Medspr17syllabus

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JumpStart Medical Education
 Course MEDSpr17 Fundamentals of Medicine
 Certification of Completion - Grade or Audit
 Length of Course: 21 weeks
 Prerequisite: None

Instructor Information Amareen Dhaliwal - amareen@axilogy.com - Instructor Office Hours: As requested Mohammad Shahin - jsmeded@gmail.com - Coordinator Meeting Hours: As requested Course Description (Catalog) This course is a detailed study of the fundamentals of medicine, to include basic anatomy, physiology, and biochemistry of nondiseased organ systems and the human body, as well as pathology, diagnosis, and treatment of diseased states. The course addresses medical humanities subjects and looks at diverse perspectives to improve understanding in care and medicine among students. Course Scope This course will teach content covered in the first two years of medical college in an intensive 21 week course. The course constitutes of weekly lectures and assignments which prepare students to take weekly case-study tests. Exams will be computer-based in a USMLE-style format, requiring advanced understanding of each module prior to taking. The course is broad and is designed to provide priming and preparation for medical school, but also can be used as a source of knowledge and motivation for premedical students from high school to post-graduates. Each week exam mimics a single block of the USMLE in timing and question format. The course is taught using new techniques to improve learning, thus it is recommended to adapt to suggested study techniques as needed. All lecture content is prepared based on the exam questions and no background information outside of the course is required. Rotations to various medical sites, humanitarian organizations, health and wellness organizations, and research laboratories is recommended to reinforce humanities content throughout the next few months. Advice/resources for LORS, MCAT, GPA, Applications, and Medical School Interviews will be available to graduates of the program. At the end of the course, students will receive a certificate of completion based on pass/fail or grade (students have until final day to choose).

Course Learning Objectives After successfully completing this course, students will be able to: • Discern how social, behavioral, environmental, and biological factors contribute to patient health and well-being • Evaluate appropriate information sources to receive medical knowledge and evaluate new research • Analyze module patient cases to develop possible diseases, narrow down a diagnosis, and develop an appropriate treatment plan • Strategize new programs and presentations to improve patient health and education about medical humanities topics • Determine how the biomedical science and humanities can be integrated in student’s future approaches to actions and behaviors in healthcare settings • Understand and recall major concepts in medicine as well as learn how to memorize and apply vast amounts of information in a timely fashion

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JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Program Objectives After completing this course, students will meet the following • • •

Generate, analyze, apply, and interpret scientific medical information to think critically Understand the fundamental concepts of medicine in all major categories and apply knowledge to case-based learning Develop a framework, based on a mission, goals, and objectives and/or competencies, to improve patient care through improved understanding of diverse needs and topics

Course Delivery Method This course delivered via distance learning will enable students to complete academic work in a flexible manner, completely online. Course materials and access to an online learning management system will be made available to each student. Online assignments are due weekly as noted on the course outline which include assignments and weekly exams. Faculty will support the students throughout this 21 week course. Course Materials Required Course Textbook: 1.

Premedical Student Planner - Axilogy Test Prep - https://www.amazon.com/Premedical-Student-Planner-AxilogyJumpStart/dp/1535463422/ref=sr_1_1?ie=UTF8&qid=1485202467&sr=8-1&keywords=premedical+student+planner

2.

Other material can be found or are recommended in the modules of the course.

Web Sites In addition to the required course texts, the following public domain web sites are useful. Evaluation Procedures Assignments: Completion of assignments is the best way to ensure passing the course as exams are curved to ensure an average of 80% per test. Please complete them as needed. Some assignments may change compared to the syllabus to enhance student understanding. Watching additional videos on concepts and to observe live effects outside of “the textbook” is important. Assignments may be on the final exam if they are MCQ-based. If only based on questions, each week’s assignments will be combined into one assignment. Weekly Exam: Weekly exams are based on the Course (USMLE) Content Outline, Syllabus, and Powerpoint. The syllabus will highlight essentials and provide extra details. The powerpoint contains high-yield information for each exam. If time limited, please use the powerpoint as your main study source. Exams are curved to ensure an average of 80% for the course. Final Exam: There will be a final exam for this course. This exam will mock the USMLE Step 1 exam required by second year medical students. This exam is timed but students can retake it twice. It will contain 322 questions in seven 46-question blocks that cover only the topics which were tested on in MCQ format. The outline for this exam is provided in the course syllabus. Final Presentation: For this course, students will be required to complete a Microsoft PowerPoint (PPT) presentation. The final paper will require students to act as healthcare professionals and engage in teaching a subject of their choice from the course. The presentation must be voice-recorded or have 2-3 sentences of notes through each slide and contain a minimum of 8 academic journal references. Students will be provided with guidelines for this. • • •

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More in-depth specific instructions for each assignment can be found in the Assignment tab within the course. Assignments submitted late without advance notice will receive a 5% per day late penalty and will not be accepted for grading five (5) days past the due date. Exams are curved - all students will pass this course as long as assignments are completed

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Course Grading Outline Grading Instrument

Points

Percentage of Final Grade

Final Exam

400

7 Blocks - 322 Questions

8%

Final Presentation

100

30 Slides with Voice-recording Minimum 8 Journal Resources

2%

Assignments

2000

20 Short Assignments (Participation only grading)

30%

Exams

3000

20 Exams - 1 Block - 46 Questions

60%

TOTAL

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Grading

5000

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus

100%


Course Calendar

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Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment (Varies)

Assgnmt. Finished? (Yes/No)

1

1-28

Molecular and Cellular Biology (A.B.P Begins) (Anatomy, Biochemist ry, Physiology Begins)

Professionalism

-Understand professionalism in healthcare setting -Apply molecular and cellular biology to patient cases

Lesson 1 Powerpoint Lesson 1 Syllabus

10 MCQ on Professionalism

36 MCQ on Molecular & Cell Biology

2

1-29

Histology & Microbiology

Patient Advocacy

-Understand reasons and methods to advocate for patients -Recognize histology slides and understanding staining methods

Lesson 2 Powerpoint Lesson 2 Syllabus

1 Case Study on Patient Advocacy

10 MCQ on Histology & Microbiology

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

3

2-04

Anatomy & Physiology

Arts & Humanities

-Learn External Structures Anatomy (Muscles, Arteries, Veins, Bones) -Be able to apply use of art for patient care

Lesson 3 Powerpoint Lesson 3 Syllabus

1 Short answer: List 5 unique studies showing art in improvement of patient health

46 MCQ on External Anatomy

4

2-05

Anatomy & Physiology

Hidden Curriculum

-Learn External Structures Anatomy (Muscles, Arteries, Veins, Bones) -Understand the hidden curriculum of education & teaching methods

Lesson 4 Powerpoint Lesson 4 Syllabus

5 MCQ on Hidden Curriculum

Optional: Quiz link on identifying external anatomy structures on cadavers

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

5

2-11

Anatomy & Physiology

Learning & Memory

-Learn Internal Structures (Organs) Anatomy -Understand process of memory & new learning methods

Lesson 5 Powerpoint Lesson 5 Syllabus

10 MCQ on Learning & Memory

46 MCQ on Internal Anatomy

6

2-12

Anatomy & Physiology

Safe Prescribing

-Learn Internal Structures (Organs) Anatomy -Learn laws and guidelines to safe prescribing

Lesson 6 Powerpoint Lesson 6 Syllabus

5 MCQ on “To Prescribe or Not to Prescribe� case studies

Optional: Quiz link on identifying internal anatomy structures on cadavers

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus

Test (1 Hour 46 MCQ Test Per Week)

Test Score (ex. 89%)


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Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

7

2-18

Anatomy & Physiology

Sleep

-Learn Head & Neck Anatomy -Understand sleep cycles & new research on sleep

Lesson 7 Powerpoint Lesson 7 Syllabus

5 MCQ on Sleep cycles & stages

46 MCQ on Head & Neck Anatomy

8

2-19

Anatomy & Physiology

Mid-Life & Death

-Learn Head & Neck Anatomy -Understand milestones of Mid-life and process of death

Lesson 8 Powerpoint Lesson 8 Syllabus

5 MCQ on Midlife & Death

Optional: Quiz link on identifying head & neck anatomy structures on cadavers

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

9

2-25

Anatomy & Physiology

Elder Abuse

-Learn structure identification on cadavers -Understand guidelines for elder abuse

Lesson 9 Powerpoint Lesson 9 Syllabus

1 MCQ on reporting elder abuse

46 MCQ on identifying structures on cadaver images

10

2-26

Anatomy & Physiology

Rural Healthcare

-Learn structure identification on cadavers -Understand current methods to improve rural health

Lesson 10 Powerpoint Lesson 10 Syllabus

1 Short Answer: List programs lacking in rural healthcare setting

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

11

3-04

Neuroscience

Behavioral Neuroanatomy

-Understand effects of nerve pathways and tracts -Understand managing behavior traits & neurology behind behaviors

Lesson 11 Powerpoint Lesson 11 Syllabus

10 MCQ on Behavioral Neuroanatomy

23 MCQ on Neuroscience

12

3-05

Genetics & Immunology

History of Medicine

-Know major genetic diseases & advancements, understand common function of immune system -Know the major advancements of medicine in past centuries

Lesson 12 Powerpoint Lesson 12 Syllabus

1 Short Answer: List major advancements in medicine in century

5 MCQ on Genetics 18 MCQ on Immunology

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


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Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

13

3-11

Cardiovascul ar System

Introduction To Public Health

-Learn nondiseased function of cardiovascular system -Understand fundamentals of public health

Lesson 13 Powerpoint Lesson 13 Syllabus

Short answer: List steps in application of a public health program model

23 MCQ in Cardiovascular system

14

3-12

Respiratory System

Medical Sociology

-Learn nondiseased function of respiratory system -Understand how medicine applies to society

Lesson 14 Powerpoint Lesson 14 Syllabus

Short answer: List how different sociology theories apply to healthcare

23 MCQ in Respiratory system

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

15

3-18

Renal System

Obesity and Eating Disorders

-Learn nondiseased function of renal system -Be able to detect typical eating disorders and obesity in all age groups

Lesson 15 Powerpoint Lesson 15 Syllabus

10 MCQ in Obesity & Eating disorders

23 MCQ in Renal System

16

3-19

Gastrointesti nal Health

Human Sexuality

-Learn nondiseased function of gastrointestinal system -Understand human sexuality

Lesson 16 Powerpoint Lesson 16 Syllabus

5 MCQ in Human sexuality

23 MCQ in Gastrointestinal health

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

17

3-25

Endocrine & Reproductive Systems

LGBTQIA Health

-Learn nondiseased function of gastrointestinal system -Understand unique ways to serve LGBTQI in healthcare & how doctors can be an ally

Lesson 17 Powerpoint Lesson 17 Syllabus

Short answer: List differences in care for L,G,B,T,Q, and I patients

30 MCQ in Endocrine & Reproductive System

18

3-26

Infectious Diseases P.T.D. Begins (Pathology,T reatment,Dia gnosis Begins)

Global Healthcare

-Understand common infectious diseases -Understand healthcare function in developing countries

Lesson 18 Powerpoint Lesson 18 Syllabus

Short answer: List costeffective methods to improve global health

16 MCQ in Infectious Diseases

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


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Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

19

4-01

Cardiovascul ar Pathology

Public Health Research Analysis

-Understand pathology, diagnosis, & treatment of cardiology -Analyze a current public health program

Lesson 19 Powerpoint Lesson 19 Syllabus

Analyze 8 Public Health Research papers Develop 700 Word Review

23 MCQ on Cardiopathy

20

4-02

Pulmonary Pathology

Smoking & Substance Misuse

-Understand pathology, diagnosis, & treatment of pulmonary system -Be able to detect smoking & substance misuse

Lesson 20 Powerpoint Lesson 20 Syllabus

Case Study on Smoking & Substance Misuse

23 MCQ on Pulmonary Pathology

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

21

4-08

Rheumatolog y

Biomedical Statistics

-Understand pathology, diagnosis, & treatment in rheumatology -Be able to make basic biomedical calculations

Lesson 21 Powerpoint Lesson 21 Syllabus

5 MCQ on applying statistics to summarize interesting patient data

20 MCQ on Rheumatology

22

4-09

Renal Pathology

Up-to-Date Online Research Portfolio

-Understand pathology, diagnosis, & treatment of renal system -Create online website using recent Up-toDate & Pubmed research articles

Lesson 22 Powerpoint Lesson 22 Syllabus

Online website development using up-to-date or pubmed articles focused on teaching disease or humanities topic which currently has limited online resources

26 MCQ on Renal Pathology

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

23

4-15

Gastrointesti nal Pathology

Prevention: Exercise & Nutrition

-Understand pathology, diagnosis, & treatment of gastrointestinal system -Know how to create diet & exercise plans for various disease states & body aspirations

Lesson 23 Powerpoint Lesson 23 Syllabus

Develop diet & fitness plan for case study

23 MCQ on Gastrointestinal Pathology

24

4-16

Neurology Part I

Mental Disabilities

-Understand pathology, diagnosis, & treatment of neurologybased disorders -Understand methods to improve daily living for patients with mental disabilities

Lesson 24 Powerpoint Lesson 24 Syllabus

Watch short video on new learning methods for Autistic students

23 MCQ on Neurology

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


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Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

25

4-22

Psychiatry Part I

Major Depression

-Understand techniques used in psychiatry -Understand major depression & effects on micro/macro level

Lesson 25 Powerpoint Lesson 25 Syllabus

Watch video on effects of depression on patient, friends, life, & family

23 MCQ on Psychiatry

26

4-23

Endocrinolog y

Behavioral Biochemistry

-Understand pathology, diagnosis, & treatment in endocrinology -Be able to predict biochemical basis of behavioral disorders

Lesson 25 Powerpoint Lesson 25 Syllabus

None

23 MCQ on Endocrinology

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

27

4-29

Reproductio n Pathology

PrenatalPreschool Development

-Understand pathology, diagnosis, & treatment in reproduction -Be able to track developmental milestones from prenatal to preschool

Lesson 25 Powerpoint Lesson 25 Syllabus

10 MCQ on PrenatalPreschool development

23 MCQ on Reproduction Pathology

28

4-30

Hematology

Alcohol Misuse and Dependence

-Understand pathology, diagnosis, & treatment in hematology -Detect & understand best treatments for alcohol misuse/ dependence

Lesson 25 Powerpoint Lesson 25 Syllabus

Watch video of effects of alcohol misuse, dependence, and recovery

23 MCQ on Hematology Pathology

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

29

5-6

Oncology

Biomedical Ethics & Laws

-Understand pathology, diagnosis, & treatment in oncology -Question challenges arising in medical ethics & laws

Lesson 25 Powerpoint Lesson 25 Syllabus

10 MCQ on Health Insurance Policy & Ethics Cases

23 MCQ on Oncology

30

5-7

Dermatology

Spirituality

-Understand pathology, diagnosis, & treatment in oncology -Know how religion and beliefs affect healthcare

Lesson 25 Powerpoint Lesson 25 Syllabus

10 MCQ on religion & beliefs in healthcare

23 MCQ on Dermatology

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


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Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

31

5-13

Internal Medicine

Health Care Disparities

-Walk through common internal medicine cases -Learn methods to act on current healthcare disparities

Lesson 25 Powerpoint Lesson 25 Syllabus

Short answer: List difference between healthcare disparity and healthcare inequity

23 MCQ on Internal Medicine

32

5-14

Surgery

Trauma Survivors

-Walk through common surgery cases -Understand medical & patient-based care for for trauma survivors

Lesson 25 Powerpoint Lesson 25 Syllabus

Watch video on trauma survivors

23 MCQ on Surgery

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

33

5-20

Family Medicine

Disaster Management

-Walk through common family medicine cases Understand major steps in managing disaster in hospitals

Lesson 25 Powerpoint Lesson 25 Syllabus

Short answer: List disaster management approach for a recent disaster (reference disaster plan)

23 MCQ on Family Medicine

34

5-21

Obstetrics/ Gynecology

Toddler-Teen Development

-Walk through common Obstetrics/ Gynecology cases -Know developmental milestones from toddler to teenage years

Lesson 25 Powerpoint Lesson 25 Syllabus

10 MCQ on Toddler-Teen development

23 MCQ on Obstetrics/ Gynecology

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

35

5-27

Psychiatry Part II

Domestic & Child Abuse

-Walk through common psychiatric cases -Understand medical & social ways to manage abuse in patients

Lesson 25 Powerpoint Lesson 25 Syllabus

5 MCQ on Domestic & Child Abuse

23 MCQ on Psychiatry

36

5-28

Neurology Part II

Veteran Health

-Walk through common neurology cases -Understand common concerns of veterans & function of VA healthcare system

Lesson 25 Powerpoint Lesson 25 Syllabus

Short answer: List causes of PTSD

23 MCQ on Neurology

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

37

6-03

Emergency Medicine

Homelessness

-Walk through common emergency medicine cases -Understand effects of homelessness on health

Lesson 25 Powerpoint Lesson 25 Syllabus

Short answer: Explain why there is continued overuse of ER by homeless citizens despite medicaid coverage

23 MCQ on Emergency Medicine

38

6-04

Geriatrics

Homelessness

-Walk through common geriatrics cases -Understand counter effects of health on causing homelessness & insurance burden

Lesson 25 Powerpoint Lesson 25 Syllabus

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

39

6-10

Clinical Exams & Sports Medicine

Pain

-Know common clinical exams -Understand behavioral and medical parts of pain management

Lesson 25 Powerpoint Lesson 25 Syllabus

5 MCQ on Pain management 15 MCQ on Clinical exams

Review for final exam

40

6-11

Team-Based Treatment

Term Presentation or Paper

-Understand function of team in care -Be able to develop education materials from novel research

Lesson 25 Powerpoint Lesson 25 Syllabus

30 Slide presentation w/ 8+ journal references & voice recording

Review for final exam

Lesson

Date

Biomedical Topic

Humanities Topic

Course Learning Objectives

Reading

Assignment

Test

41

6-17

Review Final Exam

Review Final Exam

-Review for exam

Reread Lessons 1-40

None

322 Questions 7 Blocks -Online Monitored-

42

6-18

Final Exam 8 Hours

Final Exam

-Take exam

Reread Lessons 1-40

None

23 MCQ on Geriatrics

Policies - Shorthand Drop/Withdrawal - by 2nd week Plagiarism Policy - checked for plagiarism in final presentation Extension Process and Policy - extended access to course & materials if requested up to 1 year Disability accommodations - extended testing time as referred by doctor

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JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Course Content Outline □ General Principles of Foundational Science

□ Biochemistry and molecular biology

Gene expression: DNA structure, replication, exchange, and epigenetics (eg, imprinting, Xactivation, DNA methylation)

Gene expression: transcription

□ Gene expression: translation, post-translational processing, modifications, and disposition of proteins (degradation), including protein/glycoprotein synthesis, intra-extracellular sorting, and processes/functions related to Golgi complex and rough endoplasmic reticulum □

Structure and function of proteins and enzymes (eg, enzyme kinetics and structural/regulatory proteins)

Energy metabolism (eg, ATP generation, transport chain)

Adaptive cell responses and cellular homeostasis (eg, hypertrophy)

Mechanisms of injury and necrosis, including pathologic processes (eg, liquefactive necrosis, free radical formation)

Apoptosis

Cell cycle and cell cycle regulation (eg, mitosis)

Mechanisms of dysregulation

□ Biology of cells

Cell biology of cancer (eg, role of p53, proto-oncogenes)

□ General principles of invasion and metastasis, including cancer staging

□ Cell/tissue structure, regulation, and function, including cytoskeleton, organelles, glycolipids, channels, gap junctions, extracellular matrix, and receptors

□ Human development and genetics

Principles of pedigree analysis

Population genetics

Inheritance patterns

Occurrence and recurrence risk determination

Hardy-Weinberg law

Founder effects

Mutation-selection equilibrium

Principles of gene therapy

Genetic testing and counselling

Genetic mechanisms (eg, penetrance, genetic heterogeneity)

□ Acute inflammation and mediator systems (eg, histamine, prostaglandins, bradykinins, eosinophilic basic protein, nitric oxide) □ □ Acute inflammatory responses (patterns of response)

Vascular response to injury, including mediators

□ Principles of cell adherence and migration (eg, ECAMs, selectins, leukocytic diapedesis, and rolling) □

Microbicidal mechanisms and tissue injury (eg, defensins)

□ Clinical manifestations (eg, pain, fever, leukocytosis, leukemoid reaction, chills) □ Biology of tissue response to disease □

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Chronic inflammatory responses (eg, tumor necrosis factor) □

Wound healing, repair □ Thrombosis □ Granulation tissue □ Angiogenesis □ Fibrosis □ Scar/keloid formation

Regenerative process

Reparative processes

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


□ Pharmacodynamic and pharmacokinetic processes: general principles

Pharmacokinetics

Absorption

Distribution

Metabolism

Excretion

Dosage intervals

Mechanisms of drug action, structure-activity relationships (eg, anticancer drugs)

□ Individual factors altering pharmacokinetics and pharmacodynamics (eg, age, gender, disease, tolerance, compliance, body weight, metabolic proficiency, pharmacogenetics) □

Mechanisms of drug adverse effects, overdosage, toxicology

Mechanisms of drug interactions

□ Signal transduction, including structure/function of all components of signal transduction pathways such as receptors, ligands (eg, general principles of nitric oxide, autocrine and paracrine signaling)

□ Structure (eg, cell walls, composition, appendages, virulence factors, extracellular products, toxins, mechanism of action of toxins)

Bacteria

□ Processes, replication, and genetics (eg, metabolism, growth, and regulation) □

Oncogenesis

□ Antibacterial agents (eg, mechanisms of action on organism, toxicity to humans, and mechanisms of resistance)

Structure (eg, physical and chemical properties, virulence factors)

□ Processes, replication, and genetics (eg, life cycles, location of virus in latent infection) □

□ Microbial biology: Microbial identification and classification, including principles, microorganism identification, and nonimmunologic laboratory diagnosis

Viruses

Oncogenesis

□ Antiviral agents (eg, mechanisms of action on virus, toxicity to humans, and mechanisms of resistance)

□ Structure (eg, cell wall, composition, appendages, virulence factors, extracellular products, toxins, mechanisms of action of toxins) □

Fungi

□ Processes, replication, and genetics (eg, asexual vs. sexual, metabolism, growth) □ Antifungal agents (eg, mechanisms of action on fungus, toxicity to humans, and mechanisms of resistance)

□ Structure (eg, appendages, macroscopic features, and virulence factors)

□ Processes, replication, and genetics (eg, life cycles, metabolism, and growth) Parasites

Oncogenesis

□ Antiparasitic agents (eg, mechanisms of action on parasite, toxicity to humans, and mechanisms of resistance)

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Prions

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Normal physical changes □ Linear growth, variations in linear growth, including constitutional delay □ Weight □ Head circumference □ Micturition, defecation, primary incontinence/bedwetting □ Normal physical examination □ Screening □ Sleep

Developmental stages □ Motor □ Speech □ Cognitive □ Psychosocial □ Anticipatory guidance

Lifestyle and routine preventive health care □ Nutrition □ Exercise (eg, benefits of exercise) □ Preventive/travel medicine □ Risk factors and prevention (eg, guns, swimming, motor vehicles, car seats) □ Routine vaccinations

Normal physical changes □ Linear growth, variations in linear growth including constitutional delay □ Weight □ Puberty □ Normal physical examination □ Gynecomastia □ Autonomy/self-identity □ Sleep

Developmental stages □ Cognitive (eg, abstract thought) □ Psychosocial (eg, autonomy, role confusion, sexual identity) □ Anticipatory guidance

Lifestyle and routine preventive health care □ Nutrition □ Exercise (eg, benefits of exercise) □ Preventive/travel medicine □ Risk factors and prevention (eg, risk-taking behavior, helmets, safe sex, motor vehicles, seat belts, distractions) □ Routine vaccinations

Normal physical changes □ Weight □ Normal physical examination □ Screening □ Sleep

Developmental stages □ Cognitive □ Intimacy vs isolation □ Anticipatory guidance

Lifestyle and routine preventive health care □ Nutrition □ Exercise (eg, benefits of exercise) □ Preventive/travel medicine □ Risk factors and prevention □ Routine vaccinations

Infancy and childhood (0-12 years)

Adolescence (13-17 years)

□ Normal age-related findings and care of the well patient

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Adulthood (18-64 years)

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Normal physical changes, including normal physical exam for age □ Weight, height (spinal compression), skin, bruising □ Normal physical examination □ Response to temperature □ Micturition, defecation □ Sleep

Developmental stages □ Motor □ Cognitive (eg, benign senescent forgetfulness) □ Psychosocial □ Integrity vs despair □ Retrospection □ Anticipatory guidance

Lifestyle and routine preventive health care □ Nutrition □ Exercise (eg, benefits of exercise) □ Preventive/travel medicine □ Risk factors and prevention (eg, falls, general medical condition; polypharmacy, driving, caregiver stress) □ Routine vaccinations

Senescence (65 years and older)

□ Immune System

Development of cells of the adaptive immune response, including positive and negative selection during immune development

□ Granulocytes, natural killer cells, macrophages, mast cells, dendritic cells, cell receptors (eg, complement receptors and toll-like receptors), cytokines, chemokines □ T lymphocytes, including T-lymphocyte receptors, accessory molecules (eg, CD3, CD4, CD8, B7), cell activation and proliferation, cytotoxic T lymphocytes, and memory T lymphocytes □

Structure, production, and function

□ B lymphocytes and plasma cells, including B-lymphocyte receptors, immunoglobulins, cell activation and proliferation, including development of antibodies and memory B lymphocytes □ Host defense mechanisms, host barriers to infection, mucosal immunity (eg, gutassociated lymphoid tissue and bronchus-associated lymphoid tissue), anatomical locations of T and B lymphocytes

□ Antigen processing and presentation in the context of MHC I and MHC II molecules (eg, TAP, beta-2 microglobulin), intracellular pathways, mechanisms by which MHC is expressed on the surface; including distribution of MHC I and MHC II on different cells, mechanisms of MHC I and MHC II deficiencies, and the genetics of MHC

□ Normal processes □ Cellular basis of the immune response and immunologic mediators

□ Regulation of the adaptive immune response (eg, peripheral tolerance, anergy, regulatory T lymphocytes, termination of immune response, and B-T lymphocyte interactions) □ Activation, function, and molecular biology of complement (eg, anaphylatoxins) □

Functional and molecular biology of cytokines (eg, IL 1-15)

□ Basis of immunologic diagnostics (eg, antigen-antibody reactions used for diagnostic purposes, ELISA, immunoblotting, antigen-antibody changes over time, ABO typing) □

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Vaccine production and mechanisms of vaccine action □ Biologically active antibodies (eg, monoclonal antibodies, polyclonal antibodies including IVIG, VZIG, rabies immunoglobulin)

Principles of immunologic protection

Effect of age on the function of components of the immune system

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


□ Disorders associated with immunodeficiency

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

HIV/AIDS

Deficiency primarily of humoral immunity □ Common variable immunodeficiency □ Hyper IgM syndrome □ Hypogammaglobulinemia/agammaglobulinemia, X-linked (Bruton) □ Selective immunodeficiency (eg, IgA, IgM, IgE)

Deficiency/dysfunction primarily of cell-mediated immunity □ Adenosine deaminase deficiency □ DiGeorge syndrome □ Severe combined immunodeficiency disease (SCID) □ Wiskott-Aldrich syndrome □ Granulomatosis □ Allergic reactions/skin

Complement deficiency □ Alternative pathway component deficiency (C2, C3b, C3bB, C36B6) □ Classical pathway component deficiency (C1q, C1r, C1-C5) □ Terminal component deficiency (C5b-C9; terminal complement complex) □ C1 esterase inhibitor deficiency, hereditary angioedema; mannose-binding lectin (MBL) deficiency □ Membrane attack complex deficiency

Deficiency of phagocytic cells and natural killer cells □ Chediak-Higashi disease □ Chronic granulomatous disease and other disorders of phagocytosis □ Leukocyte adhesion deficiency

HIV1 and HIV2

AIDS

AIDS complications (eg, neuropathy, dementia, renal insufficiency)

Immunology of AIDS

Immune reconstitution syndrome (IRS)

Secondary infections

Noninfectious complications

Hypersensitivity reactions □ Type 1, 2, 3, including anaphylaxis □ Type 4 □ Drug reactions □ Serum sickness

Transplantation □ Rejection □ Graft-vs-host disease

Jarisch-Herxheimer reaction

Immunologically mediated disorders

□ Adverse effects of drugs on the immune system

□ Drugs affecting the immune system (eg, prednisone, azathioprine, cyclosporine, methotrexate, monoclonal antibody drugs [eg, abciximab, adalimumab; bevacizumab, infliximab, omalizumab, rituximab]) □

Vaccine adverse effects

□ Blood & Lymphoreticular System □

Embryonic development, fetal maturation, and perinatal changes

Organ structure and function

□ Production and function of erythrocytes, including heme and hemoglobin synthesis □ Normal Processes

! 15

Cell/tissue structure and function

□ Hemoglobin O2 and CO2 transport, transport proteins, erythropoietin production and function of platelets □

Production and function of coagulation and fibrinolytic factors

Hemostasis

Repair, regeneration, and changes associated with stage of life

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Infectious and immunologic

Infectious disorders □ Bacteria □

Viral □ Hemorrhagic fever (Ebola virus, Marburg virus) □ Chikungunya □ Dengue fever

Parasitic □ Malaria (Plasmodium spp) □ Babesiosis (Babesia species)

Primary infections of lymphoid tissue □ Lymphadenitis (viral, bacterial, fungal, parasitic) □ Lymphangitis □ Buboes, bubonic plague (Yersinia pestis) □ Cat scratch disease (Bartonella henselae)

Immunologic and inflammatory disorders □ Cryoglobinemia, essential mixed cryoglobinemia □ Autoimmune hemolytic anemia □ Paroxysmal nocturnal hemoglobinuria □ Thrombotic thrombocytopenic purpura □ Hemolytic uremic syndrome

Leukemia, acute (ALL, AML)

Leukemia, chronic (CLL, CML)

□ Lymphomas, Hodgkin disease, non-Hodgkin lymphoma, Burkitt lymphoma, T-cell lymphoma □

Neoplasms

□ Multiple myeloma, dysproteinemias, monoclonal gammopathy of unknown significance (MGUS) □

Myelofibrosis

Myelodysplastic syndrome, myelodysplasias

□ Other immunoproliferative neoplasms (eg, Waldenstrom macroglobulinemia)

□ Anemia, cytopenias, and polycythemia anemias

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

! 16

Decreased production: anemia of chronic disease

Hemolysis □ Glucose-6-phosphate dehydrogenase deficiency □ Pyruvate kinase deficiency

Disorders of hemoglobin, heme, or membrane □ Disorders of red cell membranes □ Hereditary spherocytosis, elliptocytosis; methemoglobinemia, congenital □ Sickle cell disease □ Sideroblastic anemia □ Thalassemias

□ Other causes of anemia: blood loss, acute and chronic as a cause of anemia □

Cytopenias □ Aplastic anemia □ Leukopenia □ Neutropenia, cyclic neutropenia, agranulocytosis □ Pancytopenia □ Thrombocytopenia, quantitative □ Immune thrombocytopenic purpura (ITP)

Cythemias □ Leukocytosis □ Polycythemia vera □ Secondary polycythemia

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Hypocoagulable □ Disseminated intravascular coagulation □ Hemophilia, congenital factor VIII [hemophilia A] and IX [hemophilia B] □ Hypofibrinogenemia □ von Willebrand disease □ Platelet dysfunction, qualitative

Hypercoagulable □ Heparin-induced thrombocytopenia □ Other coagulopathies (eg, homocysteinemia, hypoplasminogenemia, antithrombin III, protein C/protein S deficiency, Factor V Leiden, anticardiolipin antibodies, lupus anticoagulant, prothrombin G20210A mutation)

Reactions to blood components □ ABO incompatibility/anaphylaxis □ Rh incompatibility/anaphylaxis □ Hemolysis, delayed □ Transfusion reaction □ Transfusion contaminated with bacteria □ Transfusion-related acute lung injury (TRALI) □ Anaphylactoid reaction (IgA deficiency)

Mechanical injury to erythrocytes (eg, cardiac valve hemolysis)

Disorders of the spleen

Splenic rupture/laceration

Splenic infarct

Splenic abscess

□ Coagulation disorders (hypocoagulable and hypercoagulable conditions)

□ Traumatic, mechanical, and vascular disorders

□ Effects/complications of splenectomy (eg, sepsis due to encapsulated bacteria)

Hypersplenism

Antiplatelet drugs, antithrombin drugs (eg, dabigatran)

Chemotherapeutic agents

Inhibitors of coagulation factors

Methemoglobinemia, acquired

Propylthiouracil

Tumor lysis syndrome

Warfarin

Congenital disorders

□ Adverse effects of drugs on the hematologic and lymphoreticular systems

□ Behavioral Health

Psychodynamic and behavioral factors, related past experience (eg, transference, personality traits)

Adaptive behavioral responses to stress and illness (eg, coping mechanisms)

Maladaptive behavioral responses to stress and illness (eg, drug-seeking behavior, sleep deprivation)

Patient adherence

□ Normal Processes

! 17

Psychotic disorders

General adherence

Adolescent adherence

Brief psychotic disorder

Delusional disorder

Psychotic disorder due to another medical condition

Schizophrenia

Schizoaffective disorder

Substance-induced psychotic disorder

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Anxiety disorders

Acute stress disorder

Anxiety due to another medical condition

Generalized anxiety disorder

Hyperventilation syndrome

Obsessive-compulsive disorder

Panic disorder with and without agoraphobia

Phobic disorders

Anxiety disorder (social phobia)

Post-traumatic stress disorder

Separation anxiety disorder

Substance-induced anxiety disorder, trichotillomania

□ Major depressive disorder with and without psychotic features, with and without seasonal pattern □ Major depressive disorder, postpartum, with and without psychotic features, including screening

Mood disorders

Cyclothymic disorder

Persistent depressive disorder (dysthymia)

Bipolar disorder, manic/depressed/mixed

□ Premenstrual dysphoric disorder; bipolar and related disorder or depressive disorder due to another medical condition □ Substance/medication-induced bipolar and related disorder or depressive disorder (illegal or prescribed)

Somatoform disorders

Suicidal ideation/attempt

Body dysmorphic disorder

Conversion disorder, including psychogenic seizures

Dissociative disorders

Illness anxiety disorder (hypochondriasis)

Malingering

Pain disorder

Somatic symptom disorder

Factitious disorders: factitious disorder imposed on self

□ Eating disorders and impulse control disorders

Anorexia nervosa

Binge-eating disorder

Bulimia nervosa

Eating disorder

□ Disruptive, impulse-control, and conduct disorders (eg, gambling, kleptomania, pyromania) □ Abnormal Processes: Health and Health Maintenance,

! 18

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and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

Reactive attachment disorder

Attention deficit/hyperactivity disorder

Speech sound disorder or language disorder

Learning disorder/dyslexia

□ Intellectual developmental disorder and developmental delay, undefined, including school problems, fetal alcohol syndrome □

Disorders originating in infancy/childhood

Personality disorders

Psychosocial disorders/behaviors

Sexual and gender identity disorders

Substance abuse disorders

Oppositional defiant disorder, conduct disorder

Autism spectrum disorder, Rett syndrome

Psychoses with origin specific to childhood

Elimination disorders (incontinence, encopresis)

Tic disorders/Tourette disorder

Antisocial personality disorder

Avoidant personality disorder

Borderline personality disorder

Dependent personality disorder

Histrionic personality disorder

Narcissistic personality disorder

Obsessive-compulsive personality disorder

Paranoid personality disorder

Schizoid personality disorder

Adjustment disorder

Grief response/bereavement, normal and persistent complex

□ Parent-child relational problems other than physical or emotional abuse □

Other psychosocial stress

Gender dysphoria

Psychosexual dysfunction

Alcohol use disorder/intoxication/dependence/withdrawal

Tobacco/nicotine use disorder/dependence/withdrawal

Cannabis use disorder/intoxication/ dependence

Hallucinogen use disorder/intoxication/dependence/withdrawal

Inhalant use disorder/intoxication/dependence/withdrawal

□ Opioids, heroin, including prescription drugs, use disorder/ intoxication/dependence/withdrawal □ Sedatives, hypnotics, including benzodiazepines and barbiturates use disorder/intoxication/dependence/withdrawal □ Stimulants, cocaine, methamphetamine use disorder/intoxication/ dependence/withdrawal □ Other drugs of use disorders (eg, ecstasy, PCP, bath salts)/ intoxication/dependence/ withdrawal

! 19

Adverse effects of drugs

Polysubstance use disorder/intoxication/dependence/withdrawal

Steroid-induced psychosis

Varenicline and suicide

Drug-induced psychogenic polydipsia

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□ Nervous System & Special Senses

□ Embryonic development, fetal maturation, and perinatal changes, including neural tube derivatives, cerebral ventricles, and neural crest derivatives □

Spinal cord □ Gross anatomy and blood supply □ Spinal reflexes

□ Brain stem (eg, cranial nerves and nuclei, reticular formation, anatomy and blood supply, control of eye movements)

Organ structure and function

Brain □ Gross anatomy and blood supply □ Higher function: cognition, language, memory, executive function □ Hypothalamic function □ Limbic system and emotional behaviour □ Circadian rhythms and sleep

Sensory systems □ General sensory modalities, including sharp, dull, temperature, vibratory, and proprioception □ Special sensory modalities, including vision, hearing, taste, olfaction, and balance

Motor systems □ Brain and spinal cord (upper motoneuron) □ Basal ganglia and cerebellum

Autonomic nervous system

Peripheral nerves

Axonal transport

□ Normal Processes

□ Excitable properties of neurons, axons, and dendrites, including channels □ Synthesis, storage, release, reuptake, and degradation of neurotransmitters and neuromodulators □ Cell/tissue structure and function, including neuronal cellular and molecular biology

□ Presynaptic and postsynaptic receptor interactions, trophic and growth factors □

Brain metabolism

Glia, myelin

□ Brain homeostasis: blood-brain barrier, cerebrospinal fluid formation and flow, choroid plexus

! 20

Repair, regeneration, and changes associated with stage of life

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Infectious disorders □ Meningitis: bacterial (Actinomyces israelii; Haemophilus influenzae; Listeria monocytogenes; Mycobacterium tuberculosis; Neisseria meningitidis; Staphylococcus aureus, epidermidis; Streptococcus agalactiae; Streptococcus pneumoniae) □ Viral (adenovirus, arboviruses, echovirus and coxsackie A & B viruses, polioviruses, herpes simplex virus, varicella zoster, human immunodeficiency virus, lymphocytic choriomeningitis virus, measles virus, mumps virus, St. Louis encephalitis virus, California encephalitis virus, Western equine encephalitis virus) □ Fungal (Blastomycosis dermatitidis, Cryptococcus neoformans/gattii) □ Spirochetal (Borrelia burgdorferi; Leptospira; Treponema pallidum, including neurosyphilis) □ Protozoal/helminths (Acanthamoeba, Naegleria fowleri, Strongyloides stercoralis, Angiostrongylus cantonensis, Baylisascaris procyonis) □ Encephalitis (herpesvirus [HSVI], varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, mumps virus, enterovirus, West Nile virus, St. Louis encephalitis virus, rabies virus, Eastern and Western equine encephalitis virus, poliovirus, Taenia, Toxoplasma gondii) □ Prion disease (eg, Creutzfeldt-Jakob disease) □ Botulism (Clostridium botulinum), tetanus (Clostridium tetani) □ CNS disorders associated with AIDS (eg, progressive multifocal leukoencephalopathy)

Immunologic and inflammatory disorders • Myasthenia gravis, including thymoma • Multiple sclerosis • Transverse myelitis

Benign (meningioma, neurofibromatosis)

□ Infectious, immunologic, and inflammatory disorders

Neoplasms (cerebral, spinal, and peripheral)

□ Malignant (glioblastoma multiforme, astrocytoma, medulloblastoma, primary CNS lymphoma) □

Metastatic (eg, breast, lung, pancreatic, testicular, melanoma)

Arteriovenous malformations, ectatic cerebral vessels

Transient ischemic attack

Stroke, thrombotic: cerebral artery occlusion/cerebral infarction

Stroke, embolic

Cerebral embolism

□ Stroke: intracerebral hemorrhage, including subarachnoid hemorrhage, traumatic intracranial hemorrhage □

Cerebrovascular disease

□ Disorders relating to the spine, spinal cord, and spinal nerve roots

! 21

Cerebral artery aneurysm

Carotid artery stenosis/atherosclerosis/occlusion/dissection

Vertebral artery deficiency/dissection

Subclavian steal syndrome; vascular dementia

Hypertensive encephalopathy

Posterior reversible encephalopathy syndrome

Venous sinus thrombosis

Cauda equina syndrome

Spinal artery thrombosis/embolus/infarct

Spinal cord compression

□ Spinal cord transection, paraplegia and quadriplegia, acute and chronic effects (eg, autonomic dysreflexia) □

Spinal stenosis (cervical, lumbar)

Syringomyelia

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Cranial nerve injury/disorders □ Cranial nerve injury □ Bell palsy □ Anisocoria, miosis, mydriasis □ Internuclear ophthalmoplegia □ Nystagmus and other irregular eye movements □ Vestibular neuritis, labyrinthitis □ Ptosis of the eyelid □ Horner syndrome

Peripheral nerve/plexus injury/disorders □ peripheral nerve injury, including brachial plexus □ carpal/cubital/tarsal/peroneal tunnel syndrome □ mononeuritis, Guillain-Barré syndrome □ Miller Fisher syndrome □ neuropathy (eg, Charcot-Marie-Tooth disease) □ herpes zoster

Cranial and peripheral nerve disorders

□ Complex regional pain syndrome (reflex sympathetic dystrophy, causalgia)

Neurologic pain syndromes

□ Degenerative disorders/amnestic syndromes

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

! 22

Global cerebral dysfunction

Neuromuscular disorders

Movement disorders

Metabolic disorders

Fibromyalgia

Postherpetic neuralgia

Phantom limb pain/syndrome

Thalamic pain syndrome

Trigeminal neuralgia

Alzheimer disease

□ Frontotemporal dementia, including Pick disease, progressive supranuclear palsy, Lewy body disease □

Mild neurocognitive disorder, mild cognitive impairment

Altered states of consciousness

Delirium

Coma/brain death

Amyotrophic lateral sclerosis/spinal muscular atrophy

Muscular dystrophy (eg, Duchenne, myotonic)

Muscle channelopathies (eg, hypokalemic period paralysis)

Acute dystonia

Adult tic disease

Essential tremor

Huntington disease

Parkinson disease, including Parkinson dementia

Adrenoleukodystrophy

Metabolic encephalopathy

□ Headache, including migraine, mixed, tension, ice-pick, cluster, medication withdrawal, caffeine withdrawal □

Paroxysmal disorders

□ Seizure disorders, including generalized tonic-clonic, partial, absence, febrile

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Sleep disorders

Cataplexy and narcolepsy

Circadian rhythm disorders

Insomnia, primary

Sleep terror disorder and sleepwalking

REM sleep behavior disorder

Restless legs syndrome

Anoxic brain damage, cerebral hypoxia

Epidural, subdural hematoma (cerebral and spinal)

□ Intraparenchymal hemorrhage, traumatic subarachnoid haemorrhage

□ Traumatic and mechanical disorders and disorders of increased intracranial pressure

Cerebral edema

Pseudotumor cerebri (idiopathic intracranial hypertension)

Torticollis/cervical dystonia

Hydrocephalus, including normal-pressure

□ Traumatic brain injury (concussion)/postconcussion syndrome (dementia pugilistica) □

Traumatic brain syndrome

Friedreich ataxia

□ Neural tube defects (eg, spina bifida, holoprosencephaly, anencephaly) □

Congenital disorders

□ Adverse effects of drugs on the nervous system

! 23

Microcephaly

Sturge-Weber syndrome

Tuberous sclerosis, von Hippel-Lindau disease

Hydrocephalus, obstructive (Arnold-Chiari)

Acute dystonic reaction

Drug-induced meningitis (eg, NSAIDs, sulfa drugs)

Drug-induced neuropathy (eg, vincristine, isoniazid, metronidazole)

□ Extrapyramidal adverse effects (eg, akathisia, dystonia, druginduced parkinsonism) □

Neuroleptic malignant syndrome

Poisoning by psychotropic agents, including antidepressants

Serotonin syndrome

Tardive dyskinesia

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! 24

Disorders of the eye and eyelid

Infectious and inflammatory disorders of the eye □ Blepharitis/eyelid inflammation □ Chalazion □ Chorioretinitis □ Conjunctivitis (adenovirus)/keratoconjunctivitis □ Dacryocystitis □ Endophthalmitis □ Hordeolum □ Iridocyclitis □ Optic neuritis □ Periorbital cellulitis □ Uveitis

Neoplasms of the eye □ Melanoma □ Retinoblastoma

Disorders of the eye and eyelid, structural □ Cataract □ Glaucoma □ Lacrimal system disorders □ Pterygium □ Refractive disorders (presbyopia, myopia, hyperopia, astigmatism)

Disorders of the pupil, iris, muscles (extraocular) □ Amblyopia □ Strabismus

Disorders of the retina □ Hypertensive retinopathy □ Macular degeneration □ Papilledema □ Retinal detachment □ Retinitis pigmentosa □ Vascular disorders affecting the retina, including central retinal artery embolus, retinal hemorrhage, amaurosis fugax, embolus, carotid artery stenosis, central retinal vein occlusion □ Visual impairment/blindness, night blindness

Traumatic and mechanical disorder □ Black eye □ Burn of the eye and adnexa □ Corneal abrasion, ulcer □ Dislocated lens □ Foreign body in eye □ Hyphema □ Injury to optic nerve and pathways □ Laceration of the eye and eyelid □ Ocular open wounds □ Orbital fracture □ Subconjunctival haemorrhage

Adverse effects of drugs on the eyes □ Ethambutol □ Hydroxychloroquine □ Prednisone

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Infectious and inflammatory disorders of the ear □ Chondritis □ Mastoiditis □ Otitis, externa, media, interna, serous, suppurative, malignant otitis externa

Neoplasms □ Acoustic neuroma, neurofibromatosis type 2 □ Cholesteatoma

Hearing loss/deafness □ Hearing loss, including noise induced □ Otosclerosis □ Tinnitus

Disorders of balance and spatial orientation □ Ménière disease □ Motion sickness □ Vertigo, including benign positional vertigo

Traumatic and mechanical disorders □ Barotrauma □ Foreign body in ear □ Impacted cerumen □ Laceration, avulsion □ Perforation of tympanic membrane □ Eustachian tube disorders

Adverse effects of drugs on the ear □ Antineoplastic agents, including cisplatin □ Aminoglycosides □ Furosemide □ Salicylates

Disorders of the ear

□ Skin & Subcutaneous Tissue

□ Normal Processes

Embryonic development, fetal maturation, and neonatal changes

Organ structure and function, including barrier function, thermal regulation

□ Cell/tissue structure and function, eccrine function Repair, regeneration, and changes associated with stage of life (eg, senile purpura, male pattern baldness, postmenopausal hair changes) □

! 25

Skin defense mechanisms and normal flora

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Infectious disorders and infestations □ Bacterial □ Cellulitis, erysipelas, impetigo, staphylococcal scalded skin syndrome □ Abscess, cutaneous, including septic abscess □ Anthrax (Bacillus anthracis) □ Carbuncle □ Folliculitis □ Pilonidal cyst, infected □ Pyoderma gangrenosum □ MSSA and MRSA skin infections □ Mycobacterial infections (eg, leprosy, draining sinus) □ Scarlet fever (group A Streptococcus) □ Viral □ Herpes simplex type 1 & type 2, herpes zoster, Ramsay-Hunt syndrome □ Molluscum contagiosum □ Hand-foot-and-mouth disease □ Herpangina □ Parvovirus □ Chickenpox, erythema infectiosum (fifth disease), rubella, measles, roseola (exanthema subitum) □ Verrucae vulgaris □ Fungal (deep and superficial) □ Candidiasis, skin □ Dermatophytosis, tinea corporis □ Dermatomycoses □ Diaper rash □ Onychomycosis □ Parasitic □ Cutaneous larva migrans □ Cutaneous leishmaniasis □ Infestations, nonvenomous bites, stings □ Scabies □ Lice □ Insect bites, including bed bugs

Immunologic and inflammatory disorders □ Papulosquamous and eczematous dermatoses □ Psoriasis □ Lichen planus and lichenoid dermatoses □ Allergic/irritant contact dermatitis (eg, nickel) □ Dermatoses caused by plants (poison ivy, poison oak) □ Vesiculobullous disorders □ Epidermolysis bullosa □ Dermatitis herpetiformis □ Pemphigus □ Pemphigoid □ Urticaria, erythema, exanthema, and □ Purpura □ Erythema nodosum □ Atopic dermatitis □ Pityriasis rosea □ Urticarial □ Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis □ Autoimmune disorders □ Vitiligo

Benign neoplasms, cysts and other skin lesions □ Actinic keratosis □ Cysts, including epidermal □ Hemangiomas □ Lipoma □ Pigmented nevi □ Seborrheic keratosis □ Xanthomas

Malignant neoplasms □ Basal cell carcinoma □ Squamous cell carcinoma □ Melanoma, including genital □ Kaposi sarcoma □ Cutaneous T-cell lymphoma, mycosis fungoides

□ Infectious, immunologic, and inflammatory disorders

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

! 26

Neoplasms

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□ Adnexal disorders (hair and hair follicles, nails, sweat glands, sebaceous glands, oral mucous membranes)

Disorders of the hair and hair follicles □ Alopecia □ Seborrhea capitis/seborrheic dermatitis □ Tinea barbae and capitis

Disorders of the nails (including ingrowing nail)

Disorders of sweat and sebaceous glands □ Acne vulgaris □ Hidradenitis suppurativa □ Hyperhidrosis □ Ichthyosis □ Rosacea

□ Musculoskeletal System

□ Normal processes

Embryonic development, fetal maturation, and perinatal changes

Organ structure and function

Cell/tissue structure and function

Repair, regeneration, and changes associated with stage of life

Biology of bones, joints, tendons, skeletal muscle, cartilage

Exercise and physical conditioning/deconditioning

Infectious disorders □ Gangrene, dry and wet, clostridial myonecrosis (Clostridium perfringens) □ Discitis □ Myositis, infective □ Necrotizing fasciitis □ Osteomyelitis □ Septic arthritis □ Spondylitis, tuberculous

Immunologic disorders □ Ankylosing spondylitis □ Dermatomyositis/polymyositis □ Juvenile idiopathic arthritis □ Rheumatoid arthritis, Felty syndrome □ Psoriatic arthropathy

Inflammatory disorders □ Adhesive capsulitis of shoulder (frozen shoulder syndrome) □ Ankylosis/spondylopathy (inflammatory) □ Bursitis □ Fasciitis □ Osteochondritis, osteochondritis dissecans □ Tendinitis, supraspinatus syndrome, enthesopathy of spine, elbow, ankle □ Temporomandibular joint disorders □ Fibrositis, myofascial pain syndrome □ Synovitis □ Tenosynovitis □ Myositis

Benign neoplasms (e.g., ganglion cyst)

□ Infectious, inflammatory, and immunologic disorders

Neoplasms

□ Malignant neoplasms of bone (eg, osteosarcoma, sarcoma, leiomyosarcoma, rhabdosarcoma) □

! 27

Metastases to bone, secondary malignant neoplasm of bone

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Degenerative/metabolic disorders of bone, tendon, and cartilage □ Chondromalacia □ Disc degeneration, herniated disc □ Legg-Calvé-Perthes disease □ Osgood-Schlatter disease □ Osteodystrophy □ Osteomalacia □ Osteonecrosis (avascular), bone infarct □ Osteoporosis □ Osteopenia □ Osteitis deformans (Paget disease of bone) □ Pathologic fracture □ Radiculopathies □ Spondylolisthesis/spondylosis (degenerative)

Degenerative/metabolic disorders of joints □ Gout, gouty arthritis, pseudogout □ Joint effusion □ Osteoarthritis

Degenerative/metabolic disorders of muscles, ligaments, fascia □ Dupuytren contracture □ Muscle calcification and ossification □ Muscle wasting and diffuse atrophy □ Rhabdomyolysis

Amputation and care of amputees

Backache, including low back pain

Blast injuries

Compartment syndrome

Contractures, hospital-acquired

Contusions

Dislocations

Fractures

Sprains, strains

Kyphoscoliosis, scoliosis

Rotator cuff syndrome

Slipped capital femoral epiphysis

Dislocation of hip

Achondroplasia/dwarfism

Disorders of limb development (HOX gene mutation, phocomelia)

Developmental dysplasia of the hip

Dislocation of hip in infantile spinal muscular atrophy

Genu valgum or varum

Foot deformities (flat foot, valgus/varus deformities)

Osteogenesis imperfect

McArdle disease

Mitochondrial myopathies

Drug-induced myopathy (eg, steroids, statins, cocaine, AZT)

Malignant hyperthermia

Degenerative and metabolic disorders

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

Traumatic and mechanical disorders

Congenital disorders

□ Adverse effects of drugs on the musculoskeletal system

□ Cardiovascular System

! 28

Embryonic development, fetal maturation, and perinatal transitional changes

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Organ structure and function

Chambers, valves

Cardiac cycle, mechanics, heart sounds, cardiac conduction

□ Hemodynamics, including blood volume and systemic vascular resistance □ Circulation in specific vascular beds, including pulmonary and coronary

□ Normal Processes □ Heart muscle, metabolism, oxygen consumption, biochemistry, and secretory function (eg, atrial natriuretic peptide)

Cell/tissue structure and function

□ Endothelium and secretory function, vascular smooth muscle, microcirculation, and lymph flow □ Neural and hormonal regulation of the heart, blood vessels, and blood volume, including responses to change in posture, exercise, and tissue metabolism, and autonomic responses

Repair, regeneration, and changes associated with stage of life

□ Infectious, immunologic, and inflammatory disorders

! 29

Neoplasms

Dysrhythmias

Infectious disorders □ Bacterial endocarditis □ Myocarditis

Immunologic and inflammatory disorders □ Atherosclerosis (eg, atherosclerosis of the aorta)

Myxoma

Metastases

Premature beats (PACs, PVCs)

Atrial flutter/fibrillation

Multifocal atrial tachycardia

Paroxysmal tachycardias

Ventricular tachycardia/fibrillation

Wide complex tachycardia

Torsades de pointes

Bradycardias

Atrioventricular block (first-, second-, third-degree)

Conduction disorder (LBBB, RBBB)

Cardiac arrest

Sick sinus syndrome

Prolonged QT syndrome

Wolff-Parkinson-White syndrome

Carotid sinus hypersensitivity

Pacemaker dysfunction, including failure to sense, capture

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Heart failure

Chordae tendineae rupture

Congestive heart failure

Cor pulmonale

Diastolic dysfunction

Systolic dysfunction

Mitral valve dysfunction

Heart failure secondary to myocardial infarction

□ High-output heart failure, including thyrotoxicosis-induced, anemia-induced

Ischemic heart disease

Tachycardia, induced

Cardiogenic pulmonary edema

Acute coronary syndrome, acute myocardial infarction

□ Angina pectoris, stable and unstable/coronary artery disease/ coronary insufficiency □

Coronary artery spasm

Cardiomyopathy, dilated, including alcoholic, viral, takotsubo

Cardiomyopathy, obstructive hypertrophic

Cardiomyopathy, familial dilated

Cardiomyopathy, restrictive

□ Hypertensive heart disease, left ventricular hypertrophy, right ventricular hypertrophy □

Diseases of the myocardium

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis □

Diseases of the pericardium

Complications of myocardial infarction

Traumatic tamponade post-myocardial infarction

Papillary muscle rupture/dysfunction

Ventricular free wall rupture

Myocarditis

Chronic constrictive pericarditis

Pericardial effusion

Pericardial tamponade

Acute pericarditis

Pericarditis, following myocardial infarction, surgery, trauma

□ Valve disorders, mitral/aortic/tricuspid, pulmonic (eg, regurgitation, stenosis, prolapse, insufficiency, vegetation) □

! 30

Valvular heart disease

Hypotension

Hypertension

Functional murmurs

Rheumatic heart disease

Complications of artificial valves

Orthostatic hypotension

Elevated blood pressure reading without diagnosis of hypertension

Essential hypertension

Malignant hypertension

Secondary hypertension

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Dyslipidemia

Hypercholesterolemia

Hyperlipidemia

Hypertriglyceridemia

Lipoproteins/lipoprotein lipase deficiency

Disorders of the great vessels □ Aneurysm, aortic (abdominal/thoracic), dissection, ruptured □ Aneurysm, iliac, other peripheral vascular, ruptured □ Aortoiliac disease

Peripheral arterial vascular disease □ Arterial embolus/thrombosis □ Arteriovenous fistula □ Atheroembolic disease □ Claudication □ Cholesterol emboli □ Hypertensive vascular disease □ Peripheral arterial disease □ Thromboangiitis obliterans

Diseases of the veins □ Deep venous thrombosis, venous thromboembolism □ Phlebitis/thrombophlebitis □ Varicose veins □ Venous insufficiency □ Stasis ulcers, stasis dermatitis

Ventricular puncture

Myocardial contusion

Myocardial rupture

Traumatic aortic dissection

Traumatic tamponade

Anomalous left coronary artery

Atrial septal defect

Coarctation of the aorta

Endocardial cushion defect

Patent foramen ovale

Patent ductus arteriosus

Tetralogy of Fallot

Transposition of the great vessels

Ventricular septal defect

Adriamycin

Cocaine, amphetamine, PCP

ACE inhibitors, calcium channel blockers, alpha blockers, minoxidil

Vascular disorders

Traumatic and mechanical disorders

□ Congenital disorders, including disease in adults

□ Adverse effects of drugs on the cardiovascular system

□ Respiratory System

□ □ Normal Processes

! 31

Embryonic development, fetal maturation, and perinatal changes

Organ structure and function

Airways, including mechanics and regulation of breathing

Lung parenchyma, including ventilation, perfusion, gas exchange

Pleura

Nasopharynx, sinuses

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Cell/tissue structure and function, including surfactant formation, and alveolar structure

Repair, regeneration, and changes associated with stage of life

Pulmonary defense mechanisms and normal flora

□ Infectious, immunologic, and inflammatory disorders of the upper airways □ Acute upper respiratory infection □ Viral infections (adenovirus, coronaviruses, coxsackievirus, influenza virus, parainfluenza virus, rhinoviruses) □ Sinusitis □ Nasopharyngitis □ Epiglottitis □ Bordetella pertussis pneumonia □ Croup □ Acute laryngitis □ Acute laryngotracheitis □ Tracheitis □ Pharyngitis □ Streptococcal throat infections □ Tonsillitis □ Peritonsillar abscess □ Rhinitis, allergic, chronic □ Ulcers of nasal cavity/sinuses

□ Infectious, immunologic, and inflammatory disorders

□ Infectious, immunologic, and inflammatory disorders of the lower airways □ Hospital acquired pneumonia □ Ventilator-associated pneumonia, community-acquired pneumonia, acute bronchiolitis □ Bronchiolitis obliterans with organizing pneumonia (BOOP) □ Anthrax, pulmonary (Bacillus anthracis) □ Aspiration pneumonia, pneumonitis □ Bronchitis, acute □ Bronchopneumonia □ Pneumonia (Burkholderia pseudomallei, Chlamydophila pneumoniae, Coxiella burnetii, Francisella tularensis, Haemophilus influenzae, Klebsiella pneumoniae, Legionella, Moraxella catarrhalis, Mycoplasma pneumoniae, Pseudomonas aeruginosa, Streptococcus, MSSA, MRSA, other gram- negative bacteria) □ Viral infection (eg, influenza A, B, adenovirus, H1N1, respiratory syncytial virus, parainfluenza virus) □ Fungal infection (aspergillosis, including allergic bronchopulmonary aspergillosis and aspergilloma, histoplasmosis, coccidioidomycosis, Pneumocystis jirovecii) □ Pulmonary tuberculosis □ Lung abscess □ Viral infection (eg, influenza A, B, adenovirus, respiratory syncytial virus, parainfluenza virus, avian influenza virus) □ Fungal infection (aspergillosis, including allergic bronchopulmonary aspergillosis and aspergilloma, histoplasmosis, coccidioidomycosis, Pneumocystis jirovecii)

Benign neoplasms □ Upper airways (eg, vocal cord polyps, nasal polyps, juvenile papillomatosis) □ Lungs and pleura (eg, solitary pulmonary nodule, bronchial carcinoid tumors)

Malignant neoplasms □ Upper airways □ Lip, oral cavity, and pharynx □ Head and neck cancer □ Larynx □ Trachea □ Lower airways and pleura □ Malignant neoplasms of bronchus and/or lung (squamous cell, adenocarcinoma, large cell, small cell) □ Malignant neoplasms of pleura (mesothelioma) □ Secondary malignant neoplasms of lung □ Secondary malignant neoplasms of pleura

Metastatic neoplasms including pleural

Asthma, reactive airway disease

Bronchiectasis

Chronic airway obstruction

Neoplasms

Obstructive airway disease

□ Chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema

! 32

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□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

□ Pneumoconiosis/fibrosing/restrictive pulmonary disorders/interstitial lung disease

Pneumoconiosis

Asbestosis

Silicosis

Silo-filler's lung, byssinosis, bagassosis, berylliosis

Hypersensitivity pneumonitis

Hypereosinophilic syndromes, Loeffler syndrome

□ Interstitial pneumonia, usual (UIP), desquamative (DIP), nonspecific

□ Respiratory failure/respiratory arrest and pulmonary vascular disorders

□ Metabolic, regulatory, and structural disorders

□ Disorders of the pleura, mediastinum, and chest wall

! 33

Acute respiratory distress syndrome (ARDS)

Pulmonary hypertension

Pulmonary vascular disorders, arteriovenous fistula

Pulmonary edema, pulmonary cause and unspecified

Pulmonary embolism

Air and fat embolism

Respiratory failure due to enteral feeding

Disorders of gas exchange

Hypoventilation

Hypoxia

Pulmonary alveolar proteinosis

Ventilation-perfusion imbalance

Chylothorax

Costochondritis

Empyema

Hemothorax

Mediastinitis

Pleural effusion

Pleuritis

Pneumomediastinum

Pneumothorax

Upper airways □ Epistaxis □ Barotrauma, sinus □ Laryngeal/pharyngeal obstruction □ Tracheoesophageal fistula □ Tracheal stenosis □ Tracheomalacia □ Trauma (eg, tracheal injury) □ Foreign body (nose, pharynx, larynx, trachea) □ Traumatic/mechanical disorders of the nasal cavity/sinuses (eg, septal perforation)

Lower airways and pleura □ Atelectasis □ Diaphragm/chest wall injury □ Drowning and neardrowning □ Foreign body, upper and lower respiratory tract □ Penetrating chest wounds □ Pulmonary contusion □ Sleep apnea, obstructive and central □ Hypoventilation syndrome, obesity-hypoventilation syndrome

Traumatic and mechanical disorders

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Congenital disorders

□ Adverse effects of drugs on the respiratory system

Bronchogenic cysts

Congenital cysts

Congenital diaphragmatic hernia

Pulmonary sequestration

Immotile cilia syndrome

Bleomycin, amiodarone

Adverse effects of 100% oxygen

Acute effects of tobacco/nicotine, inhalants, cocaine

□ Gastrointestinal System

Embryonic development, fetal maturation, and perinatal changes □ Anatomy of the alimentary canal, including mouth, pharynx, esophagus, stomach, small intestine, large intestine, anus, peritoneal cavity

Organ structure and function

Liver and biliary system, including enterohepatic circulation

Salivary glands and exocrine pancreas

□ Gastrointestinal motility, including defecation digestion and absorption □ Normal Processes □ Endocrine and neural regulatory functions, including GI hormones (eg, gastrin) □

Cell/tissue structure and function

□ Salivary, gastrointestinal, pancreatic, hepatic secretory products, including enzymes, proteins, bile salts, and processes □

Repair, regeneration, and changes associated with stage of life

Gastrointestinal defense mechanisms and normal flora

Infectious disorders □ Bacterial □ Pseudomembranous colitis (Clostridium difficile) □ Enteritis/enteric infections (includes gastroenteritis) (eg, Staphylococcus aureus, Escherichia coli, Listeria monocytogenes, Yersinia enterocolitica, Campylobacter species, Vibrio cholerae, Salmonella species, Shigella species, traveler's/infectious diarrhea) □ Hepatic abscess, subhepatic abscess, subphrenic abscess □ Peritonitis, primary and secondary □ Whipple disease □ Viral □ Infectious esophagitis (eg, CMV, herpes) □ Hepatitis A, B, C, D, E □ Coxsackievirus enteritis/colitis □ Echovirus enteritis/colitis □ Rotavirus enteritis □ Mumps □ Gingivostomatitis, herpetic □ Fungal □ Thrush □ Parasitic □ Cryptosporidium, Cyclospora, Entamoeba histolytica, Giardia, Isospora belli, Strongyloides stercoralis

Immunologic and inflammatory disorders □ Autoimmune hepatitis □ Celiac disease □ Eosinophilic esophagitis □ Granulomatous enteritis □ Inflammatory bowel disease, including Crohn disease, regional enteritis, microscopic colitis (collagenous and lymphocytic colitis), ulcerative colitis, toxic megacolon

□ Infectious, immunologic, and inflammatory disorders

! 34

Synthetic and metabolic functions of hepatocytes

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Benign neoplasms, including polyps, cysts □ Stomach □ Small intestine □ Colon, rectum, and anus, including polyps

Malignant neoplasms and pre-malignant conditions □ Oral cancer (eg, lips, mouth, tongue, salivary glands) □ Esophageal, squamous and adenocarcinoma □ Barrett esophagus □ Gastrinoma, Zollinger-Ellison syndrome □ Gastrointestinal carcinoid tumors □ Gastrointestinal stromal tumors □ Small intestine □ Stomach, adenocarcinoma, lymphoma, MALT □ Colon, rectum, anus □ Hereditary colon cancer syndromes, familial adenomatous polyposis (eg, Peutz-Jeghers syndrome, Gardner syndrome, Turcot syndrome) □ MUTYH-associated polyposis □ Gallbladder, cholangiocarcinoma, adenocarcinoma of the ampulla of Vater □ Liver, including hepatoma □ Peritoneal cancer, including metastatic studding with cancer □ Pancreas

Metastatic neoplasms

Upper gastrointestinal bleeding

Lower gastrointestinal bleeding

Constipation

Diarrhea

Hematochezia

Bright red rectal bleeding

Melena

Nausea, vomiting, rumination

Oral cavity and salivary glands □ Abscessed tooth □ Dental caries □ Malocclusion □ Disorders of the salivary glands (eg, stones, sialadenitis, parotitis) □ Teething syndrome

Esophagus □ Achalasia and cardiospasm □ Dysphagia □ Diverticulum (eg, Zenker) □ Esophageal periapical abscess without sinus □ Esophagitis/esophageal reflux (GERD) □ Esophagitis, pill □ Mallory-Weiss syndrome □ Paraesophageal (hiatal) hernia □ Stricture and stenosis of esophagus

Neoplasms

Signs, symptoms, and ill-defined disorders

□ Disorders of the oral cavity, salivary glands, and esophagus

! 35

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Stomach

Small intestine, colon □ Appendicitis □ Angiodysplasia □ Diverticula, diverticulitis, diverticulosis □ Duodenitis, duodenal ulcer, peptic ulcer □ Gastroenteritis and colitis (noninfectious) □ Granulomatous enterocolitis □ Hirschsprung disease □ Impaction of intestine □ Intestinal obstruction/stricture □ Intussusception □ Irritable colon/irritable bowel syndrome □ Mesenteric ischemia/ischemic bowel/ischemic colitis □ Necrotizing enterocolitis □ Paralytic ileus □ Volvulus □ Malnutrition and malabsorption, including lactose intolerance, short bowel syndrome

Rectum and anus □ Abscess of anal and rectal regions □ Anal fissure □ Anal fistula □ Ulcer □ Fecal incontinence □ Hemorrhage (rectum, anus) □ Proctitis □ Haemorrhoids □ Rectal prolapse

Liver □ Cirrhosis □ Dubin-Johnson, Rotor syndromes □ End-stage liver disease, including indications for transplantation □ Gilbert syndrome, Crigler-Najjar syndrome □ Hepatic coma/hepatic encephalopathy □ Hepatitis, non-infectious □ Hepatitis, fatty liver, alcoholic; hepatorenal syndrome □ Hepatopulmonary syndrome □ Jaundice □ Nonalcoholic fatty liver disease □ Portal hypertension/esophageal varices

Biliary system □ Bile duct obstruction/cholestasis □ Cholangitis, including ascending □ Choledocholithiasis □ Cholelithiasis/cholecystitis □ Cholestasis due to parenteral nutrition □ Gallstone ileus □ Mirizzi syndrome □ Primary biliary cirrhosis □ Primary sclerosing cholangitis

Pancreatitis, acute

Pancreatitis, chronic

Pancreatitis, hereditary

Pancreatic cyst/pseudocyst

Pancreatic duct obstruction; pancreatic insufficiency

Ascites

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

□ Disorders of the stomach, small intestine, colon, rectum, anus

□ Disorders of the liver and biliary system, noninfectious

! 36

Disorders of the pancreas

Disorders of the peritoneal cavity

□ □ □ □ □ □

Dyspepsia/hyperacidity Gastric ulcer Gastritis Peptic ulcer Peptic ulcer perforation Gastroparesis

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Abdominal wall defects

Adhesions, postsurgical

Digestive system complications of surgery

□ Post-gastric surgery syndromes (eg, blind loop syndrome, adhesions)

Traumatic and mechanical disorders

Congenital disorders

□ Adverse effects of drugs on the gastrointestinal system

Duodenal tear

Foreign body in digestive system

Inguinal, femoral, and abdominal wall hernias

Open wound, abdominal

Perforation of hollow viscus and blunt trauma

Perforation/rupture of esophagus (Boerhaave syndrome)

Umbilical hernia

Annular pancreas

Biliary atresia

Cleft lip and palate

Esophageal atresia

Malrotation without volvulus

Meckel diverticulum

Pyloric stenosis, gastric outlet obstruction

Tracheoesophageal fistula

Drug-induced changes in motility (chronic laxative abuse, opioids)

Drug-induced gastritis, duodenitis, peptic ulcer disease (NSAIDs)

Drug-induced hepatitis (eg, acetaminophen, isoniazid)

Drug-induced pancreatitis (eg, thiazide diuretics)

□ Renal & Urinary System

Embryonic development, fetal maturation, and perinatal changes

Organ structure and function

□ Normal Processes

Cell/tissue structure and function

Kidneys, ureters, bladder, urethra

Glomerular filtration and hemodynamics

Urine concentration and dilution

Renal mechanisms in acid-base balance

Renal mechanisms in body fluid homeostasis

Micturition

Renal metabolism and oxygen consumption

□ Tubular reabsorption and secretion, including transport processes and proteins □ Hormones produced by or acting on the kidney (eg, renin, aldosterone, angiotensin II, vasopressin)

! 37

Repair, regeneration, and changes associated with stage of life

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Infectious disorders □ Upper urinary tract □ Granulomatous pyelonephritis □ Perinephric abscess □ Pyelonephritis □ Pyonephrosis □ Renal abscess □ Renal tuberculosis □ Lower urinary tract and urinary tract infections of unspecified location □ Cystitis □ Chlamydial and nonchlamydial

Immunologic and inflammatory disorders □ Upper urinary tract □ Glomerular disorders □ Alport syndrome □ Glomerular disease due to hepatitis B, C □ Glomerulonephritis, including poststreptococcal □ IgA nephropathy □ Lupus nephritis □ Minimal change disease □ Mephrotic syndrome □ Thin basement membrane disease □ Tubular interstitial disease □ Acute tubular necrosis (ATN) □ Acute interstitial nephritis □ Papillary necrosis □ HIV nephropathy □ Lower urinary tract □ Interstitial cystitis

Benign neoplasms and cysts □ Polycystic kidney disease

Malignant neoplasms □ Renal (eg, Wilms tumor/nephroblastoma, renal cell carcinoma, renal tumors associated with congenital/ hereditary conditions) □ Urinary bladder and collecting system

Dysuria

Hematuria

Oliguria, anuria

Proteinuria

Acute kidney injury

Renal insufficiency

Azotemia, uremic syndrome

Chronic kidney disease, including end-stage renal disease

Cystinuria

Fanconi syndrome

Hypertensive renal disease (renal complications of hypertension)

Renal calculi, ureteral calculi, nephrolithiasis

Renal tubular acidosis

□ Infectious, immunologic, and inflammatory disorders

Neoplasms

Signs, symptoms, and ill-defined disorders

Metabolic and regulatory disorders

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

□ Renal artery stenosis (atherosclerosis, fibromuscular dysplasia, nephrosclerosis) □

! 38

Vascular disorders

Renal vein thrombosis

Renal infarction

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Traumatic and mechanical disorders

Congenital disorders

□ Adverse effects of drugs on the renal and urinary system

Bladder rupture

Neurogenic bladder

Obstructive uropathy

Posterior urethral valves

Renal laceration

Renal vascular injury

Ureteral laceration/avulsion/disruption

Urethral diverticulum

Obstruction/stricture/prolapse

Urinary incontinence, including secondary enuresis

Vesicoureteral reflux

Double ureters/ureteral duplication/double collecting system

Horseshoe kidney

Hydronephrosis/reflux

Renal agenesis, renal hypoplasia, renal dysplasia

Single kidney

ACE inhibitors

Aminoglycosides

Amphotericin B

Cisplatin

Furosemide

Gadolinium (nephrogenic systemic fibrosis)

Heroin

Iodinated contrast dye

Lithium

NSAIDs

Penicillins

Sulfa drugs

Tenofovir

Drug - induced urinary retention

□ Pregnancy, Childbirth, & the Puerperium

□ Normal Processes

! 39

Organ structure and function

□ Pregnancy, including fertilization, implantation, development of embryo, labor and delivery, the puerperium, lactation, gestational uterus, placenta

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Preconception counseling and care □ Folate deficiency prevention □ Immunizations □ Nutritional assessment, including vitamins □ Rh screening

Prenatal risk assessment/prevention □ Adolescent pregnancy □ Antepartum fetal evaluation, including biophysical profile □ Genetic screening □ α-fetoprotein □ Diabetes mellitus □ Neural tube defects □ Rh isoimmunization

Supervision of normal pregnancy □ Assessment of gestational age □ Iron deficiency prevention □ Nutrition, including weight management □ Surveillance, including ultrasonography and assessment of fetal growth □ Vitamin deficiency prevention □ Infections, maternal, fetal, newborn (focus on prevention and screening): cytomegalovirus, coxsackievirus, hepatitis B virus, herpes simplex viruses, HIV, influenza virus, parvovirus B19 virus, rubella virus, varicella-zoster virus, Chlamydia trachomatis, Treponema pallidum, Streptococcus agalactiae, Toxoplasma gondii, amnionitis □ Asymptomatic urinary tract infection

Abortion, induced, septic, missed, spontaneous, threatened

Acute fatty liver of pregnancy

Anemia of pregnancy, sickle cell disease, thalassemia in pregnancy

Antepartum hemorrhage, including third-trimester bleeding

Cardiomyopathy of pregnancy

Cervical incompetence, cervical shortening

Cholestasis of pregnancy, intrahepatic

Congenital abnormalities, maternal (eg, bicornuate uterus)

Ectopic pregnancy

Prenatal care

□ Fetal abnormality affecting management of mother (eg, hydrocephalus, spina bifida)

Obstetric complications

Fetal growth restriction

Gestational diabetes

Maternal mortality

Multiple gestation

□ Placental abnormalities (abruptio placentae, placenta previa, premature separation of placenta) □

Polyhydramnios, oligohydramnios

□ Preeclampsia, eclampsia, HELLP syndrome, gestational hypertension

! 40

Prolonged pregnancy

Rh isoimmunization affecting management of mother

Vomiting in pregnancy (morning sickness, hyperemesis gravidarum)

Trauma in pregnancy

Infections complicating pregnancy

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Labor and delivery

Labor and delivery, uncomplicated

Labor and delivery, complicated, including shoulder dystocia

Cesarean delivery, including complications

Cord compression, cord prolapse

Fetal malpresentations (eg, breech)

Intrapartum fetal evaluation, including fetal heart tones

□ Intrapartum prophylaxis (eg, HIV, Chlamydia, gonococcal prophylaxis) □

Premature rupture of membranes

□ Preterm (before 37 weeks' gestation) and postdates labor and delivery

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

! 41

Puerperium, including complications

Newborn (birth to 4 weeks of age)

Threatened preterm labor

Lactation problems

Breast-feeding problems

Lochia

Postpartum cardiomyopathy

Postpartum blues

Postpartum haemorrhage

Postpartum sepsis

Retained placenta, products of conception (eg, placenta accreta)

Uterine atony

Normal newborn □ Examination of liveborn at admission to hospital □ Screening, newborn

Disorders of the newborn □ Screening, newborn □ ABO incompatibility in newborn □ Hemolytic disease due to Rh incompatibility □ Birth asphyxia syndrome (liveborn neonate) □ Birth trauma (eg, cord compression, brachial palsy, lacerations) □ Drug withdrawal syndrome in newborn □ Feeding problems in newborn □ Fetal growth and development abnormalities, including fetal growth restriction □ Gastrointestinal obstruction □ Hypocalcemia of newborn □ Infections, congenital or peripartum (cytomegalovirus, herpes simplex viruses, HIV, hepatitis B, rubella virus, parvovirus B19 virus, varicella zoster virus, Chlamydia trachomatis, Streptococcus agalactiae, Treponema pallidum, Toxoplasma gondii) □ Intrapartum fetal distress/death including stillborn □ Jaundice, fetal/neonatal/perinatal □ Laryngomalacia □ Macrosomia (large for gestational age) □ Meconium aspiration syndrome □ Neonatal acne □ Neonatal Candida infection (thrush) □ Neonatal hypoglycaemia □ Neonatal conjunctivitis and dacryocystitis □ Ophthalmic gonorrhoea □ Phenylketonuria □ Premature infant □ Postterm infant □ Pseudomembranous colitis of infancy □ Respiratory distress syndrome (hyaline membrane disease) □ Respiratory problems after birth (eg, bronchopulmonary dysplasia, tracheomalacia; tracheoesophageal fistula in neonates) □ Retinitis of prematurity □ Seizures in newborn □ Sudden infant death syndrome (SIDS), apparent lifethreatening event (ALTE) □ Tetanus neonatorum

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Congenital disorders, neonatal

□ Adverse effects of drugs on pregnancy, childbirth, and the puerperium

□ Systemic disorders affecting pregnancy, labor and delivery, and puerperium

Congenital malformations and anomalies

Neonatal hydrocele

Alcohol, tobacco, and other drugs (ATOD)

Prenatal radiation exposure

Teratology (eg, ACE inhibitors, SSRIs, warfarin, infections, toxins)

Appendicitis

Asthma

Carpal tunnel syndrome in pregnancy

Cirrhosis

Deep venous thrombosis (DVT)

Diabetes mellitus

Heart failure, valvular heart disease; hypertension

Myasthenia gravis

Obesity

Pancreatitis

Psychiatric disorders

Renal calculus/calculi

Renal failure/renal disease, including SLE

Seizure disorders

Thyroid disorders, hypothyroidism, hyperthyroidism

□ Female Reproductive System & Breast

Embryonic development, fetal maturation, and perinatal changes, gametogenesis

Organ structure and function

□ Normal Processes

Female structure, including breast

Female function (eg, ovulation, menstrual cycle, puberty)

Intercourse, sexual response

□ Hypothalamic-pituitary-gonadal axis, sex steroids, and gestational hormones

Cell/tissue structure and function

Reproductive system defense mechanisms and normal flora

! 42

Infectious, immunologic, and inflammatory disorders □ Breast abscess □ Inflammatory disease of breast, fat necrosis □ Mastitis □ Nipple discharge

Neoplasms

Benign and undefined neoplasms □ Breast cyst, solitary □ Fibrocystic changes □ Fibroadenoma □ Hypertrophy of breast □ Intraductal papilloma

Malignant neoplasms (including screening) □ Breast cancer □ Intraductal carcinoma □ Paget disease of breast □ Phyllodes tumors

Breast

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Infectious, immunologic, and inflammatory disorders □ Bacterial vaginosis □ Bartholin gland abscess □ Cellulitis, pelvic □ Candidiasis of the vulva or vagina □ Lichen sclerosus □ Sexually transmitted infections and exposure □ Cervicitis and endocervicitis □ Chancroid (Haemophilus ducreyi) □ Genital herpes □ Gonorrhea (Neisseria gonorrhoeae) □ Human papillomavirus infection, genital/venereal/anal warts, condylomata acuminate □ Lymphogranuloma venereum (Chlamydia trachomatis), nonlymphogranuloma venereum □ Pelvic inflammatory disease □ Fitz-Hugh–Curtis syndrome □ Salpingitis and oophoritis □ Syphilis (Treponema pallidum) □ Trichomoniasis (Trichomonas vaginalis) □ Urethritis □ Vaginitis □ Vulvovaginitis

Benign neoplasms and cysts □ Abnormal Pap smear □ Benign neoplasm of ovary □ Endocervical and endometrial polyps □ Leiomyomata uteri □ Ovarian cyst

malignant and precancerous neoplasms □ Cervical cancer □ HPV causing cancer □ Cervical dysplasia, HPV causing dysplasia □ Endometrial hyperplasia □ Endometrial/uterine cancer □ Gestational trophoblastic disease (hydatidiform mole) □ Ovarian cancer □ Vulvar dysplasia and cancer

Assisted reproductive techniques (ART)

Female reproductive system

□ Neoplasms of the cervix, ovary, uterus, vagina, and vulva

□ Contraception (eg, oral contraceptives, IUD, vaginal cap, cervical sponge, diaphragm, implant, morning-after pill, male and female condoms)

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

! 43

Fertility and infertility

Menopause

Female infertility

Gonadal dysgenesis 45,X (Turner syndrome)

Sterilization

Tubal factors

Infertility

Ovarian failure, premature menopause

Premenopausal menorrhagia

Postmenopausal atrophic vaginitis (vaginal atrophy)

Postmenopausal bleeding

Vasomotor symptoms

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Abnormal uterine bleeding, including perimenopausal

□ Absence of menstruation (primary amenorrhea, secondary amenorrhea including undiagnosed pregnancy)

Menstrual and endocrine disorders

Sexual dysfunction

Traumatic and mechanical disorders

Congenital disorders

□ Adverse effects of drugs on the female reproductive system and breast

Anovulation

Dysmenorrhea

Endometriosis

Hirsutism, virilisation

Mittelschmerz

Pelvic pain

Polycystic ovarian syndrome

Postcoital bleeding

Premenstrual syndrome

Dyspareunia

Orgasmic dysfunction

Sexual desire/arousal syndrome

Vaginismus

Asherman syndrome

Chronic inversion of uterus

Chronic pelvic pain syndrome

Cystocele

Imperforate hymen

□ Injuries, wounds, and burns affecting the female reproductive system and injuries, wounds, burns, and blast injuries □

Ovarian torsion

Pelvic relaxation

Prolapse, vaginal walls, uterine, uterovaginal

Rectocele

Urethrocele

Müllerian agenesis

Uterus didelphys, bicornuate uterus

Short cervix

Antihistamines, H2-receptor blocker

Benzodiazepines

Beta-adrenergic blockers

Hormone replacement

Opioids

Spironolactone

Selective serotonin reuptake inhibitors

Tricyclic antidepressants

□ Male Reproductive System

! 44

Embryonic development, fetal maturation, and neonatal changes, gametogenesis

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□ Normal Processes

Organ structure and function

Structure, male genitalia and prostate

Function, male genitalia and prostate (eg, spermatogenesis, puberty)

Intercourse, orgasm, erection

Cell/tissue structure and function, including hypothalamic-pituitary-gonadal axis, sex steroids, and gestational hormones

Reproductive system defense mechanisms and normal flora

Infectious disorders □ Balanitis □ Epididymitis □ Orchitis □ Prostatitis □ Sexually transmitted infections and exposure □ Chancroid (Haemophilus ducreyi) □ Genital herpes □ Gonorrhea (Neisseria gonorrhoeae) □ Human papillomavirus infection, genital/venereal/anal warts, condylomata acuminate □ Lymphogranuloma venereum (Chlamydia trachomatis) □ Syphilis (Treponema pallidum) □ Trichomoniasis (Trichomonas vaginalis) □ Urethritis, chlamydial and nonchlamydial, nongonococcal

Immunologic and inflammatory disorders □ Autoimmune hypogonadism

Malignant neoplasms

Penile

Prostate

Testicular

Breast

Erectile dysfunction, impotence

Infertility, male factor

Male sexual dysfunction

Premature ejaculation

Benign prostatic hyperplasia/hypertrophy

Circumcision, including complications

Epididymal cyst

Hydrocele

□ Infectious, immunologic, and inflammatory disorders

Neoplasms

□ Metabolic and regulatory disorders, including sexual dysfunction

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

□ Injuries, wounds, and burns to male genitalia, including blast injuries

Traumatic and mechanical disorders

□ Congenital disorders of the male reproductive system

! 45

Penile laceration, penile fracture, Peyronie disease

Phimosis

Scrotal laceration

Spermatocele

Testicular rupture/avulsion/laceration

Torsion of testis

Urethral laceration/disruption

Varicocele

Hypospadias

Klinefelter syndrome

Undescended testicle

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Alcohol

Androgens, testosterone

□ Antipsychotics, antidepressants including selective serotonin reuptake inhibitors

□ Adverse effects of drugs on the male reproductive system

Betaadrenergic blockers

Diuretic including thiazides

Drug-induced priapism (eg, trazodone)

Finasteride, dutasteride

Sildenafil, tadalafil, vardenafil; marijuana

Nitric oxide reductase inhibitors

□ Endocrine System

Embryonic development, fetal maturation, and perinatal changes

Organ structure and function

□ Normal Processes

□ Cell/tissue/structure and function, including hormone synthesis, secretion, action, metabolism

Hypothalamus, posterior and anterior pituitary gland

Thyroid gland

Parathyroid gland

Adrenal cortex, adrenal medulla

Pancreatic islets

Ovary and testis

Adipose tissue

Peptide hormones

Steroid hormones, including vitamin D

Thyroid hormones

Catecholamine hormones

Renin-angiotensin system

Repair, regeneration, and changes associated with stage of life

Diabetes mellitus □ Diabetes mellitus, type 1 □ Diabetes mellitus, type 1.5 □ Diabetes mellitus, type 2 □ Diabetes mellitus, acute complications: hyperosmolar coma, hypoglycemic shock, ketoacidosis, including cerebral edema, associated electrolyte abnormalities □ Diabetes mellitus, chronic complications: gastrointestinal/ gastroparesis, neurologic/neuropathy, ophthalmologic/ retinopathy, peripheral vascular, renal/nephropathy, metabolic syndrome

Hypoglycemia and islet cell disorders □ Hypoglycemia (secondary to insulinoma, surreptitious insulin use, sepsis, liver failure) □ Hyperglycemia (secondary to glucagonoma) □ Hyperinsulinism □ Islet cell tumors/insulinoma/somatostatinoma □ Pancreatic neuroendocrine tumors

□ Diabetes mellitus and other disorders of the endocrine pancreas

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Thyroid disorders

Cyst, nodule

Euthyroid sick syndrome

Goiter (euthyroid-normal thyroid function with goiter)

Hypothyroidism

Hyperthyroidism, including thyrotoxicosis and thyroid storm

Thyroiditis, including Hashimoto

Graves disease

□ Neoplasms (benign cysts and nodules, thyroid cancer including papillary, follicular, medullary, and anaplastic)

Parathyroid disorders

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis

Adrenal disorders

Thyroid deficiency from pituitary disorder

Infertility due to thyroid disease

Secondary hypothyroidism and hyperthyroidism

Hyperparathyroidism

Hypoparathyroidism

Metabolic bone disease

Corticoadrenal insufficiency (Addison disease)

Adrenal insufficiency, secondary

Hypocortisolism

Cushing disease, Cushing syndrome

Hyperaldosteronism

□ Neoplasms, benign and malignant (adrenal neuroblastoma, pheochromocytoma, adrenal carcinoma, adrenal adenoma, aldosteronoma, adrenal incidentaloma)

Pituitary disorders

Delayed and precocious puberty

Hypertensive endocrine disease

Acromegaly/gigantism

Diabetes insipidus

Galactorrhea not associated with childbirth

Panhypopituitarism from any cause

Pituitary apoplexy (eg, Sheehan syndrome)

Growth hormone deficiency; short stature

SIADH (inappropriate secretion of ADH [vasopressin])

□ Neoplasm, benign and malignant (pituitary adenomas, craniopharyngioma, metastatic disease) □ Prolactinoma and hyperprolactinemia, including infertility due to these disorders

Hypothalamic endocrine disorders

Multiple endocrine neoplasia (MEN1, MEN2)

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Congenital disorders

Hypogonadism, primary and secondary

Disorders of sexual differentiation

Congenital adrenal hyperplasia

Androgen insensitivity/resistance syndrome

Congenital hypothyroidism

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□ Adverse effects of drugs on the endocrine system

Drug, medicinal, and biologic substance effects

Exogenous steroid suppression of adrenal glands, anabolic steroids

□ Multisystem Processes & Disorders □ Generation, expenditure, and storage of energy at the whole-body level □

Principles of nutrition

Electrolyte and water metabolism

□ Normal Processes

Functions of nutrients (eg, essential, trans-fatty acids, cholesterol)

Electrolyte metabolism (calcium, potassium, phosphorus)

Water metabolism

□ Intracellular accumulations (eg, pigments, fats, proteins, carbohydrates, minerals, inclusions, vacuoles, lysosomal/glycogen storage disease and structures related to storage diseases, glycogen phosphorylase deficiency, Zellweger syndrome)

Infectious disorders □ Bacterial: □ Brucellosis (Brucella spp) □ Leptospirosis (Leptospira interrogans) □ Lyme disease (Borrelia burgdorferi) □ Melioidosis (Burkholderia pseudomallei) □ Miliary (disseminated) tuberculosis (Mycobacterium tuberculosis) □ Tularemia (Francisella tularensis) □ Toxic shock syndrome □ Q fever (Coxiella burnetii) □ Anaplasmosis and ehrlichiosis (Anaplasma and Ehrlichia species) □ Rickettsiosis (Rocky Mountain spotted fever [Rickettsia rickettsii]) □ Viral □ Infectious mononucleosis (Epstein-Barr virus) □ Cytomegalovirus infection □ Yellow fever □ Human herpesvirus 8 (HHV-8) □ Fungal □ Blastomycosis (Blastomyces dermatitidis) □ Candidiasis (Candida albicans) □ Coccidioidomycosis (Coccidioides immitis/posadasii) □ Histoplasmosis (Histoplasma capsulatum) □ Parasitic □ Schistosomiasis (Schistosoma) □ Leishmaniasis (Leishmania spp), visceral (kalaazar) □ Trypanosomiasis/Chagas disease, acute and chronic (Trypanosoma)

Immunologic and inflammatory disorders □ Acute rheumatic fever □ Autoimmune arteritis/vasculitis □ Behçet syndrome □ Churg-Strauss syndrome □ Eosinophilic granuloma, Histiocytosis, Langerhans cell histiocytosis □ Goodpasture syndrome □ Henoch-Schönlein purpura □ Kawasaki disease □ Mixed connective tissue disease □ Polyangiitis □ Polyarteritis nodosa □ Polyglandular autoimmune syndrome, type 1 □ Polymyalgia rheumatica, temporal arteritis □ Raynaud disease/Raynaud syndrome □ Reactive arthritis, formerly Reiter disease, including Reiter arthritis □ Scleroderma (systemic sclerosis) □ Sjögren syndrome □ Systemic lupus erythematosus □ Takayasu arteritis □ Granulomatosis with polyangiitis (formerly Wegener granulomatosis) □ Familial Mediterranean fever □ Sarcoidosis, Lofgren syndrome

□ Infectious, immunologic, and inflammatory disorders

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Paraneoplastic syndromes □ Endocrine (eg, SIADH, Cushing syndrome, hypercalcemia of malignancy [parathyroid-related protein and paraneoplastic syndrome with hypercalcemia]) □ Hematologic (polycythemia, nonbacterial thrombotic endocarditis) □ Neurologic (myasthenic syndrome, paraneoplastic cerebellar degeneration, limbic encephalitis, pure sensory neuropathy) □ Mucocutaneous (eg, acanthosis nigricans) □ Musculoskeletal (eg, pulmonary osteoarthropathy, polymyositis) □ Other (membranous glomerulonephritis)

Inherited cancer syndromes □ DNA repair abnormalities (eg, Fanconi anemia) □ Lynch syndrome (gastrointestinal and female reproductive)

Arthralgias

Abdominal pain

Chest pain

Cough

Neoplasms and related disorders

□ Dizziness, light-headedness, syncope, including breath-holding spells with syncope

Signs, symptoms, and ill-defined disorders

Dyspnea, shortness of breath; edema, anasarca

Fatigue

Fever of unknown origin

Gulf War syndrome

Hemoptysis

Pain management (in a nonaddiction, nonpalliative-care setting)

Joint pain

Lymphedema

Palpitations

Pruritus

Unexpected weight gain/weight loss

Protein-calorie malnutrition (kwashiorkor, marasmus)

Vitamin deficiencies and/or toxicities □ Vitamin A □ Vitamin B □ Vitamin B1, thiamine (eg, Wernicke- Korsakoff syndrome, beriberi) □ Vitamin B3, niacin □ Vitamin B6, pyridoxine □ Vitamin B9, folic acid □ Vitamin B12, cobalamins (pernicious anemia) □ Vitamin C (scurvy) □ Vitamin D (rickets) □ Vitamin E □ Vitamin K

Mineral deficiencies and/or toxicities

Obesity

Enteral/parenteral nutrition (TPN)

□ Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis □

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Nutrition

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Physical and associated disorders □ Temperature (eg, hypothermia, hyperthermia, heat stroke) □ Radiation (eg, radon, uranium mining, imaging studies) □ Thermal injury, burns, electrocution, lightning □ Decreased atmospheric pressure, high-altitude sickness □ Increased water pressure (nitrogen narcosis)

Chemical including Gulf War illness/syndrome □ Gases, vapors, smoke inhalation □ Agricultural hazards (eg, pesticides, green tobacco poisoning, anhydrous ammonia, Agent Orange) □ Volatile organic solvents □ Heavy metals □ Other chemical agents (eg, ethylene glycol, carbon tetrachloride, methanol; BPA) □ Principles of poisoning and therapy (eg, acetylsalicylic acid [ASA], acetaminophen)

Hymenoptera bites and stings

Scorpion bites

Snake bites

Spider bites

Jellyfish sting

Fluid volume and electrolyte/ion disorders □ Fluid volume disorders □ Dehydration □ Hypovolemia □ Volume overload □ Electrolyte disorders □ Hyponatremia, hypernatremia □ Hypokalemia, hyperkalemia □ Hypocalcemia, hypercalcemia □ Hypophosphatemia, hyperphosphatemia □ Hypomagnesemia

Acid-base disorders □ Metabolic acidosis □ Metabolic alkalosis □ Respiratory acidosis □ Respiratory alkalosis □ Mixed acid-base disturbances

Toxins and environmental extremes

Venomous bites and stings

□ Fluid, electrolyte, and acid-base balance disorders

□ Child, nonaccidental trauma/inflicted head trauma/factitious disorder by proxy

□ Intimate partner abuse, sexual, emotional, and physical including injuries (eg, rib fractures) related to abuse Abuse

□ Elder abuse, sexual, emotional, and physical including injuries (eg, rib fractures) related to abuse □

Sexual assault

Multiple trauma (eg, prioritization, blast injury involving more than one organ system)

□ Shock, cardiogenic, hypovolemic, neurogenic, septic, sepsis, bacteremia, systemic inflammatory response syndrome (SIRS), refractory, multiorgan dysfunction syndrome: meningococcemia

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JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


□ Genetic metabolic and developmental disorders

□ Adverse effects of drugs on multisystem disorders

Multifactorial □ VATER syndrome, association syndromes

Large genomic changes □ Beckwith-Wiedemann syndrome □ Down syndrome □ PraderWilli syndrome

Enzymatic/metabolic □ Alpha-1 antitrypsin deficiency □ Porphyria □ Inborn errors of metabolism (eg, maple syrup urine disease, diseases involving urea cycle) □ Storage diseases (eg, Fabry disease, Tay-Sachs disease, glycogen storage disease, mucopolysaccharidoses)

Structural protein disorders □ Amyloidosis □ Ehlers-Danlos syndrome □ Immotile cilia syndrome (Kartagener syndrome; primary ciliary dyskinesia) □ Marfan syndrome

Intracellular/extracellular transport receptors □ Cystic fibrosis □ Hemochromatosis □ Wilson disease

Triplet repeat/RNA disorders □ Fragile X syndrome

□ Drug-induced electrolyte abnormalities and acid base-disorders (eg, albuterol, prednisone, diuretics, alcohol)

□ Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Literature

Measures of disease frequency: incidence/prevalence

Rates, crude and adjusted

□ Reproductive rates (eg, maternal mortality, neonatal/infant/under-5 mortality)

Measures of health status

Mortality, morbidity

Standardization

Life expectancy, health-adjusted life expectancy

□ Population attributable risk (PAR), population attributable risk percent (PAR%) □

□ Epidemiology/population health

Survival analysis interpretation (eg, Kaplan-Meier curve)

□ Composite health status indicators, measures of population impact

Years of potential life lost

Quality-adjusted life years

Disability-adjusted life years

Standardized mortality ratio

Population pyramids and impact of demographic changes

□ Disease surveillance and outbreak investigation

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Risk factors

Disease reporting

Response to public health advisory, health promotion

Recognition of clusters

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Communicable disease transmission

Points of intervention

Analytical studies: observational

Analytical studies: interventional

Systematic reviews and meta-analysis

Obtaining and describing samples

Methods to handle noncomplianc

Qualitative analysis

Relative risk

Odds ratio, hazard ratio

□ Measures of association

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Herd immunity

Reportable diseases

Primary, secondary

School policies

Access, healthy food, transportation, clean air, safe environments

Descriptive studies (case report [one person]/case series [more than one])

Attack rate

□ Community level (eg, cigarette taxes, soda taxes, smoke-free cities, buildings: restaurants, public buildings)

□ Study design, types and selection of studies (includes dependent/independent variables)

Other measures of association

Community surveys

Cross-sectional (individuals)

Ecological (populations)

Case control

Retrospective and prospective cohort

Clinical trial (randomized controlled trial

Double-blind

Placebo-controlled

Noninferiority/equivalence trials)

Community intervention

Potential uses

Estimation of effect sizes

Heterogeneity

Publication bias

Forest plots, funnel diagrams

Risk of bias, bias risk scale

□ Matching, inclusion/exclusion criteria, selecting appropriate controls for studies, lack of controls, concealed allocation, randomization, stratification

Loss to follow-up

Intention-to-treat analysis

Number needed to treat/harm

Absolute risk (AR), absolute risk percent (AR%)

□ Population attributable risk (PAR), population attributable risk percent (PAR%)

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


□ Distributions of data

□ Correlation and regression, uses and interpretation

Measures of central tendency

Measures of variability

Regression to mean

Normal distribution

Nominal measurement

Correlation coefficients

Multiple regression

□ Principles of testing and screening

Properties of a screening test

Validity, accuracy, reliability

Criteria for a screening test

Confirmatory testing

Appropriateness

Lead-time bias, length bias

Screening vs diagnostic tests

Sensitivity and specificity; predictive value, positive and negative

ROC curves

Probability

Causation

Theory (independence, product, addition rules)

Decision trees

Likelihood ratios (application of Bayes theorem)

Posttest, pretest

Hypothesis-generating vs hypothesis-driven testing

□ Causal criteria, temporality, temporal sequence, dose-response relationship □

Reverse causality

□ Null hypothesis, Type I error and alpha level (multiple comparisons, random error/chance)

□ Study interpretation, drawing conclusions from data

Sample size and Type II error, beta, power

Selection and interpretation of basic tests of statistical significance □ Chi-square □ Confidence intervals □ p-values □ t-test

a priori vs. post hoc analysis □ Subgroup analysis □ Error rate □ Affect types

Selection, sampling bias

Information bias □ Recall □ Ascertainment, ecologic fallacy, lack of blinding □ Loss to follow up

Chance

Interpretation of graphs/tables and text

□ Bias, confounding, and threats to validity (includes methods to address)

□ Confounding variables, Hawthorne effect (includes methods to address)

! 53

Internal vs. external validity

Other threats to validity (eg, placebo effect)

Generalizability (external validity)

Efficacy vs effectiveness

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


□ Clinical decision making, interpretation and use of evidence-based data and recommendations

Statistical vs. clinical significance; clinical and surrogate outcome/end point

Application of study results to patient care and practice, including patient preferences and individualization of risk profiles

Risk/benefit analysis

Synthesis of concepts with real data

Informed consent for research

Privacy of patient data (HIPAA)

Roles of institutional review boards (IRBs)

Intervention analysis

□ Research ethics

Regulatory issues

Interim analysis

Stopping analysis

Safety monitoring

Drug development, phases of approval

Appropriateness of placebo

Appropriateness of randomized clinical trial

Components of studies

Ethics

Scheduling

Off-label use

Fostering the relationship (eg, expressing interest)

Information gathering (eg, exploring patient's reaction to illness)

Other issues related to research ethics

□ Social Sciences

□ Communication and interpersonal skills, including health literacy and numeracy, cultural competence

□ Patient interviewing, consultation, and interactions with the family (patientcentered communication skills)

□ Medical ethics and jurisprudence, include issues related to death and dying and palliative care

□ Information provision (eg, providing information about working diagnosis) □

Making decisions (eg, eliciting patient's perspectives)

Supporting emotions (eg, effective discussion with difficult patients)

Enabling patient behaviors (eg, education and counseling)

Use of an interpreter

□ Consent/informed consent to treatment, permission to treat (full disclosure, risks and benefits, placebos, alternative therapies, conflict of interest, and vulnerable populations) □

Determination of medical decision-making capacity/informed refusal

Involuntary admission

□ □ Legal issues related to abuse (child, elder, and intimate partner)

! 54

Child protective services, foster care, immunizations

□ Legal requirements for reporting abuse or neglect/obligation to warn

Birth-related issues

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


Death and dying and palliative care

Life support

Advance directive, health care proxy, advance care planning

Euthanasia and physician-assisted suicide

Brain death/diagnosing brain death/diagnosing death

Pronouncing death

Organ donation

Hospice

Pain management, including ethical

□ Issues related to death and dying information sharing, counseling families □

Psychosocial and spiritual counseling, fear and loneliness

□ Physician-patient relationship (boundaries, confidentiality including HIPAA, privacy, truthtelling, other principles of medical ethics, eg, autonomy, justice, beneficence) □

Impaired physician, including duty to report impaired physician

Negligence/malpractice, including duty to report negligence and malpractice

Physician misconduct, including duty to report physician misconduct

Referrals

Cultural issues not otherwise coded

□ Characteristics of a complex system and factors leading to complexity □ How complexity leads to error

! 55

Health care/organizational behavior and culture □ Environmental factors, workplace design and process □ Staffing □ Overcommitment, space, people, time, scheduling □ Standardization, reducing variance, simplification, metrics □ Safety culture □ Integration of care across settings □ Overutilization of resources (imaging studies, antibiotics, opioids) □ Economic factors

Improvement science principles Variation and standardization □ Variation in process, practice; checklists, guidelines, and clinical pathways □ Reliability

Specific models of quality improvement □ Model for improvement: plan-do-study-act (PDSA), plan-docheck-act (PDCA)

Quality measurement □ Structure, process, outcome, and balancing measures □ Measurement tools: run and control charts □ Development and application of system and individual quality measures: core measures; physician quality report system (PQRS); event reporting system

Strategies to improve quality □ Role of leadership Principles of change management in quality improvement: specific strategies

Attributes of high-quality health care □ High-value/cost-conscious care: overutilization of resources, including diagnostic testing, medications □ Equitable care: access □ Patient-centered care □ Timely care

Complexity/systems thinking

Quality improvement

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□ Systems-based practice (including health systems, public health, community, schools) and patient safety (including basic concepts and terminology)

! 56

Patient safety principles □ Epidemiology of medical error □ Error categorization/definition: active vs latent errors; Swiss cheese model of error; preventable vs non-preventable; near miss events/safety hazards □ Causes of error □ Patient factors: understanding of medication use; health literacy; economic status; cultural factors (eg, religion); failure to make appointments; socioeconomic status □ Physician factors: deficiency of knowledge; judgment errors; diagnostic errors; fatigue, sleep deprivation; bias – cognitive, availability, heuristic, anchoring, framing □ Human factors (eg, cognitive, physical, environmental) □ High reliability of organization (HRO) principles: change management and improvement science; conceptual models of improvement □ Reporting and monitoring for errors: event reporting systems □ Communication with patients after adverse events (disclosure/transparency)

Specific types of error □ Transitions of care errors (eg, handoff communication including shift-to-shift, transfer, and discharge): handoffs and related communication; discontinuities; gaps; discharge; transfers □ Medication errors □ Ordering, transcribing, dispensing, administration (wrong quantity, wrong route, wrong drug) □ Medication reconciliation □ Mathematical error □ Procedural errors □ Universal protocol (time out); wrong patient; wrong site; wrong procedure □ Retained foreign bodies □ Injury to structures: paracentesis; bowel perforation; thoracentesis; pneumothorax; central venous/arterial line injuries; arterial puncture and bleeding and venous thrombosis; lumbar puncture bleeding; paralysis □ Other errors: anesthesia-related errors; mathematical errors □ Health care-associated infections: nosocomial infection – eg, surgical site, ventilator associated, catheter-related; handwashing procedures or inadequate number of handwashing stations; central line-associated blood stream infections; surgical site infections; catheter-associated urinary tract infections; ventilator-associated pneumonia □ Documentation errors: electronic medical record (including voice-recognition software errors); record keeping; incorrect documentation (eg, wrong patient, wrong date, copying and pasting, pre-labeling) □ Patient identification errors □ Mislabeling: transfusion errors related to mislabeling □ Verification/two identifiers: lack of dual validation, including verbal verification of lab results □ Diagnostic errors: errors in diagnostic studies; misinterpretation □ Monitoring errors Cardiac monitoring/telemetry Drug monitoring (warfarin, antibiotics) □ Device-related errors malfunction programming error incorrect use

Strategies to reduce error □ Human factors engineering □ Situational awareness □ Hierarchy of effective interventions: forcing function; visual cues □ Error analysis tools: error/near miss analysis; failure modes and effect analysis; morbidity and mortality review; root cause analysis □ Safety behavior and culture at the individual level: hierarchy of health care, flattening hierarchy, speak up to power; afraid to report, fear; psychological safety; closed-loop communication □ Teamwork: principles of highly effective teams; case management; physician teams, physician-physician communication; interprofessional/intraprofessional teams; strategies for communication among teams, including system-provider communication, physician-physician communication (eg, consultations), interprofessional communication, provider-patient communication

Patient Safety

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! 57

Health care policy and economics

Health care policy □ Health care disparities: race/ethnicity; numeracy/literacy; socioeconomic status □ Access to care: critical access systems or hospitals □ Social justice

Health care economics/Health care financing □ Types of insurance: Medicare, Medicaid, private insurance, self-pay □ Navigating the insurance system: deductibles/co-pays; in-/ out-of-network; preferred providers □ Reimbursement issues affecting safety and quality: emergency services – EMTALA; pay-for-performance

JumpStart Med Ed - Fundamentals of Medicine 501 - Course Syllabus


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