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USMLE Step 2 CK

l Internal Medicine

drug-induced lupus, 62 inﬂammatory myopathies, 75 osteoarthritis, 68–70 patient evaluation in, 53–54 rheumatoid arthritis, 57–59 scleroderma, 62–64 septic arthritis, 72–73 seronegative arthropathies, spondyloarthropathies, 65–68 Sjögren syndrome, 54, 64–65 systemic lupus erythematosus, 60–62 tests in, 54–57

vasculitis syndromes, 73–74 Rhythm control, in atrial ﬁbrillation, 167 Rhythm disturbances, 160–172 Ribavirin, 381 Rifampin (Rif), for tuberculosis, 227 Right ventricular infarction, as acute coronary syndrome

complication, 132 Riluzole, for amyotrophic lateral sclerosis, 401 Ringer’s lactate, for burn injury, 376 Rings, esophageal, 80 Rituximab

for chronic lymphocytic leukemia, 195 for cold agglutinin disease, 189

for non-Hodgkin lymphoma, 200 Rocky Mountain spotted fever, 253 Roth’s spots, 248 Rule of 10%, in pheochromocytoma, 48 Rule of nines, for burn injury assessment, 375, 376

Sacroiliitis, ankylosing spondylitis and, 66 Salicylate toxicity, 365–366 Salt wasting, in congenital adrenal hyperplasia, 46 Sarcoidosis, 328–329 Sarcoma, Kaposi, 428 Scabies, 423–424 Schatzki’s ring, 80 Schirmer’s test, in Sjögren syndrome diagnosis, 64 Schober test, in ankylosing spondylitis, 66 Sclerodactyly, in CREST syndrome, 63 Scleroderma, 62–64

esophageal involvement, 79–80

renal crisis in, 63 Screening/screening tests

abdominal aortic aneurysm, 5

alcohol abuse, 6, 8

bone density, 7

breast cancer, 2

cervical cancer, 2

colon cancer, 2, 100

diabetes mellitus, 8

domestic violence, 8

esophageal cancer, 79

familial adenomatous polyposis syndrome, 100 hereditary nonpolyposis syndrome, 100 hypercholesterolemia, 6 hypertension, 6 injury, 8 osteoporosis, 7 physical violence, 8 in polyposis and colon cancer syndromes, 101 prostate cancer, 2

sexual abuse, 8 Seborrheic dermatitis, 430 Seborrheic keratosis, 425 Second-degree AV block, 162 Secondary hyperaldosteronism, 45–46 Secondary hyperparathyroidism, 31 Secondary hypertension, 296–298 Secondary hypogonadism, 50 Secondary hypothyroidism, 25 Secondary osteoarthritis, 69 Secondary progressive multiple sclerosis, 402, 403 Secondary Raynaud phenomenon, 64 Seizure disorders, 390–393 Septic arthritis, 72–73, 244–245

synovial ﬂuid analysis in, 55 Seronegative arthropathies, 65–68 Serum ascites albumin gradient, 106 Serum osmolality

in HONK, 37

in hyponatremia, 281 Severe necrotizing pancreatitis, 104 Sex/Sex hormones, ischemic heart disease risk and, 119 Sexual abuse, screening for, 8 Sexually transmitted diseases (STDs), 234–240 Sheehan postpartum necrosis, hypopituitarism and, 15 Shingles vaccine (Zostavax), 5, 6 Shock syndromes, 176 Sickle cell disease, 186–188 Sideroblastic anemia, 179, 181–182

iron indices in, 183 Sigmoidoscopy, in colon cancer, 100 Silent thyroiditis, 26 Silicosis, 330–331 Sinus bradycardia, 160–161, 354–356 Sinus node function, disorders of, 160–170 Sinus tachycardia, 163

as acute coronary syndrome complication, 131 Sinusitis, 217–218 Sjögren syndrome, 54, 64–65 Skin

anatomy of, 411

benign/precancerous lesions of, 425–426

burn injury assessment and management, 375–376

diseases of. See Dermatology; individual diseases and conditions

necrosis of, in pulmonary thromboembolism, 337

toxidrome ﬁndings associated with, 357

470

Index

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Skin infections

bacterial, 419–421 fungal, 417–418 genital warts, 239–240

viral, 421–423 Skull fracture, emergency management of, 371–373 Sleep apnea, 338–339 Slit-lamp examination, in Wilson disease diagnosis, 108 Small cell lung carcinoma, 340 Smoke inhalation injuries, emergency management of, 375–376 Smoking

cessation of, as preventive medicine, 5

as COPD cause, 322

ischemic heart disease risk and, 117–118

peptic ulcer disease and, 85 “Smudge cells,” in chronic lymphocytic leukemia, 195 Snake bites, 381–382 Sofosbuvir, for hepatitis, 233–234 Somatostatin analogues, for acromegaly, 14 Somogyi effect, in diabetes mellitus, 39 Sonography. See Ultrasound (U/S) Spherocytosis, hereditary, 189–190 Spinal cord, diseases of

anterior spinal artery occlusion, 385–386

Brown-Séquard syndrome, 386–387

spinal cord compression, 383–384

subacute combined degeneration, 385

syringomyelia, 384–385 Spine fracture, in ankylosing spondylitis, 66 Spironolactone, for congestive heart failure, 141 Splenectomy, vaccination prior to, 4 Splenic vein thrombosis, as acute pancreatitis complication, 104 Spondyloarthropathies, 65–68 Spontaneous bacterial peritonitis (SBP), 105 Squamous cell carcinoma

of lung, 340

of skin, 428 Squatting, effect on systolic murmurs, 151 ST elevation myocardial infarction (STEMI), 126–130

localization of, 128

reperfusion therapy for, 128–129 ST segment depression, in ischemic heart disease, 120, 121 ST segment elevation, in acute pericarditis, 157–158 Stable angina

chest pain in, 112

in ischemic heart disease, 119–122 Staphylococcal scalded skin syndrome (SSSS), 424, 425 Staphylococcus aureus infection

antibiotics for, 209–211

methicillin-resistant. See Methicillin-resistant Staphylococcus

aureus (MRSA)

septic arthritis and, 72 Stasis dermatitis, 430

Statins

after acute coronary syndrome discharge, 130

for ischemic heart disease, 122 Status epilepticus, deﬁnition and management, 391, 392 Steatorrhea

in malabsorption syndromes, 96

in Zollinger-Ellison syndrome, 88 Stenosis

coronary arteries, 115, 120, 149–151

mitral, 144–146

renal artery, 265, 296–297 Stent placement, in ischemic heart disease, 122 Steroids

in inﬂammatory bowel disease management, 90

peptic ulcer disease and, 85 Stevens-Johnson syndrome, 415 Sting injuries, 380–381 Streptococcal bacteria

antibiotic therapy and, 209–211

as postinfection glomerulonephritis cause, 275 Stress, ischemic heart disease risk and, 119 Stress echocardiography, in ischemic heart disease, 121 Stroke, 387–390 Subacute combined spinal cord degeneration, 385 Subacute thyroiditis, 21, 24, 25–26 Subarachnoid hemorrhage

emergency management of, 374–375

treatment for, 389 Subconjunctival hemorrhage, 446 Subdural hematoma, emergency management of, 371–373 Subtotal thyroidectomy, for Graves’ disease, 22 Sudden cardiac death, as acute coronary syndrome complication, 132 Sulfasalazine, for rheumatoid arthritis, 59 Sulfonylureas, for diabetes mellitus, 34, 35 Supply ischemia, 119 Supraventricular arrhythmias, 163–168 Supraventricular tachycardia (SVT), 351–354 Surgery

for basal cell carcinoma, 428

for GERD, 84

for mitral stenosis, 146

for mitral valve replacement, 148

for necrotizing fasciitis, 421

for peptic ulcer disease, 87

in ST elevation myocardial infarction, 130

for ulcerative colitis, 91 Sympathomimetic amines, for congestive heart failure, 143 Syndrome of inappropriate secretion of ADH (SIADH), 18–19, 283 Synovial ﬂuid analysis, in rheumatologic disease evaluation, 54–55 Syphilis, 235–237 Syringomyelia, 384–385 Systemic lupus erythematosus (SLE), 54, 60–62

diagnostic criteria for, 60–61

pregnancy and, 61–62

renal disease and, 276

471

USMLE Step 2 CK

l Internal Medicine

Systemic sclerosis (SSc), 54, 62–64

esophageal involvement, 79–80

Systolic dysfunction, in congestive heart failure

agents lowering mortality in, 142 medical devices for, 143

Systolic murmurs, effect of maneuvers on, 151

T lymphocytes, in rheumatoid arthritis, 57 T-score, DEXA bone density scan, 7 Tachyarrhythmias, as acute coronary syndrome complication, 131 Tamoxifen, as preventive medicine, 2 Tegaserod, in irritable bowel syndrome management, 96 Telangiectasias, in CREST syndrome, 63 Telogen efﬂuvium, 432 Temporal arteritis (TA), 74 10% rule, in pheochromocytoma, 48 Tension-type headaches, 396, 397 Terbinaﬁne, for onychomycosis, 417 Terfenadine, for urticaria management, 414 Tertiary hyperparathyroidism, 31 Tertiary hypothyroidism, 25 Testes, diseases of, 50–51 Testing protocols, in cardiovascular disease, 113–114 Testosterone, for testicular disease/hypogonadism, 51 Tetanus, 260 Thalassemia, 182–183

iron indices in, 183

Theophylline

for chronic obstructive pulmonary disease, 324

overdose of, 358 Thiazides, for congestive heart failure, 141 Thiazolidinediones, for diabetes mellitus, 34, 35 Third-degree (complete) AV block, 163 Thoracocentesis, of pleural effusions, 311–312 Thrombocythemia, essential, 196 Thrombocytopenia, heparin-induced, 207–208 Thromboembolism

as acute coronary syndrome complication, 132

pulmonary, 331–338 Thrombolytics, for ST elevation myocardial infarction, 128–129 Thrombosis, in paroxysmal nocturnal hemoglobinuria, 190 Thrombotic thrombocytopenic purpura (TTP), 206, 273 Thrush (oral candidiasis), 419 Thymectomy, in myasthenia gravis, 400 Thymoma, in myasthenia gravis, 400 Thyroid function, evaluating, 20, 51 Thyroid gland

diseases of, 19–27

hormone synthesis and secretion pathways of, 19–20

hyperthyroidism, 21–23

hypothyroidism, 24–25

neoplasia of, 26–27

thyroid storm, 23–24

thyroiditis, 25–26

Thyroid-reactive iodine uptake (RAIU), 20, 22 Thyroid stimulating hormone. See Thyrotropin stimulating

hormone (TSH) Thyroid stimulating immunoglobulin (TSI), 21, 22 Thyroid storm, 23–24 Thyroidectomy, subtotal, for Graves’ disease, 22 Thyroiditis, 25–26 Thyrotoxicosis

amiodarone-induced, 24 hyperthyroidism, 21–23

thyroid storm, 23–24 Thyrotropin-releasing hormone (TRH), hyperprolactinemia and, 12 Thyrotropin stimulating hormone (TSH)

in Graves’ disease, 22

in hypopituitarism, 15

l-Thyroxine (T

Tick-borne diseases, 252–253 Tigecycline, for gram-positive cocci, 211 Tinea capitis, 417–418 Tinea corporis, 417–418 Tinea cruris, 417–418 Tinea pedis, 417–418 Tinea versicolor, 417–418

clinical correlate, 418 Tinnitus, salicylate toxicity and, 365–366 Tissue plasminogen activators (tPA), 389 TMP/SMZ

in infectious diarrhea management, 93

in Whipple disease management, 98 Tobramycin, nephrotoxicity of, 271 Topiramate, for migraine headaches, 397 Torsade de pointes, 171, 349, 350 Toxic diffuse goiter, 22 Toxic epidermal necrolysis (TEN), 415–416, 424 Toxic multinodular goiter, hyperthyroidism, 21 Toxic shock syndrome, 424 Toxicology

acetaminophen poisoning, 359–360

alcohol, 358, 360

carbon monoxide poisoning, 361

caustics/corrosives, 362

digitalis, 142–143

digoxin, 142, 366–367

drug abuse, 362–363

heavy metal exposure, 364

ingestion and overdose management, 357–358

initial evaluation in, 357

salicylates, 365–366

toxidromes, ﬁndings in, 357

toxin-induced acute renal failure, 271–272

tricyclic antidepressants, 367 Toxicology screening, 358–359 Toxin exposure, toxic shock syndrome and, 424 Toxoplasmosis, in acquired immune deﬁciency syndrome, 256

), 19–22

472

Index

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Transfusion therapy, for radiation injury, 378 Transient hyperthyroidism, 21 Transjugular intrahepatic portosystemic shunting (TIPS), 102 Transplantation, renal, 280–281 Transudative pleural effusion, 311 Trauma, to head, 371–373 Travel medicine, 2–3 Traveler’s diarrhea, management of, 3 Tricyclic antidepressants

for migraine headaches, 397 toxicity/overdose of, 367

Trigeminal neuralgia, 398

l-3,5,5’-Triiodothyronine (T

Triptans, for migraine headaches, 396 Tropheryma Whippelii, bowel biopsy positive for, 97 Tropical sprue, 97 Troponins, in cardiovascular disease testing, 113–114 Tuberculosis, 226–228

latent, 227–228 Tubulointerstitial disease, 267–271 Tumor lysis syndrome (TLS), 200–201 Tumor necrosis factor (TNF) inhibitors

for ankylosing spondylitis, 67

for rheumatoid arthritis, 59 Turcot syndrome, 101 Turner’s sign, 104 Two-dimensional/Doppler echocardiography, in mitral valve

prolapse, 148 Typhoid vaccination, for travelers, 3 Tzanck smear, 421–422

), 19–22

Ulcerative colitis (UC), 90–91

enteropathic arthropathy in, 68 primary sclerosis cholangitis in, 107

Ulcers

decubitus (pressure) ulcers, 431 peptic. See Peptic ulcers

Ultrasound (U/S)

for abdominal aortic aneurysm screening, 7

abdominal imaging with, 437 Ultraviolet (UV)-B light, systemic lupus erythematosus and, 60, 61 Unstable angina, 124–125 Upper GI bleeding, 101–103 Urate, as acute renal failure cause, 270 Urea breath test, in peptic ulcer disease, 86, 87 Uremia, acute renal failure, 263 Urethritis, 234 Uric acid stones, 291 Uric acid toxicity, 290, 291

as acute renal failure cause, 270 Urinalysis

in pheochromocytoma, 49

for renal disease diagnosis, 278–279

urinary uroporphyrins, in porphyria cutanea tarda diagnosis, 413

Urinary tract infections (UTIs), 240–242 Urine anion gap, in renal tubular acidosis, 289 Urticaria, 413–414 Uveitis, 447

Vaccines/Vaccinations

diphtheria/tetanus, 4 hepatitis A and B, 4–5 herpes zoster, 6 in HIV-positive persons, 5, 6, 256 human papilloma virus, 6 inﬂuenza, 4 pneumococcal, 226, 256 in pregnancy. See under Pregnancy before splenectomy, 4 for travelers, 3 varicella, 5. See also Shingles vaccine (Zostavax)

Valproic acid

for migraine headaches, 397 for seizure and epilepsy management, 392

Valsalva maneuver

effect on systolic murmurs, 151 for supraventricular tachycardia, 352

Valvular heart disease, 144–152

aortic regurgitation, 151–152 aortic stenosis, 115, 149–151 mitral regurgitation, 146–148, 151 mitral stenosis, 144–146 mitral valve prolapse, 148

Vancomycin

as acute renal failure cause, 272 for gram-positive cocci, 211 for meningitis, 214

for MRSA, 210 Varenicline, for smoking cessation, 7 Varicella infection, necrotizing fasciitis and, 421 Varicella vaccine, 5. See also Shingles vaccine (Zostavax) Varicella zoster virus (VZV), prophylaxis for, 5, 6 Vascular dementia, 405 Vascular diseases

as diabetes mellitus complication, 37–38

hypopituitarism and, 14 Vasculitis syndromes, 73–74 Vasodilators

in congestive heart failure management, 140, 141

for hypertension, 300 Vasopressin

for diabetes insipidus, 16–18

excess of, syndromes with, 18

inappropriate secretion of, 18–19

pituitary gland storage of, 9 Venomous bites and stings, 380–381 Venous blood gases, in carbon monoxide poisoning, 361

473

USMLE Step 2 CK

l Internal Medicine

Ventilation

invasive, 315–316 noninvasive, 315

Ventilation-perfusion (V/Q) scan, in pulmonary

thromboembolism, 335 Ventricular arrhythmias, 169–170 Ventricular ﬁbrillation, 172, 347

deﬁbrillation and, 347 Ventricular rate control, 168 Ventricular tachycardia (VT), 169–170

management of, 349–350 Verapamil, for migraine headaches, 397 Vertigo, 393–394 Violence, screening for, 8 Viral infections, of skin, 421–423 Viral load/sensitivity/resistance monitoring, in acquired immune

deﬁciency syndrome, 257 Virtual colonoscopy, 439 Virtual endoscopy, in GI bleeding diagnosis, 103 Vitamin B

Vitamin K deﬁciency, 204–205 Vitreal hemorrhage, 441 Vomiting, toxic ingestion and, 357 von Willebrand disease (VWD), 202 Voriconazole, for aspergillosis, 261 Vulvovaginitis, 419

(cyanocobalamin) deﬁciency, 385

in celiac disease, 97 in gastritis, 87 macrocytic anemia and, 183–184 in pernicious anemia, 87

X-rays

abdominal, 437–439 in ankylosing spondylitis, 66 chest. See Chest x-ray in necrotizing fasciitis, 421 in osteoarthritis, 69, 70

Xanthochromia, 375

d-Xylose testing, 97

Z-score, DEXA bone density scan, 7 Zenker diverticulum, 81–82 Zollinger-Ellison syndrome, 88

peptic ulcer disease and, 85, 86, 87

Zostavax (shingles vaccine), 5, 6

Wallenberg syndrome, 388, 389 Warfarin, 207–208

after acute coronary syndrome discharge, 130

for pulmonary thromboembolism, 336–337 Warts, genital, 239–240 Water restriction test, in diabetes insipidus, 17–18 Weber syndrome, 388, 389 Webs, esophageal, 80 Wegener granulomatosis, 54, 73, 273, 274 Weight reduction, diabetes mellitus and, 34 Wenckebach atrioventricular block, 162, 355 Wernicke encephalopathy, 370 Westermark sign, of pulmonary thromboembolism, 334 Wet skin, toxidromes and, 357 Wheals, in urticaria, 413–414 Whipple disease, 97 Whole bowel irrigation, for toxic ingestion, 358 Wilson disease, 108 Wolff-Chaikoff effect, 23 Wolff-Parkinson-White syndrome, 168–169

474

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STEP 2 CK

Lecture Notes 2017

USMLE

Obstetrics and Gynecology

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National

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Board of Medical Examiners (NBME), neither of which sponsors or endorses this product.

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Published by Kaplan Medical, a division of Kaplan, Inc. 750 Third Avenue New York, NY 10017

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