Crush Step 1 - The Ultimate USMLE Step 1 Review, 3e (April 21, 2023)_(0323878865)_(Elsevier).pdf

Front Cover Inside front cover Crush Step: The Ultimate USMLE Step 1 Review, 3rd edition Copyright Review board Contributors Introduction A note from the authors Table of contents 1 Biostatistics Mean, median, and mode Definitions Epidemiology Statistics for diagnostic tests Calculations of risk measures Probability Statistical tests and significance Statistical tests for data analysis Causality Hypothesis testing Research study design Clinical trials Research ethics Bias Application of study results Medical ethics Preventative medicine and health care Review questions 2 Biochemistry Protein structure and function Amino acid structure Protein structure Oxygen-binding proteins: Hemoglobin and myoglobin Fibrous proteins Enzymes Nitrogen metabolism Disposal of amino acid nitrogen Amino acid synthesis and degradation Amino acid derivatives Heme synthesis and metabolism Nucleic acid structure and function Nucleic acid structure Purine metabolism Pyrimidine synthesis DNA replication DNA repair Carbohydrate structure and metabolism Carbohydrate structure Glycolysis Gluconeogenesis Glycogen synthesis and degradation Glycogen storage diseases Metabolism of sugars Pentose phosphate pathway TCA cycle Electron transport and oxidative phosphorylation Lipid structure and metabolism Lipid structure Sphingolipids and sphingolipid storage diseases Eicosanoids Fatty acid oxidation and synthesis Integration of metabolism Vitamins Trace elements Genetics Patterns of inheritance Pedigree analysis Basic mendelian inheritance Autosomal dominant Autosomal recessive X-linked recessive X-linked dominant Mitochondrial inheritance Chromosomal abnormalities Nondisjunction Autosomal trisomies Sex chromosome aneuploidy Trinucleotide repeat disorders Genetic imprinting diseases Review questions 3 Dermatology Histology and physiology Adnexal structures Describing lesions Pathology Common dermatologic conditions Autoimmune diseases Conditions of pigmentation Neoplasms, dysplasias, and malignancies Vascular lesions Strawberry hemangioma (infantile hemangioma) Cherry angioma Port wine stain (capillary malformation) Pyogenic granuloma (PG) Angiosarcoma Skin infections and infestations Verrucae (warts) Dermatologic manifestations of internal disease Inherited skin disorders Skin conditions caused by environmental factors Pharmacology Review questions 4 Embryology Terminology Early embryology: The first month The first week: From fertilization to implantation Twinning The second week: The rule of twos The third week: Gastrulation and the ectoderm, endoderm, and mesoderm Ectoderm Endoderm Mesoderm The fourth week: Neural tube closure and beginning of organogenesis Embryology: Week 5 and beyond Weeks 4 to 8: Organogenesis and teratogenicity Substances of abuse Common medications Historical medications Weeks 9 to birth: The “fetal period” of organ maturation Fetal circulation and erythropoiesis Structure of the placenta and umbilical cord Overview of fetal circulation Fetal circulation summary Changes to fetal circulation at birth Fetal erythropoiesis Cardiac embryology Formation of the cardiac loop Septation of the heart: Interatrial septum formation Septation of the heart: Interventricular septum formation Vascular embryology Neuroembryology Gastrointestinal embryology Renal embryology Reproductive embryology Head and neck embryology Growth and development Neonatal medicine Apgar score Low birth weight Developmental milestones Review questions 5 Microbiology Bacteria Introduction to bacterial structure Organization of the rest of the bacteriology section Gram-positive cocci Staphylococcus Streptococcus Gram-negative cocci Neisseria Other gram-negative cocci Gram-positive rods Spore forming Non–spore forming Bacillus Clostridium: Listeria: Corynebacterium: Gram-negative enteric rods Escherichia Klebsiella: Proteus: Shigella: Salmonella: Yersinia: Vibrio: Campylobacter: Helicobacter: Pseudomonas: Burkholderia and stenotrophomonas: Bacteroides and fusobacterium: Other enterics: Gram-negative nonenteric rods Haemophilus: Gardnerella: Bordetella: Legionella: Yersinia: Francisella: Brucella: Pasteurella: Gram-positive branching filamentous bacteria Actinomyces: Nocardia: Pleomorphic bacteria Chlamydia: Rickettsia: Rickettsia-like infections Gram-negative spirals Treponema: Borrelia Leptospira: Gram-positive acid-fast bacteria Mycobacterium: Primary tuberculosis: Secondary (reactivation) tuberculosis Gram-positive bacteria with no cell wall Mycoplasma: Viruses Introduction to viruses DNA viruses Herpesviridae Cytomegalovirus Herpes simplex virus Epstein−barr virus Varicella-zoster virus Other herpes viruses Hepadnaviridae Orthohepadnavirus Parvoviridae Parvovirus Papovaviridae Human papillomavirus Polyomaviruses Adenoviridae Poxviridae RNA viruses Naked RNA viruses Picornaviruses Hepeviruses Caliciviruses Reoviruses (respiratory enteric orphan viruses) Enveloped RNA viruses Flaviviruses Togaviruses Retroviruses Coronaviruses Orthomyxoviruses Paramyxovirus Rhabdoviruses Filoviruses Deltaviruses Arenaviruses Bunyaviruses Prion diseases Fungi Introduction to fungi Superficial and cutaneous mycoses Subcutaneous fungal infections Systemic mycoses Systemic mycoses in individuals with normal immune systems Systemic mycoses in immunocompromised individuals Parasites Protozoa Protozoa that cause central nervous system infections Protozoa that cause gastrointestinal infections Protozoa that cause bloodborne infections Protozoa that are sexually transmitted Helminths Nematodes Platyhelminths Cestodes (tapeworms) Trematodes (flukes) Antimicrobials Antibiotics β-lactam antibiotics Penicillins: Penicillin G (IV); penicillin V (oral) Aminopenicillins: Ampicillin (IV, oral); amoxicillin (oral) Penicillinase-resistant penicillins: Methicillin, nafcillin, oxacillin (IV); cloxacillin, dicloxacillin (oral) Antipseudomonal penicillins: Ticarcillin, piperacillin (IV); carbenicillin (oral) Cephalosporins Monobactams—aztreonam (IV, IM) Carbapenems—imipenem/cilastatin, meropenem, ertapenem, doripenem (IV, IM) Antiribosomal antibiotics Aminoglycosides—gentamicin, amikacin, streptomycin (IV); neomycin (topical, IV, oral), tobramycin (IV, inhaled), neosporin Tetracyclines—tetracycline, doxycycline, minocycline, demeclocycline (PO, IV, topical), tigecycline (IV) Macrolides—erythromycin, azithromycin (PO, IV); clarithromycin (PO) Amphenicols—chloramphenicol (PO, IV) Lincosamides—clindamycin (PO, IV, topical) Oxazolidinones—linezolid (PO, IV) Streptogramins—quinupristin/dalfopristin (IV) Miscellaneous antibiotics Glycopeptides—vancomycin (IV, PO) Lipopeptides—daptomycin (IV) Antimetabolites—trimethoprim/sulfamethoxazole (IV, PO); dapsone, sulfoxone, sulfadiazine (PO) Quinolones: Ciprofloxacin, levofloxacin, moxifloxacin (PO, IV, some ophthalmic) Nitroimidazoles/nitrofurans—metronidazole (PO, IV, topical); nitrofurantoin (PO) Polymyxins—polymyxin B, colistin/polymyxin e (IV, inhaled, topical) Monoxycarbolic acids—mupirocin (topical) Antimycobacterial drugs Isoniazid (INH)—PO, IM, IV Rifamycins—rifampin, rifabutin (PO, IV); rifaximin (PO) Pyrazinamide (PZA)—PO Ethambutol (EMB)—PO Specific antiviral agents HIV therapeutics/antiretroviral therapy (ART) Antifungals Systemic antifungals for systemic infections Amphotericin B Flucytosine Azoles Echinocandins Oral antifungals for mucocutaneous infections Griseofulvin Terbinafine Topical antifungals for mucocutaneous infections Nystatin Topical azoles Topical allylamines Review questions 6 Immunology Lymphoid structures Anatomy of the immune system Overview of innate versus adaptive immunity Basic versus learned responses Cells of the immune system Workhorses of immunity Myeloid lineage Lymphoid lineage Lymphocytes Natural killer cells Major histocompatibility complex I and II How we differentiate ourselves from everything else B cells, antibodies, and humoral immunity B cell is king T cells, cell-mediated immunity, immune system regulation Regulators and educated assassins High-yield cytokines/interleukins T-cell deficiency syndromes Complement system The confusing cascade of complement simplified Main functions of the complement system Complement deficiencies and associated conditions Hypersensitivity response Immunity gone wild! Transplantation immunology Types of tissue transplants Types of rejection High-yield immunosuppressant drugs Review questions 7 Pharmacology and toxicology Pharmacokinetics Overview Calculations and kinetics Pharmacodynamics Overview Autonomic nervous system and signal transduction Overview Sympathetic nervous system Signal transduction pathways Parasympathetic nervous system Pharmacology Adrenergic pharmacology Cholinergic pharmacology Toxicology Common drugs and toxicology Heavy metal toxicity Environmental exposures Ethanol, methanol, and ethylene glycol Review questions 8 Cardiology Heart and blood vessels Overview Anatomy of the heart Anatomy of the circulatory system Physiology Cardiovascular terminology and formulas Electrophysiology Cardiac myocytes Frank—starling curve Cardiac cycle Heart sounds and murmurs Murmur summary Pressure in the cardiovascular system Electrocardiography Regulation of blood pressure Pathology Congenital heart disease Atherosclerosis Hypertension Ischemic heart disease Myocardial infarction Cardiomyopathies Rheumatic fever Infective endocarditis Pericardial disease Vasculitides Cardiac and vascular tumors Pharmacology Vasopressors Vasodilators Sympatholytics Diuretics Antiarrhythmics Adenosine Digoxin (cardiac glycosides) Review questions 9 Endocrinology Overview of the endocrine system Hormones Regulation Types of hormones Terminology of pathophysiology Multiple endocrine neoplasia syndromes Hypothalamus and pituitary gland Hypothalamus and pituitary function overview Pituitary hormones covered elsewhere Growth hormone Prolactin Causes of anterior pituitary dysfunction Thyroid gland Anatomy, embryology, and histology Thyroid hormone physiology Laboratory testing Pathology Pharmacology Adrenal glands (cortex and medulla) Anatomy, embryology, and histology Adrenal gland physiology Pathology Decreased adrenal cortex function Congenital adrenal hyperplasia Increased aldosterone secretion Increased cortisol secretion Increased catecholamine secretion Endocrine pancreas Anatomy, embryology, and histology Endocrine pancreas physiology Insulin (from the beta cells of the islets of langerhans) Glucagon (from the alpha cells of the islets of langerhans) Diabetes Diagnosis of diabetes Chronic effects of hyperglycemia Acute emergencies in diabetes Islet cell tumors Pharmacology of diabetes mellitus Insulin Sulfonylurea drugs—glyburide, glipizide, glimepiride Biguanides—metformin Thiazolidinediones—pioglitazone (-glitazone drugs) Incretin mimetics (-tides: exenatide, liraglutide) and DPP-4 inhibitors (-gliptins: Sitagliptin, linagliptin, saxagliptin) α-glucosidase inhibitors—acarbose, miglitol Sodium-glucose cotransporter 2 (SGLT-2) inhibitors—canaglifozin (-gliflozin drugs) Parathyroid glands Anatomy, embryology, and histology Overview of calcium homeostasis Laboratory testing and pitfalls Pathology causing increased calcium levels Pathologic causes of decreased calcium levels Review questions 10 Gastroenterology Anatomy Digestive tract anatomy Saliva Physiology Gastric histology Histology of the intestine Gastrointestinal hormones Digestion and absorption Pathology Oral pathology Salivary gland disorders Esophageal pathology Gastric and duodenal pathology Small bowel and colon Inflammatory bowel disease Diarrhea Other gastroenteritis and parasitic infections Osmotic: Secretory: Exudative: Deranged motility: Diverticular disease: Diverticulitis: Bleeding diverticulosis Anal fissure Hemorrhoids Internal hemorrhoids External hemorrhoids Other rectal disorders Laboratory tests Hepatic pathology Viral hepatitis: Nonalcoholic fatty liver disease (NAFLD) Alcoholic hepatitis Hemochromatosis Wilson disease α1-antitrypsin deficiency Cirrhosis Portal hypertension Hepatic neoplasms Hepatic hemangioma: Hepatocellular adenoma: Hepatocellular carcinoma (hepatoma, HCC): Cholangiocarcinoma: Disorders of bilirubin metabolism Gilbert syndrome: Crigler-najjar syndrome: Dubin-johnson syndrome: Autoimmune disorders Gallbladder and pancreas Pediatric gastroenterology and hepatology Pharmacology Antiemetics Ondansetron Metoclopramide Antacids Proton pump inhibitors Histamine-2 blockers Weak bases Cytoprotective agents Bismuth sucralfate Misoprostol Inflammatory bowel disease management Sulfasalazine Others Other agents Statins Cholestyramine Loperamide Octreotide Orlistat Review questions 11 Hematology and oncology Anatomy Blood The myeloid lineage Reticulocyte Key definitions Leukocytes Neutrophils The lymphoid lineage Physiology Blood groups: ABO and Rh systems Hemostasis: The coagulation cascade Adhesion Activation Aggregation Coagulation cascade: Key points Platelet and coagulation tests Anticoagulant system Fibrinolytic system and tests Pathology Anemia Laboratory testing in anemia Approach to anemia Microcytic anemias Acquired microcytic anemias: Iron metabolism and iron deficiency anemias Anemia of chronic disease Clinical signs Laboratory evaluation Treatment Heme synthesis and acquired sideroblastic anemia Causes of sideroblastic anemia X-linked sideroblastic anemia: Clinical signs specific to lead poisoning Laboratory evaluation specific to lead poisoning Treatment specific to lead poisoning Laboratory evaluation of sideroblastic anemia Inherited microcytic anemias: Thalassemias α-thalassemia: Laboratory findings in α-thalassemia trait Treatment for α-thalassemia trait β-thalassemia Laboratory findings in β-thalassemia trait Treatment Laboratory and physical examination findings in β-thalassemia major Treatment Normocytic anemias Normocytic anemias with corrected reticulocyte count less than 3%: Acute blood loss Laboratory findings in acute blood loss Treatment Aplastic anemia Laboratory findings Treatment Chronic kidney disease Laboratory findings Malignancy Normocytic anemias with corrected reticulocyte count more than 3%: Sickle cell anemia Sickle cell trait Laboratory findings Sickle cell disease Signs and symptoms of sickle cell disease Laboratory findings Factors that prevent or reverse sickling (and treatments) G6PD deficiency Signs and symptoms Laboratory findings Pyruvate kinase (PK) deficiency Laboratory findings Treatment Hereditary spherocytosis (HS): Signs and symptoms Laboratory findings Treatment Hereditary elliptocytosis (HE) Paroxysmal nocturnal hemoglobinuria (PNH) Signs and symptoms Clinical and laboratory findings Treatment Hemoglobin C (HbC) disease Signs and symptoms Clinical and laboratory findings Treatment Immune hemolytic anemias Signs and symptoms Laboratory findings Treatment Microangiopathic and macroangiopathic hemolytic anemias Macrocytic anemias Megaloblastic anemias Role of folate and cobalamin in DNA synthesis Vitamin B12 (cobalamin) deficiency anemia: Signs and symptoms of cobalamin deficiency Laboratory findings Treatment Folate deficiency anemia: Folate metabolism Causes of folate deficiency Signs and symptoms of folate deficiency Laboratory findings Treatment Orotic aciduria Signs and symptoms Laboratory findings: Treatment Nonmegaloblastic anemia Bleeding and thrombotic disorders Platelet abnormalities: Immune thrombocytopenic purpura or idiopathic thrombocytopenic purpura Chronic ITP Acute ITP Drug-induced thrombocytopenia Heparin-induced thrombocytopenia (HIT) Thrombotic thrombocytopenic purpura Hemolytic uremic syndrome Disseminated intravascular coagulation Prothrombotic stage Prohemorrhagic stage Causes of DIC include the following (mnemonic: stop making new thrombi!): Clinical and laboratory findings Treatment Clotting factor deficiencies Hemophilia A Hemophilia B Vitamin K deficiency Liver disease Hereditary thrombosis syndromes Factor V leiden Prothrombin G20210A mutation Protein C and protein S deficiency Antithrombin (AT) deficiency White blood cell neoplastic proliferation Leukemias Acute lymphoblastic leukemia (ALL) Laboratory findings Treatment Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) Laboratory findings Immunohistochemical testing Cytogenetics Treatment: Acute myelogenous leukemia (AML) Clinical and laboratory findings Immunohistochemical testing Cytogenetics Treatment Chronic myelogenous leukemia Clinical and laboratory findings Cytogenetics Treatment Leukemoid reaction Hairy cell leukemia (HCL) Lymphomas Hodgkin lymphoma (HL) Clinical and laboratory findings Treatment Non-hodgkin lymphoma (NHL) B-cell lymphomas: Follicular lymphoma (FL) Treatment Diffuse large B-cell lymphoma (DLBCL) Clinical and laboratory findings Treatment Mantle cell lymphoma (MCL) Clinical and laboratory findings Treatment Burkitt lymphoma Clinical and laboratory findings Treatment Malt lymphoma Primary central nervous system lymphoma (PCNSL) T-cell lymphomas: Adult T-cell lymphoma or leukemia (ATL) Clinical and laboratory findings Treatment Mycosis fungoides and sezary syndrome Histiocyte disorders Langerhans cell histiocytosis (LCH) and histiocytosis X Letterer-siwe disease: Eosinophilic granuloma: Hand-schuller-christian disease (multifocal LCH): Plasma cell disorders Multiple myeloma (MM) Waldenström macroglobulinemia (lymphoplasmacytic lymphoma) Monoclonal gammopathy of undetermined significance (MGUS) Myeloproliferative disorders Polycythemia vera Myeloid metaplasia with myelofibrosis Disorders of heme production Porphyria cutanea tarda Acute intermittent porphyria Pharmacologic treatment Anticoagulants Heparin Direct thrombin inhibitors (bivalirudin/argastroban and dabigatran) Warfarin (coumadin) Antiplatelet agents Aspirin Thienopyridine derivatives (clopidogrel, ticlopidine, prasugrel, ticagrelor) Glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, tirofiban) Phosphodiesterase III inhibitors (cilostazol, dipyrimadole) Thrombolytics Alteplase (tPA), reteplase (rPA), tenecteplase (TNKase), streptokinase Antineoplastics Antimetabolites Methotrexate (MTX) 5-Fluorouracil (5-FU) Thiopurines (azathioprine and 6-mercaptopurine [6-MP]) 6-Thioguanine (6-TG) Cytarabine Purine analogs (cladribine, pentostatin) Antitumor antibiotics Dactinomycin Anthracyclines (doxorubicin, daunorubicin) Bleomycin Alkylating agents Nitrogen mustards (cyclophosphamide, ifosfamide) Nitrosoureas (carmustine, iomustine, semustine, streptozocin) Busulfan Procarbazine Microtubule inhibitors Vinca alkaloids (vincristine, vinblastine) Taxanes (paclitaxel, docetaxel) Topoisomerase inhibitors Podophyllotoxins (etoposide and teniposide) Camptothecin analogs (irinotecan and topotecan) Steroid hormones and their antagonists Prednisone Tamoxifen and raloxifene Biologics and signal transduction inhibitors Anticancer monoclonal antibodies (mAb) CD20 (rituximab) CD52 (alemtuzumab) CTLA-4 (ipilimumab) EGFR (cetuximab, panitumumab) HER2 (trastuzumab) PD-1 (pembrolizumab, nivolumab, cemiplimab) PD-L1 (atezolizumab, durvalumab, avelumab) VEGF (bevacizumab) Anticancer small molecule inhibitors Anaplastic lymphoma kinase (ALK) inhibitor (alectinib) BRAF inhibitors (vemurafenib, encorafenib, dabrafenib) Cyclin-dependent kinase (CDK) inhibitor (palbociclib) Epidermal growth factor receptor (EGFR) inhibitors (erlotinib, gefitinib, afatinib) Janus kinase (JAK) inhibitor (ruxolitinib) Poly ADP ribose polymerase (PARP) inhibitor (olaparib) Proteasome inhibitors (bortezomib, ixazomib, carfilzomib) Tyrosine kinase inhibitors (imatinib, dasatinib, nilotinib) Other agents Platinum compounds (cisplatin, carboplatin, oxaliplatin) Hydroxyurea Review questions 12 Musculoskeletal/rheumatology Anatomy and physiology Upper extremity anatomy Brachial plexus syndromes Winged scapula: Erb palsy (waiter’s tip): Klumpke palsy: Thoracic outlet syndrome: Peripheral nerve lesions of the upper extremity Ulnar claw (Pope’s blessing = median nerve injury): Wrist drop: Ape hand (non-opposable thumb): Bottle sign: Carpal tunnel syndrome: Ulnar tunnel syndrome (Guyon canal syndrome): Lower extremity anatomy Peripheral nerve lesions of the lower extremity Foot drop: Trendelenburg gait: Joints Pathology Neuromuscular junction disorders Mechanical injuries Complications of fracture Osteoarthritis: Adhesive capsulitis (frozen shoulder): Disease of bone Disorders of muscle Muscular dystrophy Rheumatology Inflammatory arthritis Rheumatoid arthritis (RA): Felty syndrome: Systemic lupus erythematosus (SLE): Drug-induced lupus: Sjögren syndrome: Scleroderma: Raynaud syndrome (raynaud phenomenon): Seronegative spondyloarthropathies Psoriatic arthritis: Ankylosing spondylitis: Inflammatory bowel disease (IBD): Reactive arthritis: Monoarticular disease Infectious arthropathy Septic arthritis (acute): Disseminated gonococcus: Chronic infectious arthritis: Crystal arthropathy Gout: Pseudogout: Pediatric conditions Other conditions Neoplasms of bone Benign Osteochondroma: Osteoma: Osteoblastoma, osteoid osteoma: Giant cell tumor: Malignant Metastases: Osteosarcoma: Chondrosarcoma: Ewing sarcoma: Neoplasms of soft tissue Pharmacology Nonsteroidal anti-inflammatory drugs Acetaminophen Glucocorticoids Osteoporosis medications Skeletal muscle relaxants Gout medications Disease modifying anti-rheumatic drugs (DMARDs) Neuromuscular junction blocking agents Review questions 13 Neurology Anatomy and physiology Neurohistology Sensory receptors Cutaneous receptors Muscle receptors Neurotransmitters Amino acids Monoamines and catecholamines Dopamine (DA) Norepinephrine (NE) Serotonin (5-HT) Other neurotransmitters Adenosine Nitric oxide (NO) Substance P Cerebral perfusion pressure (CPP) Anatomy Basal ganglia Hypothalamus Thalamus Limbic system Ventricular system Cerebellum Blood supply Brainstem Cranial nerves Middle cranial fossa Posterior cranial fossa Cavernous sinus Spinal cord Auditory pathway Vestibular pathway Visual system Electroencephalogram (EEG) Pathology Developmental disorders Neural tube defects Hydrocephalus Noncommunicating, obstructive Congenital Acquired Communicating, nonobstructive Normal pressure hydrocephalus (NPH) Hydrocephalus ex vacuo Syringomyelia Neurocutaneous syndromes Neurofibromatosis (NF) Tuberous sclerosis Sturge-Weber syndrome von Hippel-Lindau (VHL) disease Brain lesions Aphasia Vascular dysfunction Stroke Aneurysm Venous Brainstem Trauma Classification Diffuse Focal Epidural hematoma Subdural hematoma (SDH) Subarachnoid hemorrhage (SAH) Intracerebral hemorrhage (ICH) Basilar skull fracture Cerebral contusion Herniation Supratentorial Central Cingulate (subfalcine) Transcalvarial Infratentorial Spinal cord Spinal cord lesions Brown-Séquard syndrome Poliomyelitis Tabes dorsalis Horner syndrome Infection Viral infections Parasitic infections Prion Demyelinating diseases Neurodegenerative diseases Movement disorders Dementia Seizures Headache (HA) Primary headaches Tension-type HA Migraine HA Cluster HA Trigeminal neuralgia Secondary headaches Subarachnoid hemorrhage (SAH) Idiopathic intracranial hypertension (IIH) Meningitis Giant cell arteritis (GCA) Brain tumors Closed-angle glaucoma Carbon monoxide (CO) poisoning Brain tumors Cranial nerve lesions Ear pathology Infection Acute otitis externa Acute otitis media (AOM) Cholesteatoma Ramsay-Hunt syndrome Hearing impairment Eye pathology External Hordeolum Chalazion Coloboma EOM abnormalities Cataracts Pupils Glaucoma Posterior eye pathology Visual field defects Pharmacology Glaucoma Opioids Epilepsy Anesthetics Neuromuscular blockade Pharmacologic treatment of other neurologic disorders Parkinson disease Alzheimer disease Huntington disease Multiple sclerosis Headaches Stroke Review questions 14 Psychiatry Psychology and development Theories of learning Freudian theory Immature ego defenses Neurotic ego defenses Mature ego defenses Miscellaneous concepts in psychology Psychopathology Psychiatric disorders of children Attention-deficit/hyperactivity disorder Treatment Oppositional defiant disorder Treatment Conduct disorder Treatment Tourette syndrome Treatment Separation anxiety disorder Pervasive developmental disorders Autism spectrum disorders Asperger disorder Rett syndrome Childhood disintegrative disorder Delirium versus dementia Schizophrenia Neurobiological mechanism Treatment First-generation (typical) antipsychotics Second-generation (atypical) antipsychotics Similar disorders Depression Neurobiological mechanism Treatment Serotonin syndrome Persistent depressive disorder (dysthymia) Bipolar disorders Bipolar I Bipolar II Cyclothymic disorder Treatment for bipolar I and bipolar II disorders Anxiety disorders Panic disorder Neurobiological mechanism Treatment Specific and social phobias Treatment Generalized anxiety disorder Neurobiological mechanism Treatment Obsessive-compulsive disorder Neurobiological mechanism Treatment Stress disorders Posttraumatic stress disorder (PTSD) Treatment Acute stress disorder Adjustment disorder Malingering Factitious disorder Somatoform disorders Personality disorders Cluster A: Weird Cluster B: Wild Cluster C: Worried Dissociative disorders Eating disorders Anorexia nervosa Bulimia nervosa Gender dysphoria Disorders of substance use Commonly abused substances Stimulants Amphetamines and cocaine Nicotine Caffeine Depressants or sedatives Alcohol Barbiturates and benzodiazepines Opiates Hallucinogens Phencyclidine (PCP, angel dust) Lysergic acid diethylamide (LSD, acid) Marijuana Medication summary Review questions 15 Nephrology Anatomy Kidneys Blood supply Urinary collecting system Physiology Overview and terminology Glomerular filtration rate Clearance and GFR The glomerulus and filtration The nephron and its segments Proximal tubule Thin loop of henle Function of the thin loop of henle: Thick ascending loop of henle Functions of the thick ascending limb: Distal convoluted tubule Functions of the distal convoluted tubule: Collecting duct Body fluid compartments and maintenance Renin-angiotensin-aldosterone axis Antidiuretic hormone and free water clearance Other endocrine functions of the kidneys pH homeostasis and acid–base disturbances Pathology Hyponatremia and hypernatremia Hyponatremia Hypovolemic hyponatremia: Euvolemic hyponatremia: Hypervolemic hyponatremia: Hypernatremia Hypokalemia and hyperkalemia Hyperkalemia Causes: Findings: Treatment: Hypokalemia Causes: Findings: Treatment: Urinalysis and urine microscopy Color Specific gravity pH Protein Glucose Ketones Bilirubin Urobilinogen Blood Nitrites Leukocyte esterase Cells Casts Crystals (stones) Kidney stones (urolithiasis) Calcium stones Magnesium ammonium phosphate (struvite) Uric acid stones Cystine stones Glomerular diseases Nephrotic and nephritic syndromes Other systemic diseases causing glomerular damage Tubular and interstitial disorders Renal tubular acidosis Type 1 RTA: Type 2 RTA: Azotemia and renal failure Prerenal azotemia Renal azotemia Postrenal azotemia Urinary tract infections Malignancies and benign tumors of the urinary tract Renal cell carcinoma Transitional cell carcinoma Nephroblastoma (Wilms tumor) Angiomyolipomas Congenital and inherited renal disorders Polycystic kidney disease Autosomal dominant PKD: Autosomal recessive PKD: Horseshoe kidney Chronic kidney disease Renal osteodystrophy Treatment Pharmacology Carbonic anhydrase inhibitors (acetazolamide) Osmotic agents Loop diuretics Thiazide diuretics Potassium-sparing diuretics Review questions 16 Reproductive system Anatomy Female reproductive anatomy Male reproductive anatomy Composition of semen Male sexual response Male and female gonadal drainage Physiology Hypothalamic-pituitary-gonadal axis Spermatogenesis Male and female hormones Female physiology Menstrual cycle Follicular (proliferative) phase Luteal (secretory) phase Definitions of abnormal menses Oogenesis Pregnancy and HCG Fertilization Hormones of pregnancy Menopause Female pathology Pathology in pregnancy Amniotic fluid disorders Benign gynecologic conditions Gynecologic malignancies Breast disorders and malignancy Common breast conditions Benign breast disorders Breast cancer Sex chromosome and hormone disorders Male pathology Sex chromosome and hormone disorders Pharmacology Review questions 17 Pulmonology Anatomy of the respiratory system The lungs Bronchopulmonary segments Pulmonary airways Conducting zone Respiratory zone Cells of the respiratory system Diaphragm and accessory respiratory muscles Respiratory physiology Spirometry Compliance and elastance Gas exchange Diffusion-limited exchange Perfusion-limited exchange Dead space Oxygen transport Hemoglobin Oxygen content of blood (Cao2) Oxygen delivery to tissues Hemoglobin-O2 dissociation curve Shifts in the hemoglobin-O2 dissociation curve Shifts to the right Shifts to the left Carboxyhemoglobin Methemoglobin Oxygen disorders Hypoxemia (low Pao2) Hypoxia (low DO2) CO2 transport Bicarbonate Bound directly to hemoglobin Dissolved CO2 Pulmonary circulation Regulation of pulmonary perfusion Ventilation-to-perfusion ratio V/Q mismatch Respiratory pathology Pneumonia Lung abscess Lung cancer Pulmonary embolism Pulmonary hypertension Pulmonary arterial hypertension Pulmonary hypertension caused by left-sided heart disease Pulmonary hypertension associated with lung disease and/or hypoxemia Chronic thromboembolic pulmonary hypertension Pulmonary hypertension with unclear multifactorial mechanisms Sleep apnea Obstructive versus restrictive lung disease Obstructive disease PFTs Restrictive disease PFTs Pathology of obstructive lung diseases Asthma Pathogenesis Findings Treatment Chronic obstructive pulmonary disease Chronic bronchitis Emphysema Bronchiectasis Cystic fibrosis Pathology of restrictive lung diseases Acute respiratory distress syndrome Neonatal respiratory distress syndrome Sarcoidosis Hypersensitivity pneumonitis Pneumoconioses Silicosis Coal Worker’s pneumoconiosis (CWP) Asbestosis Berylliosis Pleural disorders Spontaneous pneumothorax Pathogenesis Findings Trea