Produced by ACP and the Clerkship Directors in Internal Medicine (CDIM), IM Essentials Text and IM Essentials Questions are the next. IM Essentials Questions is the next generation of MKSAP for Students, and produced collaboratively between ACP and The Clerkship Directors in Internal Medicine (CDIM). IM Essentials Questions is a self-assessment question book that uses clinically based, MKSAP-style questions to. IM Essentials Questions - Download as Word Doc .doc /.docx), PDF File .pdf), Text File .txt) or read online. internal medicine MSKASAP.

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Clerkship Directors in Internal Medicine. Edition: Examination Questions IM essentials text: a medical knowledge self-assesment program (MKSAP) for. Also available is IM Essentials Questions, containing over self-assessment questions. IM Essentials Text includes FREE access to the. Read Online Premium E-Books IM Essentials Text American College of IM Essentials Text and IM Essentials Questions are the next generation of For Full BOOK ONLINE BEST PDF Premium E-Books IM Essentials Text.

Aseptic meningitis is commonly associated with genital infection caused by herpes simplex virus 2 and is characterized by recurrent episodes of fever.

Treat mild persistent asthma. Lorcaserin is as effective as orlistat but with fewer side effects. Beers Criteria: Medication that should be avoided in older patients due to being ineffective or having adverse side effects.

Alternatives to inhaled glucocorticoids include a leukotriene receptor antagonist and theophylline. After cardiac causes have been excluded by comprehensive cardiac examination.

Treat A-fib with Warfarin o Long-term anticoagulation therapy is indicated for patients with atrial fibrillation who are at increased risk for thromboembolism.

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In patients who are able to take warfarin. Diphenhydramine may be appropriate in selected clinical situations such as severe allergic reactions. Treat Obesity with Orlistat o Orlistat.

The relative effectiveness of these two agents is not well established. Choice of treatment is based on relative efficacy and. Other causes that can result in aminotransferase levels to greater than 15x ULN are medication reactions or toxicity.


Although filtered light chains are proteins. Most myelomas produce a monoclonal M protein consisting of an intact immunoglobulin composed of a heavy chain IgG. Manage Gout with Urate-lowering agents o Because gout is associated with hyperuricemia.

Acute viral hepatitis is characterized by jaundice and significant elevations of serum aminotransferase levels greater than 15 times the upper limit of normal. Labs show an elevated serum alkaline phosphatase and bilirubin levels disproportionately higher than the aminotransferase elevation.

Manage Hypothyroidism during Pregnancy Key Point: Early in pregnancy. Key Point: The serum Thyroid-stimulating hormone levels cannot be used to monitor thyroid hormone replacement in patients with central hypothyroidism o In patients with central hypothyroidism. Patients typically have mild or no symptoms of hypothyroidism.

Diagnose lymphocytic thyroiditis as a cause of hyperthyroidism Key Point: In patients with subacute.

It is also the most sensitive and specific method to help diagnose the cause of a thyroid nodule o FNA biopsy is recommended for any nodule greater than 1 cm in diameter that is solid and hypoechoic on ultrasonography and for any nodule 2 cm or greater that is mixed cystic-solid without worrisome sonographic characteristics. Thyroiditis involves transient destruction of thyroid tissue.

Evaluate thyroid nodules with fine-needle aspiration biopsy Key point: A fine-needle aspiration biopsy is the most accurate way to determine if a thyroid nodule is benign or malignant. FNA biopsy is the most accurate method to determine whether a nodule is benign or malignant.

Treat Graves Disease Key point: Toxic multinodular goiter and toxic adenoma result from an activating somatic mutation in the TSH receptor gene.

Since 0. In patients with hyperglycemic hyperosmolar syndrome. Intravenous insulin should be given to normalize his blood glucose concentration.

If results of two different diagnostic tests for diabetes mellitus are discordant. Insulin treatment in patients with type 1 diabetes helps preserve endogenous insulin secretion for a longer period of time. Differentiate type 1 from type 2 diabetes mellitus. Screen for dyslipidemia in a patient with type 1 diabetes mellitus.

In young patients with probable diabetes mellitus. Manage hypoglycemia in a patient taking a sulfonylurea. FNA biopsy is not routinely recommended for thyroid nodules less than 1 cm in diameter Prediabetes o may be diagnosed in the presence of: Diagnose type 2 diabetes mellitus. The American Diabetes Association recommends that patients with type 1 diabetes mellitus have a fasting lipid panel performed after puberty or at diagnosis if the diagnosis is established after puberty.

Treat hyperglycemic hyperosmolar syndrome with fluid resuscitation. Manage hyperglycemia in a patient in the medical intensive care unit. Diabetic ketoacidosis DKA is associated with hyperkalemia. This critically ill patient with pneumonia and sepsis is at risk for lactic acidosis. Insulin therapy will stimulate transfer of potassium from the extracellular to the intracellular space.

The optimal glucose management for critically ill hospitalized patients is unknown. When delivered by this route. As with almost all small peptides. The most bing substernal chest pain with radiation along the trapezius ridge; powerful clinical features that increase the probability of myocar- the pain is often worse with inspiration and lying flat, and is fre- dial infarction include chest pain that simultaneously radiates to quently alleviated with sitting and leaning forward.

A pericardial Table 1.

Associated with specific ECG and echocardiographic changes. Cardiac enzymes help establish diagnosis of myocardial infarction.

Aortic dissection Substernal chest pain with radiation to the back, mid-scapular region. Chest x-ray may show a widened mediastinal silhouette, a pleural effusion, or both. Aortic stenosis see Chapter 7 Chest pain with exertion, heart failure, syncope. Typical systolic murmur at the base of the heart radiating to the neck. Esophagitis see Chapter 17 Burning-type chest discomfort, usually precipitated by meals, and not related to exertion.

Often worse lying down, improved with sitting. Musculoskeletal pain Typically more reproducible chest pain. Includes muscle strain, costochondritis, and fracture. Should be a diagnosis of exclusion. Panic attack May be indistinguishable from angina. Often diagnosed after a negative evaluation for ischemic heart disease. Often associated with palpitations, sweating, and anxiety. Pericarditis Substernal chest discomfort that can be sharp, dull, or pressure-like in nature, often relieved with sitting forward.

Usually pleuritic. ECG changes may include ST-segment elevation usually diffuse or more specifically but less common PR segment depression. Pneumothorax see Chapter 74 Sudden onset of pleuritic chest pain and dyspnea.

Chest x-ray or CT confirms the diagnosis. Pulmonary embolism see Chapter 80 Commonly presents with dyspnea. Look for risk factors immobilization, recent surgery, stroke, cancer, previous VTE disease. Embed Size px. Start on. Show related SlideShares at end.

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IM Essentials Text

Associated with specific ECG and echocardiographic changes. Granulomatosis with polyangiitis formerly known as Wegener granulomatosis is a necrotizing vasculitis that typically affects the respiratory tract and kidneys.

This is compounded by a lack of circulating insulin, which is critical for intracellular potassium movement. Uncomplicated parapneumonic pleural effusion. Choice of treatment is based on relative efficacy and, most importantly, the side-effect profiles of the agents and the risk of toxicity in the individual patient. Lab values are normal. Most myelomas produce a monoclonal M protein consisting of an intact immunoglobulin composed of a heavy chain IgG. Evaluate for secondary osteoporosis Key Point: A secondary cause for osteoporosis should be suspected in younger patients, in patients without clear risk factors, and in men.

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