BOOK
The Brigham Intensive Review of Internal Medicine E-Book
Ajay K. Singh | Joseph Loscalzo
(2017)
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Book Details
Abstract
Based on the popular review course from Harvard Medical School, The Brigham Intensive Review of Internal Medicine, 3rd Edition, provides in-depth coverage on all specialties of internal medicine, as well as palliative care, occupational medicine, psychiatry, and geriatric medicine. Ideal for preparing for certification or recertification, this highly regarded review tool keeps you up to date with tremendous changes in the field, incorporating detailed discussions in every chapter, essential learning points, more than 600 review questions, numerous tables and figures, and more.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC\r | ES1 | ||
| The Brigham Intensive Review of Internal Medicine\r | i | ||
| The Brigham Intensive Review of Internal Medicine\r | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Foreword | xix | ||
| Preface | xx | ||
| Contents | xxi | ||
| The Brigham Intensive Review of Internal Medicine\r | xxv | ||
| 1 -\rInfectious Disease | 1 | ||
| 1 - Pneumonia and Respiratory Infections | 2 | ||
| Acute Bronchitis | 2 | ||
| Community-Acquired Pneumonia | 2 | ||
| 2 - HIV Infection and AIDS | 8 | ||
| History and Epidemiology | 8 | ||
| Signs and Symptoms | 8 | ||
| Establishing the Diagnosis | 9 | ||
| Initial Evaluation | 10 | ||
| Initiation of Therapy | 11 | ||
| Hepatitis Coinfection | 11 | ||
| Regimens for Initial Antiretroviral Therapy | 11 | ||
| Nucleos(t)ide Reverse Transcriptase Inhibitors | 12 | ||
| Nonnucleoside Reverse Transcriptase Inhibitors | 12 | ||
| Protease Inhibitors | 12 | ||
| Integrase Strand Transfer Inhibitors | 13 | ||
| Goals of Therapy | 13 | ||
| Monitoring and Routine Follow-Up Care | 13 | ||
| HIV Prevention | 13 | ||
| 3 - Infective Endocarditis | 16 | ||
| Pathophysiology | 16 | ||
| Predisposing Factors for Infective Endocarditis | 16 | ||
| Clinical Features | 17 | ||
| Specific Infective Endocarditis Syndromes | 19 | ||
| Intravenous Drug Abuse Infective Endocarditis | 19 | ||
| Prosthetic Valve Endocarditis | 19 | ||
| Cardiac Device Infective Endocarditis | 19 | ||
| Diagnosis and Workup of Infective Endocarditis | 20 | ||
| Treatment of Infective Endocarditis | 21 | ||
| Antimicrobial Therapy | 21 | ||
| Medical Treatment of Infective Endocarditis Complications | 21 | ||
| Surgical Indications in Infective Endocarditis | 21 | ||
| Antibiotic Prophylaxis for Infective Endocarditis | 21 | ||
| 4 - Immunizations | 25 | ||
| Basic Principles of Immunizations | 25 | ||
| Precautions and Contraindications | 25 | ||
| Adult Immunization Recommendations | 26 | ||
| Influenza | 26 | ||
| Pneumococcus | 27 | ||
| Meningococcus | 28 | ||
| Haemophilus Influenzae B | 28 | ||
| Tetanus, Diphtheria, Pertussis | 29 | ||
| Measles, Mumps, Rubella | 29 | ||
| Varicella Zoster Virus | 29 | ||
| Human Papillomavirus | 30 | ||
| Hepatitis A Virus | 31 | ||
| Hepatitis B Virus | 31 | ||
| Further Considerations | 32 | ||
| Spacing of Multiple Immunizations | 32 | ||
| Special Risk Groups | 32 | ||
| Timing of Vaccines for Persons With Immunosuppression | 32 | ||
| Close Contacts of Immunocompromised Persons | 32 | ||
| 5 - Tropical Infections | 35 | ||
| Fever | 35 | ||
| Malaria | 35 | ||
| Clinical Features | 35 | ||
| Diagnosis, Treatment, and Prevention | 35 | ||
| Babesiosis | 36 | ||
| Dengue, Chikungunya, and Zika | 36 | ||
| Rickettsial Infections | 37 | ||
| Typhoid | 37 | ||
| Clinical Features | 37 | ||
| Diagnosis, Treatment, and Prevention | 37 | ||
| Meningococcal Infection | 37 | ||
| Leptospirosis | 38 | ||
| Diarrhea | 38 | ||
| Intestinal Protozoa | 38 | ||
| Skin Diseases | 38 | ||
| Cutaneous Larva Migrans (Creeping Eruption) | 39 | ||
| Furuncular Myiasis | 39 | ||
| Cutaneous Leishmaniasis | 39 | ||
| Common Chronic Infections of Immigrants | 39 | ||
| American Trypanosomiasis (Chagas Disease) | 39 | ||
| 2 -\rHematology and Oncology | 89 | ||
| 10 - Breast Cancer | 90 | ||
| Risk Factors | 90 | ||
| Prevention | 91 | ||
| Screening | 91 | ||
| Pathology and Staging | 92 | ||
| Stage 0 Breast Cancer (Carcinoma in Situ) | 92 | ||
| Stage I, II, and III Breast Cancer (Nonmetastatic) | 93 | ||
| Local Therapy | 93 | ||
| Systemic Therapy | 93 | ||
| Stage IV Breast Cancer (Metastatic) | 95 | ||
| Targeted Therapies for Breast Cancer | 95 | ||
| Palliation of Metastatic Breast Cancer | 96 | ||
| Summary of Breast Cancer Treatment | 96 | ||
| 11 - Lung Cancer | 98 | ||
| Overview | 98 | ||
| Risk Factors | 98 | ||
| Smoking | 98 | ||
| Radon, Asbestos, and Other Exposures | 98 | ||
| Never-Smokers | 99 | ||
| Clinical Detection of Lung Cancer Symptoms | 99 | ||
| Paraneoplastic Syndromes | 99 | ||
| Hematologic Abnormalities | 99 | ||
| Syndrome of Inappropriate Antidiuretic Hormone Secretion | 99 | ||
| Hypercalcemia | 99 | ||
| Cushing Syndrome | 99 | ||
| Pancoast Syndrome | 99 | ||
| Thrombosis | 99 | ||
| Hypertrophic Pulmonary Osteoarthropathy | 99 | ||
| Lambert-Eaton Syndrome | 100 | ||
| Diagnosis | 100 | ||
| Screening | 100 | ||
| Nonsmall Cell Lung Cancer | 100 | ||
| Pathology | 100 | ||
| Histology | 100 | ||
| Molecular Changes in Nonsmall Cell Lung Cancer | 101 | ||
| Staging of Nonsmall Cell Lung Cancer | 101 | ||
| Treatment | 101 | ||
| Stage I–II Nonsmall Cell Lung Cancer | 101 | ||
| Stage III Nonsmall Cell Lung Cancer | 103 | ||
| Stage IV Nonsmall Cell Lung Cancer | 103 | ||
| Small Cell Lung Cancer | 104 | ||
| Pathology of Small Cell Lung Cancer | 104 | ||
| Diagnosis and Staging of Small Cell Lung Cancer | 104 | ||
| Treatment | 104 | ||
| Limited-Stage Small Cell Lung Cancer | 104 | ||
| Extensive-Stage Small Cell Lung Cancer | 105 | ||
| 12 - Gastrointestinal Cancers | 107 | ||
| Esophageal Cancer | 107 | ||
| Risk Factors for Esophageal Cancer | 107 | ||
| Clinical Presentation and Management of Esophageal Cancer | 107 | ||
| Gastric Cancer | 109 | ||
| Histology Types of Gastric Cancers | 109 | ||
| Risk Factors for Gastric Cancer | 109 | ||
| Clinical Presentation and Management of Gastric Cancer | 110 | ||
| Pancreas Cancer | 110 | ||
| Risk Factors for Pancreatic Cancer | 111 | ||
| Clinical Presentation and Management of Pancreatic Cancer | 111 | ||
| Liver Cancer | 113 | ||
| Risk Factors for Liver Cancer | 113 | ||
| Clinical Presentation and Management of Liver Cancer | 113 | ||
| Colorectal Cancer | 114 | ||
| Risk Factors for Colorectal Cancer | 114 | ||
| Pathologic Features and Presentation of Colorectal Cancer | 115 | ||
| Management of Colorectal Cancer | 116 | ||
| 13 - Genitourinary Cancers | 121 | ||
| Prostate Cancer | 121 | ||
| Epidemiology and Risk Factors | 121 | ||
| Screening and Diagnosis | 121 | ||
| Treatment of Localized Prostate Cancer | 122 | ||
| Treatment of Prostate Cancer Recurrence and Advanced Disease | 122 | ||
| Renal Cell Carcinoma | 122 | ||
| Epidemiology | 122 | ||
| Clinical Presentation and Diagnosis | 123 | ||
| Treatment | 123 | ||
| Bladder Cancer | 124 | ||
| 3 -\rRheumatology | 233 | ||
| 23 - Rheumatoid Arthritis | 234 | ||
| Epidemiology | 234 | ||
| Pathology and Pathogenesis | 234 | ||
| Diagnosis | 234 | ||
| Clinical Manifestations of Rheumatoid Arthritis | 235 | ||
| Laboratory Testing | 236 | ||
| Musculoskeletal Imaging | 237 | ||
| Special Considerations | 237 | ||
| Treatment | 238 | ||
| Traditional Non-DMARD Pharmacotherapy | 238 | ||
| Traditional Small-Molecule DMARDs | 240 | ||
| Biological DMARDs | 241 | ||
| Emerging Small-Molecule DMARDs | 242 | ||
| Summary | 242 | ||
| 24 - Acute Monoarticular Arthritis | 245 | ||
| Evaluation of a Patient With Acute Monoarticular Arthritis | 245 | ||
| History and Physical Examination | 245 | ||
| Diagnostic Studies | 245 | ||
| Imaging Studies | 246 | ||
| Synovial Biopsy and Arthroscopy | 246 | ||
| Differential Diagnosis | 246 | ||
| Septic Arthritis | 248 | ||
| Pathogenesis | 248 | ||
| Microbiology | 249 | ||
| Risk Factors | 249 | ||
| Clinical Features | 250 | ||
| Diagnostic Workup | 250 | ||
| Therapy | 250 | ||
| Lyme Disease | 251 | ||
| Viral | 251 | ||
| Mycobacterial and Fungal | 251 | ||
| Gonococcal Arthritis | 251 | ||
| Crystal-Induced Monoarticular Arthritis | 252 | ||
| Gout | 253 | ||
| Epidemiology and Risk Factors | 253 | ||
| Clinical Presentations | 253 | ||
| Diagnostic Workup | 253 | ||
| Treatment | 254 | ||
| Calcium Pyrophosphate Crystal Deposition Disease (Pseudogout) | 255 | ||
| Basic Calcium Phosphate Deposition Disease | 255 | ||
| Calcium Oxalate | 256 | ||
| Lipid-Laden Crystals | 256 | ||
| Osteoarthritis | 256 | ||
| Hemarthrosis | 256 | ||
| Reactive Arthritis | 256 | ||
| Systemic Diseases | 256 | ||
| Summary | 257 | ||
| 25 - Systemic Lupus Erythematosus and Related Disorders | 259 | ||
| History and Epidemiology | 259 | ||
| Genetics, Hormones, and the Immune System | 259 | ||
| Clinical Manifestations | 260 | ||
| Cutaneous | 260 | ||
| Subacute Cutaneous Lupus Erythematosus | 260 | ||
| Chronic Cutaneous Lupus Erythematosus | 260 | ||
| Acute Cutaneous Lupus Erythematosus | 260 | ||
| Other | 261 | ||
| Pulmonary Manifestations | 261 | ||
| Cardiac Involvement | 261 | ||
| Joint Symptoms | 261 | ||
| Hematologic Disorders | 261 | ||
| Kidney Disease | 262 | ||
| Neurologic Disease | 262 | ||
| Drug-Induced Systemic Lupus Erythematosus | 263 | ||
| Autoantibodies | 263 | ||
| Diagnosis | 263 | ||
| Treatment of Systemic Lupus Erythematosus | 264 | ||
| Antimalarials | 264 | ||
| Corticosteroids | 265 | ||
| Methotrexate and Leflunomide | 265 | ||
| Azathioprine | 265 | ||
| Cyclosporine | 265 | ||
| Mycophenolate Mofetil | 265 | ||
| Tacrolimus | 265 | ||
| Cyclophosphamide | 265 | ||
| Belimumab | 265 | ||
| Other Biologics and Other Therapies | 265 | ||
| Treatment Approaches | 265 | ||
| Conclusion | 266 | ||
| Antiphospholipid Syndrome | 266 | ||
| Clinical Features | 266 | ||
| Antibodies | 266 | ||
| Diagnosis | 267 | ||
| Treatment | 267 | ||
| Sjögren Syndrome | 267 | ||
| Clinical | 267 | ||
| Keratoconjunctivitis Sicca | 267 | ||
| Xerostomia | 267 | ||
| Vaginal Dryness | 267 | ||
| Diagnosis of Sjögren Syndrome | 267 | ||
| Other Clinical Findings | 267 | ||
| Progressive Systemic Sclerosis (Limited and Diffuse) | 268 | ||
| Limited Systemic Sclerosis (CREST) | 268 | ||
| Progressive Systemic Sclerosis | 268 | ||
| Organ Involvement | 268 | ||
| Cutaneous | 268 | ||
| Pulmonary Disease | 268 | ||
| Renal Disease | 269 | ||
| Cardiac Disease | 269 | ||
| Gastrointestinal Disease | 269 | ||
| Musculoskeletal Involvement | 269 | ||
| Treatment | 269 | ||
| Mixed Connective Disease and Overlap Syndrome | 269 | ||
| Idiopathic Inflammatory Myopathies: Polymyositis, Dermatomyositis, and Inclusion Body Myositis | 269 | ||
| Clinical Symptoms | 270 | ||
| Skin | 270 | ||
| Pulmonary | 270 | ||
| Cardiac | 270 | ||
| Gastrointestinal | 270 | ||
| Laboratory Abnormalities | 270 | ||
| Differential Diagnosis | 270 | ||
| Diagnosis | 270 | ||
| Malignancy Association | 270 | ||
| Treatment | 271 | ||
| Conclusion | 271 | ||
| 26 - Systemic Vasculitis | 273 | ||
| Clinical Presentation | 273 | ||
| Antineutrophil Cytoplasmic Autoantibody Vasculitis | 273 | ||
| Granulomatosis With Polyangiitis (Wegener) | 273 | ||
| Diagnosis | 274 | ||
| Treatment | 274 | ||
| Microscopic Polyangiitis | 275 | ||
| Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss Syndrome) | 275 | ||
| Treatment | 275 | ||
| Polyarteritis Nodosa | 275 | ||
| Diagnosis | 276 | ||
| Treatment | 276 | ||
| Drug-Induced Vasculitis | 276 | ||
| Cryoglobulinemic Vasculitis | 276 | ||
| Giant Cell Arteritis and Takayasu Arteritis | 277 | ||
| Behçet Disease | 277 | ||
| Primary Central Nervous System Vasculitis | 278 | ||
| Treatment Strategies in Vasculitis | 278 | ||
| 27 - Common Soft Tissue Pain Syndromes | 280 | ||
| Classification of Disorders | 280 | ||
| Pathophysiology | 280 | ||
| Presentation | 280 | ||
| Patient Demographics and Common Presentations | 281 | ||
| Specific Soft Tissue Pain Disorders | 281 | ||
| Causes of Shoulder Pain | 281 | ||
| Physical Examination: Shoulder | 282 | ||
| Elbow Pain | 283 | ||
| Olecranon Bursitis | 283 | ||
| Wrist and Hand Disorders | 283 | ||
| Pelvis and Hip | 284 | ||
| Soft Tissue Disorders Around the Knee | 284 | ||
| Foot Pain | 285 | ||
| Fibromyalgia | 285 | ||
| Establishing the Diagnosis of a Soft Tissue Pain Disorder | 286 | ||
| Ancillary Studies | 286 | ||
| Therapy | 286 | ||
| 28 - Laboratory Tests in Rheumatic Disorders | 289 | ||
| Acute-Phase Proteins | 289 | ||
| Comparison of Erythrocyte Sedimentation Rate and C-Reactive Protein | 289 | ||
| Rationale for Using Multiple Tests | 289 | ||
| Systemic Lupus Erythematosus | 290 | ||
| Antibodies to DNA | 291 | ||
| Anti-Smith Antibodies and Antiribonucleoprotein Antibodies | 291 | ||
| Anti-Ro/SSA and Anti-La/SSB Antibodies | 292 | ||
| Antinucleoprotein Antibodies | 292 | ||
| Systemic Sclerosis (Scleroderma) | 292 | ||
| Polymyositis/Dermatomyositis | 292 | ||
| Antiribosomal P Protein Antibodies | 293 | ||
| Antihistone Antibodies | 293 | ||
| Rheumatoid Factors | 293 | ||
| Antibodies to Citrullinated Proteins | 294 | ||
| Antineutrophil Cytoplasmic Antibodies | 294 | ||
| Drug-Associated Antineutrophil Cytoplasmic Antibodies | 295 | ||
| Antiglomerular Basement Membrane Antibody Disease | 295 | ||
| Antiphospholipid Antibodies | 295 | ||
| Lupus Anticoagulants | 295 | ||
| Anticardiolipin Antibodies | 295 | ||
| Anti–Beta-2-Glycoprotein I Antibodies | 296 | ||
| False-Positive Serologic Test for Syphilis | 296 | ||
| Associated Disorders | 296 | ||
| Testing for Ankylosing Spondylitis | 296 | ||
| Testing for Lyme Disease | 296 | ||
| Enzyme-Linked Immunosorbent Assay | 296 | ||
| Western Blot | 296 | ||
| Cautions to Be Used in Interpretation | 296 | ||
| False Positives With ELISA | 296 | ||
| Lack of Sensitivity in Early Disease | 297 | ||
| Effects of Antibiotic Therapy | 297 | ||
| Interlaboratory Variation | 297 | ||
| Persistence of Positivity | 297 | ||
| Usefulness of Serologic Tests | 297 | ||
| Complement | 297 | ||
| CH50 | 297 | ||
| Plasma C3 and C4 Levels | 297 | ||
| Clinical Significance | 297 | ||
| Inherited Complement Deficiency | 298 | ||
| C1 Inhibitor Deficiency | 298 | ||
| Uric Acid | 298 | ||
| Synovial Fluid | 298 | ||
| Examination of Synovial Fluid | 298 | ||
| Routine Culture | 299 | ||
| Gonococcal Arthritis | 299 | ||
| When Should Cultures Be Sent for Unusual Organisms? | 299 | ||
| Synovial Fluid Crystal Analysis | 299 | ||
| Immunoglobulins | 300 | ||
| Acknowledgment | 300 | ||
| 29 - Board Simulation: Rheumatic and Immunologic Disease | 302 | ||
| 30 - Rheumatology Summary | 307 | ||
| Idiopathic Autoimmune Disorders | 307 | ||
| Rheumatoid Arthritis | 307 | ||
| Polymyalgia Rheumatica | 308 | ||
| Spondyloarthritides | 308 | ||
| Systemic Lupus Erythematosus | 309 | ||
| Scleroderma | 310 | ||
| Other Connective Tissue Diseases | 311 | ||
| Sjögren Syndrome | 311 | ||
| Idiopathic Inflammatory Myopathies | 311 | ||
| Adult-Onset Still Disease | 311 | ||
| Mixed Connective Tissue Disease | 312 | ||
| The Vasculitides | 312 | ||
| Large-Vessel Vasculitides | 312 | ||
| Giant Cell Arteritis | 312 | ||
| Takayasu Arteritis | 313 | ||
| Medium-Vessel Vasculitides | 313 | ||
| Polyarteritis Nodosa | 313 | ||
| Kawasaki Disease | 313 | ||
| Small-Vessel Vasculitides | 313 | ||
| ANCA-Associated Vasculitides | 313 | ||
| Immune Complex–Mediated Small-Vessel Vasculitides | 314 | ||
| Other Inflammatory Arthritides | 314 | ||
| Microcrystalline Arthritis | 314 | ||
| Infectious Arthritis | 314 | ||
| Noninflammatory Rheumatic Disorders | 315 | ||
| Osteoarthritis | 315 | ||
| Regional Musculoskeletal Disorders | 315 | ||
| Fibromyalgia | 316 | ||
| Summary | 316 | ||
| 4 - Pulmonary and Critical Care Medicine\r | 317 | ||
| 31 - Asthma | 318 | ||
| Epidemiology | 318 | ||
| Assessment and Management of Asthma | 318 | ||
| Defining Good Asthma Control | 318 | ||
| Achieving Good Asthma Control | 319 | ||
| Making the Correct Diagnosis | 319 | ||
| Reducing Environmental Triggers of Asthma | 320 | ||
| Treating With Appropriate Medications | 321 | ||
| Helping Patients Prepare for Asthmatic Attacks | 324 | ||
| Consulting With a Specialist | 326 | ||
| Summary | 327 | ||
| 32 - Pleural Diseases | 329 | ||
| Pleural Effusion | 329 | ||
| Clinical Features of Pleural Effusions | 329 | ||
| Diagnostic Evaluation of a Pleural Effusion | 329 | ||
| Chest Imaging | 330 | ||
| Pleural Aspiration/Thoracentesis | 330 | ||
| Pleural Fluid Analysis | 331 | ||
| Characteristics and Management of Common Transudative and Exudative Pleural Effusions | 333 | ||
| Transudative Effusions | 333 | ||
| Congestive Heart Failure | 333 | ||
| Hepatic Hydrothorax | 333 | ||
| Peritoneal Dialysis | 334 | ||
| Urinothorax | 334 | ||
| Nephrotic Syndrome | 334 | ||
| Exudative Effusions | 334 | ||
| Parapneumonic Pleural Effusions and Empyema | 334 | ||
| Tuberculosis | 335 | ||
| Chylothorax | 335 | ||
| Malignancy | 335 | ||
| Autoimmune Diseases | 336 | ||
| Asbestosis | 336 | ||
| Hemothorax | 336 | ||
| Pleural Tumors | 336 | ||
| 33 - Evaluation of the Dyspneic Patient in Primary Care | 339 | ||
| Epidemiology | 339 | ||
| Mechanism | 339 | ||
| Dyspnea and Exercise Physiology | 340 | ||
| Pathophysiology of Disorders Associated With Exertional Dyspnea | 340 | ||
| Pulmonary Causes of Dyspnea | 340 | ||
| Cardiovascular Causes of Dyspnea | 342 | ||
| Pulmonary Vascular Disease | 342 | ||
| Disorders of Peripheral Oxygen Transport and Use | 343 | ||
| Multifactorial Causes of Dyspnea | 343 | ||
| Diagnostic Evaluation | 343 | ||
| History | 343 | ||
| Physical Examination | 344 | ||
| Diagnostic Testing | 345 | ||
| Therapy | 346 | ||
| Summary | 346 | ||
| 34 - Chronic Obstructive Pulmonary Disease\r | 348 | ||
| Definition of Chronic Obstructive Pulmonary Disease | 348 | ||
| Pathogenesis | 348 | ||
| Classification of Chronic Obstructive Pulmonary Disease | 349 | ||
| Clinical Presentation | 349 | ||
| Demographics and Symptoms | 349 | ||
| Physical Examination | 350 | ||
| Differential Diagnosis | 350 | ||
| Pulmonary Function Testing | 350 | ||
| Arterial Blood Gases and Assessment of Oxygenation | 350 | ||
| Thoracic Imaging | 351 | ||
| Blood Tests | 352 | ||
| Summary of Diagnosis of Chronic Obstructive Pulmonary Disease | 352 | ||
| Controversies Concerning Screening for Chronic Obstructive Pulmonary Disease | 352 | ||
| Therapy for Chronic Obstructive Pulmonary Disease | 352 | ||
| Goals of Therapy | 352 | ||
| Disease Prevention | 353 | ||
| Therapy of Chronic Stable Disease | 353 | ||
| Vaccines | 353 | ||
| Influenza Vaccine | 353 | ||
| Pneumococcal Vaccine | 353 | ||
| Pharmacotherapy | 353 | ||
| Short-Acting Beta Agonists | 353 | ||
| Long-Acting Beta Agonists | 353 | ||
| Short-Acting Inhaled Anticholinergics | 354 | ||
| Long-Acting Anticholinergics | 354 | ||
| Inhaled Corticosteroids | 354 | ||
| Oral and Parenteral Corticosteroids | 355 | ||
| Aminophylline/Theophylline/Methylxanthines | 355 | ||
| Combination Bronchodilator Therapy | 355 | ||
| Antioxidants/Mucolytics | 355 | ||
| Alpha-1-Antiprotease Replacement Therapy | 355 | ||
| Oxygen Therapy | 355 | ||
| Pulmonary Rehabilitation | 355 | ||
| Newer Therapeutic Strategies | 356 | ||
| . PDE4 inhibitors (roflumilast) reduce inflammation by inhibiting breakdown of cyclic AMP. Roflumilast is a once-daily medicatio... | 356 | ||
| . Previously it was thought that continuous use of antibiotics had no effect on exacerbation frequency, and use of antibiotics i... | 356 | ||
| . Mepolizumab, a monoclonal antibody against interleukin-5, is used in severe eosinophilic asthma and has been studied in COPD a... | 356 | ||
| Palliative Care. COPD patients can continue to have significant dyspnea despite maximal therapy, and this can lead to anxiety, p... | 356 | ||
| Surgical Therapy for Chronic Obstructive Pulmonary Disease | 356 | ||
| Summary of the Approach to Individuals With Stable Chronic Obstructive Pulmonary Disease | 357 | ||
| Chronic Obstructive Pulmonary Disease Exacerbations | 357 | ||
| Definition | 357 | ||
| Etiology | 357 | ||
| Prevention | 357 | ||
| Assessment of the Patient With Exacerbation | 358 | ||
| Treatment | 358 | ||
| Antibiotics | 358 | ||
| Corticosteroids | 358 | ||
| Bronchodilators | 358 | ||
| Supportive Therapies | 358 | ||
| Acknowledgments | 359 | ||
| 35 - Venous Thromboembolic Diseases | 360 | ||
| Pathophysiology | 360 | ||
| Clinical Risk Factors | 360 | ||
| Pathophysiology of Deep Vein Thrombosis | 361 | ||
| Pathophysiology of Pulmonary Embolism | 361 | ||
| Diagnosis | 361 | ||
| Deep Vein Thrombosis | 361 | ||
| Clinical Findings | 361 | ||
| Laboratory Evaluation | 361 | ||
| Imaging | 361 | ||
| Pulmonary Embolism | 362 | ||
| Clinical Findings | 362 | ||
| Clinical Decision Rule | 362 | ||
| Laboratory Evaluation | 362 | ||
| Electrocardiogram | 363 | ||
| Imaging | 363 | ||
| Risk Stratification for Pulmonary Embolism | 363 | ||
| Management | 365 | ||
| Anticoagulation Strategies | 365 | ||
| Duration of Anticoagulation | 366 | ||
| Use of Aspirin | 367 | ||
| Primary Therapy | 367 | ||
| Thrombolysis | 367 | ||
| Catheter-Assisted and Surgical Interventions | 367 | ||
| Inferior Vena Cava Filters | 368 | ||
| Heparin-Induced Thrombocytopenia | 368 | ||
| Prevention | 368 | ||
| Options for Prophylaxis | 368 | ||
| Duration of Prophylaxis | 368 | ||
| Recommendations | 368 | ||
| 36 - Sleep Apnea | 371 | ||
| Definition of Obstructive Sleep Apnea | 371 | ||
| Epidemiology | 371 | ||
| Pathophysiology | 372 | ||
| Upper Airway Anatomy | 372 | ||
| Upper Airway Muscle Control | 372 | ||
| Collapsibility | 372 | ||
| Arousal Threshold | 372 | ||
| Feedback Loops | 372 | ||
| Lung Volume | 373 | ||
| Clinical Evaluation of Obstructive Sleep Apnea | 373 | ||
| Consequences of Obstructive Sleep Apnea | 375 | ||
| Hypertension | 375 | ||
| Cardiovascular Morbidity and Mortality | 375 | ||
| Cerebrovascular Disease | 376 | ||
| Heart Failure | 376 | ||
| Diabetes Mellitus Type 2 | 376 | ||
| Motor Vehicle Crashes | 376 | ||
| Treatment of Obstructive Sleep Apnea | 376 | ||
| Medical Therapy | 376 | ||
| Positive-Pressure Therapy | 377 | ||
| Oral Appliances | 377 | ||
| Surgery | 378 | ||
| Recent Interventions | 378 | ||
| A Brief Comment on Central Sleep Apnea | 378 | ||
| Summary | 379 | ||
| 37 - Interstitial Lung Diseases | 380 | ||
| Nomenclature | 380 | ||
| The Idiopathic Interstitial Pneumonias | 380 | ||
| Workup and Diagnosis of Interstitial Lung Disease | 381 | ||
| Idiopathic Pulmonary Fibrosis | 384 | ||
| Conclusion | 386 | ||
| 38 - Pulmonary Function Tests | 388 | ||
| Technical Considerations | 388 | ||
| Spirometry: Measurement, Values, and Flow-Volume Loops | 388 | ||
| Lung Volumes: Measurement and Values | 390 | ||
| Diffusion Capacity for Carbon Monoxide: Measurement and Correction Factors | 391 | ||
| Obstructive Ventilatory Deficits | 392 | ||
| Definition and Characteristics | 392 | ||
| Differential Diagnosis | 392 | ||
| GOLD Criteria and Confidence Intervals | 393 | ||
| Bronchodilator Responsiveness | 393 | ||
| How Pulmonary Function Tests Guide Treatment | 393 | ||
| Restrictive Ventilatory Deficits | 394 | ||
| Definition and Characteristics | 394 | ||
| Differential Diagnosis | 394 | ||
| Grading Severity | 394 | ||
| Reduced Diffusing Capacity for Carbon Monoxide | 394 | ||
| Definition, Characteristics, and Physiology of Decreased Diffusing Capacity for Carbon Monoxide | 394 | ||
| Clinical Utility and Meaning of Diffusing Capacity for Carbon Monoxide | 395 | ||
| Differential Diagnosis | 395 | ||
| Association of Diffusing Capacity for Carbon Monoxide With Functional Capacity | 396 | ||
| Mixed Disorders: Interpreting Mixed Obstructive and Restrictive Deficits | 396 | ||
| Respiratory Muscle Forces: Maximal Inspiratory Pressure and Maximal Expiratory Pressure | 396 | ||
| Definition | 396 | ||
| Differential Diagnosis | 397 | ||
| Clinical Utility: When to Order, How to Interpret, Further Testing | 397 | ||
| Advanced Pulmonary Function Tests | 397 | ||
| Resistance and Compliance | 397 | ||
| Bronchoprovocation | 398 | ||
| Acknowledgment | 398 | ||
| 39 - Chest X-Ray Refresher | 400 | ||
| Hemoptysis | 400 | ||
| Chronic Interstitial Lung Diseases | 402 | ||
| Obstructive Lung Diseases | 406 | ||
| 40 - Mechanical Ventilation | 410 | ||
| Indications for Mechanical Ventilation | 410 | ||
| Role of Respiratory System Mechanics | 410 | ||
| Modes of Ventilation | 411 | ||
| Discontinuation of Mechanical Ventilation | 413 | ||
| Noninvasive Positive Pressure Ventilation | 413 | ||
| Summary | 414 | ||
| 41 - Sepsis Syndrome | 416 | ||
| Definitions | 416 | ||
| Epidemiology | 417 | ||
| Clinical Presentation and Diagnosis | 417 | ||
| Pathophysiology | 418 | ||
| Management | 419 | ||
| Early Management | 419 | ||
| Source Control | 419 | ||
| Initial Resuscitation | 420 | ||
| Corticosteroids | 420 | ||
| Glucose Control | 421 | ||
| Summary | 421 | ||
| 42 - Essentials of Hemodynamic Monitoring | 424 | ||
| Invasive Hemodynamic Monitoring | 424 | ||
| Arterial Lines | 424 | ||
| Central Venous Pressure | 425 | ||
| Pulmonary Artery Catheter | 426 | ||
| Noninvasive Hemodynamic Monitoring | 429 | ||
| Summary | 430 | ||
| 43 - Arterial Blood Gases | 432 | ||
| Technical Considerations: How to Obtain an Arterial Blood Gas | 432 | ||
| Hypoxemia | 433 | ||
| A-a Gradient and the Alveolar Gas Equation | 433 | ||
| Effects of Supplemental Oxygen | 434 | ||
| Carboxyhemoglobinemia and Methemoglobinemia | 434 | ||
| Acid-Base Disorders | 435 | ||
| Hypercapnia and Acute Respiratory Acidosis | 435 | ||
| Compensatory Mechanisms | 436 | ||
| Chronic Respiratory Acidosis | 436 | ||
| Respiratory Alkalosis | 436 | ||
| Metabolic Acidosis | 437 | ||
| Metabolic Alkalosis | 438 | ||
| Mixed Disorders | 438 | ||
| Expected Compensation | 438 | ||
| True Mixed Acid-Base Disorders | 439 | ||
| 44 - Board Simulation: Critical Care | 442 | ||
| 45 - Board Simulation: Pulmonary Medicine | 450 | ||
| 46 - Pulmonary and Critical Care Medicine Summary | 461 | ||
| Diagnostic Evaluation of Lung Disease | 461 | ||
| Chest Radiography | 461 | ||
| Pulmonary Function Testing | 461 | ||
| Respiratory Disorders | 462 | ||
| Asthma | 462 | ||
| Chronic Obstructive Pulmonary Disease | 463 | ||
| Diffuse Parenchymal Lung Diseases | 464 | ||
| Venous Thromboembolic Disease | 465 | ||
| Obstructive Sleep Apnea | 465 | ||
| Critical Care | 466 | ||
| Shock and Sepsis | 466 | ||
| Mechanical Ventilation | 466 | ||
| Arterial Blood Gas Interpretation | 467 | ||
| 5 -\rEndocrinology | 468 | ||
| 47 - Pituitary Disorders | 469 | ||
| Pituitary Anatomy and Physiology | 469 | ||
| Pituitary Lesions | 469 | ||
| Pituitary Adenomas | 469 | ||
| Prolactinomas | 471 | ||
| Clinical Presentation | 471 | ||
| Differential Diagnosis of Hyperprolactinemia | 471 | ||
| Diagnosis | 471 | ||
| Management | 472 | ||
| Acromegaly | 473 | ||
| Clinical Presentation | 473 | ||
| Diagnosis | 473 | ||
| Management | 473 | ||
| Cushing Disease | 474 | ||
| Thyroid-Stimulating Hormone and Gonadotropin-Producing Pituitary Adenomas | 475 | ||
| Genetic Syndromes Associated With Pituitary Tumors | 475 | ||
| Hypopituitarism | 476 | ||
| Differential Diagnosis | 476 | ||
| Clinical Presentation, Diagnosis, and Management of Pituitary Hormone Deficiencies | 477 | ||
| Adrenocorticotropic Hormone (Corticotropin) Deficiency | 477 | ||
| Thyroid-Stimulating Hormone (Thyrotropin) Deficiency | 478 | ||
| Luteinizing Hormone and Follicle-Stimulating Hormone (Gonadotropin) Deficiency | 478 | ||
| Growth Hormone (Somatotropin) Deficiency | 479 | ||
| Prolactin Deficiency | 479 | ||
| Posterior Pituitary Deficiency | 479 | ||
| Etiology | 479 | ||
| Clinical Presentation | 479 | ||
| Diagnosis | 479 | ||
| Management | 480 | ||
| 48 - Thyroid Disease | 482 | ||
| Screening for Thyroid Disease | 482 | ||
| Hyperthyroidism | 483 | ||
| Hypothyroidism | 485 | ||
| Thyroid Nodules | 486 | ||
| Summary | 488 | ||
| 49 - Reproductive and Androgenic Disorders | 490 | ||
| Female Reproductive Endocrinology | 490 | ||
| Amenorrhea | 490 | ||
| Hypothalamic and Pituitary Gland Disorders | 490 | ||
| Ovarian Dysfunction (Spontaneous Primary Ovarian Insufficiency/Premature Ovarian Failure) | 490 | ||
| Polycystic Ovary Syndrome | 491 | ||
| Uterine/Outflow Tract Disorders | 491 | ||
| Evaluation of the Patient with Amenorrhea | 491 | ||
| History | 491 | ||
| Physical Examination | 491 | ||
| Laboratory Evaluation and Diagnostic Tests | 492 | ||
| Treatment | 492 | ||
| Hypothalamic Amenorrhea | 492 | ||
| Primary Ovarian Insufficiency | 492 | ||
| Polycystic Ovary Syndrome | 492 | ||
| Male Reproductive Endocrinology | 492 | ||
| Male Hypogonadism Symptoms | 492 | ||
| Physical Examination | 492 | ||
| Laboratory Assessment | 492 | ||
| Primary Hypogonadism | 493 | ||
| Secondary Hypogonadism | 493 | ||
| Treatment | 493 | ||
| 50 - Adrenal Disorders | 495 | ||
| Glucocorticoids | 495 | ||
| Regulation of the Hypothalamic-Pituitary-Adrenal Axis | 495 | ||
| Physiologic and Pathophysiologic Actions of Glucocorticoids | 495 | ||
| Cushing Syndrome | 496 | ||
| Clinical Features of Cushing Syndrome | 496 | ||
| Screening for Cushing Syndrome | 497 | ||
| Investigations to Identify the Cause of Cushing Syndrome | 497 | ||
| Differential Diagnosis | 497 | ||
| Pseudo-Cushing Syndrome | 497 | ||
| Management | 498 | ||
| Medical Therapies for Cushing Syndrome | 498 | ||
| Adrenal Insufficiency | 498 | ||
| Etiology | 498 | ||
| Clinical Features | 499 | ||
| Diagnosis | 499 | ||
| Differential Diagnosis | 500 | ||
| Management | 500 | ||
| Regulation of Renin-Angiotensin-Aldosterone Axis | 500 | ||
| Primary Aldosteronism | 500 | ||
| Diagnosis | 501 | ||
| Treatment | 502 | ||
| Glucocorticoid-Remediable Aldosteronism | 503 | ||
| Secondary Hyperaldosteronism | 503 | ||
| Other Causes of Hypermineralocorticoidism | 503 | ||
| Hypoaldosteronism With Suppressed Plasma Renin Activity | 503 | ||
| Hyperaldosteronism With Elevated Plasma Renin Activity | 503 | ||
| Hypoaldosteronism | 503 | ||
| The Sympathoadrenal System | 503 | ||
| Pheochromocytoma and Paraganglioma | 503 | ||
| Clinical Features | 504 | ||
| Diagnosis | 504 | ||
| Treatment | 504 | ||
| Pheochromocytoma and Genetic Syndromes | 504 | ||
| Adrenal Incidentaloma | 505 | ||
| Congenital Adrenal Hyperplasia | 505 | ||
| 51 - Disorders of Calcium Metabolism | 508 | ||
| The Parathyroid Glands and Parathyroid Hormone | 508 | ||
| Hypercalcemia | 509 | ||
| Primary Hyperparathyroidism | 510 | ||
| Non–Parathyroid Hormone–Mediated Hypercalcemia | 512 | ||
| Hypocalcemia | 513 | ||
| Hypoparathyroidism | 514 | ||
| Pseudohypoparathyroidism | 514 | ||
| Vitamin D Deficiency | 514 | ||
| Chronic Kidney Disease | 515 | ||
| Miscellaneous | 515 | ||
| Treatment | 515 | ||
| 52 - Diabetes Mellitus | 517 | ||
| Classification | 517 | ||
| Type 1 Diabetes | 517 | ||
| Type 2 Diabetes | 517 | ||
| Gestational Diabetes Mellitus | 517 | ||
| Other Specific Types | 518 | ||
| Diagnosis | 518 | ||
| Categories of Risk for Diabetes | 518 | ||
| Screening for Diabetes | 519 | ||
| Prevention of Diabetes and Its Complications | 519 | ||
| Prevention of Type 1 Diabetes | 519 | ||
| Prevention of Type 2 Diabetes | 519 | ||
| Prevention of Complications | 519 | ||
| General Preventive Care Practices | 520 | ||
| Treatment of Cardiovascular Risk Factors | 520 | ||
| Treatment of Hyperglycemia | 521 | ||
| Glycemic Goals | 521 | ||
| Hyperglycemia Treatment Strategies | 522 | ||
| Type 1 Diabetes | 522 | ||
| Insulin Preparations | 522 | ||
| Insulin Delivery Options | 523 | ||
| Insulin Regimens for Type 1 Diabetes | 523 | ||
| Multiple Daily Injections | 523 | ||
| Insulin Pumps | 523 | ||
| Amylin Analogues | 523 | ||
| Type 2 Diabetes | 523 | ||
| Lifestyle Measures | 523 | ||
| . It is recommended that the term “ADA diet” not be used because the ADA does not endorse a single nutrition plan. Meal plans sh... | 523 | ||
| . Exercise in diabetes is associated with potential risks as well as benefits. Patients should be counseled about what types of ... | 524 | ||
| Noninsulin Medications | 524 | ||
| Commonly Used Noninsulin Agents for Type 2 Diabetes | 524 | ||
| . Metformin, the only biguanide available in the United States, works primarily by decreasing hepatic glucose production. Metfor... | 524 | ||
| . Although SUs have been a mainstay of T2DM pharmacotherapy for many years, potential adverse effects of SUs have been raised by... | 524 | ||
| . Exenatide, exenatide extended-release, liraglutide, dulaglutide, lixisenatide, and albiglutide are members of this class of ag... | 524 | ||
| . Sitagliptin, linagliptin, alogliptin, and saxagliptin are currently approved in the United States. By inhibiting DPP-IV, these... | 527 | ||
| . Cana | 527 | ||
| Less Commonly Used Noninsulin Agents for Type 2 Diabetes | 527 | ||
| . Two agents, repaglinide and nateglinide, are available in this class. Similar to SUs, they stimulate insulin secretion by bind... | 527 | ||
| . Two thiazolidinediones (TZDs; also known as glitazones), rosiglitazone and pioglitazone, are currently available. They improve... | 527 | ||
| . Acarbose and miglitol are the two agents in the alpha-glucosidase inhibitor (AGI) class of antihyperglycemic compounds. AGIs r... | 527 | ||
| . Colesevelam, a bile acid sequestrant that has been used for some time as a lipid-lowering agent, received FDA approval for the... | 527 | ||
| . Bromocriptine is approved for treatment of T2DM. Its mechanism of action for the glucose-lowering effect is not clear but invo... | 527 | ||
| Insulin Regimens in Type 2 Diabetes | 527 | ||
| Selection and Progression of Therapy in Type 2 Diabetes | 528 | ||
| Metabolic (Weight-Loss) Surgery | 528 | ||
| Obesity Medications | 529 | ||
| Special Populations | 529 | ||
| Pregnancy | 529 | ||
| Hospitalized Patients | 529 | ||
| 53 - Diabetes Mellitus: Control and Complications | 531 | ||
| Control | 531 | ||
| Real-Time Glucose Measurements | 531 | ||
| Measuring Long-Term Glucose Control | 531 | ||
| Complications of Diabetes: General Overview | 532 | ||
| Acute Complications | 532 | ||
| Hypoglycemia | 532 | ||
| Hyperglycemia | 532 | ||
| Chronic Complications | 532 | ||
| Overview | 532 | ||
| Glucose Hypothesis | 532 | ||
| Major Trials Examining the Glucose Hypothesis | 533 | ||
| Role of Blood Pressure, Lipids, and Lifestyle | 535 | ||
| Complications of Diabetes: Specific Conditions | 535 | ||
| Retinopathy | 535 | ||
| Nephropathy | 537 | ||
| Neuropathy | 537 | ||
| Cardiovascular Disease | 538 | ||
| Musculoskeletal Complications of Diabetes | 539 | ||
| Acknowledgment | 539 | ||
| 54 - Metabolic Syndrome | 541 | ||
| Definition | 541 | ||
| Prevalence | 541 | ||
| Pathogenesis | 541 | ||
| Clinical Significance | 543 | ||
| Management of Metabolic Syndrome | 543 | ||
| General Considerations | 543 | ||
| Management of Obesity in Metabolic Syndrome | 543 | ||
| Reduction of Insulin Resistance With Drug Therapy | 544 | ||
| Treatment of Dyslipidemia in Metabolic Syndrome | 544 | ||
| Treatment of High Blood Pressure | 544 | ||
| Treatment for Proinflammatory and Prothrombotic State | 544 | ||
| Unusual Conditions Associated With Metabolic Syndrome | 544 | ||
| Summary | 544 | ||
| 55 - Metabolic Bone Diseases | 546 | ||
| Osteoporosis | 546 | ||
| Role of Calcium | 549 | ||
| Role of Vitamin D | 549 | ||
| Exercise | 550 | ||
| Bone Remodeling and Treatment of Osteoporosis | 550 | ||
| Hormone Therapy | 551 | ||
| Estrogen Agonists/Antagonists | 551 | ||
| Calcitonin | 551 | ||
| Bisphosphonates | 551 | ||
| Bisphosphonate Holiday | 553 | ||
| Parathyroid Therapy | 553 | ||
| Abaloparatide | 554 | ||
| Denosumab | 554 | ||
| Other Emerging Osteoporosis Therapies | 554 | ||
| Osteomalacia | 554 | ||
| Paget’s Disease of Bone | 555 | ||
| 56 - Board Simulation: Endocrinology | 558 | ||
| 57 - Endocrine Summary | 565 | ||
| Pituitary Tumors | 565 | ||
| Prolactinoma | 565 | ||
| Clinical Features | 565 | ||
| Evaluation | 565 | ||
| Treatment | 565 | ||
| Acromegaly | 567 | ||
| 6 -\rNephrology and Hypertension | 581 | ||
| 58 - Acute Kidney Injury | 582 | ||
| Regulation of Glomerular Filtration | 582 | ||
| Mechanisms of Reduced Glomerular Filtration | 582 | ||
| Postrenal | 582 | ||
| Prerenal | 582 | ||
| Intrinsic Causes of Acute Kidney Injury | 584 | ||
| Tubular Etiologies of Acute Kidney Injury | 584 | ||
| Glomerular Etiologies of Acute Kidney Injury | 585 | ||
| Vascular Etiologies of Acute Kidney Injury | 586 | ||
| Common Scenarios of Acute Kidney Injury in Hospitalized Patients | 586 | ||
| Postoperative Acute Kidney Injury | 586 | ||
| Postintravenous Contrast and Angiographic Procedure Acute Kidney Injury | 587 | ||
| Management of Acute Kidney Injury | 588 | ||
| 59 - Electrolyte Disorders | 591 | ||
| Sodium Disorders | 591 | ||
| Hyponatremia | 591 | ||
| Diagnostic Approach | 591 | ||
| Hypovolemic Hyponatremia | 593 | ||
| Hypervolemic Hyponatremia | 593 | ||
| Euvolemic Hyponatremia | 593 | ||
| Treatment of Hyponatremia | 595 | ||
| Hypernatremia | 596 | ||
| Diagnostic Approach | 596 | ||
| Treatment of Hypernatremia | 597 | ||
| Potassium Disorders | 598 | ||
| Hypokalemia | 598 | ||
| Treatment of Hypokalemia | 599 | ||
| Hyperkalemia | 601 | ||
| Treatment of Hyperkalemia | 602 | ||
| 60 - Acid-Base Disturbances | 606 | ||
| Signs and Symptoms of Acid-Base Disorders | 606 | ||
| Definitions | 606 | ||
| Analysis of Acid-Base Disorders | 606 | ||
| Compensations | 607 | ||
| Metabolic Acidosis | 608 | ||
| Anion-Gap Metabolic Acidosis | 608 | ||
| Lactic Acidosis | 609 | ||
| Salicylate Overdose | 610 | ||
| Oxoproline | 610 | ||
| Hyperchloremic Acidosis | 611 | ||
| Metabolic Alkalosis | 612 | ||
| Chloride-Responsive Alkalosis | 612 | ||
| Chloride-Unresponsive Alkalosis | 612 | ||
| Respiratory Acidosis | 613 | ||
| Respiratory Alkalosis | 613 | ||
| 61 - Dialysis and Transplantation | 615 | ||
| Preparing the Patient for Renal Replacement Therapy | 615 | ||
| Hemodialysis Versus Peritoneal Dialysis | 615 | ||
| Technical Aspects of Hemodialysis | 616 | ||
| Technical Aspects of Peritoneal Dialysis | 616 | ||
| Vascular Access | 617 | ||
| Complications Related to Dialysis Access | 618 | ||
| Anemia Management | 619 | ||
| Bone Disease and Mineral Metabolism Management | 619 | ||
| Evaluation of the Patient for Kidney Transplantation | 620 | ||
| Transplant Medications | 621 | ||
| Maintenance Therapies | 621 | ||
| Antimetabolites | 622 | ||
| Calcineurin Inhibitors | 622 | ||
| Mammalian Target of Rapamycin Inhibitors | 622 | ||
| Abatacept and Belatacept | 622 | ||
| Induction and Antirejection Therapies | 622 | ||
| Polyclonal Antibodies | 623 | ||
| Monoclonal Antibodies | 623 | ||
| Infectious Posttransplant Complications | 623 | ||
| Noninfectious Posttransplant Complications | 623 | ||
| 62 - Hematuria and Proteinuria | 626 | ||
| Hematuria | 626 | ||
| Risk Factors for Malignancies | 628 | ||
| Evaluation of Hematuria | 628 | ||
| History | 628 | ||
| Examination | 628 | ||
| Laboratory Evaluation | 628 | ||
| Imaging | 628 | ||
| Intravenous Urography | 628 | ||
| Ultrasound | 628 | ||
| Computed Tomography Scan | 628 | ||
| Retrograde Pyelogram | 629 | ||
| Cystoscopy | 629 | ||
| Approach to the Patient With Hematuria | 629 | ||
| Proteinuria | 630 | ||
| Classification of Proteinuria | 630 | ||
| Classification of Overt Proteinuria | 630 | ||
| Differential Diagnosis | 631 | ||
| Evaluation of Proteinuria | 632 | ||
| History | 632 | ||
| Physical Examination | 632 | ||
| Laboratory Evaluation | 632 | ||
| Imaging | 634 | ||
| Kidney Biopsy | 634 | ||
| Therapy of Specific Kidney Conditions | 634 | ||
| General Management of Proteinuria | 635 | ||
| 63 - Parenchymal Renal Disease | 637 | ||
| Syndromes of Nephronal Injury | 637 | ||
| Isolated Glomerular Hematuria | 637 | ||
| Isolated Nonnephrotic Proteinuria | 637 | ||
| Nephrotic Syndrome | 637 | ||
| Acute Nephritic Syndrome | 637 | ||
| Unexplained Acute Kidney Injury | 637 | ||
| Important Causes of Nephrotic Syndrome | 637 | ||
| Minimal Change Disease | 637 | ||
| Focal and Segmental Glomerulosclerosis | 638 | ||
| Membranous Glomerulopathy | 640 | ||
| Nephritic Syndrome | 641 | ||
| Important Causes of Nephritic Syndrome | 641 | ||
| Acute Diffuse Proliferative Glomerulonephritis (Postinfectious Glomerulonephritis) | 641 | ||
| IgA Nephropathy or Berger Disease | 642 | ||
| Rapidly Progressive or Crescentic Glomerulonephritis | 643 | ||
| Four Classes of Crescentic Glomerulonephritis Based on Pathogenetic Mechanisms | 644 | ||
| Antiglomerular Basement Membrane Nephritis (Type 1) | 644 | ||
| Lupus Nephritis (Example of Type 2) | 644 | ||
| Antineutrophil Cytoplasmic Antibody–Associated Vasculitis (Example of Type 3): Wegener Granulomatosis (Renamed as Granulomatosis... | 645 | ||
| 64 - Chronic Kidney Disease | 649 | ||
| Staging and Classification of Chronic Kidney Disease | 649 | ||
| Epidemiology of Chronic Kidney Disease | 649 | ||
| Screening for Chronic Kidney Disease | 650 | ||
| Measurement of Kidney Function | 650 | ||
| Use of Serum Creatinine | 650 | ||
| Prediction Equations for Glomerular Filtration Rate | 651 | ||
| Cockcroft-Gault Equation | 651 | ||
| Modification of Diet in Renal Disease | 651 | ||
| Clearance by Radiologic Contrast Agents and Radioactive Isotopes | 652 | ||
| Creatinine Clearance Measurement by 24-Hour Urine Collection | 652 | ||
| Cystatin C | 652 | ||
| Management of Chronic Kidney Disease Progression | 652 | ||
| KDOQI Action Plan by Stage of Chronic Kidney Disease | 654 | ||
| Use of Angiotensin Blockers to Protect the Kidney | 654 | ||
| Control of Blood Pressure | 655 | ||
| Adjunctive Strategies in Retarding Progression | 655 | ||
| Strict Glycemic Control | 655 | ||
| Protein Restriction | 655 | ||
| Smoking Cessation | 655 | ||
| Management of Obesity | 655 | ||
| Complications of Chronic Kidney Disease | 656 | ||
| Anemia | 656 | ||
| Erythropoiesis Stimulating Agents | 656 | ||
| Iron Supplementation to Treat Chronic Kidney Disease Anemia | 658 | ||
| Sexual Dysfunction | 658 | ||
| Male Sexual Dysfunction | 658 | ||
| Female Sexual Dysfunction | 659 | ||
| Amenorrhea in Women With Chronic Kidney Disease | 659 | ||
| Metabolic Bone Disease | 659 | ||
| Hyperphosphatemia | 660 | ||
| Renal Bone Disease | 660 | ||
| 65 - Essential and Secondary Hypertension | 664 | ||
| Definition of Hypertension | 664 | ||
| Primary Hypertension | 665 | ||
| Management of Hypertension | 665 | ||
| Lifestyle Modifications | 666 | ||
| Pharmacotherapy | 666 | ||
| Hypertension Syndromes | 666 | ||
| Hypertension Emergencies | 666 | ||
| Malignant Hypertension | 666 | ||
| Resistant Hypertension | 668 | ||
| Endocrine Hypertension Syndromes | 669 | ||
| Primary Aldosteronism | 669 | ||
| Cushing Syndrome | 670 | ||
| Pheochromocytoma | 670 | ||
| Hypertension in the Elderly | 671 | ||
| Hypertension in Diabetics | 672 | ||
| Hypertension in Pregnancy | 672 | ||
| Chronic Hypertension | 672 | ||
| Preeclampsia | 672 | ||
| Management of Mild Preeclampsia | 673 | ||
| Management of Severe Preeclampsia | 673 | ||
| Eclampsia | 673 | ||
| Management of Eclampsia | 674 | ||
| Gestational Hypertension | 674 | ||
| Renovascular Hypertension | 674 | ||
| 66 - Urinalysis | 678 | ||
| Practical Aspects to Specimen Collection | 678 | ||
| Physical Properties of Urine | 678 | ||
| Chemical Properties of Urine | 678 | ||
| Specific Gravity | 678 | ||
| Urine pH | 678 | ||
| Glucose | 679 | ||
| Ketones | 679 | ||
| Protein | 680 | ||
| Summary of Key Points in Proteinuria | 680 | ||
| Blood | 680 | ||
| Summary of Key Points on Positive Dipstick for Blood | 680 | ||
| Leukocyte Esterase and Nitrites | 681 | ||
| Microscopic Examination | 682 | ||
| Cells | 682 | ||
| Casts | 682 | ||
| Crystals | 683 | ||
| Lipids | 683 | ||
| Organisms | 683 | ||
| Urinalysis Patterns in Kidney Disease | 686 | ||
| Heavy Proteinuria With Fatty Casts or Bland Sediment | 686 | ||
| Dysmorphic Red Blood Cells or Red Blood Cell Casts With Proteinuria | 688 | ||
| Hematuria With Dysmorphic Red Blood Cells and Pyuria | 688 | ||
| Isolated Hyaline Casts | 688 | ||
| Isolated Hematuria With Monomorphic Red Blood Cells | 688 | ||
| Free Tubular Epithelial Cells, Epithelial Cell Casts, and Granular Casts | 688 | ||
| Free White Blood Cells, White Blood Cell Casts, Granular Casts, and Mild Proteinuria | 688 | ||
| Dipstick Urinalysis Screening | 688 | ||
| 67 - Board Simulation: Nephrology and Hypertension | 691 | ||
| 68 - Nephrology Summary | 696 | ||
| Diabetic Nephropathy | 696 | ||
| Clinical Features | 696 | ||
| Pathology | 696 | ||
| Diagnosis | 696 | ||
| Treatment and Prognosis | 697 | ||
| Hypertensive Nephropathy/Nephrosclerosis | 699 | ||
| Clinical Features | 699 | ||
| Pathogenesis | 699 | ||
| Pathology | 699 | ||
| Diagnosis | 700 | ||
| Treatment and Prognosis | 700 | ||
| Cystic Diseases of the Kidney | 700 | ||
| Autosomal Dominant Polycystic Kidney Disease | 700 | ||
| Medullary Cystic Kidney Disease | 701 | ||
| Medullary Sponge Kidney | 701 | ||
| Renal Cell Cancer | 701 | ||
| Kidney Stones | 701 | ||
| Management of Kidney Stones | 702 | ||
| 7 - Digestive Diseases and Disorders of thePancreas and Liver\r | 703 | ||
| 69 - Esophageal Disorders | 704 | ||
| Esophageal Anatomy and Physiology | 704 | ||
| The Symptoms of Esophageal Disease | 704 | ||
| Gastroesophageal Reflux Disease | 705 | ||
| Epidemiology | 705 | ||
| Clinical Findings | 706 | ||
| Diagnosis | 706 | ||
| Upper Endoscopy | 706 | ||
| Intraesophageal Ambulatory pH Monitoring | 706 | ||
| Multichannel Intraluminal Impedance | 707 | ||
| Management | 707 | ||
| Clinical Course and Prognosis | 708 | ||
| Barrett Esophagus | 708 | ||
| Esophageal Structural Abnormalities | 709 | ||
| Rings and Webs | 709 | ||
| Esophageal Diverticula | 709 | ||
| Inflammatory and Infectious Disorders | 709 | ||
| Eosinophilic Esophagitis | 709 | ||
| Pill Esophagitis | 710 | ||
| Infectious Causes of Esophagitis | 710 | ||
| Esophageal Motility Disorders | 711 | ||
| Achalasia | 711 | ||
| Diffuse Esophageal Spasm | 712 | ||
| Ineffective Esophageal Motility | 712 | ||
| Hypertensive Peristalsis (Nutcracker Esophagus) | 712 | ||
| Scleroderma | 712 | ||
| 70 - Peptic Ulcer Disease | 714 | ||
| Pathophysiology | 714 | ||
| Causes of Peptic Ulcer Disease | 714 | ||
| Helicobacter pylori | 714 | ||
| Nonsteroidal Antiinflammatory Drugs | 715 | ||
| Zollinger-Ellison Syndrome (Gastrinoma) | 715 | ||
| Other Causes of Gastroduodenal Ulcers | 716 | ||
| Clinical Presentation | 716 | ||
| Diagnostic Evaluation of Peptic Ulcer Disease | 717 | ||
| Testing for Helicobacter pylori | 717 | ||
| Endoscopic and Radiographic Evaluation | 718 | ||
| Treatment of Peptic Ulcer Disease | 718 | ||
| Antisecretory Therapy | 718 | ||
| Proton-Pump Inhibitors | 718 | ||
| H2-Receptor Antagonists | 720 | ||
| Helicobacter pylori Eradication Therapy | 720 | ||
| Endoscopic Treatment of Peptic Ulcer Disease | 720 | ||
| Surgical Treatment of Peptic Ulcer Disease | 721 | ||
| 71 - Diarrhea and Malabsorption | 723 | ||
| Normal Intestinal Physiology | 723 | ||
| Acute Diarrhea | 723 | ||
| Etiology | 723 | ||
| Evaluation | 723 | ||
| Physical Examination | 726 | ||
| Initial Laboratory Evaluation | 727 | ||
| Stool Studies | 727 | ||
| Radiologic Evaluation | 728 | ||
| Endoscopic Evaluation | 728 | ||
| Treatment | 728 | ||
| Supportive Therapy | 728 | ||
| Antidiarrheal Agents | 729 | ||
| Empirical Antibiotic Therapy | 729 | ||
| Chronic Diarrhea | 729 | ||
| Etiology | 729 | ||
| Osmotic Diarrhea | 730 | ||
| Secretory Diarrhea | 731 | ||
| Steatorrheal Diarrhea | 732 | ||
| Inflammatory Diarrhea | 732 | ||
| Dysmotility Diarrhea | 732 | ||
| Evaluation | 733 | ||
| History | 733 | ||
| Physical Examination | 733 | ||
| Initial Laboratory Evaluation | 733 | ||
| Stool Studies | 733 | ||
| Endoscopic Evaluation | 733 | ||
| Approach to Evaluation Based on Pathophysiologic Mechanism | 733 | ||
| Treatment | 735 | ||
| 72 - Inflammatory Bowel Disease | 737 | ||
| Epidemiology | 737 | ||
| Pathology | 737 | ||
| Ulcerative Colitis | 737 | ||
| Crohn Disease | 738 | ||
| Clinical Presentation | 738 | ||
| Ulcerative Colitis | 738 | ||
| Complications | 738 | ||
| Laboratory Findings | 738 | ||
| Endoscopic and Radiographic Findings | 739 | ||
| Crohn Disease | 739 | ||
| Ileocolitis | 739 | ||
| Colitis and Perianal Disease | 739 | ||
| Jejunoileitis | 739 | ||
| Gastroduodenal Disease | 739 | ||
| 8 -\rCardiovascular Disease | 809 | ||
| 79 - Cardiac Examination | 810 | ||
| General | 810 | ||
| Eye Examination | 810 | ||
| Oral Cavity | 811 | ||
| General Skin Examination | 811 | ||
| Skeleton and Joints | 811 | ||
| Thyroid Gland | 811 | ||
| Jugular Venous Pressure | 811 | ||
| Carotid Artery Examination | 812 | ||
| Lung Examination | 813 | ||
| Abdominal Examination | 813 | ||
| Peripheral Arterial Examination | 813 | ||
| Heart Inspection | 814 | ||
| Auscultation of the Heart | 815 | ||
| Specific Valvular Conditions | 816 | ||
| Aortic Stenosis | 816 | ||
| Aortic Regurgitation | 816 | ||
| Mitral Regurgitation | 816 | ||
| Tricuspid Regurgitation | 816 | ||
| Tricuspid Stenosis | 816 | ||
| Pulmonic Stenosis and Regurgitation | 817 | ||
| Continuous Murmurs | 817 | ||
| Mitral Stenosis | 817 | ||
| Other Congenital Heart Disease Murmurs | 817 | ||
| Atrial Septal Defect | 817 | ||
| Ventricular Septal Defect | 817 | ||
| Innocent Murmur | 817 | ||
| Significance of Murmurs | 817 | ||
| Other Sounds | 818 | ||
| Pericardial Rub | 818 | ||
| Maneuvers | 818 | ||
| Murmur of Hypertrophic Cardiomyopathy | 818 | ||
| Prosthetic Heart Valves | 818 | ||
| Blood Pressure | 818 | ||
| 80 - Acute Coronary Syndromes | 820 | ||
| Pathophysiology | 820 | ||
| Diagnosis | 820 | ||
| Clinical Presentation | 820 | ||
| Physical Examination | 820 | ||
| Electrocardiogram | 822 | ||
| Cardiac Biomarkers | 822 | ||
| Cardiac-Specific Markers | 822 | ||
| Treatment | 825 | ||
| Basic Management | 825 | ||
| Management of ST-Segment Elevation Myocardial Infarction | 826 | ||
| Emergent Reperfusion | 826 | ||
| Fibrinolysis | 826 | ||
| Percutaneous Coronary Intervention | 827 | ||
| Immediate Medical Therapies for ST-Segment Elevation Myocardial Infarction | 827 | ||
| Antiplatelet Agents | 827 | ||
| Anticoagulants | 828 | ||
| Antiischemics | 828 | ||
| Additional Therapies | 828 | ||
| Management of Non–ST-Segment Elevation Acute Coronary Syndromes | 828 | ||
| Immediate Medical Therapies for Non–ST-Segment Elevation Acute Coronary Syndromes | 828 | ||
| Antiplatelets | 828 | ||
| Anticoagulants | 829 | ||
| Antiischemics | 829 | ||
| Additional Therapies | 829 | ||
| Cardiac Catheterization | 829 | ||
| Complications | 830 | ||
| Cardiogenic Shock | 830 | ||
| Mechanical Complications | 830 | ||
| Dysrhythmias | 830 | ||
| Other Complications | 832 | ||
| Secondary Prevention | 832 | ||
| 81 - Valvular Heart Disease | 834 | ||
| Mitral Stenosis | 834 | ||
| Etiology and Pathology | 834 | ||
| Pathophysiology | 834 | ||
| Symptoms | 834 | ||
| Physical Examination | 835 | ||
| Laboratory Evaluation | 835 | ||
| Treatment | 835 | ||
| Mitral Regurgitation | 835 | ||
| Etiology and Pathology | 835 | ||
| Pathophysiology | 836 | ||
| Symptoms | 836 | ||
| Physical Examination | 836 | ||
| Laboratory Evaluation | 836 | ||
| Treatment | 837 | ||
| Mitral Valve Prolapse | 837 | ||
| Etiology and Pathology | 837 | ||
| Pathophysiology | 837 | ||
| Symptoms | 837 | ||
| 9 -\rNeurology | 956 | ||
| 92 - The Neurologic Examination | 957 | ||
| Functional Neurologic Disorders | 957 | ||
| Neurologic Examination of the Awake/Interactive Patient | 957 | ||
| Mental Status | 957 | ||
| Psychiatric Examination | 959 | ||
| Neurologic Mental Status Examination | 959 | ||
| Cranial Nerves | 960 | ||
| I: Olfactory | 960 | ||
| II: Optic | 960 | ||
| III, IV, VI: Oculomotor, Trochlear, Abducens | 960 | ||
| V: Trigeminal | 960 | ||
| VII: Facial | 960 | ||
| VIII: Vestibulocochlear | 961 | ||
| IX, X: Glossopharyngeal, Vagus | 961 | ||
| XI: Spinal Accessory | 961 | ||
| XII: Hypoglossal | 961 | ||
| Motor | 961 | ||
| Appearance | 961 | ||
| Tone | 961 | ||
| Strength | 961 | ||
| Finger Tap | 962 | ||
| Sensation | 962 | ||
| Reflexes | 963 | ||
| Coordination | 963 | ||
| Gait | 964 | ||
| Neurologic Examination of the Less-Awake/Interactive Patient | 964 | ||
| Mental Status | 964 | ||
| Cranial Nerves | 964 | ||
| Motor | 965 | ||
| Sensation | 965 | ||
| Reflexes | 965 | ||
| 93 - Stroke Prevention | 967 | ||
| Assessing the Risk of First Stroke: Recommendations | 967 | ||
| Generally Nonmodifiable Risk Factors and Risk Assessment | 967 | ||
| Age | 967 | ||
| Low Birth Weight | 967 | ||
| Race/Ethnicity | 967 | ||
| Genetic Factors | 968 | ||
| Genetic Factors: Recommendations | 968 | ||
| Well-Documented and Modifiable Risk Factors | 969 | ||
| Physical Inactivity | 969 | ||
| Physical Inactivity: Recommendations | 969 | ||
| Dyslipidemia | 969 | ||
| Total Cholesterol | 969 | ||
| High-Density Lipoprotein Cholesterol | 969 | ||
| Triglycerides | 970 | ||
| Treatment of Dyslipidemia | 970 | ||
| Dyslipidemia: Recommendations | 971 | ||
| Diet and Nutrition | 971 | ||
| Diet and Nutrition: Recommendations | 972 | ||
| Hypertension | 973 | ||
| Hypertension: Recommendations | 975 | ||
| Obesity and Body Fat Distribution | 975 | ||
| Obesity and Body Fat Distribution: Recommendations | 976 | ||
| Diabetes Mellitus | 976 | ||
| Glycemic Control | 977 | ||
| Diabetes Mellitus and Hypertension | 977 | ||
| Lipid-Altering Therapy and Diabetes Mellitus | 978 | ||
| Diabetes Mellitus, Aspirin, and Stroke | 979 | ||
| Diabetes: Recommendations | 979 | ||
| Cigarette Smoking | 980 | ||
| Cigarette Smoking: Recommendations | 981 | ||
| Atrial Fibrillation | 981 | ||
| Risk Stratification in Patients With Atrial Fibrillation | 981 | ||
| Selecting Treatment to Reduce Stroke Risk in Patients With Atrial Fibrillation | 981 | ||
| Atrial Fibrillation: Recommendations | 985 | ||
| Other Cardiac Conditions | 985 | ||
| Acute Myocardial Infarction | 985 | ||
| Cardiomyopathy | 985 | ||
| Valvular Heart Disease | 986 | ||
| Patent Foramen Ovale and Atrial Septal Aneurysms | 987 | ||
| Cardiac Tumors | 987 | ||
| Aortic Atherosclerosis | 987 | ||
| Other Cardiac Conditions: Recommendations | 988 | ||
| Asymptomatic Carotid Artery Stenosis | 988 | ||
| Assessment of Carotid Stenosis | 988 | ||
| Endarterectomy for Asymptomatic Carotid Stenosis | 989 | ||
| Endovascular Treatment for Asymptomatic Carotid Stenosis | 989 | ||
| Screening of Asymptomatic Carotid Stenosis | 990 | ||
| Asymptomatic Carotid Stenosis: Summary and Gaps | 990 | ||
| Asymptomatic Carotid Stenosis: Recommendations | 991 | ||
| Sickle Cell Disease | 991 | ||
| Sickle Cell Disease: Recommendations | 993 | ||
| Migraine | 993 | ||
| Migraine: Recommendations | 995 | ||
| Metabolic Syndrome | 995 | ||
| Metabolic Syndrome: Recommendations | 996 | ||
| Alcohol Consumption | 996 | ||
| Alcohol Consumption: Recommendations | 997 | ||
| Sleep-Disordered Breathing | 997 | ||
| Sleep-Disordered Breathing: Recommendations | 998 | ||
| Hypercoagulability | 998 | ||
| Acquired Hypercoagulable State: Relationship to Ischemic Stroke | 998 | ||
| Hypercoagulability: Recommendations | 999 | ||
| Antiplatelet Agents for Primary Prevention of Stroke | 999 | ||
| Antiplatelet Agents and Aspirin: Recommendations | 1001 | ||
| Conclusion | 1001 | ||
| 94 - Dementia | 1002 | ||
| Alzheimer Disease | 1002 | ||
| Overview | 1002 | ||
| Clinical Presentation | 1003 | ||
| Diagnostic Criteria | 1003 | ||
| Workup | 1003 | ||
| Structural Imaging | 1003 | ||
| Additional Tests | 1004 | ||
| Stages of Alzheimer Disease Dementia | 1004 | ||
| Differential Diagnosis | 1005 | ||
| Treatment of Alzheimer Disease | 1006 | ||
| Mild Cognitive Impairment | 1006 | ||
| Clinical Presentation | 1006 | ||
| Workup | 1006 | ||
| Structural Imaging | 1006 | ||
| Functional Imaging | 1007 | ||
| 10 -\rGeneral Internal Medicine | 1057 | ||
| 98 - Preoperative Evaluation and Management Before Major Noncardiac Surgery | 1058 | ||
| American College of Cardiology/American Heart Association Guidelines on Perioperative Cardiovascular Evaluation and Management o... | 1058 | ||
| Risk Assessment | 1060 | ||
| Revascularization Before Surgery and Management After Revascularization | 1060 | ||
| Beta-Blockers | 1060 | ||
| Statins | 1061 | ||
| Aspirin | 1062 | ||
| Bridging Anticoagulation | 1062 | ||
| Bacterial Endocarditis Prophylaxis | 1063 | ||
| Glucocorticoids in Surgical Patients | 1063 | ||
| Pulmonary Risk Factors and Risk Reduction | 1064 | ||
| 99 - Basic Principles of Epidemiology and Biostatistics | 1067 | ||
| Screening for Disease Control | 1067 | ||
| Validity and Yield of a Screening Test | 1067 | ||
| What Influences the Sensitivity, Specificity, and Predictive Value? | 1068 | ||
| Bias in the Interpretation of Screening Results | 1068 | ||
| Measurement of Data: Measures of Disease Frequency and Measures of Association | 1068 | ||
| Measures of Disease Frequency | 1068 | ||
| Calculation of Measures of Disease Frequency | 1069 | ||
| Measures of Association | 1069 | ||
| Calculation of Measures of Association | 1070 | ||
| Overview of Epidemiological Study Designs and the Interpretation of Study Results | 1070 | ||
| What Kind of Study Design Was This? | 1070 | ||
| What Is the Magnitude of the Association Between the Exposure and the Outcome? | 1071 | ||
| Is this Observed Association Valid? | 1072 | ||
| 100 - Contraception | 1074 | ||
| Efficacy of Contraceptive Methods | 1074 | ||
| Long-Acting Reversible Contraception | 1074 | ||
| Short-Acting Hormonal Contraception | 1076 | ||
| Combined Hormonal Contraception | 1076 | ||
| Short-Acting Progestin-Only Contraception | 1077 | ||
| Barrier Methods | 1077 | ||
| Emergency Contraception | 1078 | ||
| Eligibility for Contraceptive Methods | 1079 | ||
| Special Populations | 1079 | ||
| Adolescents | 1079 | ||
| Obese Women | 1079 | ||
| History of Cancer | 1080 | ||
| Women With a History of Breast Cancer | 1080 | ||
| Other Malignancies | 1080 | ||
| Other Medical Problems | 1080 | ||
| 101 - Board Simulation: Women’s Health | 1082 | ||
| 102 - Dermatology for the Internist | 1089 | ||
| Premalignant and Malignant Skin Neoplasms | 1089 | ||
| Nonmelanoma Skin Cancers | 1090 | ||
| Melanoma | 1091 | ||
| Benign Skin Growths | 1092 | ||
| Nevi | 1092 | ||
| Seborrheic Keratosis | 1093 | ||
| Keratin-Filled Cysts | 1093 | ||
| Acne and Rosacea | 1093 | ||
| Acne Pathogenesis and Therapy | 1093 | ||
| Rosacea/Periorificial Dermatitis | 1094 | ||
| Dermatitis | 1094 | ||
| Atopic Dermatitis | 1094 | ||
| Contact Dermatitis | 1095 | ||
| Drug Rashes | 1095 | ||
| Autoimmune Connective Tissue Diseases | 1096 | ||
| Lupus Erythematosus | 1096 | ||
| Autoimmune Disorders of Skin Thickening | 1097 | ||
| Dermatomyositis | 1098 | ||
| Papulosquamous Diseases | 1099 | ||
| Pigmentary Disorders | 1100 | ||
| Bullous Disorders | 1101 | ||
| Hair and Nails | 1102 | ||
| 103 - Occupational Medicine | 1106 | ||
| The Occupational Medicine Epidemiology | 1106 | ||
| Occupational Medicine Effective History Elements | 1106 | ||
| Disability and Return to Work | 1107 | ||
| Organs-Based Highlights of Occupational Illnesses and Diseases | 1108 | ||
| Musculoskeletal and Peripheral Nervous System | 1108 | ||
| Special Senses | 1108 | ||
| Immune System | 1109 | ||
| Respiratory System (Upper and Lower) | 1109 | ||
| Cardiovascular System | 1109 | ||
| Gastrointestinal and Renal Systems | 1109 | ||
| Reproductive System | 1110 | ||
| Central Nervous System | 1110 | ||
| Psychological Stressors, Mental and Behavioral Illness, and Substance Abuse | 1111 | ||
| Summary | 1111 | ||
| 104 - Allergy and Immunology | 1113 | ||
| Allergic Rhinitis and Conjunctivitis | 1113 | ||
| Asthma | 1113 | ||
| Immunotherapy for the Treatment of Allergic Asthma and Rhinoconjunctivitis | 1114 | ||
| Asthma and Aspirin Sensitivity: Aspirin-Exacerbated Respiratory Disease | 1114 | ||
| Urticaria and Angioedema | 1114 | ||
| Angioedema | 1115 | ||
| Allergic Bronchopulmonary Aspergillosis | 1116 | ||
| Food Allergy | 1116 | ||
| Anaphylaxis | 1116 | ||
| Hymenoptera Allergy and Anaphylaxis | 1117 | ||
| Management of Anaphylaxis | 1117 | ||
| Exercise-Induced Anaphylaxis | 1117 | ||
| Adverse Reactions to Medications | 1117 | ||
| Mastocytosis | 1118 | ||
| Immunodeficiencies | 1118 | ||
| 105 - Psychiatry Essentials | 1120 | ||
| Depression | 1120 | ||
| Diagnosis | 1121 | ||
| Screening for Depression | 1122 | ||
| Suicide | 1123 | ||
| Suicide Risk Assessment | 1123 | ||
| Protective Factors | 1124 | ||
| Managing Risk of Suicide | 1124 | ||
| Treatment of Depression in Adults | 1124 | ||
| Psychotherapy | 1124 | ||
| Antidepressant Medications | 1125 | ||
| Choice of Antidepressant | 1125 | ||
| Overview of Antidepressants | 1125 | ||
| Drug Interactions | 1125 | ||
| Discontinuation Syndrome From SSRIs and SNRIs | 1125 | ||
| Serotonin Syndrome | 1125 | ||
| Effects of SSRIs and Other Newer Antidepressants on Suicide Risk in Adults | 1125 | ||
| Psychopharmacologic Approaches to Refractory Depression | 1126 | ||
| Bipolar Disorder | 1127 | ||
| Distinguishing Unipolar and Bipolar Depression | 1127 | ||
| Treatment and Prevention of Bipolar Disorder | 1128 | ||
| Treatment of Bipolar Depression | 1128 | ||
| Lithium | 1128 | ||
| Lamotrigine | 1129 | ||
| Atypical Antipsychotics | 1129 | ||
| Anxiety Disorders | 1129 | ||
| Panic Disorder | 1129 | ||
| Clinical Manifestations | 1129 | ||
| Acute Treatment | 1129 | ||
| Generalized Anxiety Disorder | 1130 | ||
| Clinical Manifestations and Diagnosis | 1130 | ||
| Treatment of Generalized Anxiety Disorder | 1130 | ||
| Drug Therapy | 1130 | ||
| Psychotherapy in the Treatment of Panic Disorder and Generalized Anxiety Disorder | 1131 | ||
| Schizophrenia and Related Disorders | 1131 | ||
| Antipsychotic Medications | 1131 | ||
| Somatization | 1132 | ||
| Somatization Disorder | 1132 | ||
| Treatment of Somatic Symptom Disorders | 1133 | ||
| Delirium | 1133 | ||
| Clinical Features | 1133 | ||
| Approach to the Patient | 1133 | ||
| Management | 1133 | ||
| 106 - Geriatrics | 1136 | ||
| Frailty and Multimorbidity | 1136 | ||
| Polypharmacy | 1136 | ||
| Dementia | 1137 | ||
| Background | 1137 | ||
| Epidemiology | 1137 | ||
| Pathophysiology | 1138 | ||
| Clinical Presentation | 1138 | ||
| Diagnosis | 1138 | ||
| Treatment | 1139 | ||
| Delirium | 1140 | ||
| Background | 1140 | ||
| Epidemiology | 1140 | ||
| Pathophysiology | 1140 | ||
| Clinical Presentation | 1140 | ||
| Diagnosis | 1140 | ||
| Treatment | 1140 | ||
| Late-Life Depression | 1141 | ||
| Background | 1141 | ||
| Epidemiology | 1141 | ||
| Pathophysiology | 1141 | ||
| Clinical Presentation | 1141 | ||
| Diagnosis | 1141 | ||
| Treatment | 1141 | ||
| Urinary Incontinence | 1142 | ||
| Background | 1142 | ||
| Epidemiology | 1142 | ||
| Pathophysiology | 1142 | ||
| Clinical Presentation | 1142 | ||
| Diagnosis | 1142 | ||
| Treatment | 1143 | ||
| Falls | 1143 | ||
| Background | 1143 | ||
| Epidemiology | 1143 | ||
| Risk Factors | 1143 | ||
| Evaluation | 1144 | ||
| Management | 1144 | ||
| Hypertension in the Older Adults | 1144 | ||
| Pain Management in Older Adults | 1145 | ||
| Health Screening in Older Adults | 1145 | ||
| Perioperative Issues in the Elderly | 1145 | ||
| 107 - Palliative Care | 1148 | ||
| Communication | 1148 | ||
| Ask-Tell-Ask | 1148 | ||
| Deepening the Conversation | 1148 | ||
| Responding to Emotion | 1149 | ||
| Goals of Care Discussion | 1150 | ||
| REMAP Model | 1150 | ||
| Pain | 1150 | ||
| Pain Assessment | 1150 | ||
| Initial Opioid Prescribing | 1150 | ||
| Long-Acting Opioids | 1151 | ||
| Example 1: Opioid Escalation | 1151 | ||
| Opioid Conversion | 1151 | ||
| Example 2: Equianalgesic Conversion | 1152 | ||
| Opioid Toxicity | 1152 | ||
| Buprenorphine and Methadone | 1152 | ||
| Adjuvant Pain Medications | 1153 | ||
| Procedural Pain Interventions | 1153 | ||
| Nausea and Vomiting | 1153 | ||
| Nausea Mechanisms | 1153 | ||
| Nausea Treatment | 1153 | ||
| Dyspnea | 1154 | ||
| Anorexia | 1154 | ||
| Fatigue | 1154 | ||
| Summary | 1155 | ||
| 108 - Board Simulation: General Internal Medicine | 1157 | ||
| 109 - Internal Medicine Summary | 1166 | ||
| Cancer Screening | 1166 | ||
| Breast Cancer | 1167 | ||
| Cervical Cancer | 1170 | ||
| Prostate Cancer | 1170 | ||
| Colorectal Cancer | 1170 | ||
| Controversies in Screening Lung Cancer | 1171 | ||
| Cardiovascular Screening | 1171 | ||
| Hypertension | 1171 | ||
| Abdominal Aortic Aneurysms | 1171 | ||
| Cholesterol/Lipid Screening | 1171 | ||
| Controversies in Cardiovascular Screening | 1173 | ||
| Diabetes Mellitus | 1173 | ||
| Lifestyle Factors | 1173 | ||
| Obesity | 1173 | ||
| Alcohol and Tobacco Abuse | 1173 | ||
| Infectious Disease/Sexually Transmitted Disease | 1173 | ||
| Human Immunodeficiency Virus | 1174 | ||
| Osteoporosis | 1174 | ||
| 11 -\rBoard Practice | 1176 | ||
| 110 - Approach to the Internal Medicine Board Examination | 1177 | ||
| 111 - Board Practice 1 | 1182 | ||
| 112 - Board Practice 2 | 1195 | ||
| 113 - Board Practice 3 | 1206 | ||
| Index | 1213 | ||
| A | 1213 | ||
| B | 1217 | ||
| C | 1218 | ||
| D | 1222 | ||
| E | 1224 | ||
| F | 1225 | ||
| G | 1226 | ||
| H | 1227 | ||
| I | 1229 | ||
| J | 1231 | ||
| K | 1231 | ||
| L | 1231 | ||
| M | 1233 | ||
| N | 1235 | ||
| O | 1236 | ||
| P | 1237 | ||
| Q | 1240 | ||
| R | 1241 | ||
| S | 1242 | ||
| T | 1244 | ||
| U | 1246 | ||
| V | 1246 | ||
| W | 1247 | ||
| X | 1247 | ||
| Y | 1247 | ||
| Z | 1247 | ||
| IBC\r | ES2 |