DIC)...................................... 27 AntiphospholipidAntibodySyndrome............................................................ 27 ThromboticThrombocytopenicPurpura(TTP)......................................... 27 MyeloproliferativeDisorders...................................................................... 28 HenochSchonleinPurpura......................................................................... 28 MultipleMyeloma...................................................................................... 29 Leukemia.................................................................................................... 29 Lymphoma................................................................................................. 30 CommonBloodTransfusionReactions...................................................... 31 RenalSystem................................................................................................... 31 Introduction............................................................................................... 31 FluidMeasurements................................................................................... 31 Acid-baseBalance...................................................................................... 31 Electrolytes................................................................................................. 32 NephroticSyndrome.................................................................................. 32 NephriticSyndrome................................................................................... 33 UrinaryTractInfection(UTI).................................................................... 33 InterstitialNephritis................................................................................... 34 PolycysticKidneyDisease(PKD).............................................................. 34 AcuteRenalFailure................................................................................... 34 ChronicKidneyDisease(CKD)................................................................. 34 Nephro-andUretero-Lithiasis................................................................... 35 RenalTubularAcidosis(RTA).................................................................. 35 RenalArteryStenosis(RAS)...................................................................... 35 UrinaryIncontinence.................................................................................. 36 NeurogenicBladder.................................................................................... 36 Drug-InducedNephropathy....................................................................... 36 NephrologyNotes...................................................................................... 36 Rheumatology................................................................................................. 37 RheumatoidArthritis................................................................................. 37 Osteoarthritis.............................................................................................. 38 SystemicLupusErythematosus(SLE)........................................................ 38 PolyarteritisNodosa(P.A.N.).................................................................... 39 AnkylosingSpondylitis............................................................................... 39 Reiter’sSyndrome...................................................................................... 39 Contents xi TemporalArteritis........................................................................................ 39 WegenerGranulomatosis........................................................................ 40 TakayasauDisease.................................................................................. 40 BehcetSyndrome..................................................................................... 40 Dermatomyositis..................................................................................... 40 GoutandPseudogout.............................................................................. 40 Scleroderma............................................................................................. 41 PolymyalgiaRheumatica......................................................................... 41 OsteoporosisandOsteomalacia............................................................... 41 Paget’sDiseaseoftheBone..................................................................... 41 SepticArthritis........................................................................................ 41 Fibromyalgia........................................................................................... 42 CardiovascularSystem................................................................................. 42 Introduction............................................................................................ 42 ElectrocardiogramWaves........................................................................ 42 ActionPotentials..................................................................................... 43 CardiacCycle.......................................................................................... 43 HeartSounds........................................................................................... 43 HeartMurmurs....................................................................................... 43 JugularVeinWaves................................................................................. 43 ImportantEquations............................................................................... 44 Hypertension........................................................................................... 44 CongestiveHeartFailure(CHF)............................................................. 46 Atherosclerosis........................................................................................ 48 MyocardialInfarction............................................................................. 48 Pericarditis............................................................................................... 49 PericardialEffusionandTamponade...................................................... 49 RheumaticFever..................................................................................... 49 Endocarditis............................................................................................ 49 HypertrophicObstructiveCardiomyopathy(HOCM)............................ 50 CoarctationoftheAorta......................................................................... 50 AorticDissection..................................................................................... 50 AorticAneurysm..................................................................................... 51 Arrhythmias............................................................................................ 51 Shock....................................................................................................... 54 Dyslipidemia............................................................................................ 55 Neurology..................................................................................................... 55 CerebralCortex....................................................................................... 55 Alzheimer’sDisease................................................................................. 56 GlioblastomaMultiforme........................................................................ 57 PseudotumorCerebri............................................................................... 57 CavernousSinusThrombosis.................................................................. 57 Meningitis................................................................................................ 57 Meningiomas........................................................................................... 58 Hydrocephalus........................................................................................ 58 Arnold-ChiariMalformation................................................................... 59 CerebrovascularAccident(CVA)............................................................ 59 IntracranialHemorrhage......................................................................... 60 Concussion.............................................................................................. 61 SpinaBifida............................................................................................. 61 Craniopharyngioma................................................................................ 61 CerebellarLesions................................................................................... 61 HypothalamusLesions............................................................................ 61 BasalGangliaLesions............................................................................. 62 MidbrainLesions.................................................................................... 62 xii Contents PontineLesions.......................................................................................... 63 MedullaryLesions...................................................................................... 63 TractsandInjuries...................................................................................... 63 SpinalCordLesions................................................................................... 64 CranialNerves............................................................................................ 65 Seizures....................................................................................................... 68 MuscularDisorders.................................................................................... 69 DiscProlapse.............................................................................................. 69 CarpalTunnelSyndrome........................................................................... 69 Migraine..................................................................................................... 70 NerveInjuries............................................................................................. 70 Ophthalmology........................................................................................... 71 E.N.T.......................................................................................................... 71 ImportantNotesandKeywords................................................................. 71 RespiratorySystem.......................................................................................... 72 ImportantDefinitions................................................................................. 72 PulmonaryFunctionTests(PFTs)............................................................. 72 DeadSpace................................................................................................. 72 RespiratoryMuscles................................................................................... 72 Compliance................................................................................................. 72 Bronchio-Alveolar-PulmonarySystem....................................................... 72 BreathingandGases................................................................................... 73 Asthma....................................................................................................... 73 ChronicObstructivePulmonaryDisease(COPD)...................................... 74 RespiratoryFailure.................................................................................... 74 Pneumothorax............................................................................................ 74 LungCancer............................................................................................... 75 Pneumonia.................................................................................................. 76 Bronchiectasis............................................................................................. 77 PulmonaryEmbolism................................................................................. 77 PleuralDiseases.......................................................................................... 77 InterstitialLungDisease(ILD).................................................................. 78 SilicosisandAsbestosis............................................................................... 78 Sarcoidosis.................................................................................................. 78 Tuberculosis(TB)....................................................................................... 79 SleepApnea................................................................................................ 79 SolitaryLungNodule................................................................................. 79 Cough......................................................................................................... 80 Drug-InducedPulmonaryDiseases............................................................ 80 InfectiousDiseases.......................................................................................... 80 HumanImmunodeficiencyVirus(HIV)..................................................... 80 Rabies......................................................................................................... 81 ClostridiumTetani..................................................................................... 81 ClostridiumDifficile................................................................................... 81 ListeriaMonocytogenes............................................................................. 82 Salmonella.................................................................................................. 82 Rickettsia.................................................................................................... 82 BacillusCereus........................................................................................... 82 CryptococcusNeoformans......................................................................... 82 CoccidiodesImmitis................................................................................... 83 EntamoebaHistolytica............................................................................... 83 GiardiaLamblia......................................................................................... 83 Plasmodium................................................................................................ 83 Miscellaneous............................................................................................. 83 Miscellaneous.................................................................................................. 84
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