Passing the USMLE: Clinical Knowledge

227 Pages·2009·4.926 MB·English

by  Ahmad Wagih Abdel-Halim (auth.)

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