The Ultimate Medical School Rotation Guide

Preface
Acknowledgments
Introduction
Contents
Contributors
Faculty Reviewers
Student Reviewers
Fellow Reviewer
Resident Reviewers
1: Interpersonal Skills
1.1 Introduction
1.2 Sections
1.2.1 The Medical Learning Environment
1.2.2 The AMIGAS Framework
1.2.3 Suggestion Tables for Various Relationships and Scenarios
1.3 Special Topics
2: Wellness
Reference
3: What Attendings and Residents Look For
3.1 Overview
3.2 The Unaltered Answers
3.3 Dissecting the Answers
3.3.1 Interpersonal Skills
3.3.2 Knowledge Base
3.3.3 Clinical Reasoning
3.3.4 Curiosity
3.3.5 Reliability
3.3.6 Honesty
3.3.7 Enthusiasm
3.3.8 Proactivity
3.3.9 Teamwork
3.3.10 Professionalism
3.4 Example Evaluations
3.5 Dealing with Negative Evaluations
3.6 Mid-Rotation Feedback
3.7 Concluding Remarks
4: Clinical Tips and Pearls
4.1 General Rotation Considerations
4.2 Feedback and Learning
4.3 Pre-rounding
4.4 History-Taking
4.5 Physical Exam
4.6 Objective Data
4.7 Oral Presentation
4.7.1 General Tips
4.7.2 One-Liner
4.7.3 History of Present Illness
4.7.4 All Other History (Medical, Surgical, Medications, Social, etc.)
4.7.5 Vitals
4.7.6 Physical Exam
4.7.7 Objective Data
4.7.8 Assessment/Plan
4.8 Note-Writing
4.9 Calling a Consult
4.10 Logistical Tips
5: EMR Tips and Tricks
5.1 Overview
5.2 Prior to the Rotation
5.2.1 Create Patient Lists
5.2.2 Smart Phrases
5.2.3 Dot Phrases
5.3 Daily Workflow
5.3.1 Creating Notifications
5.3.2 Chart Search
5.3.3 Chart Review Filters
5.3.4 Time Mark Results
5.3.4.1 Compare Labs to Baseline/Prior Values
5.3.5 Summary Tab
5.3.6 Copy Note
6: Internal Medicine
6.1 Overview
6.1.1 Setting Goals
6.1.2 Rotation Structure
6.1.3 Team Structure
6.2 Practical Tips
6.2.1 External Resources
6.2.2 Shelf Prep
6.2.3 Pre-rounding
6.2.3.1 Sign-Out
6.2.3.2 Pre-rounding
Prior to Seeing Your Patients
Pre-rounding Chart Review Checklist
With the Patient
After Seeing the Patients
6.2.4 Oral Presentation
6.2.4.1 One-liner
6.2.4.2 History of Present Illness (HPI)
6.2.4.3 Past History
6.2.4.4 Medications
6.2.4.5 Vital Signs
6.2.4.6 Physical Exam
6.2.4.7 Objective Data
6.2.4.8 Assessment/Plan
6.2.5 Rounding
6.2.6 EMR Setup
6.2.7 Calling Consults
6.2.7.1 Why Consult?
6.2.7.2 What Makes an Effective Consult?
6.2.8 Road to Discharge
6.3 Fundamentals
6.3.1 Basic Metabolic Panel (BMP)
6.3.2 Complete Blood Count (CBC)
6.3.3 Physical Exam
6.3.4 Bowel Regimen
6.3.5 IV Fluids
6.3.5.1 Fluid Choice
6.3.5.2 Volume
6.3.5.3 Rate
6.3.6 DVT Prophylaxis
6.3.7 Insulin Management
6.3.8 Approach to Supplemental Oxygen
6.3.9 When to Provide Supplemental Oxygen
6.4 Common Cases
6.4.1 Pneumonia (Question-Based Approach)
6.4.2 Pneumonia
6.4.2.1 Goals of Admission
6.4.2.2 Presentation
History
Exam
6.4.2.3 Workup
Differentiating the Differential
6.4.2.4 Management
Goals
Treating the Infection
Contingencies
6.4.2.5 When to Discharge?
6.4.3 COPD Exacerbation
6.4.3.1 Goals of Admission
6.4.3.2 Presentation
History
Exam
6.4.3.3 Workup
Differentiating the Differential
6.4.3.4 Management
Goals
Treat the Inflammation
Correct Oxygen Requirements
Reduce Future Exacerbations
Smoking Cessation
Contingencies
6.4.3.5 When to Discharge?
6.4.4 Urinary Tract Infection (UTI)
6.4.4.1 Goals of Admission
6.4.4.2 Presentation
History
Exam
6.4.4.3 Workup
Urinalysis (UA)
Urine Culture (UCx)
Differentiating the Differential
6.4.4.4 Management
Goals
Empiric Antibiotics
Reduce Future UTIs
Contingencies
6.4.5 Acute Kidney Injury
6.4.5.1 Goals of Admission
6.4.5.2 Presentation
History
Exam
6.4.5.3 Workup
6.4.5.4 Management
Goals
Restore Intravascular Volume
Stabilize and Improve Renal Function
Contingencies
6.4.5.5 When to Discharge?
6.4.5.6 Oral Presentation Pearls
6.4.6 Chest Pain Rule-Out Myocardial Infarction (CPROMI)
6.4.6.1 Goals of Admission
Presentation
History
Exam
General: No Acute Distress
6.4.6.2 Workup
Differentiating the Differential
6.4.6.3 Management
Goals
Contingencies
6.4.6.4 When to Discharge?
6.4.7 Syncope
6.4.7.1 Goals of Admission
6.4.7.2 Presentation
History
Exam
6.4.7.3 Differentiating the Differential
6.4.7.4 Workup
6.4.7.5 Management
Contingencies
6.4.7.6 When to Discharge?
6.4.8 Other Cases
7: General Surgery
7.1 Introduction
7.1.1 The Surgeon’s Mindset
7.1.2 Establishing Objectives
7.1.3 Learning in the OR
7.2 Clinical Knowledge
7.2.1 Resources
7.2.2 Content Checklist
7.2.3 Studying for Shelf
7.2.4 Studying for the Rotation
7.3 What to Expect
7.3.1 Before the Rotation
7.3.2 Team Roles
7.3.2.1 Attending Surgeon
7.3.2.2 Senior Resident
7.3.2.3 Junior Resident/Intern
7.3.2.4 Nurse Practitioner, Physician Assistants (Floor)
7.3.2.5 OR Physician Assistants and Nurse Practitioners
7.3.2.6 Scrub Nurse/Tech
7.3.2.7 Circulator
7.3.2.8 Anesthesia
7.3.3 Getting Started
7.3.4 Schedule
7.3.4.1 Sample OR Day
7.3.4.2 Sample Clinic Day
7.4 A Practical Guide
7.4.1 The Floor
7.4.1.1 Preparing for Rounds
7.4.1.2 Presenting on Rounds
7.4.1.3 Progress Notes
7.4.1.4 Handoffs/Sign-Outs
7.4.1.5 Consults
7.4.1.6 Discharge
7.4.2 The Operating Room
7.4.2.1 General Considerations
7.4.2.2 Pre-op
7.4.3 In the OR
7.4.4 Post-op
7.4.4.1 Post-op Check
7.5 The Clinic
7.5.1 New Patients
7.5.2 Follow-Up Visits
7.6 The Emergency Department
7.6.1 Admissions
7.6.2 Trauma
7.6.2.1 General Tips
7.6.2.2 What to Expect
7.6.2.3 Primary Survey
7.6.2.4 Secondary Survey
7.6.2.5 ED to OR
7.7 Technical Skills
7.7.1 References/Resources
7.7.2 Bedside Procedures
7.7.2.1 Chest Tube Placement
Equipment Required (See 7 Sect. 7.6)
Positioning
Placing the Tube
7.7.2.2 Nasogastric Tube Placement
7.7.2.3 Additional Procedures
7.7.3 Operating Room Skills
7.7.3.1 Knot-Tying
Two-Handed
One-Handed
7.7.3.2 Suturing
Types of Sutures
Basic Stitches
7.7.3.3 Basics of Laparoscopy
Camera Driving
Entry/Port Sites
7.8 Conclusion
7.9 Examples
8: Obstetrics and Gynecology
8.1 Introduction
8.1.1 Overview
8.1.2 An Introduction to the Specialty
8.1.3 Before Your Rotation: Resources to Download or Subscribe to
8.1.4 OB-GYN Fundamentals
8.2 Obstetrics
8.2.1 OB Fundamentals
8.2.2 Prenatal Care
8.2.2.1 Preparing for OB Clinic
Introduce Yourself (1–3 Days Before Clinic)
Prep Your List (0–24 Hours Before Clinic)
Learn and Shine (in Clinic)
8.2.2.2 Prenatal Care: Important Content and Checklists
The New OB Visit
The Return OB Visit
Key Points for Pregnancy Counseling
Common Complaints and Diagnoses During Pregnancy
In Summary, to Prepare for and Shine in OB Clinic
Antenatal Testing: Indications and Interpretations
8.2.3 Labor and Delivery
8.2.3.1 Signout
8.2.3.2 OB Triage
8.2.3.3 Common CCs in OB Triage
8.2.3.4 Key Terms/Definitions for the Labor Floor
8.2.3.5 Normal Labor
8.2.3.6 Fetal Monitoring
8.2.3.7 Presenting the OB Triage Patient: Template
8.2.3.8 Presenting the OB Triage Patient: Example
8.2.3.9 Intrapartum Fever: Differentiating the Differential
8.2.3.10 Intra-amniotic Infection (IAI)
8.2.3.11 The Vaginal Delivery
8.2.3.12 The Cesarean Delivery
8.2.3.13 Postpartum Hemorrhage (PPH)
8.2.3.14 The L&D Handoff/Signout: Checklist and Example
8.2.4 MFM (High-Risk Pregnancy): Select Conditions
8.2.4.1 Hypertensive Disorders of Pregnancy
8.2.4.2 Gestational Diabetes (GDM)
8.2.4.3 Preterm Labor (PTL)
8.2.4.4 PPROM (Preterm Pre-labor ROM)
8.2.5 Postpartum Care
8.2.5.1 Postpartum Fever: Differentiating the Differential
8.2.5.2 The Postpartum Visit
8.2.5.3 Postpartum Visit Checklist
8.3 Gynecology
8.3.1 GYN Fundamentals
8.3.2 Outpatient GYN
8.3.2.1 GYN Clinic Checklist
8.3.2.2 Common Outpatient GYN Conditions
Well-Person Care
Vulvovaginitis
Chronic Pelvic Pain
Abnormal Uterine Bleeding (AUB)
DDX by Age
Uterine Fibroids
8.3.3 Inpatient GYN
8.3.3.1 GYN Consults
GYN Consult Checklist
8.3.3.2 Common Conditions
Acute Pelvic Pain (. Fig. 8.14)
Differentiating the Differential: Acute Pelvic Pain in the Reproductive-Age Patient
Ovarian Torsion
Pelvic Inflammatory Disease (PID)
8.3.3.3 Early Pregnancy Complications
Differentiating the Differential: Vaginal Bleeding in a Patient with a Positive Pregnancy Test
Ectopic Pregnancy
Spontaneous Abortion (SAB)
8.3.3.4 The OR
Anatomy Checklists
Checklist: Preparing for the OR
Checklist: Entering the OR and Setting Up
Common Questions and Pearls for the OR
Procedure-Specific Tips and Pearls
8.3.4 Postoperative Care
8.3.4.1 Post-op Check and SOAP Note
8.3.4.2 Pre-rounding Checklist
8.3.4.3 Presentation Example
8.3.4.4 Post-op Milestones (Discharge Checklist)
8.3.5 Select Subspecialty Topics in Gynecology
8.3.5.1 Family Planning
Contraception
Contraceptive Counseling
Pregnancy Options Counseling
Abortion
8.3.5.2 Pediatric and Adolescent Gynecology (PAGS)
8.3.5.3 Reproductive Endocrinology and Infertility (REI)
8.3.5.4 Urogynecology
Urinary Incontinence
Pelvic Organ Prolapse (POP)
8.3.5.5 Menopause
8.3.5.6 Gynecologic Oncology (GYN ONC)
Cervical Cancer
Endometrial Cancer
Ovarian Cancer
Appendix (. Table 8.6)
OB Triage Note Template
9: Neurology
9.1 Overview
9.2 The Neurological Examination
9.2.1 Overview
Box 9.1 The Steps to Performing the Core Neurological Examination
Mental Status
CN II-XII
Motor Examination
Sensory Examination
Reflexes
Cerebellar Examination
Gait
9.2.2 The Mental Status Examination
9.2.2.1 Arousal
9.2.2.2 Attention
9.2.2.3 Memory
9.2.2.4 Language
9.2.2.5 Spokes
9.2.3 The Cranial Nerve Examination
9.2.3.1 Visual Fields (CN II)
9.2.3.2 Extraocular Movements (CN III, IV, VI)
9.2.3.3 Nystagmus
9.2.3.4 Facial Nerve (CN V)
9.2.3.5 Glossopharyngeal (CN IX) and Vagus Nerves (CN X)
9.2.3.6 Hypoglossal Nerve (CN XII)
9.2.4 The Motor Examination
9.2.4.1 Hyperkinetic Motor Findings
9.2.4.2 Strength Testing
9.2.5 Sensory Examination
9.2.6 Reflexes
9.2.6.1 Tips for Getting It Right
9.2.6.2 The Pectoral Jerk
9.2.7 Cerebellar (Coordination) Examination
9.2.7.1 Overview
9.2.7.2 Spoke Movements
9.2.8 Gait Examination
9.2.9 Non-neurological Examination
9.3 The Oral Presentation
Box 9.2 Steps for the Oral Presentation on Your Neurology Rotation
9.3.1 One-Liner
9.3.2 History
9.3.3 Examination
9.3.4 Objective Data
Box 9.3 The Approach to Interpreting Neuroimaging
9.3.5 Assessment
9.3.6 Plan
9.4 Common Cases
9.4.1 Delirium
9.4.1.1 Does This Patient Actually Have Delirium?
9.4.1.2 Is There an Identifiable Cause for Delirium?
Box 9.4 Mnemonic for Causes of Delirium
9.4.1.3 Is This Patient Generally at Risk for Delirium?
9.4.1.4 Examination
9.4.1.5 Work-Up and Treatment
9.4.1.6 Treatment
9.4.2 Headache
Box 9.5 Mnemonic for Causes of Secondary Headache
9.4.2.1 Work-Up and Treatment Approach
9.4.3 First Seizure
9.4.3.1 Did This Patient Have a Seizure?
9.4.3.2 Why Did the Patient Have a Seizure?
Box 9.6 Mnemonic for Causes of Seizure
9.4.3.3 Is This Patient at Risk for a Second Seizure?
9.4.3.4 Examination
9.4.3.5 Work-Up
9.4.4 Bacterial Meningitis
9.4.4.1 Diagnosis
9.4.4.2 Examination
9.4.4.3 Work-Up and Management
9.5 Evidence-Based Neurology
9.5.1 POINT [5] Trial: Dual Antiplatelet Therapy for Secondary Prevention of Ischemic Stroke
9.5.2 SPARCL Trial [6]: Statin Therapy for Secondary Prevention of Ischemic Stroke
9.5.2.1 Takeaway
9.5.3 NINDS Trial [7]: Stroke
9.5.3.1 Takeaway
9.5.4 FIRST Trial [8]: Seizures
9.5.4.1 Takeaway
9.5.5 The Optic Neuritis Treatment Trial (ONTT) [9]: Multiple Sclerosis
9.5.5.1 Takeaway
References
10: Pediatrics
10.1 Overview
10.1.1 History Taking
10.1.2 Past Medical History
10.1.3 Medication Choice
10.1.4 Medications to Avoid
10.1.5 Labs and Imaging
10.1.6 Family-Centered Rounding
10.1.7 How to Really Shine
10.1.8 Well-Child Visits
10.2 6-Month-Old Well-Child Visit
10.2.1 Subjective
10.2.2 Previous Immunizations
10.2.3 Objective
10.2.4 Assessment/Plan
10.3 Sick vs Not Sick
10.4 Approach to Acute Fever from Infection
10.5 Diseases
10.6 Infectious Complaints
10.6.1 Meningitis
10.6.2 Urinary Tract Infections
10.6.3 Sepsis
10.6.4 Acute Otitis Media
10.6.5 Conjunctivitis
10.6.6 Bronchiolitis
10.6.7 Croup
10.6.8 Influenza
10.6.9 Pneumonia
10.7 Atopy
10.7.1 Asthma
10.7.2 Atopic Dermatitis
10.8 Food Allergies
10.8.1 Food Protein-Induced Colitis
10.9 Strep Throat and Complications
10.9.1 Strep Pharyngitis
10.9.2 Rheumatic Fever
10.9.3 Post-Streptococcal/Infectious Glomerulonephritis
10.10 Skin Rashes
10.10.1 Tinea Corporis
10.10.2 Tinea Versicolor
10.10.3 Pityriasis Alba
10.10.4 Impetigo
10.10.5 Erythema Toxicum Neonatorum and Neonatal Cephalic Pustulosis
10.10.5.1 Erythema Toxicum Neonatorum
10.10.5.2 Neonatal Cephalic Pustulosis
10.11 Gastrointestinal Complaints
10.11.1 Physiologic Reflux
10.11.2 Pyloric Stenosis
10.11.3 Lead Exposure
10.11.4 Foreign Bodies
10.11.4.1 Foreign Body Ingestion
10.11.4.2 Foreign Body Aspiration
10.11.5 Viral Gastroenteritis
10.11.6 Constipation
10.12 Acute and Chronic Knee Pain
10.12.1 Acute Knee Pain
10.12.2 Fractures
10.12.3 Knee Strains and Sprains
10.12.4 Transient Synovitis
10.12.5 Septic Arthritis
10.12.6 Chronic Knee Pain
10.13 Seizures
10.13.1 Diabetic Ketoacidosis (DKA)
10.14 Example Day in Clinic
10.15 Example Day on a General Inpatient Service
10.16 Review Questions
10.16.1 Answers
11: Radiology
11.1 Overview
11.2 Recommended Resources
11.3 The Rotation
11.4 Fundamentals
11.4.1 The Black and White Language
11.4.2 Systematic Reading of CXRs
11.4.3 Image Quality (Mainly Applicable to X-rays)
11.4.3.1 Lines/Tubes
11.4.3.2 Bones
11.5 Common Images
12: Psychiatry
12.1 Introduction
12.2 The Interview
12.2.1 The Biopsychosocial Formulation
12.2.2 History
12.2.2.1 History of Present Illness (HPI)
Informational Cues
Interrupting Patients
Setting Boundaries
12.2.3 History Checklist
12.2.4 Sensitive Topics
12.2.5 Handling Displays of Emotion
12.2.6 Safety
12.3 Verbal Aggression
12.3.1 Mental Status Examination (MSE)
12.3.2 Other Sources of Information
12.4 Clinical Vignette and Note Template
12.5 Inpatient Psychiatry Initial Note
12.6 Differentiating the Differential
12.7 A Day in the Life
12.7.1 Daily Task List
12.8 The Team
12.9 Common Errors
12.10 How to Stand Out
13: Primary Care
13.1 Overview
13.2 Fundamentals
13.2.1 Checkup Visits
13.2.1.1 Before the Visit
Establishing the Baseline
13.2.1.2 During the Visit
13.2.1.3 After the Visit
13.2.2 Follow-Up Visits
13.2.2.1 Before the Visit
13.2.2.2 During the Visit
13.2.2.3 After the Visit
13.2.3 New Complaint
13.2.3.1 Before the Visit
13.2.3.2 During the Visit
13.2.3.3 After the Visit
13.3 Common Cases
13.3.1 Diabetes
13.3.1.1 New Diagnosis
Goals of Visit
Presentation
Key Symptom Checklist
Exam
Labs
Treatment
Diabetic Treatment Checklist
13.3.1.2 Follow-Up Visits
Goals of Visit
Checking for Complications of Diabetes
13.3.2 Hypertension
13.3.2.1 Compliance and Why Hypertension Matters
13.3.2.2 New Diagnosis
Goals of Visit
Presentation
Treatment
13.3.2.3 Follow-Up Visits
Goals of Visit
13.3.3 Chronic Obstructive Pulmonary Disease (COPD)
13.3.3.1 Diagnosis
13.3.3.2 Treatment
13.3.4 Congestive Heart Failure (CHF)
13.3.4.1 Goal-Directed Medical Therapy
13.3.5 CAD Primary Prevention
13.3.6 Musculoskeletal Complaints
13.3.6.1 Presentation
13.3.6.2 Exam
13.3.6.3 Treatment
13.4 Screening
13.5 Vaccinations
14: Emergency Medicine
14.1 Introduction
14.1.1 Emergency Medicine Settings
14.1.2 First Day of Your Rotation
14.2 Before the Shift
14.3 During the Shift
14.3.1 Preparing for the Patient Encounter
14.3.2 The Patient Encounter
14.3.3 History of Present Illness
14.3.4 Review of Systems
14.3.5 Past Medical/Surgical History, Family History, Medications, Allergies and Social History
14.3.6 Physical Exam
14.3.7 Managing Patient Expectations
14.3.8 After the Patient Encounter
14.3.9 The Oral Presentation
14.3.10 Assessment and Plan
14.3.11 After the Oral Presentation
14.3.12 The Patient Note
14.3.13 Follow-Up and Reassessment
14.4 End and Beyond
14.4.1 Calling Consults
14.4.2 The Discharge
14.4.3 Signing Out Your Patient to Another Team Member/Pass-off
14.4.4 Final Tips
14.5 Most Common Emergency Department Chief Complaints
14.5.1 Chief Complaint: Chest Pain
14.5.1.1 Acute Coronary Syndrome
14.5.1.2 Aortic Dissection
14.5.1.3 Cardiac Tamponade
14.5.1.4 Esophageal Rupture
14.5.1.5 Pulmonary Embolism
14.5.2 Chief Complaint: Dyspnea/Shortness of Breath
14.5.2.1 Asthma
14.5.2.2 COPD
14.5.2.3 Congestive Heart Failure
14.5.2.4 Pneumonia
14.5.3 CC: Abdominal Pain
14.5.3.1 Acute Cholecystitis
14.5.3.2 Cholangitis
14.5.3.3 Pancreatitis
14.5.3.4 Appendicitis
14.5.3.5 Diverticulitis
14.5.3.6 Ectopic Pregnancy
14.5.3.7 Ovarian Torsion
14.5.3.8 Testicular Torsion
14.6 Additional Skills/Procedures to Learn About
14.6.1 Trauma/Resuscitation
14.6.2 Important Procedures
14.6.3 Laceration Repairs
14.6.4 Incision and Drainage (I&D)
14.6.5 Splinting
14.6.6 Ultrasound-Guided IV Placement
15: Critical Care
15.1 Overview
15.2 ICU Design and Cast of Characters
15.2.1 Nursing
15.2.2 Respiratory Therapy
15.2.3 Pharmacy
15.2.4 Primary Team
15.2.5 Medical Students
15.2.6 Schedule
15.2.7 Medical Student Routines
15.3 The ICU Patient
15.4 Fundamentals
15.4.1 A Review of the Data
15.4.2 ICU Assessment of Fluid Status
15.4.3 Oxygen Delivery Systems and Noninvasive Positive Pressure Ventilation
15.4.4 Basics of Mechanical Ventilation
Box 15.1 Lung Protective Ventilation
15.4.5 Pressors and Inotropes
15.4.6 ICU Sedation and Analgesia
15.4.7 ICU Prophylaxis
15.5 Common ICU Procedures
15.5.1 Central Venous Access
15.5.2 Arterial Access/Invasive Hemodynamics
15.5.3 Intubation
15.5.4 Bronchoscopy with Bronchoalveolar Lavage
15.5.5 Extracorporeal Membrane Oxygenation (ECMO)
15.5.6 Lumbar Puncture
15.5.7 Thoracentesis
15.5.8 Paracentesis
15.5.9 Thoracic Ultrasound in the ICU
15.6 Common Cases
Box 15.2 Common ICU Conditions
15.7 Acute Respiratory Failure
15.7.1 Hypoxemic Respiratory Failure and Acute Respiratory Distress Syndrome (ARDS)
15.7.2 Hypercapnic Respiratory Failure
15.8 Septic Shock
15.9 Helpful Tables
15.10 Common ICU Equations
15.10.1 Alveolar Gas Equation
15.10.2 Alveolar–Arterial Gradient
15.10.3 Dead Space Ventilation
15.10.4 Alveolar Ventilation
15.10.5 Ideal Body Weight Equation
15.10.6 Mean Arterial Pressure
15.10.7 Acid/Base Compensations
16: Cardiology
16.1 Overview
16.2 Fundamentals
16.2.1 Heart Rate
16.2.2 Blood Pressure
16.2.2.1 Systolic Pressure
16.2.2.2 Diastolic Pressure
16.2.2.3 Mean Arterial Pressure (MAP)
16.2.2.4 Pulse Pressure
16.2.3 Oxygen Saturation
16.2.4 Chest Pain and/or Pressure
16.2.5 Shortness of Breath (SOB)
16.2.6 Volume Status
16.2.6.1 Jugular Venous Pressure
16.2.6.2 Lower Extremity Edema
16.2.7 Heart Auscultation
16.2.8 Normal Heart Sounds
16.2.9 Extra Heart Sounds
16.2.9.1 Concerning Extra Heart Sounds
16.2.9.2 Describing Extra Heart Sounds
16.2.9.3 Insufficiency (Regurgitation) Murmurs
16.2.9.4 Ejection Murmurs
16.2.9.5 Other Murmurs
16.2.9.6 Mechanical Valves
16.2.9.7 Bioprosthetic Valves
16.2.9.8 Gallops
16.2.9.9 Rub
16.2.9.10 Grading Murmurs
16.2.10 Cardiac Anatomy
16.2.10.1 Coronary Vasculature
16.2.10.2 Heart Structure
16.2.11 EKGs
16.2.11.1 Rate
16.2.11.2 Rhythm
16.2.11.3 Axis
16.2.12 PQRSTU Approach
16.2.13 Common EKG Findings
16.2.13.1 Sinus Arrhythmia
16.2.13.2 Non-ST Segment Elevation Myocardial Infarction (N/STEMI)
16.2.13.3 T Wave Inversions (TWI)
16.2.13.4 Nonspecific T Wave Changes
16.2.13.5 Atrioventricular (AV) Blocks
16.2.13.6 Bundle Branch Blocks (BBB)
16.2.13.7 Left Anterior Fascicular Block (LAFB)
16.2.13.8 Left Atrial Enlargement
16.2.13.9 Ventricular Hypertrophy
16.2.13.10 Atrial and Ventricular Arrhythmias
16.2.13.11 Atrial Fibrillation (Afib)
16.2.13.12 Atrial Flutter
16.2.13.13 Monomorphic Ventricular Tachycardia (Vtach)
16.2.13.14 Premature Atrial/Ventricular Contractions (PAC/PVCs)
16.2.14 Telemetry
16.2.15 Pacemakers
16.2.16 Echo
16.3 Practical Tips
16.3.1 Pre-Rounding
16.3.2 Rounds
16.3.3 Cardiology-Specific Oral Presentations
16.3.4 Tasks
16.3.4.1 Tasks to Consider
16.3.5 Admissions/Consults
16.3.6 Sign-Out
16.3.7 Discharges
16.4 Approach to Cardiac Disease
16.4.1 Mechanics
16.4.1.1 Diastole
16.4.1.2 Systole
16.4.1.3 Valvular Function
16.4.2 Electrical Activity
16.4.2.1 Electrical Signal Origin
16.4.2.2 Transmission Integrity
16.4.3 Reacting to Stress
16.5 Acute Coronary Syndrome
16.5.1 Differentiating the Differential
16.5.2 Chart Review
16.5.2.1 Chart Review Checklist
16.5.3 History
16.5.4 Examination
16.5.4.1 ACS Physical Exam Checklist
16.5.5 Initial Management
16.5.6 Goals of Admission (Management)
16.5.6.1 Risk Stratification for Early Invasive Therapy
16.5.6.2 Determination of Coronary Blockage
16.5.6.3 Revascularization
16.5.6.4 Post-MI Heart Remodeling Prevention
16.5.6.5 Secondary Prevention
16.5.6.6 Other
16.5.7 When to Discharge
16.6 Heart Failure
16.6.1 Heart Failure Exacerbation
16.6.2 Causes of Heart Failure Exacerbation
16.6.3 Differentiating the Differential
16.6.4 Chart Review
16.6.5 History
16.6.6 Exam
16.6.7 Objective Data
16.6.8 Goals of Admission
16.6.8.1 Determining the Cause of Current Exacerbation
16.6.8.2 Optimizing Hemodynamics
16.6.8.3 Clinical Pearls and Exceptions
16.6.8.4 Twice-Daily (Morning, Afternoon) ADHF Diuresis Checklist
16.6.8.5 Common Knowledge Questions
16.6.8.6 Assessment/Plan Examples
16.6.9 Optimizing Guideline-Directed Medical Therapy (GDMT)
16.7 Arrhythmias
16.7.1 Atrial Fibrillation
16.7.2 Chart Review Checklist
16.7.3 History
16.7.4 Exam
16.7.5 Goals of Admission
16.7.6 Determining the Afib Etiology
16.7.7 Controlling the Afib
16.7.8 Anticoagulation
16.7.9 Atrial Flutter
16.7.10 Monomorphic Ventricular Tachycardia
16.7.11 Goals of Admission
16.7.12 EP Recs
16.7.13 Ventricular Fibrillation (VFib)
16.7.14 Atrioventricular (AV) Blocks
16.8 Valvular Disease
16.8.1 Replacement Valve Types
16.8.1.1 Mechanical Valves
16.8.1.2 Bioprosthetic Valves
16.8.1.3 Surgical Versus Minimally Invasive Methods
16.8.1.4 Aortic Stenosis
16.9 Note Examples
17: Gastroenterology
17.1 Overview
17.2 Gastroenterology-Focused History
17.3 Gastroenterology-Focused Abdominal Exam
17.3.1 Appearance
17.3.2 Auscultation
17.3.3 Percussion
17.3.4 Palpation
17.3.5 Additions for Liver Disease
17.4 Unique Vocabulary
17.4.1 Scoring Systems and Calculations
17.4.2 Endoscopy Terminology
17.5 Lab Interpretation
17.5.1 Liver Function Test (LFT) Abnormalities
17.5.2 Viral Hepatitis Antibody Interpretation
17.5.2.1 Hepatitis A
17.5.2.2 Hepatitis B
17.5.2.3 Hepatitis C
17.6 GI-Specific Diagnostic Testing
17.7 Chief Complaints and Diagnoses: Approach To …
17.7.1 Abdominal Pain
17.7.2 Biliary Pathology
17.7.3 Diagnosis and Treatment
17.7.3.1 Peptic Ulcer Disease (PUD)
17.7.3.2 Intestinal Ischemia
17.7.4 Diarrhea
17.7.4.1 Watery Diarrhea
17.7.4.2 Fatty Diarrhea (Steatorrhea)
17.7.4.3 Inflammatory Diarrhea
17.7.5 Dysphagia
17.7.6 Gastrointestinal Bleeding
17.7.7 Upper GI Bleeding (UGIB)
17.7.8 Lower GI Bleeding (LGIB)
17.7.8.1 Colorectal Cancer (CRC) Screening
17.7.9 Liver Pathophysiology
17.7.9.1 Cirrhosis
17.7.9.2 Acute Liver Failure (ALF)
17.7.9.3 Alcohol-Related Hepatitis
17.7.9.4 Viral Hepatitis
17.8 Procedures
17.8.1 Digital Rectal Exam (DRE)
17.8.2 Diagnostic Paracentesis
17.8.3 Therapeutic (Large Volume) Paracentesis
18: Nephrology
18.1 Overview
18.2 Fundamentals
18.2.1 Big Picture
18.2.2 Urine Output (UOP)
18.2.3 Glomerular Filtration Rate (GFR)
18.2.4 Creatinine (Cr)
18.2.5 Blood Urea Nitrogen (BUN)
18.2.6 Sodium
18.2.7 Urine Electrolytes
18.2.8 Volume Status
18.2.9 Fluid Choice
18.2.10 Renal Replacement Therapy (Dialysis)
18.3 Practical Tips
18.3.1 Foley Management
18.3.2 Urine Sediment
18.4 Common Cases
18.4.1 Acute Kidney Injury
18.4.1.1 Treatment
18.4.2 Electrolyte Disorders
18.4.3 Sodium Disorders
18.4.3.1 Hyponatremia
18.4.3.2 Hypernatremia
18.4.4 Potassium Disorders
18.4.4.1 Hypokalemia
18.4.4.2 Hyperkalemia
18.4.5 Calcium Disorders
18.4.5.1 Hypocalcemia
18.4.5.2 Hypercalcemia
18.4.6 Diuresis
18.4.6.1 Loop Diuretics
18.4.6.2 Thiazide Diuretics
18.4.6.3 Potassium-Sparing Diuretics
18.4.6.4 Diuresis Principles
18.4.6.5 Strategies for Diuresis-Refractoriness
18.4.6.6 Adverse Effects
18.4.6.7 Electrolyte Balance
18.4.6.8 Sulfa Allergy
18.4.7 Cardiorenal Syndrome (CRS)
18.4.8 Hepatorenal Syndrome (HRS)
18.4.9 Acid–Base
18.4.9.1 Primary Disturbance
18.4.9.2 Compensation
18.4.9.3 Metabolic Acidosis
18.4.9.4 Anion Versus Non-anion Gap Metabolic Acidosis
18.4.9.5 Management
18.4.9.6 Metabolic Alkalosis
18.4.10 Glomerular Disease
18.4.10.1 Nephrotic Syndrome
18.4.10.2 Nephrotic Diseases
18.4.10.3 Nephritic Syndrome
19: Infectious Diseases
19.1 Overview
19.2 Fundamentals
19.2.1 Fever
19.2.2 Other Vital Signs
19.2.3 White Blood Cell (WBC) Count
19.2.4 CBC with Differential
19.2.5 ESR/CRP
19.2.6 Antibiotics
19.2.7 Antibiotics Checklist
19.2.8 Sensitivities (Sensis)
19.2.9 ID-Specific History
19.2.10 Chart Review
19.3 Microbes
19.3.1 Gram Positives
19.3.1.1 S. aureus
19.3.1.2 Coagulase-Negative Staph (CoNS)
19.3.1.3 Streptococci
19.3.1.4 Enterococci
19.3.1.5 Clostridium difficile
19.3.2 Gram Negatives
19.3.2.1 Pseudomonas (aeruginosa)
19.3.2.2 E. coli
19.4 Antimicrobials Review
19.4.1 Spectrum of Coverage
19.4.2 Beta-Lactams
19.4.2.1 Penicillins (The “OG Gram-Positive” Antibiotic)
19.4.2.2 Aminopenicillins (“Penicillin 2.0” – More Gram-Positive and Gram-Negative Coverage)
19.4.2.3 Beta-Lactamase-Inhibitor Combinations (“Penicillin 3.0” – Not Only Do We Get More Gram-Positive and Gram-Negative Coverage, But Most Importantly Anaerobic Coverage!)
19.4.2.4 Semisynthetic Penicillins (“The MSSA Drug”: Semisynesthetic with Two S’s as in MSSA)
19.4.2.5 Cephalosporins
19.4.2.6 Carbapenems
19.4.2.7 Monobactams (The “Second-Line Gram-Negative Beta-Lactam”)
19.4.2.8 Glycopeptides (The “Gram-Positive King”)
19.4.2.9 Linezolid and Daptomycin (The “Evil Twins of Vancomycin”)
19.4.2.10 Clindamycin (The “Gram-Positive and Anaerobe Antibiotic”)
19.4.2.11 Fluoroquinolones
19.4.2.12 Macrolides
19.4.2.13 Tetracyclines (The “King of Atypicals”)
19.4.2.14 Aminoglycosides
19.4.2.15 Bactrim (Trimethoprim-Sulfamethoxazole) (MRSA and PJP Prophylaxis)
19.4.2.16 Metronidazole (The “King of Anaerobes”)
19.4.2.17 Other Antimicrobials
19.4.2.18 Antibiotic Interactions Worth Remembering
19.4.2.19 Key Antimicrobial Recap
19.5 Top Infectious Disease Consults
19.5.1 Bacteremia
19.5.1.1 Identifying the Organism
19.5.1.2 Identifying the Source
19.5.1.3 Assessing for Complications
19.5.1.4 Identifying the Treatment
19.5.2 Endocarditis
19.5.3 Meningitis
19.5.4 Skin and Soft-Tissue Infections (SSTIs)
19.5.4.1 Cellulitis
19.5.4.2 Necrotizing Fasciitis
19.5.4.3 Diabetic Foot Infections (DFI)
19.5.5 Osteomyelitis
19.5.6 HIV/AIDS
19.5.6.1 Common Knowledge Questions
19.5.7 Recap Questions
19.5.8 Answers for Common Empiric Antibiotic Regimens
20: Anesthesia
20.1 Introduction
20.1.1 Anesthesiologists’ Role
20.1.2 Anesthesia Training
20.1.3 Exceling on the Anesthesia Rotation
20.2 Fundamentals
20.2.1 Machine (. Table 20.2)
20.2.2 Suction (. Table 20.3)
20.3 NG and OG Tubes
20.3.1 Noninvasive and Invasive Monitoring (. Table 20.4)
20.4 Pulse Oximetry
20.5 Blood Pressure
20.6 EKG
20.7 Anesthetic Depth Monitoring
20.8 Temperature Monitoring
20.9 Train of Four (TOF)
20.10 Urinary Catheters
20.10.1 Airway Management (. Table 20.5)
20.11 Bag-Mask Ventilation
20.12 Laryngeal Mask Airways (LMAs)
20.13 Intubation
20.13.1 IV Access (. Table 20.7)
20.13.1.1 Central Venous Access
20.13.1.2 Arterial Lines
20.13.2 Regional Blockade
20.13.2.1 Peripheral Nerve Blocks
20.13.2.2 Spinal Anesthesia
20.13.2.3 Epidural Anesthesia
20.14 Drugs, Drugs, Drugs
20.14.1 Preinduction
20.14.2 Induction
20.14.3 Maintenance of Anesthesia
20.14.4 Emergence
20.14.5 Summary (. Table 20.14)
20.15 A Day in the Life
20.15.1 The Schedule
20.15.2 The Night Before
20.15.3 The Day
20.15.4 Summary
20.16 Conclusion
21: Radiation Oncology
21.1 Introduction to Radiation Oncology
21.1.1 What Is Radiation Oncology?
21.1.2 What Is Radiation Therapy?
21.1.3 How Do RT and Fractionation Work?
21.1.4 How Is the RT Dose Measured?
21.1.5 What Are the Various Types of Ionizing Radiation?
21.1.6 What Are the Various Delivery Techniques for EBRT?
21.1.7 What Are the Side Effects of RT?
21.2 Steps of Radiation Therapy: Role of Medical Students
21.2.1 What Is the Workflow for Receiving RT?
21.2.1.1 Consultation: How to Prepare
21.2.1.2 The Night Before
Essential Components of Chart Review
Preparing the Note
Review of Literature
21.2.1.3 Seeing the Patient
21.2.1.4 Assessment and Plan
21.2.1.5 Simulation
21.2.1.6 Contouring
21.2.1.7 Treatment Planning and Quality Assurance
Plan Generation
Plan Evaluation
21.2.1.8 Treatment
Radiation Delivery
On-Treatment Visits (OTVs)
History
Physical Exam
Laboratory Order
21.3 Disease Site Overview
21.3.1 Central Nervous System
21.3.1.1 Glioblastoma
21.3.1.2 Low-Grade Glioma
21.3.1.3 Meningioma
21.3.1.4 CNS-Associated Radiation Toxicity
21.3.2 Head and Neck
21.3.2.1 Nasopharyngeal Cancer
21.3.2.2 Oropharyngeal Cancer (OPC)
21.3.2.3 Oral Cavity Cancer
21.3.2.4 Laryngeal and Hypopharyngeal Cancers
21.3.2.5 Post-op Radiation Therapy for Head and Neck Cancers
21.3.2.6 Head and Neck-Associated Radiation Toxicity
21.3.3 Thoracic
21.3.3.1 Early-Stage (I–II) Non-small Cell Lung Cancer (NSCLC)
21.3.3.2 Small Cell Lung Cancer
21.3.3.3 Thoracic-Associated Radiation Toxicity
21.3.4 Breast
21.3.4.1 Ductal and Lobular Carcinoma In Situ
21.3.4.2 Early-Stage (I–II) Breast Cancer
21.3.4.3 Breast-Associated Radiation Toxicity
21.3.5 Gastrointestinal
21.3.5.1 Esophageal Cancer
21.3.5.2 Gastric Cancer
21.3.5.3 Pancreatic Cancer
21.3.5.4 Rectal Cancer
21.3.5.5 Anal Cancer
21.3.5.6 Gastrointestinal-Associated Radiation Toxicity
21.3.6 Genitourinary
21.3.6.1 Prostate Cancer
21.3.6.2 Prostate-Associated Radiation Toxicity
21.3.7 Gynecology
21.3.7.1 Cervical Cancer
21.3.7.2 Cervix-Associated Radiation Toxicity
21.3.8 Palliative
21.3.8.1 Brain Metastases
21.3.8.2 Bone Metastases
21.3.8.3 Spinal Cord Compression
References
Other Resources
22: Dermatology
22.1 Introduction
22.1.1 Skin Structure
22.1.1.1 Epidermis
22.1.1.2 Dermis
22.1.1.3 Subcutis
22.2 Fundamentals of Dermatology
22.2.1 How to Approach a Skin Lesion
22.2.2 Fitzpatrick Skin Type
22.2.3 Basics of Dermatologic Therapy
22.2.3.1 Topical Steroids
22.2.3.2 Cryotherapy
22.2.3.3 Wound Care
22.2.4 Basics of Dermoscopy
22.2.4.1 How to Use a Dermatoscope
22.2.4.2 How to Describe What You See
22.2.5 Other Clinical Exam Techniques
22.2.5.1 Nikolsky Sign
22.2.5.2 Diascopy
22.2.5.3 Wood’s Lamp Skin Exam
22.2.6 Diagnostic Tests by Clinical Presentation
22.2.7 Skin Biopsies
22.3 Patient Clinical Encounter
22.3.1 Oral Presentations
22.3.2 Note-Writing
22.4 Differentiating the Differential
22.4.1 Pigmented Lesions
22.4.1.1 Melanoma
22.4.1.2 Seborrheic Keratosis
22.4.1.3 Other Conditions to Consider
22.4.2 Scaly Patch
22.4.2.1 Atopic Dermatitis
22.4.2.2 Contact Dermatitis
22.4.2.3 Psoriasis
22.4.2.4 Seborrheic Dermatitis
22.4.2.5 Other Conditions to Consider
22.4.3 Non-melanoma Skin Cancer and Other Discrete Scaly or Smooth Papules
22.4.3.1 Basal Cell Carcinoma
22.4.3.2 Squamous Cell Carcinoma
22.4.3.3 Actinic Keratosis
22.4.3.4 Other Conditions to Consider
22.4.4 Follicular-Based Papules/Pustules
22.4.4.1 Acne
22.4.4.2 Hidradenitis Suppurativa
22.4.4.3 Other Conditions to Consider
22.4.5 Erythematous Cheeks
22.4.5.1 Rosacea
22.4.5.2 Other Conditions to Consider
22.4.6 Lighter Skin Patches
22.4.6.1 Vitiligo
22.4.6.2 Other Conditions to Consider
22.4.7 Leg Conditions
22.4.7.1 Cellulitis
22.4.7.2 Other Conditions to Consider
22.4.8 Ulcers
22.4.8.1 Pyoderma Gangrenosum
22.4.8.2 Other Conditions to Consider
22.4.9 Urticaria and Angioedema
22.4.9.1 Table of Urticaria vs. Angioedema
22.4.10 Blistering Diseases
22.4.10.1 Pemphigus Vulgaris
22.4.10.2 Bullous Pemphigoid
22.4.10.3 Other Conditions to Consider
22.4.11 Target and Targetoid Lesions
22.4.11.1 Other Conditions to Consider
22.4.12 Red/Violaceous Papules and Plaques
22.4.12.1 Other Conditions to Consider
22.4.13 Viral Exanthems
22.4.13.1 Table of Important Viral Exanthems
22.4.14 Drug Reactions
22.4.14.1 Table of Cutaneous Drug Reactions
22.4.15 Erythroderma
22.4.16 Nail Disorders
22.4.16.1 Onychomycosis
22.4.16.2 Pigmentation in the Nail
22.4.16.3 Other Conditions to Consider
22.4.17 Hair Loss
22.4.17.1 Telogen Effluvium
22.4.17.2 Alopecia Areata
22.4.17.3 Other Conditions to Consider
23: Orthopaedic Surgery
23.1 Introduction
23.2 What Is the Role of an Orthopaedic Surgeon?
23.2.1 Clinic Days
23.2.2 OR Days
23.2.3 Emergency Department
23.2.4 Practice Settings
23.3 Useful Resources
23.3.1 Web-Based Services
23.3.1.1 Orthobullets
23.3.1.2 AO Surgery Reference
23.3.1.3 Digital Anatomy Atlas
23.3.2 Textbooks
23.3.2.1 Netter’s Concise Orthopaedic Anatomy
23.3.2.2 Surgical Exposures in Orthopaedics: The Anatomic Approach (Hoppenfeld, Surgical Exposures in Orthopaedics)
23.3.2.3 Pocket Pimped: Orthopaedic Surgery
23.3.2.4 Other Textbooks
23.3.3 Surgical Technique Guides
23.3.4 Zuckerman and Koval’s (Handbook of Fractures)
23.3.5 Rockwood and Green’s Fractures in Adults, Rockwood and Wilkin’s Fractures in Children (Three Volume Set)
23.3.6 Miller’s Review of Orthopaedics
23.3.7 VuMedi and the Orthopaedic Video Theater (OVT) from AAOS
23.4 A Typical Day: OR
23.4.1 Introduction
23.4.2 General
23.4.2.1 A Typical Day: Morning Rounds (. Fig. 23.1)
23.4.2.2 The Night/Day Before
23.4.2.3 During the Case
23.4.2.4 Do’s and Don’ts on Orthopaedic Services
23.4.2.5 Pimping
23.4.2.6 Closing/After the Case
23.4.2.7 In Between Cases
23.4.2.8 Ending the Day
23.5 A Typical Day: Clinic
23.5.1 The Night Before
23.5.2 During Clinic
23.6 A Typical Night: Call Nights
23.7 Procedure Guide
23.7.1 Supplies
23.7.2 Splint Rolling and Application
23.8 Compartment Syndrome
23.8.1 Splint Takedown
23.8.2 Cast Application
23.8.3 Fracture Reduction
24: Neurosurgery
24.1 Neurosurgery Mentality
24.2 The Neurosurgical Neuro Exam
24.3 How to Look at Images
24.3.1 Tips for Being Pimped
24.3.2 How to Read a Head CT
24.3.3 How to Read a Head MRI
24.3.4 How to Present Images on Rounds
24.4 Rounding
24.4.1 Pre-Rounding
24.4.2 On Rounds
24.4.3 Patient Presentations (. Table 24.15)
24.5 OR
24.5.1 Night Before the Case
24.5.2 Before Rounds
24.5.3 Before the Patient Rolls In
24.5.4 When the Patient Rolls In
24.5.5 During the Case
24.5.6 Technical Skills
24.5.7 Instruments and Proper Handling (. Table 24.22)
24.5.8 Pterional Cranial Exposure
24.5.9 Open Posterior Lumbar Approach
24.5.10 Minimally Invasive (MIS) Posterior Lumbar Approach
24.5.11 Closure
24.5.12 After the Case
24.6 Neuro ICU Essentials
24.6.1 Management of Post-Op Neurosurgical Patients
24.6.2 Postoperative DVT Prophylaxis (. Table 24.34)
24.6.3 Paroxysmal Sympathetic Hyperactivity (Storming)
24.6.4 ICP Management
24.6.5 Procedures
24.7 Consults
24.7.1 Consult 1: Malignant Cerebral Edema ISO MCA Infarction (. Table 24.38)
24.7.2 Consult 2: Intracerebral Hemorrhage (ICH) (. Table 24.40)
24.7.3 Consult 3: Traumatic Brain Injury (TBI)
24.7.4 Consult 4: Spontaneous SAH
24.7.5 Consult 5: New Brain Tumor (. Table 24.46)
24.7.6 Consult 6: Pituitary Tumor (. Table 24.47)
24.7.7 Consult 7: Shunt Evaluation (. Table 24.48)
24.7.8 Consult 8: Cauda Equina (. Table 24.49)
24.7.9 Consult 9: Spinal Cord Injury (SCI) (. Table 24.51)
24.8 Essential Cases
24.8.1 Case 1: Decompressive Hemicrani (“Crash Case”)
24.8.2 Case 2: MCA Aneurysm Clipping
24.8.3 Case 3: ACDF
24.8.3.1 Anesthesia
24.8.3.2 Field Prep
24.8.4 Case 4: Open Posterior Lumbar Laminectomy
24.8.5 Case 5: Ventriculoperitoneal Shunt Insertion
24.9 Resources
25: Ophthalmology
25.1 Introduction
25.2 High-Yield Abbreviations
25.3 High-Yield Anatomy
25.3.1 Eyelids
25.3.2 EOMs and Cranial Nerves
25.3.3 Globe
25.3.4 Conjunctiva/Sclera
25.3.5 Cornea
25.3.6 Uvea
25.3.7 Lens
25.3.8 Vitreous
25.3.9 Retina
25.3.10 Optic Nerve/Disc
25.3.11 Orbit
25.4 History, Exam, and Presentation
25.4.1 External Structures
25.4.2 Lids and Lacrimation
25.4.3 Conjunctiva and Sclera
25.4.4 Cornea
25.4.5 Anterior Chamber
25.4.6 Iris
25.4.7 Lens
25.4.8 Vitreous
25.4.9 Retina
25.5 High-Yield Investigative Tools and Resources for In-Depth Orientation
25.5.1 Conditions by Subspecialty
25.6 Cornea and Refractive
25.6.1 DtDx: Corneal Abrasion vs Corneal Ulcer
25.6.2 High-Yield Trials
25.6.3 Procedures for Further Review
25.7 Cataract and Lens
25.7.1 Grading of Nuclear Sclerotic Cataracts in Clinic
25.7.2 Topics for Further Review
25.8 Glaucoma
25.8.1 Options for Management
25.8.2 High-Yield Trials
25.8.3 Visual Field Findings in Glaucoma
25.8.4 Topics for Further Review
25.9 Pediatric Ophthalmology
25.9.1 Differentiating the Differential: Leukocoria
25.9.2 High-Yield Trials
25.9.3 Topics for Further Review
25.10 Trauma
25.10.1 Topics for Further Review
25.11 Neuro-ophthalmology
25.11.1 Differentiating the Differential: Cause of a Third Nerve Palsy
25.11.2 DtDx: NAION vs AAION
25.11.3 High-Yield Trials
25.11.4 Topics for Further Review
25.12 Retina
25.12.1 DtDx: Floaters
25.12.2 High-Yield Trials
25.12.3 Surgical Techniques and Topics for Further Review
25.13 Infection and Inflammation
25.13.1 DtDx: Preseptal vs Orbital Cellulitis
25.13.2 Options for Management of Uveitis
25.13.3 High-Yield Trials
25.13.4 Topics for Further Review
25.14 Oculoplastics
25.14.1 Surgical Techniques for Further Review
Index