Additional Information
Book Details
Abstract
The Gunner Goggles Series is the first exam prep resource written by a high-scoring peer group of medical students, ensuring the most practical and efficient study guidance. It organizes topics around the USMLE and NBME content outlines for the required shelf exams and features state-of-the-art Augmented Reality (AR) mobile application to extend learning beyond the book. This innovative series features AR opportunities throughout the text for an integrated print-mobile experience that maximizes learning and test preparation. The Gunner Goggle function allows you to scan pages for integrated AR links, unlocking animations, visuals, and 3D models that clarify complex anatomy, conditions, and concepts in a remarkably effective and unique manner.
Gunner Goggles Series: Medicine is one of seven authoritative exam preparation guides that use cutting-edge AR technology to fully prepare you for the NBME clinical shelf exams, the USMLE Step 2 Clinical Knowledge (CK) exam, and successful clinical rotations.
- Topics are organized around the USMLE and NBME content outlines for specific shelf exams, and information is presented in a highly templated, concise manner.
- The Augmented Reality application allows you to efficiently study and learn using an integrated print-mobile approach. In addition to unlocking animations and other visuals, AR app access also includes additional content, links to provide feedback to the authors, community pages, and more.
- All test topics are covered in just enough detail to help you hone in on key points you must know for exam success.
- Unique! Every disease is described by its stem clues (buzzwords that appear in question stems) and prophylactic measures (PPx), mechanism (MoD), diagnostic tests (Dx) and treatment/management principles (Tx/Mgmt) – the four "Physician Tasks" that the NBME requires students to know about each disease.
- You’ll also get real-world tips for your clinical rotations from your peers – information that won’t show up on the shelf exam but is ideal for maximum impact when on rounds (knowing the prognosis for a specific disease, for example).
- Plus … effective study techniques, sample study schedules, tips and tricks to better retain information learned from review questions, and methods to self-generate mnemonics.
- Edited, written, and crowdsourced by high-performing medical students and residents and reviewed by experts in the field to ensure accuracy, relevancy, and accessibility.
Titles in the Gunner Goggles series:
Family Medicine • Print ISBN: 978-0-323-51034-9 • e-Book ISBN: 978-0-323-52756-9
Medicine • Print ISBN: 978-0-323-51035-6 • e-Book ISBN: 978-0-323-52758-3
Neurology • Print ISBN: 978-0-323-51036-3 • e-Book ISBN: 978-0-323-52760-6
Ob-Gyn • Print ISBN: 978-0-323-51037-0 • e-Book ISBN: 978-0-323-52768-2
Pediatrics • Print ISBN: 978-0-323-51038-7 • e-Book ISBN: 978-0-323-52763-7
Psychiatry • Print ISBN: 978-0-323-51039-4 e-Book ISBN: 978-0-323-52765-1
Surgery • Print ISBN: 978-0-323-51040-0 • e-Book ISBN: 978-0-323-52767-5
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
IFC | ES1 | ||
Gunner Goggles | i | ||
GUNNER GOGGLES:Medicine | iii | ||
Copyright | iv | ||
Gunner Goggles Honors Shelf Review Series | v | ||
Contributors | vi | ||
Acknowledgments | viii | ||
Contents | ix | ||
1 - Introduction | 1 | ||
I. The Gunner’s Guide to a Better Test Score | 1 | ||
II. Augmented Reality: A New Paradigm for Shelf Exam Test Prep | 2 | ||
Presentation | 3 | ||
Evaluation | 3 | ||
Community Engagement | 4 | ||
Augmented Reality Frequently Asked Questions | 4 | ||
III. Study Smart: Mnemonics and Gunner Study Tips | 5 | ||
Understand the Organizing Principle | 5 | ||
Create Effective Mnemonics | 5 | ||
Devise a Study Schedule and Stick to It | 7 | ||
Distinguish Rotation-Knowledge From Shelf-Knowledge | 7 | ||
IV. Intro to the National Board of Medical Examiners Clinical Science Medicine Subject Exam | 8 | ||
2 - General Principles for the Internal Medicine Shelf | 11 | ||
Introduction | 11 | ||
How to Read the Vital Signs and Metabolic Panel | 11 | ||
Hyponatremia | 13 | ||
Hypernatremia | 14 | ||
Hypokalemia | 15 | ||
Hyperkalemia | 15 | ||
How to Read an Electrocardiography | 16 | ||
How to Deal With Bacteria and Antibiotics | 22 | ||
Methicillin-Resistant Staphylococcus aureus | 24 | ||
Pseudomonas | 24 | ||
Enterococcus | 24 | ||
Bacteroides fragilis | 24 | ||
Common Antibiotic Toxicities Tested on the Medicine Shelf | 25 | ||
How to Read a Chest X-Ray | 25 | ||
Biostatics and Epidemiology for the Medicine Shelf | 27 | ||
Medical Ethics for the Medicine Shelf | 31 | ||
Patient With Suicidal Ideation | 31 | ||
Action | 31 | ||
3 - Immunologic Disorders | 49 | ||
Introduction | 49 | ||
Disorders Associated With Immunodeficiency | 50 | ||
Deficiency Primarily of Humoral Immunity | 51 | ||
Common Variable Immunodeficiency | 51 | ||
Hyper-IgM Syndrome | 51 | ||
X-Linked Bruton (Agammaglobulinemia) | 52 | ||
IgA Immunodeficiency | 53 | ||
Deficiency/Dysfunction Primarily of Cell-Mediated Immunity | 53 | ||
22q11.2 Deletion Syndrome (DiGeorge) | 55 | ||
Severe Combined Immunodeficiency Disease | 56 | ||
Wiskott-Aldrich Syndrome | 57 | ||
Complement Deficiency | 57 | ||
Terminal Complement Deficiency | 58 | ||
C1 Esterase Inhibitor Deficiency (Acquired Angioedema) | 58 | ||
Hereditary Angioedema | 59 | ||
Deficiency of Phagocytic Cells and Natural Killer Cells | 59 | ||
Chediak-Higashi Syndrome | 59 | ||
Chronic Granulomatous Disease | 60 | ||
Leukocyte Adhesion Deficiency | 61 | ||
Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome | 61 | ||
Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome | 61 | ||
Immunologically Mediated Disorders | 63 | ||
Adverse Effects of Drugs on the Immune System | 63 | ||
Jarisch-Herxheimer Reaction | 65 | ||
Notes | 67 | ||
4 - Diseases of the Blood and Blood-Forming Organs | 71 | ||
Introduction | 71 | ||
Infections of the Blood | 71 | ||
Bacterial Infections of the Blood | 71 | ||
Infections of Lymphoid Tissue | 75 | ||
Lymphadenitis | 75 | ||
Lymphangitis | 76 | ||
Bubonic Plague (Yersinia pestis) | 76 | ||
Cat Scratch Disease (Bartonella henselae) | 77 | ||
Immunologic and Inflammatory Disorders | 77 | ||
Cryoglobulinemia (Essential Mixed Cryoglobulinemia) | 77 | ||
Autoimmune Hemolytic Anemia | 78 | ||
Paroxysmal Nocturnal Hemoglobinuria | 80 | ||
Thrombotic Thrombocytopenia Purpura | 80 | ||
Hemolytic Uremic Syndrome | 81 | ||
Neoplasms | 81 | ||
Acute Lymphoblastic Leukemia | 82 | ||
Acute Myelogenous Leukemia | 82 | ||
Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia | 83 | ||
Chronic Myelogenous Leukemia | 84 | ||
Hodgkin Lymphoma | 86 | ||
Non-Hodgkin Lymphoma | 87 | ||
Burkitt Lymphoma | 88 | ||
T-cell Lymphoma | 88 | ||
Multiple Myeloma | 89 | ||
Monoclonal Gammopathy of Unknown Significance | 90 | ||
Myelofibrosis | 91 | ||
Myelodysplastic Syndrome | 92 | ||
Waldenstrom Macroglobulinemia (Lymphoplasmacytic Lymphoma) | 92 | ||
Anemia | 93 | ||
Microcytic Anemia | 93 | ||
G6PD Deficiency | 94 | ||
Pyruvate Kinase Deficiency | 95 | ||
Hereditary Spherocytosis | 96 | ||
Hereditary Elliptocytosis (Ovalocytosis) | 97 | ||
Methemoglobinemia | 97 | ||
Sickle Cell Disease | 98 | ||
Sideroblastic Anemia | 99 | ||
Thalassemias | 101 | ||
Anemia from Blood Loss | 102 | ||
Cytopenias | 103 | ||
Aplastic Anemia | 103 | ||
Leukopenia | 103 | ||
Immune Thrombocytopenic Purpura | 104 | ||
Polycythemias | 104 | ||
Polycythemia Vera | 104 | ||
Essential Thrombocythemia (Essential Thrombocytosis) | 105 | ||
Coagulation Disorders | 106 | ||
Hypocoagulable States | 107 | ||
Disseminated Intravascular Coagulation | 108 | ||
Hemophilia A | 109 | ||
Hemophilia B | 109 | ||
Hypofibrinogenemia/Afibrinogenemia (Factor I deficiency) | 110 | ||
Von Willebrand Disease | 110 | ||
Bernard-Soulier Syndrome (Hemorrhagiparous Thrombocytic Dystrophy) | 111 | ||
Glanzmann Thrombasthenia | 111 | ||
Hypercoagulable States | 112 | ||
Heparin-Induced Thrombocytopenia/Thrombosis | 113 | ||
Warfarin-Induced Skin Necrosis | 113 | ||
Homocysteinemia | 114 | ||
Hypoplasminogenemia | 114 | ||
Antithrombin III Deficiency | 115 | ||
Protein C/S Deficiency | 115 | ||
Factor V Leiden | 116 | ||
Antiphospholipid Syndrome (Lupus Anticoagulant, Anticardiolipin) | 116 | ||
Prothrombin G20210A Mutation | 117 | ||
Reactions to Blood Components | 118 | ||
Traumatic, Mechanical, and Vascular Disorders | 118 | ||
Cardiac Valve Hemolysis | 118 | ||
Splenic Rupture/Laceration | 118 | ||
Splenic Infarct | 120 | ||
Splenic Abscess | 120 | ||
Effects/Complications of Splenectomy | 120 | ||
Hypersplenism | 121 | ||
Adverse Effects of Drugs on the Hematologic and Lymphoreticular System | 121 | ||
Notes | 127 | ||
5 - Diseases of the Nervous System and Special Senses | 132 | ||
General Principles for Diseases of the Nervous System and Special Senses | 132 | ||
Infectious, Immunologic, and Inflammatory Disorders | 133 | ||
Acute Bacterial Meningitis | 133 | ||
Acute Viral Meningitis (Aseptic Meningitis) | 135 | ||
Fungal Meningitis | 136 | ||
Spirochetal Meningitis (Neurosyphilis) | 137 | ||
Protozoal/Helminth Meningitis | 138 | ||
Acute Encephalitis | 139 | ||
Subacute Sclerosing Panencephalitis | 139 | ||
Prion Disease | 140 | ||
Opportunistic Central Nervous System Disorders Associated With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome | 141 | ||
Immunologic and Inflammatory Disorders | 141 | ||
Myasthenia Gravis | 142 | ||
Lambert Eaton Syndrome | 143 | ||
Multiple Sclerosis | 144 | ||
Internuclear Ophthalmoplegia | 146 | ||
Optic Neuritis | 146 | ||
Transverse Myelitis | 147 | ||
Central Nervous System Neoplasms | 147 | ||
Malignant | 148 | ||
Glioblastoma Multiforme | 148 | ||
Pilocytic Astrocytoma | 148 | ||
Medulloblastoma | 149 | ||
Primary Central Nervous System Lymphoma | 150 | ||
Metastatic | 150 | ||
Benign | 150 | ||
Meningioma | 150 | ||
Pituitary Adenoma | 151 | ||
Cerebrovascular Disease | 153 | ||
Cerebral Artery Occlusion/Infarction | 153 | ||
Transient Ischemic Attack | 156 | ||
Subarachnoid Hemorrhage (Non-Traumatic) | 157 | ||
Major Artery Stenosis/Dissection | 157 | ||
Carotid Artery Dissection | 158 | ||
Subclavian Steal Syndrome | 158 | ||
Vascular Dementia | 158 | ||
Venous Sinus Thrombosis | 159 | ||
Arterio-Venous Malformation | 159 | ||
Disorders Relating to Spine, Spinal Cord, Spinal Nerve Roots | 160 | ||
Cauda Equina Syndrome | 160 | ||
Conus Medullaris Syndrome | 160 | ||
Spinal Cord Compression | 161 | ||
Spinal Stenosis (Lumbar) | 162 | ||
Spinal Artery Thrombosis/Embolus/Infarct | 162 | ||
Cranial and Peripheral Nerve Disorders | 164 | ||
Cranial Nerve Injuries/Disorders | 164 | ||
Facial Nerve Palsy (Peripheral Type) | 164 | ||
Vestibular Neuritis (CN VIII Disease) | 165 | ||
Peripheral Nerve/Plexus Disorders | 166 | ||
Klumpke’s Palsy (Brachial Plexus Lower Trunk injury) | 166 | ||
Thoracic Outlet Syndrome | 167 | ||
Axillary Neuropathy | 167 | ||
Musculocutaneous Neuropathy | 167 | ||
Radial Neuropathy (“Saturday Night Palsy”) | 167 | ||
Median Neuropathy | 168 | ||
Carpal Tunnel | 168 | ||
Guillain-Barré Syndrome (Acute Inflammatory Demyelinating Polyneuropathy) | 170 | ||
Herpes Zoster (Shingles) | 171 | ||
Neurologic Pain Syndromes | 171 | ||
Trigeminal Neuralgia | 171 | ||
Global Cerebral Dysfunction | 173 | ||
Delirium (State of Acute Confusion) | 173 | ||
Alzheimer Disease | 173 | ||
Frontotemporal Dementia (aka Pick Disease) | 174 | ||
Lewy Body Dementia | 174 | ||
Amyotrophic Lateral Sclerosis and Muscle Diseases | 175 | ||
Amyotrophic Lateral Sclerosis (Motor Neuron Disease) | 175 | ||
Muscular Dystrophy (Duchenne Versus Becker) | 176 | ||
Movement Disorders | 176 | ||
Acute Dystonia | 177 | ||
Essential Tremor | 177 | ||
Huntington Disease | 178 | ||
Parkinson Disease | 179 | ||
Headache | 179 | ||
Migraine | 180 | ||
Tension | 180 | ||
Cluster | 181 | ||
Epilepsy | 181 | ||
Generalized Clonic-Tonic Seizure | 181 | ||
Partial Seizures | 182 | ||
Sleep Disorders | 183 | ||
Cataplexy and Narcolepsy | 183 | ||
Insomnia | 184 | ||
Sleep Terrors | 184 | ||
Rapid Eye Movement Sleep Behavior Disorders | 184 | ||
Restless Leg Syndrome | 185 | ||
Traumatic and Mechanical Disorders of Increased Intracranial Pressure | 185 | ||
Elevated Intracranial Pressure | 186 | ||
Epidural Hematoma | 186 | ||
Subdural Hematoma | 186 | ||
Intraparenchymal Hemorrhage | 187 | ||
TBI (Contusion, Concussion, Post-Concussion Syndrome) | 188 | ||
Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) | 189 | ||
Normal Pressure Hydrocephalus | 189 | ||
Congenital/Genetic Disorders | 190 | ||
Friedreich Ataxia | 191 | ||
Neural Tube Defects | 192 | ||
Sturge-Weber | 192 | ||
Tuberous Sclerosis | 192 | ||
Von Hippel Lindau syndrome | 193 | ||
Neurofibromatosis I (Von Recklinghausen Disease) | 194 | ||
Adverse Effects of Drugs on the Nervous System | 195 | ||
Drug-Induced Meningitis | 195 | ||
Drug-Induced Neuropathy | 195 | ||
Extrapyramidal Adverse Effects | 196 | ||
Neuroleptic Malignant Syndrome | 196 | ||
Notes | 199 | ||
6 - Cardiovascular Disease | 204 | ||
Introduction | 204 | ||
The Heart and Great Vessels | 204 | ||
Ischemic Heart Disease | 205 | ||
Stable Angina | 205 | ||
Unstable Angina | 206 | ||
Non-ST-Elevation Myocardial Infarction | 206 | ||
ST-Elevation Myocardial Infarction | 207 | ||
Prinzmetal Angina (Variant Angina) | 209 | ||
Arrhythmias | 209 | ||
Premature Atrial Contractions/Premature Ventricular Contractions | 209 | ||
Atrial Arrhythmia | 210 | ||
Atrial Fibrillation | 210 | ||
Atrial Flutter | 211 | ||
Multifocal Atrial Tachycardia | 212 | ||
Reentrant Tachycardia | 213 | ||
Ventricular Arrhythmia | 213 | ||
Ventricular Tachycardia | 213 | ||
Ventricular Fibrillation | 214 | ||
Conduction Blocks | 215 | ||
1st Degree Heart Block | 215 | ||
2nd Degree Heart Block | 216 | ||
3rd Degree (Complete) Heart Block | 217 | ||
Bundle Branch Blocks | 217 | ||
Long-QT Syndromes | 219 | ||
Sick Sinus Syndrome | 219 | ||
Wolf-Parkinson-White Syndrome | 220 | ||
Heart Failure | 221 | ||
Congestive Heart Failure | 221 | ||
Systolic Dysfunction (heart failure with reduced ejection fraction/HFrEF) | 221 | ||
High-Output Cardiac Failure | 222 | ||
Valvular Heart Disease | 223 | ||
Aortic Valve Disease | 223 | ||
Aortic Stenosis | 223 | ||
Aortic Regurgitation | 224 | ||
Mitral Valve Disease | 225 | ||
Mitral Stenosis | 225 | ||
Mitral Valve Prolapse | 225 | ||
Mitral Regurgitation | 226 | ||
Tricuspid Valve Disease | 226 | ||
Tricuspid Stenosis | 226 | ||
Tricuspid Regurgitation | 227 | ||
Pulmonic Valve Disease | 227 | ||
Pulmonic Stenosis | 227 | ||
Pulmonic Regurgitation | 228 | ||
Pericardial Disease | 228 | ||
Pericardial Effusion | 228 | ||
Pericarditis | 230 | ||
Acute | 230 | ||
Constrictive | 231 | ||
Endocarditis and Myocarditis | 231 | ||
Endocarditis | 231 | ||
Infectious | 231 | ||
Non-Infectious (marantic endocarditis) | 233 | ||
Myocarditis | 233 | ||
Cardiac Trauma | 234 | ||
Myocardial Contusion | 234 | ||
Myocardial Free Wall Rupture | 234 | ||
Traumatic Aortic Rupture | 235 | ||
Congenital Cardiac Malformations | 235 | ||
Endocardial Cushion Defects | 235 | ||
Ventricular Septal Defect | 235 | ||
Atrial Septal Defect | 237 | ||
Patent Foramen Ovale | 237 | ||
Patent Ductus Arteriosus | 237 | ||
Tetralogy of Fallot (Fig. 6.23) | 237 | ||
Transposition of the Great Vessels (Fig. 6.25) | 238 | ||
Total Anomalous Pulmonary Venous Return | 239 | ||
Truncus Arteriosus | 239 | ||
Tricuspid Atresia | 241 | ||
Cardiac Neoplasms | 241 | ||
Atrial Myxoma | 241 | ||
Hypertension and Hypotension | 241 | ||
Hypotension | 241 | ||
Orthostatic Hypotension | 241 | ||
Carotid Sinus Hypersensitivity | 242 | ||
Hypertension | 242 | ||
Hypertensive Urgency | 243 | ||
Hypertensive Emergency | 243 | ||
Vascular Disease | 245 | ||
Arterial Disease | 245 | ||
Peripheral Artery Disease | 245 | ||
Thromboangiitis Obliterans (Buerger Disease) | 245 | ||
Embolic Disease | 245 | ||
Compartment Syndrome | 246 | ||
Venous Disease | 246 | ||
Deep Vein Thrombosis | 246 | ||
Venous Insufficiency | 247 | ||
Disorders of the Great Vessels | 248 | ||
Aortic Aneurysm | 248 | ||
Aortic Dissection | 248 | ||
Dyslipidemia | 250 | ||
Familial Hypercholesterolemia | 250 | ||
Familial Hyperchylomicronemia (Lipoprotein Lipase Deficiency) | 251 | ||
Familial Hypertriglyceridemia | 251 | ||
Medication Side Effects Involving the Heart | 252 | ||
Cardiotoxic Drugs | 252 | ||
Cocaine—May Cause Coronary Artery Vasospasm and Typical ACS Chest Pain, Diaphoresis, HTN | 252 | ||
QT-prolonging Medications | 252 | ||
Anti-hypertensives | 252 | ||
7 - Diseases of the Respiratory System | 258 | ||
Introduction | 258 | ||
Disorders of the Lung Parenchyma | 258 | ||
Alpha-1 Antitrypsin Deficiency | 258 | ||
Cystic Fibrosis | 259 | ||
Acute Nasopharyngitis (“The Common Cold”) | 261 | ||
Influenza (“The Flu”) | 261 | ||
Sinusitis | 262 | ||
Epiglottitis | 263 | ||
Croup (Laryngotracheobronchitis) | 264 | ||
Acute Laryngitis | 265 | ||
Bacterial Tracheitis | 265 | ||
Streptococcal pharyngitis | 265 | ||
Peritonsillar Abscess | 266 | ||
Allergic Rhinitis | 266 | ||
Infectious, Immunologic, and Inflammatory Disorders of the Lower Airway | 267 | ||
Pneumonia | 267 | ||
Cryptogenic Organizing Pneumonia (formerly bronchiolitis obliterans organizing pneumonia) | 268 | ||
Anthrax | 269 | ||
Bordetella pertussis (Whooping Cough) | 270 | ||
Aspiration Pneumonia/Lung Abscess | 270 | ||
Fungal Infections | 271 | ||
Allergic Bronchopulmonary Aspergillosis | 271 | ||
Histoplasmosis | 271 | ||
Coccidioidomycosis | 272 | ||
Blastomycosis | 273 | ||
Pneumocystis Pneumonia | 273 | ||
Obstructive Airway Disease | 274 | ||
Asthma | 274 | ||
Acute Asthma Management | 275 | ||
Long-Term Asthma Management | 275 | ||
Chronic Obstructive Pulmonary Disease | 276 | ||
Pneumoconioses | 277 | ||
Hypersensitivity Pneumonitis | 277 | ||
Interstitial Lung Disease/Idiopathic Pulmonary Fibrosis | 277 | ||
Benign Neoplasms of Upper Airways | 279 | ||
Vocal Cord Polyps | 279 | ||
Nasal Polyps | 279 | ||
Benign Neoplasms of Lung and Pleura | 280 | ||
Solitary Pulmonary Nodule | 280 | ||
Bronchial Carcinoid Tumor | 281 | ||
Malignant Neoplasms of Upper Airways | 281 | ||
Lip—Squamous Cell Carcinoma (SCC) | 281 | ||
Oral Cavity—Squamous Cell Carcinoma | 283 | ||
Pharynx—Squamous Cell Carcinoma | 283 | ||
Larynx—Squamous Cell Carcinoma | 283 | ||
Malignant Neoplasms of Lower Airway | 283 | ||
Squamous Cell Carcinoma | 283 | ||
Adenocarcinoma | 285 | ||
Large Cell Carcinoma | 285 | ||
Small Cell Carcinoma | 286 | ||
Malignant Neoplasms of Pleura | 287 | ||
Mesothelioma | 287 | ||
Metastasis to Lung | 288 | ||
Respiratory Failure/Respiratory Arrest and Pulmonary Vascular Disorders | 288 | ||
Acute Respiratory Distress Syndrome | 288 | ||
Pulmonary Hypertension | 289 | ||
Pulmonary Arteriovenous Malformations (PAVMs) | 290 | ||
Noncardiogenic Pulmonary Edema | 291 | ||
Cardiogenic Pulmonary Edema | 291 | ||
Pulmonary Embolism | 292 | ||
Air Embolism | 293 | ||
Fat Embolism | 294 | ||
Respiratory Failure Due to Enteral Feeding | 294 | ||
Disorders of the Pleura, Mediastinum, and Chest Wall | 295 | ||
Pleural Effusion | 295 | ||
Chylothorax | 296 | ||
Empyema | 296 | ||
Mediastinitis | 297 | ||
Pleuritis | 298 | ||
Spontaneous Pneumothorax | 298 | ||
Costochondritis | 299 | ||
Traumatic and Mechanical Disorders of Upper Airways | 299 | ||
Epistaxis | 299 | ||
Barotrauma | 300 | ||
Laryngeal/Pharyngeal Obstruction | 300 | ||
Tracheal Stenosis | 301 | ||
Tracheomalacia | 301 | ||
Blunt Tracheal Injury | 302 | ||
Penetrating Neck/Tracheal Injury | 303 | ||
Foreign Body Aspiration (Pharynx, Larynx, and Trachea) | 303 | ||
Septal Perforation | 304 | ||
Traumatic Disorders of Lower Airways and Pleura | 304 | ||
Atelectasis | 304 | ||
Blunt Chest Wall and Diaphragm Injury | 305 | ||
Penetrating Chest Wound | 306 | ||
Traumatic Pneumothorax/Tension Pneumothorax | 307 | ||
Hemothorax | 308 | ||
Pulmonary Contusion | 308 | ||
Pneumomediastinum | 308 | ||
Foreign Body Aspiration (Bronchi and Lungs) | 309 | ||
Upper and Lower Respiratory Tract | 309 | ||
Obstructive Sleep Apnea | 309 | ||
Central Sleep Apnea | 310 | ||
Obesity-Hypoventilation Syndrome | 311 | ||
Congenital Disorders | 311 | ||
Bronchogenic Cysts | 311 | ||
Congenital Diaphragmatic Hernia | 312 | ||
Pulmonary Sequestration | 312 | ||
Immotile Cilia Syndrome/Primary Ciliary Dyskinesia | 313 | ||
Tracheoesophageal Fistula | 314 | ||
8 - Nutritional and Digestive Disorders | 322 | ||
General Signs and Symptoms | 323 | ||
Dysphagia | 323 | ||
Paralytic Ileus | 323 | ||
Impaction | 324 | ||
Intestinal Obstruction/Stricture | 324 | ||
Fecal Incontinence | 325 | ||
Proctitis | 325 | ||
Ascites | 326 | ||
Ischemic Hepatitis | 327 | ||
Jaundice | 327 | ||
Infectious Disorders | 328 | ||
Bacterial | 328 | ||
Pseudomembranous Colitis (Clostridium difficile) | 328 | ||
Enteric Infections | 328 | ||
Staphylococcus aureus | 328 | ||
Escherichia coli | 329 | ||
Listeria monocytogenes | 330 | ||
Yersinia enterocolitica | 331 | ||
Campylobacter spp | 331 | ||
Vibrio cholera | 332 | ||
Salmonella spp | 332 | ||
Shigella spp | 333 | ||
Hepatic Abscess | 333 | ||
Pyogenic | 333 | ||
Amebic Abscess | 334 | ||
Echinococcus | 334 | ||
Peritonitis | 335 | ||
Primary Peritonitis | 335 | ||
Secondary Peritonitis | 336 | ||
Whipple Disease | 336 | ||
Viral Infections of the Gastrointestinal Tract | 337 | ||
Infectious Esophagitis | 337 | ||
Hepatitis A | 337 | ||
Hepatitis B | 338 | ||
Hepatitis C | 338 | ||
Hepatitis D | 339 | ||
Hepatitis E | 340 | ||
Rotavirus Enteritis | 340 | ||
Mumps | 340 | ||
Gingivostomatitis, Herpetic | 341 | ||
Fungal | 341 | ||
Thrush | 341 | ||
Parasitic | 342 | ||
Cryptosporidium | 342 | ||
Cyclospora | 342 | ||
Entamoeba histolytica | 343 | ||
Giardia | 343 | ||
Cystoisospora (isospora) belli | 344 | ||
Strongyloides stercoralis | 344 | ||
Immunologic and Inflammatory Disorders | 345 | ||
Autoimmune Hepatitis | 345 | ||
Celiac Disease | 345 | ||
Eosinophilic Esophagitis | 346 | ||
Inflammatory Bowel Disease | 346 | ||
Crohn Disease | 348 | ||
Ulcerative Colitis | 348 | ||
Microscopic Colitis | 349 | ||
Toxic Megacolon | 349 | ||
Neoplasms | 350 | ||
Benign Neoplasms | 350 | ||
Polyps | 350 | ||
Gastric Polyps | 350 | ||
Small and Large Bowel Polyps | 350 | ||
Oral Leukoplakia | 351 | ||
Oral Cancer | 351 | ||
Squamous Cell Carcinoma | 351 | ||
Salivary Gland Neoplasm | 351 | ||
Barrett Esophagus | 352 | ||
Esophageal Cancer | 352 | ||
Squamous Cell Carcinoma | 352 | ||
Adenocarcinoma | 353 | ||
Gastrinoma and Zollinger-Ellison Syndrome | 353 | ||
Carcinoid Tumors | 354 | ||
Gastrointestinal Stromal Tumors | 354 | ||
Stomach | 355 | ||
Adenocarcinoma | 355 | ||
Gastric Lymphoma | 356 | ||
Colon, Rectum, Anus | 357 | ||
Hereditary Colon Cancer Syndromes | 357 | ||
Familial Adenomatous Polyposis | 357 | ||
Hereditary Nonpolyposis Colon Cancer (Lynch Syndrome) | 357 | ||
Peutz-Jeghers Syndrome (PJS) | 358 | ||
Gardner Syndrome | 359 | ||
MUTYH-Associated Polyposis | 359 | ||
Biliary Tract | 360 | ||
Gallbladder Adenocarcinoma | 360 | ||
Cholangiocarcinoma | 360 | ||
Adenocarcinoma of the Ampulla of Vater | 360 | ||
Liver | 361 | ||
Cavernous Hemangioma | 361 | ||
Focal Nodular Hyperplasia | 361 | ||
Hepatic Adenoma | 362 | ||
Hepatocellular Carcinoma | 362 | ||
Peritoneal Cancer | 363 | ||
Pancreas | 363 | ||
Exocrine Pancreas, Pancreatic Carcinoma | 363 | ||
Signs, Symptoms and Ill-Defined Disorders | 365 | ||
Upper Gastrointestinal Bleeding | 365 | ||
Lower Gastrointestinal Bleeding | 366 | ||
Constipation | 366 | ||
Diarrhea | 366 | ||
Nausea and Vomiting | 367 | ||
Disorders of the Salivary Gland and Esophagus | 368 | ||
Disorders of the Salivary Glands | 368 | ||
Stones | 368 | ||
Sialadenitis | 368 | ||
Suppurative Parotitis | 368 | ||
Esophagus | 369 | ||
Achalasia | 369 | ||
Zenker Diverticulum | 370 | ||
Esophagitis/Esophageal Reflux | 370 | ||
Esophagitis, Pill | 371 | ||
Mallory-Weiss Syndrome | 371 | ||
Paraesophageal (Hiatal) Hernia | 371 | ||
Diffuse Esophageal Spasm | 372 | ||
Disorders of the Stomach, Small Intestine, Colon, Rectum, Anus | 373 | ||
Stomach | 373 | ||
Peptic Ulcer Disease | 373 | ||
Peptic Ulcer Perforation | 374 | ||
Small Intestine and Colon | 375 | ||
Appendicitis | 375 | ||
Angiodysplasia | 375 | ||
Diverticulosis and Diverticulitis | 376 | ||
Hirschsprung Disease | 377 | ||
Irritable Colon/Irritable Bowel Syndrome | 377 | ||
Ischemic Bowel | 378 | ||
Malnutrition | 378 | ||
Malabsorption | 379 | ||
Dumping Syndrome | 380 | ||
Lactose Intolerance | 380 | ||
Short Bowel Syndrome | 380 | ||
Rectum and Anus | 381 | ||
Abscess of Anal and Rectal Regions | 381 | ||
Anorectal Fistula | 382 | ||
Anal Fissure | 382 | ||
Hemorrhoids | 383 | ||
Rectal Prolapse | 384 | ||
Disorders of the Liver and Biliary System, Noninfectious | 384 | ||
Liver | 384 | ||
Cirrhosis | 384 | ||
Dubin-Johnson Syndrome | 385 | ||
Rotor Syndrome | 386 | ||
Gilbert Syndrome | 386 | ||
Crigler-Najjar Syndrome | 387 | ||
End-Stage Liver Disease (Including Indications for Transplantation) | 387 | ||
Hepatic Coma/Encephalopathy | 388 | ||
Fatty Liver, Alcoholic Hepatitis | 389 | ||
Hepatorenal Syndrome | 389 | ||
Hepatopulmonary Syndrome | 390 | ||
Jaundice | 391 | ||
Nonalcoholic Fatty Liver Disease | 391 | ||
Portal Hypertension/Esophageal Varices | 392 | ||
Biliary System | 393 | ||
Cholestasis | 393 | ||
Ascending Cholangitis | 394 | ||
Cholelithiasis and Acute Cholecystitis | 394 | ||
Choledocholithiasis | 395 | ||
Cholestasis Due to Parenteral Nutrition | 396 | ||
Gallstone Ileus | 396 | ||
Mirizzi Syndrome | 396 | ||
Primary Biliary Cirrhosis | 397 | ||
Primary Sclerosing Cholangitis | 397 | ||
Disorders of the Pancreas | 398 | ||
Acute Pancreatitis | 398 | ||
Chronic Pancreatitis | 399 | ||
Hereditary Pancreatitis | 400 | ||
Pancreatic Cyst/Pseudocyst | 401 | ||
Pancreatic Insufficiency | 401 | ||
Traumatic and Mechanical Disorders | 401 | ||
Postgastric Surgery Syndromes | 401 | ||
Blind Loop Syndrome | 401 | ||
Adhesions | 402 | ||
Hernias | 402 | ||
Direct Inguinal Hernia | 402 | ||
Indirect Inguinal Hernia | 403 | ||
Femoral Hernia | 403 | ||
Umbilical Hernia | 403 | ||
Penetrating Wounds, Abdominal | 404 | ||
Perforation of Hollow Viscus and Blunt Abdominal Trauma | 404 | ||
Perforation/Rupture of Esophagus (Boerhaave Syndrome) | 405 | ||
Congenital Disorders | 405 | ||
Intussusception | 405 | ||
Necrotizing Enterocolitis | 406 | ||
Volvulus | 407 | ||
Annular Pancreas | 407 | ||
Biliary Atresia | 408 | ||
Cleft Lip and Palate | 408 | ||
Esophageal Atresia | 409 | ||
Malrotation Without Volvulus | 409 | ||
Meckel Diverticulum | 410 | ||
Pyloric Stenosis | 410 | ||
Gastric Outlet Obstruction | 411 | ||
Tracheoesophageal fistula | 411 | ||
Wilson Disease | 412 | ||
Adverse Drug Effects | 413 | ||
Drug-Induced Changes in Motility | 413 | ||
Chronic Laxative Abuse | 413 | ||
Opioids | 413 | ||
Drug-Induced Gastritis, Duodenitis, and Peptic Ulcer | 413 | ||
Drug-Induced Hepatitis | 414 | ||
Drug-Induced Pancreatitis (e.g., Thiazides) | 414 | ||
Notes | 417 | ||
9 - Gynecologic Disorders | 421 | ||
Introduction | 421 | ||
Menopause | 421 | ||
Gynecologic Neoplasms | 422 | ||
Fibroadenoma | 422 | ||
Intraductal Papilloma | 423 | ||
Breast Cancer | 423 | ||
Paget Disease of the Breast | 424 | ||
Ovarian Cancer | 426 | ||
Sexually Transmitted Infections | 427 | ||
Herpes Simplex Virus | 427 | ||
Neisseria Gonorrhea | 429 | ||
Chlamydia Trachomatis | 429 | ||
Fitz-Hugh-Curtis Syndrome | 430 | ||
Pelvic Inflammatory Disease (Acute Salpingitis) | 430 | ||
Tubo-ovarian Abscess (TOA) | 431 | ||
Syphilis | 432 | ||
Granuloma Inguinale | 433 | ||
Lymphogranuloma Venereum | 434 | ||
Chancroid | 434 | ||
Trichomoniasis | 435 | ||
Bacterial Vaginosis (BV) | 435 | ||
Multisystem Processes | 436 | ||
Polycystic Ovarian Syndrome (PCOS, Stein-Leventhal Syndrome) | 436 | ||
Endometriosis | 437 | ||
Ectopic Pregnancy | 438 | ||
Notes | 441 | ||
10 - Renal, Urinary, and Male Reproductive System | 445 | ||
Introduction | 445 | ||
Organizing Principles and Key Terms | 445 | ||
Acute Kidney Injury/Acute Renal Failure | 445 | ||
Prerenal Renal Failure | 446 | ||
Intrinsic Renal Failure | 446 | ||
Postrenal Acute Renal Failure | 447 | ||
Chronic Kidney Disease/Chronic Renal Failure | 447 | ||
Dialysis | 448 | ||
Hematuria | 449 | ||
Proteinuria | 449 | ||
Nephritic Versus Nephrotic Syndrome | 450 | ||
The Upper Urinary Tract | 450 | ||
Infectious Disorders of the Upper Urinary Tract | 457 | ||
Pyelonephritis | 457 | ||
Xanthogranulomatous Pyelonephritis | 457 | ||
Perinephric and Renal Abscess | 458 | ||
Renal Tuberculosis | 458 | ||
Renal Stones | 458 | ||
Neoplastic Disorders and Cysts of the Upper Renal Tract | 460 | ||
Simple Renal Cyst | 460 | ||
Autosomal Dominant Polycystic Kidney Disease | 460 | ||
Autosomal Recessive Polycystic Kidney Disease | 461 | ||
Medullary Sponge Kidney Disease | 461 | ||
Renal Cell Carcinoma | 462 | ||
Wilms Tumor/Nephroblastoma | 462 | ||
Vascular Pathology Affecting the Upper Urinary Tract | 462 | ||
Renal Infarction | 463 | ||
The Lower Urinary Tract | 464 | ||
Cystitis | 464 | ||
Chlamydial Urethritis | 465 | ||
Inflammatory Processes | 466 | ||
Interstitial Cystitis/Hemorrhagic Cystitis | 466 | ||
Neoplasms of the Lower Urinary Tract | 467 | ||
Bladder Cancer | 467 | ||
Prostate Cancer | 467 | ||
Testicular Cancer | 468 | ||
Penile Cancer | 469 | ||
Double Collecting System, Double Ureter, Bifid Ureter | 470 | ||
Horseshoe Kidney | 470 | ||
Klinefelter Syndrome | 471 | ||
Hypospadias/Epispadias | 471 | ||
Genitourinary Trauma and Mechanical Disorders | 472 | ||
Kidney, Bladder, or Urethral Trauma | 472 | ||
Penile Fracture | 473 | ||
Testicular Rupture/Avulsion/Hematocele | 473 | ||
Peyronie Disease | 473 | ||
Sexual Dysfunction | 474 | ||
Impotence/Erectile Dysfunction | 474 | ||
Premature Ejaculation | 474 | ||
Dyspareunia | 475 | ||
Arousal Disorder | 475 | ||
Adverse Effects of Drugs on the Renal, Urinary, and Male Reproductive System | 475 | ||
Notes | 479 | ||
11 - Disorders of the Skin and Subcutaneous Tissues | 482 | ||
Diseases | 482 | ||
Infections and Infestations | 482 | ||
Bacterial | 482 | ||
Cellulitis | 482 | ||
Erysipelas | 483 | ||
Impetigo | 483 | ||
Skin Abscesses, Furuncles, and Carbuncles | 485 | ||
Folliculitis | 485 | ||
Pilonidal Disease | 487 | ||
Cutaneous Anthrax Infection | 487 | ||
Cutaneous Mycobacterial Infection | 487 | ||
Viral | 487 | ||
Herpes Simplex Virus Types 1 and 2 | 487 | ||
Varicella-Zoster Virus | 489 | ||
Molluscum Contagiosum | 491 | ||
Hand-Foot-and-Mouth Disease | 492 | ||
Parvovirus B19 | 492 | ||
Rubella | 494 | ||
Rubeola | 495 | ||
Verrucae Vulgaris | 495 | ||
Fungal | 496 | ||
Candidiasis | 496 | ||
Tinea (Pedis, Cruris, Corporis, Capitis) and Onychomycosis | 497 | ||
Tinea Versicolor | 498 | ||
Sporotrichosis | 499 | ||
Parasitic | 500 | ||
Cutaneous Larva Migrans | 500 | ||
Cutaneous Leishmaniasis | 500 | ||
Infestations and Bites | 501 | ||
Scabies | 501 | ||
Lice | 502 | ||
Arthropod Bites and Bed Bugs | 502 | ||
Inflammatory and Immunologic Disorders | 503 | ||
Psoriasis | 503 | ||
Lichenoid Disorders | 503 | ||
Lichen Planus | 503 | ||
Lichen Sclerosis | 504 | ||
Lichen Simplex Chronicus | 505 | ||
Pityriasis Rosea | 505 | ||
Dermatitis | 506 | ||
Atopic Dermatitis (Eczema) | 506 | ||
Allergic and Irritant Contact Dermatitis | 506 | ||
Urticaria | 507 | ||
Erythema Multiforme | 507 | ||
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis | 508 | ||
Dermatitis Herpetiformis | 508 | ||
Pyoderma Gangrenosum | 509 | ||
Erythema Nodosum | 509 | ||
Pemphigus Vulgaris, Foliaceus, and Bullous Pemphigoid | 510 | ||
Vitiligo | 510 | ||
Neoplasms | 511 | ||
Benign Neoplasms | 511 | ||
Actinic Keratosis | 511 | ||
Seborrheic Keratosis | 511 | ||
Nevus | 511 | ||
Epidermoid Cyst | 512 | ||
Lipoma | 513 | ||
Xanthoma | 513 | ||
Malignant Neoplasms | 513 | ||
Basal Cell Carcinoma | 513 | ||
Squamous Cell Carcinoma | 513 | ||
Melanoma | 514 | ||
Kaposi Sarcoma | 515 | ||
Cutaneous T-cell Lymphoma | 515 | ||
Other Disorders | 516 | ||
Disorders of the Hair | 516 | ||
Alopecia | 516 | ||
Seborrheic Dermatitis | 516 | ||
Disorders of the Nails | 517 | ||
Paronychia | 517 | ||
Ingrown Nail | 517 | ||
Disorders of Sweat and Sebaceous Glands | 517 | ||
Acne Vulgaris | 517 | ||
Rosacea | 518 | ||
Hidradenitis Suppurativa | 518 | ||
Hyperhidrosis | 519 | ||
Ichthyosis Vulgaris | 519 | ||
Oral Disease | 519 | ||
Aphthous Ulcers | 519 | ||
Leukoplakia | 520 | ||
Disorders of Pigmentation | 520 | ||
Albinism | 520 | ||
Lentigo | 520 | ||
Traumatic, Mechanical, and Latrogenic Disorders | 521 | ||
Animal Bites | 521 | ||
Burns | 521 | ||
Pernio and Frostbite | 522 | ||
Pressure Ulcers | 522 | ||
Keloids and Hypertrophic Scars | 522 | ||
Drug and Vaccine Eruptions | 523 | ||
Notes | 525 | ||
12 - Diseases of the Musculoskeletal System and Connective Tissue | 529 | ||
Introduction | 529 | ||
Infectious Disorders | 529 | ||
Gangrene | 529 | ||
Discitis (Vertebral Osteomyelitis) | 530 | ||
Infective Myositis | 531 | ||
Necrotizing Fasciitis | 531 | ||
Osteomyelitis | 532 | ||
Septic Arthritis | 532 | ||
Immunologic Disorders | 533 | ||
Adhesive Capsulitis (Frozen Shoulder Syndrome) | 533 | ||
Ankylosing Spondylitis | 533 | ||
Bursitis | 534 | ||
Osteochondritis Dissecans | 535 | ||
Tendinitis | 535 | ||
Temporomandibular Joint Disorders | 536 | ||
Autoimmune Myositis Polymyositis/Dermatomyositis | 536 | ||
Benign Neoplasms | 537 | ||
Osteochondroma | 537 | ||
Giant Cell Tumor | 538 | ||
Malignant Neoplasms | 538 | ||
Osteosarcoma | 538 | ||
Ewing Sarcoma | 539 | ||
Cancer Metastases to Bone | 539 | ||
Degenerative and Metabolic Disorders of Bone, Tendon, and Cartilage | 539 | ||
Chondromalacia Patellae (Patellofemoral Pain Syndrome) | 539 | ||
Herniated Disc | 540 | ||
Legg-Calve-Perthes Disease | 541 | ||
Osgood-Schlatter Disease | 542 | ||
Osteodystrophy | 542 | ||
Osteomalacia/Rickets | 543 | ||
Avascular Necrosis of Femoral Head | 543 | ||
Osteopenia/Osteoporosis | 544 | ||
Osteitis Deformans (Paget Disease of Bone) | 544 | ||
Spondylolisthesis | 545 | ||
Degenerative and Metabolic Disorders of Joints | 545 | ||
Gout | 545 | ||
Pseudogout (Calcium Pyrophosphate Dihydrate Deposition Disease) | 546 | ||
Osteoarthritis | 547 | ||
Degenerative and Metabolic Disorders of Muscles, Ligaments, and Fascia | 547 | ||
Dupuytren Contracture | 547 | ||
Myositis Ossificans | 548 | ||
Rhabdomyolysis | 548 | ||
Traumatic and Mechanical Disorders | 549 | ||
Kyphoscoliosis | 549 | ||
Rotator Cuff Tear | 549 | ||
Slipped Capital Femoral Epiphysis | 550 | ||
Congenital Disorders | 550 | ||
Developmental Dysplasia of the Hip | 550 | ||
Genu Valgum (Knock-Knee) and Genu Varum (Bow-Leg) | 551 | ||
Foot Deformities | 551 | ||
Osteogenesis Imperfecta (“Brittle Bone Disease”) | 552 | ||
McArdle Disease (Glycogen Storage Disease V) | 552 | ||
Mitochondrial Myopathies | 553 | ||
Adverse Defects of Drugs on the MSK System | 553 | ||
Drug-induced Myopathy | 553 | ||
Malignant Hyperthermia | 554 | ||
13 - Endocrine and Metabolic Disorders | 559 | ||
Introduction | 559 | ||
Diabetes and the Endocrine Pancreas | 560 | ||
Diabetes | 560 | ||
Diabetes Mellitus Type 1 | 560 | ||
Diabetes Mellitus Type 2 | 561 | ||
Chronic Complications of Diabetes Mellitus | 563 | ||
Hypoglycemia and Islet Cell Disorders | 564 | ||
Hyperglycemia (Glucagonoma) | 564 | ||
Thyroid Disorders | 565 | ||
Thyroid Nodule | 565 | ||
Euthyroid Sick Syndrome | 565 | ||
Hypothyroidism | 566 | ||
Hashimoto Thyroiditis | 567 | ||
Subacute (Viral) Thyroiditis | 567 | ||
Myxedema Coma | 567 | ||
Hyperthyroidism | 567 | ||
Graves Disease | 568 | ||
Thyroid Storm | 569 | ||
Thyrotoxicosis | 569 | ||
Neoplasms | 570 | ||
Thyroid Deficiency from Pituitary Disorder (Refer to Pituitary Section) | 570 | ||
Secondary Hypothyroidism and Hyperthyroidism | 570 | ||
Parathyroid Disorders | 570 | ||
Hyperparathyroidism | 570 | ||
Hypoparathyroidism | 572 | ||
Metabolic Bone Disease | 572 | ||
Adrenal Disorders | 573 | ||
Addison Disease | 573 | ||
Secondary Adrenal Insufficiency | 574 | ||
Cushing Syndrome | 574 | ||
Cushing Disease | 576 | ||
Hyperaldosteronism | 576 | ||
Pheochromocytoma | 577 | ||
Endocrine Diseases Which Cause Hypertension | 577 | ||
Pituitary Disorders | 577 | ||
Pituitary Adenomas | 577 | ||
Acromegaly/Gigantism | 578 | ||
Diabetes Insipidus | 579 | ||
Panhypopituitarism | 579 | ||
Pituitary Apoplexy (Sheehan Syndrome) | 580 | ||
Growth Hormone Deficiency | 580 | ||
SIADH | 580 | ||
Prolactinoma and Hyperprolactinemia | 581 | ||
Craniopharyngiomas | 581 | ||
Hypogonadism, Primary and Secondary | 582 | ||
Multiple Endocrine Neoplasia (MEN1, MEN2) | 583 | ||
Notes | 585 | ||
14 - Gunner Jim’s Guide to Exam Day Success | 588 | ||
“Master One Review Book” | 588 | ||
“Do as Many Quality Questions as You Can” | 589 | ||
“Review Questions in Excel” | 589 | ||
Index | 591 | ||
A | 591 | ||
B | 593 | ||
C | 595 | ||
D | 598 | ||
E | 599 | ||
F | 600 | ||
G | 601 | ||
H | 602 | ||
I | 604 | ||
J | 606 | ||
K | 606 | ||
L | 606 | ||
M | 608 | ||
N | 610 | ||
O | 612 | ||
P | 613 | ||
Q | 615 | ||
R | 615 | ||
S | 616 | ||
T | 618 | ||
U | 619 | ||
V | 620 | ||
W | 620 | ||
X | 621 | ||
Y | 621 | ||
Z | 621 | ||
How to Contribute to Gunner Goggles Medicine | ES2 |