Toronto notes 2015 : comprehensive medical reference and review for the Medical Council of Canada Qualifying Exam part 1 and the United States Medical Licensing Exam step 2 PDF
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2015 Essential Med Notes Comprehensive medical reference and review for the United States Medical Licensing Exam Step 2 and the Medical Council of Canada Qualifying Exam Part I 31st Edition Editors-in-Chief: Justin Hall and Azra Premji Wherever the art of medicine is loved, there is also a love of humanity. – Hippocrates Toronto Notes for Medical Students, Inc. Toronto, Ontario, Canada Thirty-first Edition Copyright © 2015 – Toronto Notes for Medical Students, Inc. Toronto, Ontario, Canada. Typeset and production by Type & Graphics Inc. ISBN 978-1-927363-20-1 (31st ed.) All rights reserved. Printed in Toronto, Ontario, Canada. Essential Med Notes 2015 is provided for the sole use of the purchaser. It is made available on the condition that the information contained herein will not be sold or photocopied. No part of this publication may be used or reproduced in any form or by any means without prior written permission from the publisher. Every effort has been made to obtain permission for all copyrighted material contained herein. Previous editions copyright © 2012 to 2015. Cover design: Ashley Hui and Kateryna Procunier Illustrations: Biomedical Communications, University of Toronto Notice: THIS PUBLICATION HAS NOT BEEN AUTHORED, REVIEWED, OR OTHERWISE SUPPORTED BY THE MEDICAL COUNCIL OF CANADA NOR DOES IT RECEIVE ENDORSEMENT BY THE MEDICAL COUNCIL AS REVIEW MATERIAL FOR THE MCCQE PART I. THIS PUBLICATION HAS NOT BEEN AUTHORED, REVIEWED, OR OTHERWISE SUPPORTED BY THE NATIONAL BOARD OF MEDICAL EXAMINERS U.S.A. NOR DOES IT RECEIVE ENDORSEMENT BY THE NATIONAL BOARD AS REVIEW MATERIAL FOR THE USMLE. The editors of this edition have taken every effort to ensure that the information contained herein is accurate and conforms to the standards accepted at the time of publication. However, due to the constantly changing nature of the medical sciences and the possibility of human error, the reader is encouraged to exercise individual clinical judgement and consult with other sources of information that may become available with continuing research. The authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this textbook, atlas, or software and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. In particular, the reader is advised to check the manufacturer’s insert of all pharmacologic products before administration. FEEDBACK AND ERRATA We are constantly trying to improve the Essential Med Notes and welcome your feedback. If you have found an error in this edition please do not hesitate to contact us. As well, we look forward to receiving any comments regarding any component of the Essential Med Notes package and website. Please send your feedback to: [email protected] Alternatively, send mail to: Toronto Notes for Medical Students Editors-in-Chief c/o The Medical Society 1 King’s College Circle, Room 2260 Toronto, Ontario M5S 1A8 Canada email: [email protected] Tel: 1-416-946-3047 Fax: 1-416-978-8730 Library of Congress Cataloging-in-Publication Data is available upon request 2 Essential Med Notes 2015 Dedicated to all past and present contributors and supporters of Essential Med Notes who have made the production of the 2015 edition possible! E N The Essential Med Notes is dedicated to helping fund many charitable endeavors and medical student initiatives at the University of Toronto’s Faculty of Medicine. Programs that have received Essential Med Notes funding include: Community Affairs Projects Medical School Clubs • Saturday Program for Inner City High School • Books with Wings and Grade 8 students • Women in Medicine • St. Felix Mentorship Program for Inner City children • University of Toronto International Health Program • Parkdale Mentorship Program for Grade 10-12 students • Complementary and Alternative Medicine • WoodGreen Community Centre • Peer Support for Students • Let’s Talk Science • History of Medicine Society • Growing Up Healthy • Faculty of Medicine Yearbook Annual Faculty Showcase Events Scholarships and Bursaries • Bruce Tovee Lecture Series • Nishant Fozdar Memorial Award • Daffydil, in support of the Canadian Cancer Society • Graduating Medical Class Scholarships and Bursaries • Earthtones Benefit Concert • Convocation and Ceremonies Note: Many of you have wondered about the Toronto Notes logo, which is based on the rod of Asclepius, the Greek god of medicine. The rod of Asclepius consists of a single serpent entwined around a staff. This icon symbolizes both rebirth, by way of a snake shedding its skin, and also authority, by way of the staff. In ancient Greek mythology, Asclepius was the son of Apollo and a skilled practitioner of medicine who learned the medical arts from the centaur Chiron. Asclepius’ healing abilities were so great that he was said to be able to bring back people from the dead. These powers displeased the gods, who punished Asclepius by placing him in the sky as the constellation Orphiuchus. The rod of Asclepius is at times confused with the caduceus, or wand, of Hermes, a staff entwined with two serpents and often depicted with wings. The caduceus is often used as a symbol of medicine or medical professionals, but there is little historical basis for this symbolism. As you may have guessed, our logo uses the rod of Asclepius that is modified to also resemble the CN Tower – our way of recognizing the university and community in which we have been privileged to learn the art and science of medicine. Thomas O’Brien, MD Class of 2009 M.D. Program, University of Toronto 3 Essential Med Notes 2015 Preface – From the Editors Dear Readers, As Editors-in-Chief of Essential Med Notes 2015, we University of Toronto Medical Society, charitable are proud to present the current edition. events, and student bursaries and scholarships. First produced in 1985 from a set of study notes The production of this text would not have been drafted by medical students at the University of possible without the commitment, energy, and Toronto, Toronto Notes and its international version, passion of our dedicated team of over 150 students, Essential Med Notes, have grown to be one of the artists, and faculty members at the University of premier study resources for generations of medical Toronto’s Faculty of Medicine as well as numerous graduates in Canada and abroad. This rich history is faculty members at top-ranked U.S. institutions. rooted in our commitment to publish a student-edited, We are grateful for the dedication and significant comprehensive study resource to serve students across contributions of our lead editors: Amin Bahubeshi, clinical rotations and in preparation for the USMLE Jillian Bardsley, Mandeep Pinky Gaidhu, Amanda Step 2 and the Canadian MCCQE Part I. Huynh, Jessica Huynh, Vahagn Karapetyan, Evan Lilly, Khaled Ramadan, and Karim Virani. We would For 30 years, we have remained committed to our also like to thank our Production Managers, Charles original vision. With each successive edition, we He and Ilya Mukovozov, for their hard work and strive to enhance the features of our print and efforts toward making this year’s edition a success. online resources by listening to the feedback of our Our website team has been invaluable in improving users. The focus of Essential Med Notes 2015 is to our online resources to offer our users an enhanced make medical knowledge accessible and retainable electronic experience. We appreciate the creativity by distilling information into high-quality figures, put forth by the Biomedical Communications tables, algorithms, and clinical pearls. This edition artists in conceptualizing and developing numerous of Essential Med Notes offers new and exciting new illustrations as well as the innovative three- changes. We feature a consistent and easy-to-view dimensional cover rendering. We would also like layout across 30 chapters including the new Vascular to acknowledge our partners at Type & Graphics, Surgery chapter. Moreover, we have updated the particularly Enrica Aguilera, for their continued text to reflect current best practice guidelines and guidance in the production of this text. Finally we clinically-relevant advances in medical research. would like to express our deepest gratitude to all As well, the text has been revised to reflect the new previous Editors-in-Chief of Essential Med Notes. DSM-5 clinical guidelines. We are particularly excited to present the new accompanying Essential We hope you find Essential Med Notes to be an Med Notes Handbook. In response to user feedback, indispensable resource. We encourage your feedback the Handbook has been streamlined to provide you and place tremendous importance on making changes with the most essential and up-to-date information based on the user experience. On behalf of the 2015 on clinical scenarios commonly encountered while editorial team, we wish you the best in your studies on the ward, in the clinic, or in the operating room. and hope that you will find Essential Med Notes 2015 Finally, we have enhanced the Essential Med Notes a valuable asset to your success. eBook to include additional high-quality color images for a superior mobile learning experience. Sincerely, Essential Med Notes 2015 is produced by Toronto Notes for Medical Students Inc., a non-for- Justin Hall, MSc, MPH and Azra Premji, MSc, RRT profit organization supporting various medical Editors-in-Chief, Essential Med Notes 2015 student initiatives including community outreach MD Program, University of Toronto programs and medical school clubs through the 4 Essential Med Notes 2015 Acknowledgements We would like to acknowledge the exceptional work of all previous Essential Med Notes and Toronto Notes (formerly MCCQE Notes) Editors-in-Chief and their editorial teams. The 2015 edition of this text was made possible with their contributions. 2014 (30th ed.): Miliana Vojvodic and Ann Young 2013 (29th ed.): Curtis Woodford and Christopher Yao 2012 (28th ed.): Jesse M. Klostranec and David L. Kolin 2011 (27th ed.): Yingming Amy Chen and Christopher Tran 2010 (26th ed.): Simon Baxter and Gordon McSheffrey 2009 (25th ed.): Sagar Dugani and Danica Lam 2008 (24th ed.): Rebecca Colman and Ron Somogyi 2007 (23rd ed.): Marilyn Heng and Joseph Ari Greenwald 2006 (22nd ed.): Carolyn Jane Shiau and Andrew Jonathan Toren 2005 (21st ed.): Blair John Normand Leonard and Jonathan Chi-Wai Yeung 2004 (20th ed.): Andrea Molckovsky and Kashif S. Pirzada 2003 (19th ed.): Prateek Lala and Andrea Waddell 2002 (18th ed.): Neety Panu and Sunny Wong 2001 (17th ed.): Jason Yue and Gagan Ahuja 2000 (16th ed.): Marcus Law and Brian Rotenberg 1999 (15th ed.): Sofia Ahmed and Matthew Cheung 1998 (14th ed.): Marilyn Abraham and M Appleby 1997 (13th ed.): William Harris and Paul Kurdyak 1996 (12th ed.): Michael B. Chang and Laura J. Macnow 1995 (11th ed.): Ann L. Mai and Brian J. Murray 1994 (10th ed.): Kenneth Pace and Peter Ferguson 1993 (9th ed.): Joan Cheng and Russell Goldman 1992 (8th ed.): Gideon Cohen-Nehemia and Shanthi Vasudevan All former Chief Editors from 1991 (7th ed.) to 1985 (1st ed.) 5 Essential Med Notes 2015 Student Contributors Editors-in-Chief Production Managers Clinical Handbook Editors Atlas Editor and Website and Justin Hall Charles He Amin Bahubeshi Medical Imaging Special Ops Azra Premji Ilya Mukovozov Mandeep Pinky Gaidhu Jacob Rullo Vishaal Gupta Copy Editors Associate Editor – BMC Production Fiona Almeida Joanne Jiang Erika Reiser Essential Med Notes Editors Alfred Basilious Alex Leung Christine Tenedero Vahagn Karapetyan Naveen Devasagayam Zack Bordman Evan Lilly Karim Virani Ashley Hui Shawn Chhabra David MacLean David Wang Justin Hall Sabrina Nurmohamed Fanyu Yang Amanda Huynh Ryan Pratt Gary Yang Jessica Huynh Azra Premji PRIMARY AND OTHER SPECIALTIES MEDICINE SURGERY Associate Editors EBM Editor Associate Editors EBM Editor Associate Editors EBM Editor Jillian Bardsley Ilya Mukovozov Amanda Huynh Tina Hu Khaled Ramadan Alexa Bramall Evan Lilly Jessica Huynh Karim Virani Chapter Editors Chapter Editors Chapter Editors Ethical, Legal, and Family Medicine Cardiology and Nephrology General Surgery Otolaryngology Organizational Medicine Nadia Salvo Cardiac Surgery Shayna Bejaimal Hala Muaddi Charnelle Carlos Melanie Bechard Giorgia Tropini Adrianna Douvris Vlad Dragan Maria Querques Joel Davies Christine Desjardins Andrew Xiao Michael Fridman Alisa Loo Lina Roa Laura Kim Gary Yang Anesthesia and Medical Imaging Neurology Gynecology Plastic Surgery Perioperative Medicine Shawn Bailey Endocrinology Ayan Dey Kinsey Lam Mo Sabri Hilary Felice Gurnaam Kasbia Liana Kaufman Louise Guolla Elizabeth Miazga Neil D’Souza Spencer Heffernan Ryan Lo Derek Smith Nardin Samuel Lisa Zhang Monica Yu Rohan Kothari Heather Sawula Pediatrics Respirology Neurosurgery Urology Clinical Pharmacology Julia DiLabio Gastroenterology Kaustubh Bal Mostafa Fatehi Udi Blankstein Tara He David Kodama Nicola Goldberg Justin Chow David Ben-Israel Zachary Longarini Vivian Wang Josip Marcinko Nicole Kraus Eric Grayson Francois Mathieu Allison Yantzi Stephanie Tung Vascular Surgery Dermatology Rheumatology Obstetrics Caleb Zavitz Robin Kaloty Population Health Geriatric Medicine Dylan Kelly Meg Casson Annie Liu and Epidemiology Farah Pabani Lisa Liang Anna Ly Sheila Wang Eva Ouyang Esther Rosenthal Bahar Moghaddam Anna Mackenzie Carla Rosario Emergency Medicine Hematology Ophthalmology Jonathan Hsu Psychiatry Lucy Duan Brian Ballios Caroline O’Shaughnessy Sarah Levitt James England Jeremy Goldfarb Bo Zheng Marty Rotenberg Rebecca Smith Ritesh Gupta Robyn Thom Infectious Diseases Orthopedics Julie Caron Thomas Gregory Lucas Djelic Michel Saccone Sameer Rawal Ian Whatley BMC ILLUSTRATORS Cassandra Cetlin Jean Lin Kateryna Procunier Nicole Clough Man-San Ma Andrew Q Tran Natalie Cormier Derek Ng Marissa Webber Ashley Hui Priya Panchal Jerry Won Erin Kenzie 6 Essential Med Notes 2015 Faculty Contributors, U.S. and Canada All contributing professors have been appointed to universities across the United States or Canada David Adam, MD, FRCPC Maria Cino, HonBSc, MSc, MD, FRCPC Chloe Leon, MD, FRCPC Division of Dermatology Division of Gastroenterology Division of Brain and Therapeutics Department of Medicine University Health Network Department of Psychiatry St. Michael’s Hospital Toronto Western Hospital Centre for Addiction and Mental Health Anne M. R. Agur, BSc, MSc, PhD Isabella Devito, MD, FRCPC Benjamin Levi, MD Division of Anatomy Department of Anesthesia and Director, Burn Wound and Regenerative Department of Surgery Pain Management Medicine Laboratory University of Toronto University Health Network and Division of Plastic and Reconstructive Surgery Mount Sinai Hospital University of Michigan Iqbal Ike K. Ahmed, MD, FRCSC Department of Ophthalmology Mark Freedman, MD, FRCPC Armando Lorenzo, MD, FRCSC and Vision Sciences Department of Emergency Medicine Division of Urology, Department of Surgery Trillium Health Partners Sunnybrook Health Sciences Centre The Hospital for Sick Children Lori Albert, MD, FRCPC Barry J. Goldlist, MD, FRCPC Julia Lowe, MBChB, MMedSci, FRCPC Division of Rheumatology Division of Geriatric Medicine Division of Endocrinology and Metabolism Department of Medicine Department of Medicine Department of Medicine University Health Network University Health Network Sunnybrook Health Sciences Centre Toronto Western Hospital Philip C. Hébert, MA, PhD, MD, FCFPC Catherine L. Mah, MD, FRCPC, PhD Ruby Alvi, MD, CCFP, MHSc Department of Family and Division of Community Health and Humanities Department of Family and Community Medicine Community Medicine and Discipline of Paediatrics University of Toronto Joint Centre for Bioethics Faculty of Medicine Sunnybrook Health Sciences Centre Memorial University of Newfoundland Meyer Balter, MD, FRCPC Division of Clinical Public Health Division of Respiratory Medicine Sender Herschorn, MDCM, FRCSC Dalla Lana School of Public Health Department of Medicine Division of Urology University of Toronto Mount Sinai Hospital Department of Surgery Sunnybrook Health Sciences Centre and Todd Mainprize, MD, FRCSC Nirit Bernhard, MSc, MD, FRCPC Women’s College Hospital Department of Neurosurgery Department of Pediatrics Sunnybrook Health Sciences Centre Hospital for Sick Children Jonathan C. Irish, MD, MSc, FRCSC Department of Otolaryngology - Eric Massicotte, MD, MSc, FRCSC Nikolai A. Bildzukewicz, MD FACS Head and Neck Surgery Department of Neurosurgery Division of Upper GI and General Surgery University Health Network University Health Network Keck School of Medicine Toronto Western Hospital University of Southern California Nasir Jaffer, MD, FRCPC Division of Abdominal Imaging Michael McDonald, MD, FRCPC Matthew Binnie, MD Department of Medical Imaging Division of Cardiology and Division of Respirology Joint Department of Medical Imaging The Multi-Organ Transplant Program University Health Network and University of Toronto Department of Medicine St. Michael’s Hospital University Health Network David Juurlink, BPhm, MD, PhD, FRCPC Toronto General Hospital Michael Blankstein, MD, MSc, FRCSC Division of Clinical Pharmacology Division of Orthopedics & Rehabilitation and Toxicology Heather McDonald-Blumer, MD, MSc, FRCPC The University of Vermont Medical Center Departments of Medicine and Pediatrics Division of Rheumatology Sunnybrook Health Sciences Centre Department of Medicine Andrea Boggild, MSc, MD, FRCPC Mount Sinai Hospital Tropical Disease Unit and Gabor Kandel, MD, FRCPC Division of Infectious Diseases Division of Gastroenterology Adam C. Millar, MD, MScCH University Health Network Department of Medicine Division of Endocrinology and Metabolism Toronto General Hospital St. Michael’s Hospital Department of Medicine Mt. Sinai Hospital Esther Bui, MD, FRCPC Sari L. Kives, MD, FRCSC Division of Neurology and Department of Obstetrics and Gynecology Yvette Miller-Monthrope, MD, FRCPC Division of Obstetrical Medicine St. Michael’s Hospital and Division of Dermatology Department of Medicine The Hospital for Sick Children Department of Medicine Sunnybrook Health Sciences Centre Women’s College Hospital Wai-Ching Lam, MD, FRCSC Susan Burgin, MD Department of Ophthalmology and Azadeh Moaveni, MD, CCFP Division of Dermatology Vision Science Department of Family and Beth Israel Deaconess Medical Center University Health Network Community Medicine Toronto Western Hospital University Health Network Chi-Ming Chow, MDCM, MSc, FRCPC Toronto Western Hospital Division of Cardiology Katherine Layton, MD Department of Medicine Division of Pediatrics Eva Mocarski, MD, FRCSC St. Michael’s Hospital Assistant Medical Director, Children’s National Department of Obstetrics and Gynecology Programs at Peninsula Regional Medical Center St. Michael’s Hospital The George Washington School of Medicine 7 Essential Med Notes 2015 Faculty Contributors, U.S. and Canada Andrew Morris, MD, SM, FRCPC Graham Roche-Nagle, Margaret Thompson, MD, FRCPC, FACMT Division of Infectious Diseases MD, MBA, FRCSI, EBSQ-VASC Department of Emergency Medicine Department of Medicine Division of Vascular Surgery St. Michael’s Hospital and Mount Sinai Hospital University Health Network The Hospital for Sick Children Toronto General Hospital Brian J. Murray, MD, FRCPC, D,ABSM Martina Trinkaus, MD, FRCPC Division of Neurology and Sleep Medicine Gary John Schiller, MD Division of Hematology Department of Medicine Hematological Malignancy/ Department of Medicine Sunnybrook Health Sciences Centre Stem Cell Transplant Unit St. Michael’s Hospital David Geffen School of Medicine Melinda Musgrave, MD, PhD, FRCSC University of California - Los Angeles Herbert P. von Schroeder, MD, MSc, FRCSC Division of Plastic and Reconstructive Surgery Divisions of Orthopedic Surgery and Department of Surgery Fran E. Scott, MD, CCFP, FRCPC, MSc Plastic Surgery St. Michael’s Hospital Division of Epidemiology Department of Surgery Dalla Lana School of Public Health University Health Network Govind Nandakumar, MD, FACS, FASCRS Division of General Surgery Phillip Segal, MD, FRCPC Oshrit Wanono, MD, FRCPC Weill Cornell Medical College New York Division of Endocrinology and Metabolism Division of Child and Adolescent Psychiatry Department of Medicine Department of Psychiatry Sharon Naymark, MD, FRCPC University Health Network Centre for Addiction and Mental Health Department of Pediatrics Toronto General Hospital St. Joseph’s Health Centre Kyle R. Wanzel, MD, MEd, FRCSC Amanda Selk, MD, FRCSC Division of Plastic Surgery Nathaniel Nelms, MD Department of Obstetrics and Gynecology St Joseph’s Health Centre Division of Orthopedics & Rehabilitation Mount Sinai Hospital The University of Vermont Medical Center Richard Ward, MBBS, MRCP, FRCPath Rajiv Shah, MD, MSc, FRCSC Division of Hematology Markku T. Nousiainen, MD, MSc, MEd, FRCSC Department of Obstetrics and Gynecology Department of Medicine Division of Orthopedic Surgery St. Michael’s Hospital University Health Network Department of Surgery Sunnybrook Health Sciences Centre Marisa Sit, MD, FRCSC Alice Wei, MD CM, MSc, FRCSC Holland Orthopedic & Arthritic Centre Department of Ophthalmology Division of General Surgery and Vision Science Department of Surgery Melissa Nutik, MD, CCFP, FCFP University Health Network University Health Network Department of Family and Toronto Western Hospital Community Medicine Gabrielle Weiler, MD, FRCPC Mount Sinai Hospital Sri Sivalingam MD, MSc, FRCSC Department of Pediatrics Center for Endourology & Stone Disease, Children’s Hospital of Eastern Ontario George Oreopoulos, MD, MSc, FRCSC Lerner College of Medicine University of Ottawa Division of Vascular Surgery Glickman Urological & Kidney Institute Department of Surgery Cleveland Clinic Fay Weisberg, MD, FRCSC University Health Network Division of Reproductive Endocrinology Gideon Smith, MD, PhD and Infertility Andrea V. Page, MD, FRCPC Division of Dermatology Department of Obstetrics and Gynecology Division of Infectious Diseases Director of Connective Tissue Diseases Clinic University of Toronto Department of Medicine MGH Dermatology University Health Network Massachusetts General Hospital Michael Wiley, BSc, MSc, PhD Division of Anatomy, Department of Surgery Phillip M. Pierorazio, MD Diana Tamir, MD, FRCPC University of Toronto Department of Urology Department of Anesthesia and James Buchanan Brady Urological Institute Pain Management Anna Woo, MD CM, SM, DABIM, FRCPC Johns Hopkins Medicine University Health Network Division of Cardiology Department of Medicine Susan Poutanen, MD, MPH, FRCPC Darrell Tan, MD, PhD, FRCPC University Health Network Department of Microbiology Division of Infectious Diseases Toronto General Hospital University Health Network and St. Michael’s Hospital Mount Sinai Hospital Jensen Yeung, MD, FRCPC David Tang-Wai, MDCM, FRCPC Division of Dermatology Ramesh Prasad, MBBS, MSc, FRCPC Division of Neurology and Geriatric Medicine Department of Medicine Division of Nephrology Department of Medicine Women’s College Hospital Department of Medicine University Health Network St. Michael’s Hospital Eugene Yu, MD, FRCPC Piero Tartaro, MD, FRCPC Division of Neuroradiology Evan Propst, MD, MSc, FRCSC Division of Gastroenterology Department of Medical Imaging Division of Head and Neck Surgery Department of Medicine University Health Network Department of Otolaryngology Sunnybrook Health Sciences Centre The Hospital for Sick Children Alireza Zahirieh, MD, FRCPC Fernando Teixeira, MD, FRCPC Division of Nephrology Angela Punnett, MD, FRCPC Department of Emergency Medicine Department of Medicine Department of Pediatrics St. Michael’s Hospital Sunnybrook Health Sciences Centre The Hospital for Sick Children 8 Essential Med Notes 2015 Table of Contents Index Abbreviations 1. Common Unit Conversions 2. Commonly Measured Laboratory Values 3. Ethical, Legal, and Organizational Medicine.............................................. ELOAM 4. Anesthesia and Perioperative Medicine ................................................. A 5. Cardiology and Cardiac Surgery....................................................... C 6. Clinical Pharmacology............................................................... CP 7. Dermatology....................................................................... D 8. Emergency Medicine................................................................ ER 9. Endocrinology ..................................................................... E 10. Family Medicine.................................................................... FM 11. Gastroenterology................................................................... G 12. General Surgery.................................................................... GS 13. Geriatric Medicine .................................................................. GM 14. Gynecology ....................................................................... GY 15. Hematology ....................................................................... H 16. Infectious Diseases ................................................................. ID 17. Medical Imaging.................................................................... MI 18. Nephrology........................................................................ NP 19. Neurology......................................................................... N 20. Neurosurgery...................................................................... NS 21. Obstetrics......................................................................... OB 22. Ophthalmology..................................................................... OP 23. Orthopedics ....................................................................... OR 24. Otolaryngology .................................................................... OT 25. Pediatrics ......................................................................... P 26. Plastic Surgery..................................................................... PL 27. Population Health and Epidemiology ................................................... PH 28. Psychiatry......................................................................... PS 29. Respirology ....................................................................... R 30. Rheumatology ..................................................................... RH 31. Urology........................................................................... U 32. Vascular Surgery ................................................................... VS 33. Index 9 Essential Med Notes 2015
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