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First Aid Q&A for the USMLE Step 2 CK, 2e (First Aid USMLE) [McGraw-Hill Medical] [2009]

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FIRST AID ™ Q&A FOR THE USMLE STEP CK Second Edition SENIOR EDITORS EDITORS TAO LE, MD, MHS HERMAN SINGH BAGGA, MD Assistant Clinical Professor Chief, Section of Allergy and Clinical Immunology Department of Medicine University of Louisville Resident Department of Urology University of California, San Francisco Medical Center KRISTEN VIERREGGER, MD Resident Department of Dermatology Mayo Clinic Resident Department of Pathology University of California, Irvine Medical Center THOMAS L.H HOCKER, MD CHRISTOPHER R KINSELLA, JR., MD Research Fellow University of Pittsburgh Medical Center MATTHEW O'ROURKE, MD Resident Morgan Stanley Children's Hospital of New York– Presbyterian Columbia University Medical Center JOHN RHYNER, MD Resident Department of Internal Medicine University of Michigan Medical Center SADE CLARKE UDOETUK, MD Resident Department of Psychiatry Baylor College of Medicine New York / Chicago / San Francisco / Lisbon / London / Madrid / Mexico City Milan / New Delhi / San Juan / Seoul / Singapore / Sydney / Toronto Copyright © 2010, 2008 by Tao Le All rights reserved Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher ISBN: 978-0-07-162930-0 MHID: 0-07-162930-0 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-162571-5, MHID: 0-07-162571-2 All trademarks are trademarks of their respective owners Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark Where such designations appear in this book, they have been printed with initial caps McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs To contact a representative please e-mail us at bulksales@mcgraw-hill.com Medicine is an ever-changing science As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work Readers are encouraged to confirm the information contained herein with other sources For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration This recommendation is of particular importance in connection with new or infrequently used drugs TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc (“McGraw-Hill”) and its licensors reserve all rights in and to the work Use of this work is subject to these terms Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGrawHill’s prior consent You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited Your right to use the work may be terminated if you fail to comply with these terms THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE McGraw-Hill and its licensors not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom McGraw-Hill has no responsibility for the content of any information accessed through the work Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise D E D I C AT I O N To the contributors to this and future editions, who took time to share their knowledge, insight, and humor for the benefit of residents and clinicians and To our families, friends, and loved ones, who supported us in the task of assembling this guide This page intentionally left blank CONTENTS Authors vii Faculty Reviewers ix Preface xi Acknowledgments xiii How to Contribute xv S EC T IO N I O R G A N SYST E M S Chapter Cardiovascular Chapter Dermatology 47 Chapter Endocrinology 57 Chapter Epidemiology and Preventive Medicine 91 Chapter Ethics and Legal Issues 117 Chapter Gastrointestinal 127 Chapter Hematology/Oncology 167 Chapter Infectious Disease 211 Chapter Musculoskeletal 261 Chapter 10 Neurology 285 Chapter 11 Obstetrics 321 Chapter 12 Gynecology 351 Chapter 13 Psychiatry 375 Chapter 14 Pulmonary 409 Chapter 15 Renal/Genitourinary 441 S EC T IO N I I F U LL-LE N G T H E X A M I NAT I O N S 471 Test Block 473 Test Block 507 Test Block 539 v Test Block 573 Test Block 607 Test Block 641 Test Block 675 Test Block 709 About the Authors 743 vi AUTHORS CYNTHIA ADAMS, MD LAURA MEINTS Resident Boston Combined Residency Program in Pediatrics Children's Hospital Boston Vanderbilt University School of Medicine Class of 2009 CLARISSA BARNES, MD Resident Department of Internal Medicine Johns Hopkins University School of Medicine RACHEL BORTNICK, MPHIL Medical Scientist Training Program Harvard Medical School CHRISTOPHER CHAPMAN, MD Resident Department of Internal Medicine University of Chicago Medical Center LIA CLATTENBURG, MD, MPH Resident Department of Internal Medicine Union Memorial Hospital Baltimore, Md GILLIAN DIERCKS Columbia University College of Physicians and Surgeons Class of 2009 VAHID ENTEZARI, MD Postdoctoral Research Fellow Orthopedic Biomechanics Laboratory Beth Israel Deaconess Medical Center JOHNATHAN ETHRIDGE Johns Hopkins University School of Medicine Class of 2009 ROBERT MICHELETTI, MD Resident Departments of Internal Medicine and Dermatology Hospital of the University of Pennsylvania DANIEL L MILLER Johns Hopkins University School of Medicine Class of 2009 Johns Hopkins Bloomberg School of Public Health Class of 2009 DEEPIKA NEMANI University of Pennsylvania School of Medicine Class of 2009 TIMOTHY NIESSEN Johns Hopkins University School of Medicine Class of 2009 Johns Hopkins Bloomberg School of Public Health Class of 2009 HOWARD O'ROURKE, MD Resident Department of Diagnostic Radiology University of Pittsburgh Medical Center NISHANT PATEL Johns Hopkins University School of Medicine Class of 2009 ROHITH PIYARATNA, MD ERICA Y FAN Resident Department of Anesthesiology Stanford University Medical Center St Louis University School of Medicine Class of 2009 ANTHONY PRINCE, MD CARL ERIK FISHER Resident Department of Otolaryngology Mount Sinai Medical Center Columbia University College of Physicians and Surgeons Class of 2009 SATTAR GOJRATY, MD FIORELLA SAPONARA, MD Resident Department of Internal Medicine Hospital of the University of Pennsylvania Resident Transitional Program Maimonides Medical Center New York City NILAY KAVATHIA, MD ASHA JAYENDRAKUMAR SHAH, MD Resident Department of Internal Medicine Thomas Jefferson University Hospital Intern Department of Internal Medicine Emory University School of Medicine vii MONICA E SHUKLA BRANT W ULLERY, MD Vanderbilt University School of Medicine Class of 2009 Resident Department of Surgery Hospital of the University of Pennsylvania MEGHAN SISE Columbia University College of Physicians and Surgeons Class of 2009 D'MITRI SOFIANOS, MD Resident Department of Orthopedic Surgery University of Utah Medical Center ANNA E TEETER Duke University School of Medicine Class of 2009 JOSHUA D UDOETUK, MD KELLY VRANAS, MD Resident Department of Internal Medicine Hospital of the University of Pennsylvania DAVID WEI Columbia University College of Physicians and Surgeons Class of 2009 ZACHARY ZAVODNI Duke University School of Medicine Class of 2009 Transitional Intern University of Texas-Houston Medical School ASSOCIATE AUTHORS MARINA FRIMER, MD SUNIL SHETH Resident Department of Obstetrics and Gynecology and Women's Health Albert Einstein College of Medicine Harvard Medical School Class of 2009 MARK J MANN, MD Resident Department of Urology State University of New York Upstate Medical University Syracuse, N.Y PARIN J PATEL, MD Resident Department of Internal Medicine Hospital of the University of Pennsylvania viiiviii LEANNE STANLEY Duke University School of Medicine Class of 2009 TIAN ZHANG Harvard Medical School Class of 2009 FACULTY REVIEWERS JONATHAN W BRESS, MD KERILYN MORGAN, MD Nephrologist Philadelphia Hypertension & Nephrology Consultants RACHEL CHONG, MD Associate Program Director Department of Internal Medicine Banner Good Samaritan Medical Center Phoenix, Ariz Endocrinologist Lakeridge Health Corporation RINI BANERJEE RATAN, MD PETER DANYI, MD, MPH, MBA Assistant Clinical Professor Department of Obstetrics and Gynecology Columbia University College of Physicians & Surgeons Instructor, Hospitalist Program Division of General Internal Medicine Johns Hopkins University School of Medicine ROBIN GIRDHAR, MD Vice Chairperson and Director of Quality Assurance Division of Cardiology Shadyside Hospital University of Pittsburgh School of Medicine ANDREW J LENNEMAN, MD Clinical Fellow Cardiovascular Medicine Division Vanderbilt University School of Medicine ESTER C LITTLE, MD Associate Director Banner Liver Disease Center Clinical Assistant Professor of Medicine University of Arizona College of Medicine MARCUS A MCFERREN, MD, PHD Department of Dermatology Yale-New Haven Hospital ELIZABETH SASTRE, MD Assistant Professor Vanderbilt University Medical Center Attending Physician Medical Service, Primary Care Tennessee Valley Healthcare Veteran’s Administration Hospital JERRY D SMILACK, MD Emeritus Associate Professor of Medicine Mayo College of Medicine Retired Consultant Department of Internal Medicine Mayo Clinic MYRA J WICK, MD, PHD Department of Medical Genetics Mayo Clinic APRIL ZHU, MD The Permanente Medical Group Santa Clara, Calif ix

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