THIRD EDITION Master the Boards USMLE Step CK ® THIRD EDITION Master the Boards USMLE Step CK ® TARGETED REVIEW IN FULL COLOR USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), neither of which sponsors or endorses this product This publication is designed to provide accurate information in regard to the subject matter covered as of its publication date, with the understanding that knowledge and best practice constantly evolve The publisher is not engaged in rendering medical, legal, accounting, or other professional service If medical or legal advice or other expert assistance is required, the services of a competent professional should be sought This publication is not intended for use in clinical practice or the delivery of medical care To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book © 2015, 2013, 2011 by Conrad Fischer, MD The authors of the following sections have granted Conrad Fischer, MD, and Kaplan Publishing exclusive use of their work: Elizabeth V August, MD: Section 6, Obstetrics and Gynecology Alina Gonzalez-Mayo, MD: Section 9, Psychiatry Niket Sonpal, MD: Section 4, Surgery, and Section 5, Pediatrics Published by Kaplan Publishing, a division of Kaplan, Inc 750 Third Avenue New York, NY 10017 All rights reserved under International and Pan-American Copyright Conventions By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this eBook on screen No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of the publisher 10 ISBN-13: 978-1-5062-0728-5 Kaplan Publishing books are available at special quantity discounts to use for sales promotions, employee premiums, or educational purposes For more information or to purchase books, please call the Simon & Schuster special sales department at 866-5061949 Acknowledgments Elizabeth August wishes to acknowledge Professor Edward C August, Mrs Donna M August, and Eric D August for their love, generosity, and unwavering support Without them, my dreams would not be a reality Niket Sonpal wishes to acknowledge Mr Navin Sonpal, Mahendra Patel, Raj Patel, and Dr Mukul Arya for their unwavering support, hope, and stance by me through thick and thin Without them my path to becoming a physician would not have been possible The authors wish to acknowledge the expert attention to detail of Dr Ana Franceschi and Dr Gabriel Vílchez Molina About the Author Conrad Fischer, MD, is director of the residency program at Brookdale University Hospital and Medical Center in New York City Dr Fischer is associate professor of physiology, pharmacology, and medicine at Touro College of Osteopathic Medicine in New York City Section Authors Elizabeth V August, MD, is chief medical officer of Bergen County for Riverside Medical and Pediatric Group and former chief resident at Hoboken University Medical Center–NY Medical College (2012–2013) She is co-author of the best-selling review book Master the Boards: USMLE Step Alina Gonzalez-Mayo, MD, author of the Psychiatry section, is a psychiatrist at Bay Pines VA Medical Center in Bay Pines, Florida Niket Sonpal, MD, is former chief resident at Lenox Hill Hospital–North Shore–LIJ Health System (2013–2014) and assistant clinical professor of medicine at both Touro College of Osteopathic Medicine and St Georges University School of Medicine He is a fellow in gastroenterology and co-author of the best-selling review books Master the Boards: USMLE® Step and Master the Boards: Internal Medicine Section Editors Imaging Editor: Pramod Theetha Kariyanna, MD Ethics: Robert Goldberg, DO, Professor and Dean of Touro College of Osteopathic Medicine Cardiology: Hal Chadow, MD Endocrinology: Chris Paras, DO Neurology: Robert Goldberg, DO; Anjula Gandhi, MD Infectious Diseases: Farshad Bagheri, MD; Richard Cofsky, MD Gastroenterology: Anjula Gandhi, MD Oncology: Vlad Gottlieb, MD; Hamza Minhas, MD Preventive Medicine: Herman Lebovitch, MD Rheumatology: Debabrata Sen, MD Nephrology: Debabrata Sen, MD General Medicine: Sudheer Chauhan, MD Hematology: Vlad Gottlieb, MD; Hamza Minhas, MD For Test Changes or Late-Breaking Developments kaptest.com/publishing The material in this book is up-to-date at the time of publication However, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) may have instituted changes in the test after this book was published Be sure to carefully read the materials you receive when you register for the test If there are any important late-breaking developments—or any changes or corrections to the Kaplan test preparation materials in this book—we will post that information online at kaptest.com/publishing Table of Contents Author’s Note How to Use This Book Section 1: Internal Medicine Chapter 1: Infectious Diseases Chapter 2: Allergy and Immunology Chapter 3: Cardiology Chapter 4: Endocrinology Chapter 5: Pulmonology Chapter 6: Rheumatology Chapter 7: Hematology Chapter 8: Gastroenterology Chapter 9: Neurology Chapter 10: Nephrology Chapter 11: Oncology Section 2: Preventive Medicine Section 3: Dermatology Section 4: Surgery Section 5: Pediatrics Section 6: Obstetrics and Gynecology Section 7: Radiology Section 8: Ophthalmology Section 9: Psychiatry Section 10: Emergency Medicine Section 11: Ethics Index ... of the material contained in this book © 20 15, 20 13, 20 11 by Conrad Fischer, MD The authors of the following sections have granted Conrad Fischer, MD, and Kaplan Publishing exclusive use of their... Master the Boards USMLE Step CK ® TARGETED REVIEW IN FULL COLOR USMLE? ? is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), neither... Medical Center–NY Medical College (20 12? ? ?20 13) She is co-author of the best-selling review book Master the Boards: USMLE Step Alina Gonzalez-Mayo, MD, author of the Psychiatry section, is a psychiatrist