Mayo Clinic Images in Internal Medicine: Self-Assessment for Board Exam Review

385 Pages·2004·23.77 MB·English

by  Furman S. McDonald

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Mayo Clinic
Images in Internal Medicine
Self-Assessment for Board Exam Review
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Mayo Clinic
Images in Internal Medicine
Self-Assessment for Board Exam Review
Editor
Furman S. McDonald, MD
Co-Editors
Paul S. Mueller, MD
Gautam Ramakrishna, MD
MAYO CLINIC SCIENTIFIC PRESS
CRC PRESS
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ISBN-0-8493-3079-3
The triple-shield Mayo logo and the words MAYO and MAYO CLINIC are
marks of Mayo Foundation for Medical Education and Research.
©2004 Mayo Foundation for Medical Education and Research.
All rights reserved. This book is protected by copyright. No part of it may be
reproduced, stored in a retrieval system, or transmitted, in any form or by any
means—electronic, mechanical, photocopying, recording, or otherwise—without
the prior written consent of the copyright holder, except for brief quotations
embodied in critical articles and reviews. Inquiries should be addressed to
Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
For order inquiries, contact CRC Press, 2000 NW Corporate Blvd., Boca Raton,
FL33431.
www.crcpress.com
Care has been taken to confirm the accuracy of the information presented and
to describe generally accepted practices. However, the authors, editors, and
publisher are not responsible for errors or omissions or for any consequences
from application of the information in this book and make no warranty, express
or implied, with respect to the contents of the publication. This book should not
be relied on apart from the advice of a qualified health care provider.
The authors, editors, and publisher have exerted efforts to ensure that
drug selection and dosage set forth in this text are in accordance with current
recommendations and practice at the time of publication. However, in view of
ongoing research, changes in government regulations, and the constant flow of
information relating to drug therapy and drug reactions, the reader is urged to
check the package insert for each drug for any change in indications and dosage
and for added warnings and precautions. This is particularly important when
the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food
and Drug Administration (FDA) clearance for limited use in restricted research
settings. It is the responsibility of the health care providers to ascertain the
FDAstatus of each drug or device planned for use in their clinical practice.
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DEDICATED TO
Four very special people:
• Charles H. Rohren, MD—the best physical diagnostician I
know. Agreat physician, teacher, mentor, and friend. You
are the reason I am an internist today. I will always see you
when I think of the physician I want to be.
• Darryl S. Chutka, MD—a great physician and teacher. When
you told me to “make the book as large as you like,” I don’t
think you expected what would come of it. Without your
support and allowance for creative freedom, this book would
never have been written.
• Henry J. Schultz, MD—the greatest single influence on my
professional life. Program director, adviser, friend. I hope
that this book will be useful to the residents you care so
much about, of whom I know I am one.
• Elizabeth S. McDonald, MD, PhD—my devoted wife.
Thanks for putting up with me while I put so much time
into this book.
One very special program:
Proceeds from the book will support the Mayo International
Health Program, which defrays the cost of elective experiences
for Mayo Clinic residents and fellows caring for underserved
patients in international settings.
Furman S. McDonald, MD
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PREFACE
Mayo Clinic Images in Internal Medicine: Self-Assessment for Board
Exam Reviewwas begun in 1998 as an adjunct to a presentation
for the Mayo Internal Medicine Board Review Course. Images
were presented in random order with brief case scenarios. The
reader was encouraged to consider the cases before turning the
page to read a few learning points about each image. That first
book contained 38 cases and 57 images from 6 contributors.
Year by year the work was expanded until now the current
book has 173 cases with 287 images from 28 contributors. As
with the first book, all images are from patients seen at Mayo
Clinic, and the cases have been designed to illustrate important
teaching points. American Board of Internal Medicine–type
board review questions accompany the cases. The references
from which the content for each case scenario was built are
provided so the reader can obtain further information. Cases
are presented in random order to be a more effective review
tool that simulates examination (and clinical practice) condi-
tions. However, with the increase in size, a detailed index was
developed to allow the reader to find cases more efficiently. In
addition, this edition introduces chain referencing, an innova-
tive learning technique that allows the reader to move from
case to case based on specialty designation. With access to
the information in this book through random case review, the
detailed reference index, and specialty chain referencing, Mayo
Clinic Images in Internal Medicine: Self-Assessment for Board Exam
Reviewis really three effective learning texts bound in one cover.
It is hoped that Mayo Clinic Images in Internal Medicine:
Self-Assessment for Board Exam Reviewwill be an aid for prepa-
ration for board examination certification or recertification
and medical clerkship review and also a useful update for
practicing clinicians.
Furman S. McDonald, MD
Editor
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ACKNOWLEDGMENTS
Many thanks are due to all who helped in the preparation of this
book. There are many, and I will not try to name them all.
This work was supported in part by the Clinical Educator and
Educational Initiative Program, an integral grant program of
Mayo Clinic. We are most appreciative of this support.
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AUTHOR AFFILIATIONS
Furman S. McDonald, MD
Senior Associate Consultant, Division of General Internal
Medicine–Hospital Medicine, Mayo Clinic
Associate Program Director, Internal Medicine Residency, Mayo
School of Graduate Medical Education, Mayo Clinic College of
Medicine
Assistant Professor of Medicine, Mayo Clinic College of Medicine
Rochester, Minnesota
Paul S. Mueller, MD
Consultant, Division of General Internal Medicine, Mayo Clinic
Assistant Professor of Medicine, Mayo Clinic College of Medicine
Rochester, Minnesota
Gautam Ramakrishna, MD
Fellow in Cardiovascular Diseases, Mayo School of Graduate
Medical Education, Mayo Clinic College of Medicine
Assistant Professor of Medicine, Mayo Clinic College of Medicine
Rochester, Minnesota
Image Contributors
Edith M. Andrist Elizabeth S. McDonald, MD, PhD
Marc H. Bivins, MD Furman S. McDonald, MD
Emmanouil S. Brilakis, MD David E. Midthun, MD
B. Ryan Brady, MD Victor M. Montori, MD
Darryl S. Chutka, MD Carlos E. Morales, MD
Mark D. P. Davis, MD John (Jack) D. Myers, MD
Laura A. Diamondopoulos, MD Roger L. Nelson, MD
David Dingli, MD Julian J. Nicholas, MD
Jon O. Ebbert, MD Lynne E. Nowak, MD
Stephen C. Hammill, MD David M. Phelan, MD
Melinda J. Johnson, MD Jan Stepanek, MD
Patrick S. Kamath, MD Craig S. Stump, MD
Thomas S. Lin, MD Wilber W. Su, MD
James S. Mathur, MD Farhad Zangeneh, MD
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