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Exam Code: USMLE Practice exam 2022 by Killexams.com team
USMLE United States Medical Licensing Examination Step 1

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Beginning in May 2020, Step 1 examinations will include an increased number of questions that assess communications skills. The tables below provide information on the content weighting for Step 1 examinations administered before and after May 2020.

Table of Contents
- General Principles of Foundational Science
- Immune System
- Blood & Lymphoreticular System
- Behavioral Health
- Nervous System & Special Senses
- Skin & Subcutaneous Tissue
- Musculoskeletal System
- Cardiovascular System
- Respiratory System
- Gastrointestinal System
- Renal & Urinary System
- Pregnancy, Childbirth, & the Puerperium
- Female Reproductive System & Breast
- Male Reproductive System
- Endocrine System
- Multisystem Processes & Disorders
- Biostatistics, Epidemiology/Population Health
- Interpretation of the Medical Literature
- Social Sciences

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) Biology of cells 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 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 inheritance patterns occurrence and recurrence risk determination Population genetics: Hardy-Weinberg law, founder effects, mutation-selection equilibrium Principles of gene therapy Genetic testing and counseling Genetic mechanisms (eg, penetrance, genetic heterogeneity) Biology of tissue response to disease Acute inflammatory responses (patterns of response) acute inflammation and mediator systems (eg, histamine, prostaglandins, bradykinins, eosinophilic basic protein, nitric oxide) 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) Chronic inflammatory responses (eg, tumor necrosis factor) Reparative processes wound healing, repair: thrombosis, granulation tissue, angiogenesis, fibrosis, scar/keloid formation regenerative process Pharmacodynamic and pharmacokinetic processes: general principles Pharmacokinetics: absorption, distribution, metabolism, excretion, dosage intervals Mechanisms of drug action, structure-activity relationships (eg, anticancer drugs) Concentration and dose-effect relationships (eg, efficacy, potency), types of agonists (eg, full, partial, inverse) and antagonists and their actions 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) Microbial biology Microbial identification and classification, including principles, microorganism identification, and non-immunologic laboratory diagnosis Bacteria structure (eg, cell walls, composition, appendages, virulence factors, extracellular products, toxins, mechanism of action of toxins) 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) Viruses structure (eg, physical and chemical properties, virulence factors) processes, replication, and genetics (eg, life cycles, location of virus in latent infection) oncogenesis antiviral agents (eg, mechanisms of action on virus, toxicity to humans, and mechanisms of resistance) Fungi structure (eg, cell wall, composition, appendages, virulence factors, extracellular products, toxins, mechanisms of action of toxins) 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) Parasites structure (eg, appendages, macroscopic features, and virulence factors) processes, replication, and genetics (eg, life cycles, metabolism, and growth) oncogenesis antiparasitic agents (eg, mechanisms of action on parasite, toxicity to humans, and mechanisms of resistance) Prions Normal age-related findings and care of the well patient Infancy and childhood (0-12 years) 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; teething syndrome 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 Adolescence (13-17 years) 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 Adulthood (18-64 years) 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 Senescence (65 years and older) 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 Immune System Normal processes Development of cells of the adaptive immune response, including positive and negative selection during immune development Structure, production, and function 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 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 Cellular basis of the immune response and immunologic mediators 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 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) Principles of immunologic protection vaccine production and mechanisms of vaccine action biologically active antibodies (eg, monoclonal antibodies, polyclonal antibodies including IVIG, VZIG, rabies immunoglobulin) Effect of age on the function of components of the immune system Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Disorders associated with immunodeficiency 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 HIV/AIDS: HIV1 and HIV2; AIDS; AIDS complications (eg, neuropathy, dementia, renal insufficiency); immunology of AIDS; immune reconstitution syndrome (IRS); secondary infections; noninfectious complications Immunologically mediated disorders hypersensitivity reactions: type 1, 2, 3, including anaphylaxis; type 4; drug reactions; serum sickness transplantation: rejection; graft-vs-host disease Adverse effects of drugs on the immune system: Jarisch-Herxheimer reaction; 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 Normal Processes Embryonic development, fetal maturation, and perinatal changes Organ structure and function Cell/tissue structure and function production and function of erythrocytes, including heme and hemoglobin synthesis; 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 Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious and immunologic infectious disorders bacteria viral: hemorrhagic fever (Ebola virus, Marburg virus); chikungunya; dengue fever; Zika virus disease 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 Neoplasms: leukemia, acute (ALL, AML); leukemia, chronic (CLL, CML); lymphomas, Hodgkin disease, non-Hodgkin lymphoma, Burkitt lymphoma, T-cell lymphoma; multiple myeloma, dysproteinemias, monoclonal gammopathy of unknown significance (MGUS); myelofibrosis; myelodysplastic syndrome, myelodysplasias; other immunoproliferative neoplasms (eg, Waldenstrom macroglobulinemia) Anemia, cytopenias, and polycythemia anemias 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 Coagulation disorders (hypocoagulable and hypercoagulable conditions) 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) Traumatic, mechanical, and vascular disorders: mechanical injury to erythrocytes (eg, cardiac valve hemolysis); disorders of the spleen; splenic rupture/laceration; splenic infarct; splenic abscess; effects/complications of splenectomy (eg, sepsis due to encapsulated bacteria); hypersplenism Adverse effects of drugs on the hematologic and lymphoreticular systems: antiplatelet drugs, antithrombin drugs (eg, dabigatran); chemotherapeutic agents; inhibitors of coagulation factors; methemoglobinemia, acquired; propylthiouracil; tumor lysis syndrome; warfarin Behavioral Health Normal Processes 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: general adherence; adolescent adherence Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Psychotic disorders: brief psychotic disorder; delusional disorder; psychotic disorder due to another medical condition; schizophrenia; schizoaffective disorder; substance-induced psychotic disorder Anxiety disorders: acute stress disorder; anxiety disorders (generalized anxiety disorder, anxiety due to another medical condition, social phobia); hyperventilation syndrome; obsessive-compulsive disorder; panic disorder with and without agoraphobia; phobic disorders; post-traumatic stress disorder; separation anxiety disorder; substance-induced anxiety disorder, trichotillomania Mood disorders: major depressive disorder with and without psychotic features, with and without seasonal pattern; major depressive disorder, postpartum, with and without psychotic features, including screening; 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); suicidal ideation/attempt Somatoform disorders: 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) Disorders originating in infancy/childhood: reactive attachment disorder; attentiondeficit/hyperactivity disorder; speech sound disorder or language disorder; learning disorder/dyslexia; intellectual developmental disorder and developmental delay, undefined, including school problems, fetal alcohol syndrome; oppositional defiant disorder, conduct disorder; autism spectrum disorder, Rett syndrome; psychoses with origin specific to childhood; elimination disorders (incontinence, encopresis); tic disorders/Tourette disorder Personality disorders: 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 Psychosocial disorders/behaviors: adjustment disorder; grief response/bereavement, normal and persistent complex; parent-child relational problems other than physical or emotional abuse; other psychosocial stress Sexual and gender identity disorders: gender dysphoria; psychosexual dysfunction Substance use disorders: alcohol use disorder/intoxication/dependence/withdrawal; tobacco/nicotine use disorder/dependence/withdrawal; varenicline use; cannabis use disorder/intoxication/dependence; hallucinogen use disorder/intoxication/dependence/withdrawal; inhalant use disorder/intoxication/dependence/withdrawal; opioid, heroin, including prescription drug, use disorder/intoxication/dependence/withdrawal; sedative, hypnotic, including benzodiazepine and barbiturate use disorder/intoxication/dependence/withdrawal; stimulant, cocaine, methamphetamine use disorder/intoxication/dependence/withdrawal; other drugs of use disorders (eg, ecstasy, PCP, bath salts)/intoxication/dependence/withdrawal; polysubstance use disorder/intoxication/dependence/withdrawal Nervous System & Special Senses Normal Processes Embryonic development, fetal maturation, and perinatal changes, including neural tube derivatives, cerebral ventricles, and neural crest derivatives Organ structure and function 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) brain gross anatomy and blood supply higher function: cognition, language, memory, executive function hypothalamic function limbic system and emotional behavior circadian rhythm sleep-wake disorder 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 Cell/tissue structure and function, including neuronal cellular and molecular biology axonal transport excitable properties of neurons, axons, and dendrites, including channels synthesis, storage, release, reuptake, and degradation of neurotransmitters and neuromodulators 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 Repair, regeneration, and changes associated with stage of life Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, immunologic, and inflammatory disorders 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 Neoplasms (cerebral, spinal, and peripheral): benign (meningioma, neurofibromatosis); malignant (glioblastoma multiforme, astrocytoma, medulloblastoma, primary CNS lymphoma); metastatic (eg, breast, lung, pancreatic, testicular, melanoma) Cerebrovascular disease: 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; 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 Disorders relating to the spine, spinal cord, and spinal nerve roots: 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 Cranial and peripheral nerve disorders 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 Neurologic pain syndromes: complex regional pain syndrome (reflex sympathetic dystrophy, causalgia); fibromyalgia; postherpetic neuralgia; phantom limb pain/syndrome; thalamic pain syndrome; trigeminal neuralgia Degenerative disorders/amnestic syndromes: Alzheimer disease; frontotemporal dementia, including progressive supranuclear palsy, Lewy body disease; mild neurocognitive disorder, mild cognitive impairment Global cerebral dysfunction: altered states of consciousness; delirium; coma/brain death Neuromuscular disorders: amyotrophic lateral sclerosis/spinal muscular atrophy; muscular dystrophy (eg, Duchenne, myotonic); muscle channelopathies (eg, hypokalemic period paralysis) Movement disorders: acute dystonia; adult tic disease; essential tremor; Huntington disease; Parkinson disease, including Parkinson dementia Metabolic disorders: adrenoleukodystrophy; metabolic encephalopathy Paroxysmal disorders: headache, including migraine, mixed, tension, ice-pick, cluster, medication withdrawal, caffeine withdrawal; seizure disorders, including generalized tonic-clonic, partial, absence, febrile Sleep disorders: cataplexy and narcolepsy; circadian rhythm sleep-wake disorder; insomnia, primary; sleep terror disorder and sleepwalking; REM sleep behavior disorder; restless legs syndrome Traumatic and mechanical disorders and disorders of increased intracranial pressure: anoxic brain damage, cerebral hypoxia; epidural, subdural hematoma (cerebral and spinal); intraparenchymal hemorrhage, traumatic subarachnoid hemorrhage; 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 Congenital disorders: Friedreich ataxia; neural tube defects (eg, spina bifida, holoprosencephaly, anencephaly); microcephaly; Sturge-Weber syndrome; tuberous sclerosis, von Hippel-Lindau disease; hydrocephalus, obstructive (Arnold-Chiari) Adverse effects of drugs on the nervous system: acute dystonic reaction; drug-induced meningitis (eg, NSAIDs, sulfa drugs); drug-induced neuropathy (eg, vincristine, isoniazid, metronidazole); extrapyramidal adverse effects (eg, akathisia, dystonia, drug-induced parkinsonism); neuroleptic malignant syndrome; poisoning by psychotropic agents, including antidepressants; serotonin syndrome; tardive dyskinesia 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 disorders: 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 hemorrhage adverse effects of drugs on the eyes: ethambutol; hydroxychloroquine; prednisone Disorders of the ear 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 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) Skin defense mechanisms and normal flora Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, immunologic, and inflammatory disorders 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; urticaria; Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis autoimmune disorders: vitiligo Neoplasms benign neoplasms, cysts and other skin lesions: actinic keratoses; 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 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 Oral disease: aphthous ulcers (stomatitis, canker sores); leukoplakia Disorders of pigmentation: albinism; lentigo Traumatic and mechanical disorders: animal bites (dogs, cats, etc); burns or wounds affecting the skin or subcutaneous tissue (eg, sunburn, other including blast injuries and burns); cauliflower ear; effects of ultraviolet light; keloids; tattoo; thermal injury, perniosis, frostbite; ulcers, decubitus Congenital disorders: xeroderma pigmentosum; benign lesions in neonates, infants, children (eg, congenital nevi) Adverse effects of drugs on skin and subcutaneous tissue: drug reactions, eruptions, including local reaction to vaccine Musculoskeletal System Normal processes Embryonic development, fetal maturation, and perinatal changes Organ structure and function Cell/tissue structure and function biology of bones, joints, tendons, skeletal muscle, cartilage exercise and physical conditioning/deconditioning Repair, regeneration, and changes associated with stage of life Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, inflammatory, and immunologic disorders 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 Neoplasms: benign neoplasms (e.g., ganglion cyst); malignant neoplasms of bone (eg, osteosarcoma, sarcoma, leiomyosarcoma, rhabdosarcoma); metastases to bone, secondary malignant neoplasm of bone Degenerative and metabolic disorders 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 Traumatic and mechanical disorders: 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 Congenital disorders: 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 imperfecta; McArdle disease; mitochondrial myopathies Adverse effects of drugs on the musculoskeletal system: drug-induced myopathy (eg, steroids, statins, cocaine, AZT); malignant hyperthermia Cardiovascular System Normal Processes Embryonic development, fetal maturation, and perinatal transitional changes 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 Cell/tissue structure and function heart muscle, metabolism, oxygen consumption, biochemistry, and secretory function (eg, atrial natriuretic peptide) 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 Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, immunologic, and inflammatory disorders infectious disorders: bacterial endocarditis, myocarditis immunologic and inflammatory disorders: atherosclerosis (eg, atherosclerosis of the aorta) Neoplasms: myxoma, metastases Dysrhythmias: 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 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; tachycardia-induced; cardiogenic pulmonary edema Ischemic heart disease: acute coronary syndrome, acute myocardial infarction; angina pectoris, stable and unstable/coronary artery disease/coronary insufficiency; coronary artery spasm Diseases of the myocardium: cardiomyopathy, dilated, including alcoholic, viral, takotsubo; cardiomyopathy, obstructive hypertrophic; cardiomyopathy, familial dilated; cardiomyopathy, restrictive; hypertensive heart disease, left ventricular hypertrophy, right ventricular hypertrophy; complications of myocardial infarction; nontraumatic tamponade post-myocardial infarction; papillary muscle rupture/dysfunction; ventricular free wall rupture; myocarditis Diseases of the pericardium: chronic constrictive pericarditis; pericardial effusion; pericardial tamponade; acute pericarditis; pericarditis, following myocardial infarction, surgery, trauma Valvular heart disease: valve disorders, mitral/aortic/tricuspid, pulmonic (eg, regurgitation, stenosis, prolapse, insufficiency, vegetation); functional murmurs; rheumatic heart disease; complications of artificial valves Hypotension: orthostatic hypotension Hypertension: elevated blood pressure studying without diagnosis of hypertension; essential hypertension; malignant hypertension; secondary hypertension Dyslipidemia: hypercholesterolemia; hyperlipidemia; hypertriglyceridemia; lipoproteins/lipoprotein lipase deficiency Vascular disorders 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 Traumatic and mechanical disorders: ventricular puncture; myocardial contusion; myocardial rupture; traumatic aortic dissection; traumatic tamponade Congenital disorders, including disease in adults: 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 Adverse effects of drugs on the cardiovascular system: adriamycin; cocaine, amphetamine, PCP; ACE inhibitors, calcium channel blockers, alpha blockers, minoxidil Respiratory System Normal Processes 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 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 Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, immunologic, and inflammatory disorders 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 of the lower airways: hospitalacquired 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) Neoplasms 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 Obstructive airway disease: asthma, reactive airway disease; bronchiectasis; chronic airway obstruction; chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema 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: 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 Metabolic, regulatory, and structural disorders: disorders of gas exchange; hypoventilation; hypoxia; pulmonary alveolar proteinosis; ventilation-perfusion imbalance Disorders of the pleura, mediastinum, and chest wall: chylothorax; costochondritis; empyema; hemothorax; mediastinitis; pleural effusion; pleuritis; pneumomediastinum; pneumothorax Traumatic and mechanical disorders 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 Congenital disorders: bronchogenic cysts; congenital cysts; congenital diaphragmatic hernia; pulmonary sequestration; immotile cilia syndrome Adverse effects of drugs on the respiratory system: bleomycin, amiodarone; adverse effects of 100% oxygen; acute effects of tobacco/nicotine, inhalants, cocaine Gastrointestinal System Normal Processes Embryonic development, fetal maturation, and perinatal changes Organ structure and function anatomy of the alimentary canal, including mouth, pharynx, esophagus, stomach, small intestine, large intestine, anus, peritoneal cavity liver and biliary system, including enterohepatic circulation salivary glands and exocrine pancreas gastrointestinal motility, including defecation digestion and absorption Cell/tissue structure and function endocrine and neural regulatory functions, including GI hormones (eg, gastrin) salivary, gastrointestinal, pancreatic, hepatic secretory products, including enzymes, proteins, bile salts, and processes synthetic and metabolic functions of hepatocytes Repair, regeneration, and changes associated with stage of life Gastrointestinal defense mechanisms and normal flora Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, immunologic, and inflammatory disorders 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 Neoplasms 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 Signs, symptoms, and ill-defined disorders: upper gastrointestinal bleeding; lower gastrointestinal bleeding; constipation; diarrhea; hematochezia; bright red rectal bleeding; melena; nausea, vomiting, rumination Disorders of the oral cavity, salivary glands, and esophagus oral cavity and salivary glands: abscessed tooth; dental caries; malocclusion; disorders of the salivary glands (eg, stones, sialadenitis, parotitis) 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 Disorders of the stomach, small intestine, colon, rectum, anus stomach: dyspepsia/hyperacidity; gastric ulcer; gastritis; peptic ulcer; peptic ulcer perforation; gastroparesis 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; hemorrhoids; rectal prolapse Disorders of the liver and biliary system, noninfectious liver: cirrhosis; Dubin-Johnson, Rotor syndromes; end-stage liver disease, including indications for transplantation; Gilbert syndrome, Crigler-Najjar syndrome; hepatic coma/hepatic encephalopathy; hepatitis, noninfectious; 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 Disorders of the pancreas: pancreatitis, acute; pancreatitis, chronic; pancreatitis, hereditary; pancreatic cyst/pseudocyst; pancreatic duct obstruction; pancreatic insufficiency Disorders of the peritoneal cavity: ascites Traumatic and mechanical disorders: abdominal wall defects; adhesions, postsurgical; digestive system complications of surgery; post-gastric surgery syndromes (eg, blind loop syndrome, adhesions); 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 Congenital disorders: annular pancreas, biliary atresia, cleft lip and palate, esophageal atresia, malrotation without volvulus, Meckel diverticulum, pyloric stenosis, tracheoesophageal fistula Adverse effects of drugs on the gastrointestinal system: 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 Normal Processes Embryonic development, fetal maturation, and perinatal changes Organ 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 Cell/tissue structure and function 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) Repair, regeneration, and changes associated with stage of life Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, immunologic, and inflammatory disorders 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; nephrotic syndrome; thin basement membrane disease tubular interstitial disease: acute tubular necrosis (ATN); acute interstitial nephritis; papillary necrosis; HIV nephropathy lower urinary tract: interstitial cystitis Neoplasms 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 Signs, symptoms, and ill-defined disorders: dysuria; hematuria; oliguria, anuria; proteinuria Metabolic and regulatory disorders: 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 Vascular disorders: renal artery stenosis (atherosclerosis, fibromuscular dysplasia, nephrosclerosis); renal vein thrombosis; renal infarction Traumatic and mechanical disorders: bladder rupture; neurogenic bladder; obstructive uropathy; posterior urethral valves; renal laceration; renal vascular injury; ureteral laceration/avulsion/disruption; urethral diverticulum; urethral/ureteral obstruction/stricture/prolapse; urinary incontinence, including secondary enuresis; vesicoureteral reflux Congenital disorders: double ureters/ureteral duplication/double collecting system; horseshoe kidney; hydronephrosis/reflux; renal agenesis, renal hypoplasia, renal dysplasia; single kidney Adverse effects of drugs on the renal and urinary system: 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 Organ structure and function: pregnancy, including fertilization, implantation, development of embryo, labor and delivery, the puerperium, lactation, gestational uterus, placenta Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Prenatal care 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 Obstetric complications: 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; fetal abnormality affecting management of mother (eg, hydrocephalus, spina bifida); 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; prolonged pregnancy; Rh isoimmunization affecting management of mother; vomiting in pregnancy (morning sickness, hyperemesis gravidarum); trauma in pregnancy; infections complicating pregnancy 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; threatened preterm labor Puerperium, including complications: lactation problems; breast-feeding problems; lochia; postpartum cardiomyopathy; postpartum blues; postpartum hemorrhage; postpartum sepsis; retained placenta, products of conception (eg, placenta accreta); uterine atony Newborn (birth to 4 weeks of age) 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 hypoglycemia; neonatal conjunctivitis and dacryocystitis; ophthalmic gonorrhea; 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 life-threatening event (ALTE); tetanus neonatorum Congenital disorders, neonatal: congenital malformations and anomalies; neonatal hydrocele Adverse effects of drugs on pregnancy, childbirth, and the puerperium: alcohol, tobacco, and other drugs (ATOD); prenatal radiation exposure; teratology (eg, ACE inhibitors, SSRIs, warfarin, infections, toxins) Systemic disorders affecting pregnancy, labor and delivery, and puerperium: 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 Normal Processes Embryonic development, fetal maturation, and perinatal changes, gametogenesis Organ structure and function female structure, including breast female function (eg, ovulation, menstrual cycle, puberty) intercourse, sexual response Cell/tissue structure and function: hypothalamic-pituitary-gonadal axis, sex steroids, and gestational hormones Reproductive system defense mechanisms and normal flora Repair, regeneration, and changes associated with stage of life Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Breast 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 Female reproductive system 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 acuminata; lymphogranuloma venereum (Chlamydia trachomatis), non-lymphogranuloma venereum; pelvic inflammatory disease; Fitz-Hugh–Curtis syndrome; salpingitis and oophoritis; syphilis (Treponema pallidum); trichomoniasis (Trichomonas vaginalis); urethritis; vaginitis; vulvovaginitis Neoplasms of the cervix, ovary, uterus, vagina, and vulva 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 Fertility and infertility: assisted reproductive techniques (ART); contraception (eg, oral contraceptives, IUD, vaginal cap, cervical sponge, diaphragm, implant, morning-after pill, male and female condoms); female infertility; gonadal dysgenesis 45,X (Turner syndrome); sterilization; tubal factors; infertility Menopause: ovarian failure, premature menopause; perimenopause; premenopausal menorrhagia; postmenopausal atrophic vaginitis (vaginal atrophy); postmenopausal bleeding; vasomotor symptoms Menstrual and endocrine disorders: abnormal uterine bleeding, including perimenopausal; absence of menstruation (primary amenorrhea, secondary amenorrhea including undiagnosed pregnancy); anovulation; dysmenorrhea; endometriosis; hirsutism, virilization; mittelschmerz; pelvic pain; polycystic ovarian syndrome; postcoital bleeding; premenstrual syndrome Sexual dysfunction: dyspareunia; orgasmic dysfunction; sexual desire/arousal syndrome; vaginismus Traumatic and mechanical disorders: 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 Congenital disorders: müllerian agenesis; uterus didelphys, bicornuate uterus; short cervix Adverse effects of drugs on the female reproductive system and breast: antihistamines, H2-receptor blockers; benzodiazepines; beta-adrenergic blockers; hormone replacement; opioids; spironolactone; selective serotonin reuptake inhibitors; tricyclic antidepressants Male Reproductive System Normal Processes Embryonic development, fetal maturation, and neonatal changes, gametogenesis 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 Repair, regeneration, and changes associated with stage of life Abnormal Processes: Health and Health Maintenance, Screening, Diagnosis, Management, Risks, Prognosis Infectious, immunologic, and inflammatory disorders infectious disorders: balan

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United States Medical Licensing Examination Step 1
USMLE Examination Study Guide
https://killexams.com/pass4sure/exam-detail/USMLE Search results https://killexams.com/pass4sure/exam-detail/USMLE https://killexams.com/exam_list/USMLE

Introduction

With the dreaded USMLE Step 1 now always around the corner -- it's now given 6 days a week, every week! -- the test has become a popular course of questions on Medscape Med Students' discussion boards. I decided to go straight to the source for some answers, so here's a Q & A with Chirag Amin, MD, and Tao Le, MD, 2 of the authors of that USMLE bible, First Aid for the USMLE Step 1 2001: A Student to Student Guide. Dr. Amin is now Vice President of Content and Community for www.medschool.com, where Dr. Le is Chief Medical Officer.

Medscape: Describe the USMLE.

Drs. Amin and Lee: The USMLE Step 1 computer-based test (CBT) is a 1-day test, taken on a computer, that's administered once a day (except Sunday) on a year-round basis at hundreds of testing centers around the world. The test consists of a total of 350 multiple-choice, single-best-answer questions that are broken down into seven 1-hour blocks, with 50 questions per block. Examinees are given short breaks between blocks, as well as a lunch break.

M: How long in advance of Step 1 should students start preparing? Should they make studying for the USMLE a part of studying for regular courses?

A&L: The USMLE Step 1 was designed to assess medical science knowledge and concepts taught during the preclinical years at a typical medical school. Therefore, medical students who studied diligently during their first- and second-year coursework end up minimizing the stress and workload of a USMLE Step 1 review. Regardless, most students start intensive examination preparation on a full-time basis (ie, 6-8 hours of studying per day) approximately 4-6 weeks before the actual examination date. Due to differences in their medical education/training and curriculum as well as the time that often lapses since the completion of basic science coursework, international medical graduates (IMGs) usually need 2-4 months of study before taking the USMLE Step 1.

M: If you have a month, as many schools supply students, what's a good schedule?

A&L: In the month leading up to the exam, the majority of medical students find themselves studying anywhere from 6-12 hours each day, dividing their study time proportionally over the 7 traditional basic science disciplines, which include anatomy, behavioral sciences, biochemistry, microbiology/immunology, pathology, pharmacology, and physiology. In addition, many students devote the last week of their exam preparation to comprehensive review as well as going through trial questions. Many students recommend thorough review of the high-yield facts in First Aid for the USMLE Step 1 during the last week. Generally, students devote more time to the more clinically relevant disciplines, such as pathology, pharmacology, and microbiology/immunology. However, a common mistake that students make is not spending enough time covering all subject disciplines thoroughly.

M: What books can you recommend for general review? For specific subjects?

A&L: Students usually find themselves buying anywhere from 10-25 review as well as question-and-answer (Q&A) books, but most will start with our First Aid for the USMLE Step 1. The major medical publishing companies such as McGraw-Hill, Lippincott Williams & Wilkins, Blackwell Science, and Harcourt Health Sciences have several excellent titles for USMLE review. In addition, many students have benefited from books that present this basic science material from a clinical perspective, such as our Underground Clinical Vignettes series.

M: What kind of surprises, in terms of subject material, have students told you about?

A&L: Many medical students that we have talked to underestimate the amount of clinical material on the USMLE Step 1 examination. For example, a significant portion of the anatomy that is tested on the USMLE exam is based on one's ability to recognize anatomical structures on common radiographic images, such as x-rays, CT, and MRI scans. Furthermore, many students also leave the exam feeling somewhat intimidated regarding the clinical slant of how the basic science material is tested. Knowing specific disease pathophysiology as well as drug mechanism of action in the context of a clinical scenario is essential for doing well on the USMLE.

M: Do courses work?

A&L: This depends on the student's learning style and level of discipline. Only a small percentage of students take a review course for the USMLE Step 1 examination. Many students feel that they can benefit more by organizing a study schedule that is focused around their own strengths and weaknesses. However, there are some students who are not effectively able to manage their own study time. Those students may benefit from a structured review course.

M: What about cramming?

A&L: Because the material tested on the USMLE Step 1 examination covers a large amount of information that is learned over the course of 2 years in medical school, strict cramming is usually not an effective method for USMLE preparation. Furthermore, since many questions on the exam are asked from a clinical standpoint, requiring medical reasoning and problem-solving skills, a structured and disciplined review over the course of several weeks is far more effective in terms of doing well on the exam as compared to cramming. That being said, anecdotes abound about medical students passing just by cramming First Aid for the USMLE Step 1. Again, cramming is not recommended.

M: What kind of advice do you have for international medical graduates?

A&L: The most important advice for international medical graduates is to become familiar with taking exams on the computer. The vast majority of international medical graduates have never taken an exam on the computer, and this is a major obstacle. Factors such as eye strain and mouse dexterity can serve as a major obstacle when taking the examination. The more that one is able to become familiar with the specific test-taking environment, the better that person is able to concentrate on the test itself.

M: Any particular advice for students who are retaking the exam after failing?

Honestly assess your weaknesses and shortfalls in your previous exam preparation, and focus on improving in those areas. Retakers have the advantage of experience, and most use this advantage to their benefit in terms of revising their method of exam preparation when studying the second time around. The good news is that retakers generally have a very high pass rate.

M: Can you list helpful resources?

A&L: There are a number of helpful resources for USMLE preparation. In terms of textbooks, one textbook that gives an excellent overview of the exam, including a database of high-yield facts and a detailed list of useful resources, is our First Aid for the USMLE Step 1. Many students consider this book the best place to start their exam preparation. In addition, Medschool.com's community Web site (https://students.medschool.com) has a USMLE Study Center that provides a wealth of free information, including online USMLE lectures, trial training schedules, simulated exam modules, recommended books, discussion forums, and much more. Another important resource is the National Board of Medical Examiners (NBME) Web site at https://www.nbme.org, which provides students with the most up-to-date information about the examination.

Thu, 04 Aug 2022 12:00:00 -0500 en text/html https://www.medscape.com/viewarticle/403686

There are a few different ways that Anki is usually incorporated into Step 1 studying:

Pre-Made decks

Zanki and Anking are two pre-made decks that have been curated over recent years to capture the best and most high yield Step 1 content from almost any and all resources that students find useful, including Pathoma, First Aid, Sketchy, etc. Both decks are very large and extremely comprehensive, sometimes emphasizing information that isn’t always high-yield or testable.

Making your own cards (content)

For some students, taking traditional handwritten or typed notes is cumbersome and disengaging. With that in mind, it’s not uncommon that students will do their “note taking” by taking the material they find in resources like First Aid, Boards and Beyond, etc and creating their own cards to capture the content in whatever way makes the most sense for them.

Making your own cards (missed questions)

Knowing that UWorld offers a wealth of information in the explanation of answer choices and through outlining the educational objectives of different question types, it should be no surprise that a lot of that content can be ideal for Anki. In this approach it’s important to do your best to pinpoint specific and succinct knowledge gaps so that you can make cards that aren’t so dense that they’re not helpful. It’s important to note that if not appropriately focused, this approach can be incredibly time intensive and can sometimes not be the most productive way to use your time, so be thoughtful in how you incorporate this into your overall study strategy.

Fri, 03 Dec 2021 01:09:00 -0600 en text/html https://www.bcm.edu/education/school-of-medicine/m-d-program/current-students/student-affairs/usmle-preparation

Editor's Note:

The goal of this column is to provide you with the resources you need to excel in medical school. For more clinical resources, visit Emily Cooper's blog, Med-Source, which she maintains as a "one-stop guide" for med students.

I was planning to expound upon pathology this month, but having just completed Step 1 of the boards (formally known as the US Medical Licensing exam or USMLE), it seemed appropriate that I share the pearls that I gleaned while the material was still somewhat fresh in my mind. I studied for just over 5 weeks, which felt like just the right amount of time. Any shorter and I would not have been fully prepared, any longer and I would have started to forget what I learned at the beginning.

From the outset, I would highly recommend creating a study schedule in which you cover all of the material in First Aid during the first 3 1/2 to 4 weeks, doing at least 50 questions each night and then only reviewing questions during the last week.

The highest-yield online sites for the Boards are the question banks. Although pricey, the questions provide the best way to assess your progress and, next to First Aid, were my most valuable study resource.

1. Kaplan Qbank still serves as the industry standard. Your subscription provides access to more than 2000 questions that can be sorted by both discipline and organ system. A 1-month subscription costs $199, a 3-month subscription costs $279, and a 6-month subscription costs $499 (discounts may be available through your medical school). This program allows you to customize tests with your unused and/or incorrect questions, so that you can focus on your weaker areas. Although the interface is not identical to the real exam, it is close enough that the real exam will not feel foreign. Kaplan's other strong points are their explanations for the answers. After completing a test, make sure to read the full answers, as a lot of information is packed into explaining why certain choices are incorrect.

2. USMLE World is the steadily growing upstart rival to Kaplan. They have now amassed more than 2000 questions as well, making this q-bank capable of standing on its own as a review source. The format is identical to the FRED format that you will see on the real thing. As with Kaplan, you can track your performance. I found the questions to be slightly more representative of the real exam than the Kaplan questions, but the explanations were not as thorough.

3. Practice exams provided by the National Board of Medical Examiners also come highly recommended and are available for $45 each. Other students who have used these exams say that they are the most representative of the real exam, with form 1 being the easiest and form 3 the most difficult.

4. When you register for Step 1, you get access to practice content. The 3 blocks of content are easier than the real exam, but they are a good confidence booster and are worth running through if only to know that you have covered the "official" material. The Kaplan Qbank subscription also comes with a .pdf file of explanations (an answer key without explanations comes with the content).

5. Also, be sure to check out resources offered by your school. At the University of Pennsylvania, we have access to USMLEasy, which provides online question banks for all of the step exams. If you don't have free access, you can check out sample quizzes on Medscape and learn more about the Step 1 q-bank.

The volume of print material available to prep for the boards is virtually limitless. Fortunately, First Aid -- along with upperclassmen -- should help you wade through and select the most valuable choices. Below, I listed the top 1 or 2 choices that my colleagues and I chose for each subject. It may be useful to go to your medical bookstore and look through the major series (High Yield, BRS, and Rapid Review) to decide which style works best for you. Also, First Aid has extensive reviews of the subject-based review books in the last section.

1. First Aid for the USMLE Step 1 2008 (Le T, Bhushan V, Rao DA): Treat this book as your Boards bible. Learn it, love it, know it. Take all of your notes in this book so that when you review at the end, you only have to go back to 1 book.

2. Biochemistry: Focus on the key enzymes and clinical consequences. Any one of the following will suffice:

   • Lippincott's Illustrated Reviews: Biochemistry (Champe PC, Harvey RA, Ferrier DR);

   • BRS Biochemistry and Molecular Biology (Swanson TA, Kim SI, Glucksman MJ);

   • High-Yield Biochemistry (Wilcox B).

   
   

3. Pharmacology: Focus only on those drugs mentioned in First Aid and master the general pharmacology chapter. I used only the flashcards and felt that they were more than adequate.

   • Pharmacology Flashcards (Barron) -- One side has a clinical vignette and the other has all the key information on the drug;

   • Lippincott's Illustrated Reviews: Pharmacology (Howland RD, Mycek MJ, Harvey RA, et al);

   • Appleton & Lange Review of Pharmacology (Krzanowski JJ).

   
   

4. Microbiology: Clinical Microbiology Made Ridiculously Simple (Gladwin M, Trattler B)

5. Immunology: High-Yield Immunology (Johnson AG) or Medical Microbiology and Immunology (Immunology section only) (Levinson WE)

6. Pathology: BRS Pathology (Schneider AS, Szanto PA, Kim SI, et al)

7. Physiology: BRS Physiology (Costanzo LS)

8. Anatomy: High-Yield Gross Anatomy (Dudek RW, Louis TM)

9. Embryology: High-Yield Embryology (Dudek RW) or BRS Embryology (Dudek RW)

10. Neuroanatomy: High-Yield Neuroanatomy (Fix JD) or Clinical Neuroanatomy Made Ridiculously Simple (Goldberg S)

11. Behavioral Science: High-Yield Behavioral Science (Fadem B)

12. Histology: High-Yield Histology (Dudek RW)

As indicated above, First Aid is the quintessential source for Boards review. Take all of your notes in this book, writing in it as you go over your q-bank answers.

1. During your review days at the end, go back and reread your annotated copy.

2. Do questions! Each night after studying, answer at least 50 questions on what you studied that day. Towards the end of your studying, complete blocks of 50 random questions to better simulate the real exam.

3. Know the basic pharmacology chapter. The concept of epinephrine reversal will be on your Boards.

4. Study with a friend. You may or may not want to actually study out loud, but at the very least you should have someone you meet everyday and sit with to help get you through. Five weeks is a long time to sit in a room by yourself.

5. Sleep, eat, exercise, go out. Your life doesn't need to stop because you are studying. If you get going before 10 am, you should be done by 8 pm with time to chill out.

One last thought: you will be fine. If you feel overwhelmed, channel that energy into doing an extra block of questions rather than freaking out about the exam. Everyone panics a little at some point, but panicking is not productive. Doing questions is. Good luck!

Mon, 21 Jun 2021 02:32:00 -0500 en text/html https://www.medscape.com/viewarticle/570444

The Ministry of Health has indicated that it cannot automatically absorb all Sri Lankan doctors to the Heath Services. This, and many other reasons, may prompt a doctor to explore working overseas. One country that regularly employs a substantial number of foreign doctors is the United States of America. This question and answer session attempts to answer some of the initial questions posed by doctors interested in practicing in the US. We invite readers to ask questions from the author so that we may provide the most relevant information to those considering practicing medicine in the US.

Can Sri Lankan Doctors Practice Medicine in the United States of America?

Yes, there are no nationality barriers to practice medicine in the USA. The USA has a very fair system of examinations that are open to its nationals as well as foreigners. Both foreign doctors and American medical students/doctors sit for the same standardized examinations. However, hospitals usually interview their prospective doctors before they employ them. American medical graduates usually have an advantage because of the language, their familiarity with the US hospital system and the fact that there are fewer restrictions on them in general (i.e. no requirement for a work visa). However, as the amount of doctors that the US produces is grossly inadequate to cater to their demand, each year thousands of foreign doctors enter the US medical practice. In recent years about 6500 foreign medical graduates applied for US residency out of which about 45% succeed in securing a place. This is in addition to about 15,000 US medical graduate applicants out of which about 90% secure a place.
What are the things a doctor has to do to be eligible to practice medicine in America?

First, the doctor should have graduated from a medical school that is listed in the World Health Organization (WHO) directory of medical schools. Six Sri Lankan medical faculties are in the directory. They are Colombo, Peradeniya, Jaffna, Galle, Ragama (incuding North Colombo Medical College) and Sri Jayawardenapura medical faculties. A full list is available in the United States Medical Licensing Examination (USMLE) web site. Sri Lankan doctors who have gone abroad for medical education should check whether their medical school is in the directory.

The doctor should register with the Education Commission for Foreign Medical Graduates (ECFMG). This can be done online by visiting the ECFMG Web site (www.usmle.org) - CHECK. Registering involves answering many questions related to you and your medical education. All clinical appointments need to be entered with dates, consultants etc. No errors should be made during this process. Therefore it's a good idea to get the help of someone who has gone through the process to avoid delays and rejection of the application.

The doctor should pass the USMLE Step 1 and Step 2 (Clinical Knowledge and Clinical Skills) examinations to be eligible to apply for residency.

What is ECFMG ?
ECFMG is the Education Commission for Foreign Medical Graduates. It is the entity that coordinates all examination related affairs of a foreign medical graduate until he or she has completed residency. It also sponsors foreign medical graduates so that they legally work in the US during their period of training as a resident.

What is USMLE ?
USMLE is the United States Medical Licensing Examination . The USMLE consists of 3 steps, Step 1, Step 2 and Step 3. In step 1, students are mainly tested in the pre-clinical subjects. Step 2 has two parts, Step 2 CK or Clinical Knowledge and Step 2 CS or Clinical Skills. Then there is the Step 3. Step 3 is not necessary to get a residency. Most US doctors do Step 3 during their 2nd or 3rd year of residency. Doing Step 3 early is a special advantage to foreign doctors as there are certain advantages in securing a less restrictive working visa if all USMLE examinations have been passed at the time of applying.

How do I Register to take the USMLE?
Unlike US doctors, foreign medical graduates do not directly register with the USMLE. They register with the ECFMG to do the USMLE examination. As I have stated earlier, one should first visit the ECFMG web site, apply and get a registration number from ECFMG. This number is necessary to fill the online application for the USMLE examinations. The ECFMG and USMLE examination application process can take quite some time as the ECFMG writes directly to your medical school and gets your transcript etc.

This question and answer session is the first one in a series of three. In the next session, we will be addressing issues such as, details of the different USMLE examinations, whether there is any order in which you should sit the examinations, where you can sit the examinations, advise on preparation etc.
"Please log in to www.sl2college.com and visit the USMLE forum to post your questions. The questions will be used as a guide to generate the next article by the author."

Sun, 13 Feb 2022 08:51:00 -0600 text/html https://www.sundaytimes.lk/081228/Education/eu608.html No result found, try new keyword!No student wants to use multiple attempts on any USMLE step exam. Students should continue to study and do their best, regardless of this change. The intent here is to avoid anyone taking the CS ... Tue, 05 May 2020 02:35:00 -0500 text/html https://www.usnews.com/education/blogs/medical-school-admissions-doctor/articles/what-premeds-should-know-about-usmle-changes No result found, try new keyword!Potential doctors should also take demanding science classes to assess their personal affinity for technical fields of study ... Medical Licensing Examination, or USMLE, while D.O. students ... Mon, 30 Nov 2020 02:52:00 -0600 text/html https://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/how-to-become-a-doctor-a-step-by-step-guide

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The website introduces its thousand practice questions and tests in detail.

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The health and medical exams require a lot of expert knowledge to pass. Therefore, this is not straightforward for people to learn about health and medicine without a learning plan and taking practice questions continuously. For candidates still concerned about where it is reliable to learn and practice, Medtutor is the top website that provides free thousands of questions and practice tests. With the belief that everybody can become a soldier, Medtutor was founded to help users have the best preparation for their upcoming Health And Medical-Related Exams in the future. 

Users can find needed subjects to learn and practice easily because Medtutor divides it into different practice tests, including CNA, EMT, HESIA2, MCAT, NCLEX PN, NCLEX RN, and USMLE. In each test, there are thousands of exercise questions on diverse subjects such as Basic Nurse Skills, Restorative Skills, Anatomy&Physiology, Medical and Obstetrics/Gynecology, Cardiology and Resuscitation and much more. All the questions are designed and followed by Health And Medical expertise to provide users with the most complete and reliable documentation source. Users can find all they need for the Medtutor exam from the website.

After practicing the questioning that simulated a real exam for specific topics, users can identify their strengths and weaknesses and where to pay more attention. For each question, Medtutor has a detailed explanation to help users get deep knowledge of why correct or not, from there help users learn from the mistake to Improve the result.

The website also has different features to help optimize the user learning experience. For instance, 3 interesting test modes allow users to practice more excitedly by increasing the difficulty level of the examination. Special review mode help reevaluate the past result, which is good, medium or bad, to help the user use their study time effectively. Moreover, the website also has a 'Blog' to share the knowledge and information about each test type. From the blog, the user can know about the differences between CNA and CMA, Study Guide, Daily Tips, Interview Tips, CNA Duties, Perineal Hygiene, Qualities Of A Nurse, and extensively more. Blog articles are updated continuously to provide the user with the most complete, fast and accurate information.

Not only the website, but Medtutor also offers the application on google play or AppStore and allows lifetime access 100% free. Therefore, users can learn with any device, at any time, without requiring an internet connection or member registration. 

With outstanding training and testing services, Medtutor has successfully designed a professional, simple and useful e-education platform. With more than 10,123 users and 20,432 downloaded and the application, which is always in the top 3 on both App Store and Google Play, Medtutor is expected to become one of the top 5 biggest education companies in the US. 

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About the company: Medtutor is a top e-education platform that provides users with thousands of questions and practice questions about Health And Medical. The company's priority mission is to help people have the best preparation, learn happier, and pass easier with the flying colors.

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The College of Medicine provides students with a supportive network of mentors and advisors. From upperclassmen to faculty members and administrators, there are many options for school and career guidance.

Academic Support for MD Program Students

The Student Academic Support Office offers a variety of resources to help MD Program students learn more efficiently and effectively. The academic load in medical school can be a difficult and demanding. Students may seek academic assistance for a variety of reasons. Our goal is to support all students as they adapt their study skills, test taking strategies and personal habits to the demands of the medical curriculum.

We understand that the amount of material and the pace of the curriculum can present difficulties for many students. Our office is committed to working with students through those challenges.

The director of academic support is available to meet with students individually or in a small group to identify their learning styles, analyze their study habits and test taking techniques, and to discuss any difficulties that they may be experiencing in their classes.

We also provide resources to students for the purposes of course preparation, USMLE Step 1 and Step 2 exam preparation or remediation, and other academic matters.

Faculty Advisor

All incoming first-year medical students are assigned a faculty advisor. The faculty advisor will meet individually with the student to supply academic and personal support and guidance. Students will also meet with other advisees in small groups to discuss common experiences and learn from each other. Medical students are also assigned a preclinical and clinical peer mentor.

The Student Success Network Program (Individual or Small Group Tutoring)

Academic Coaches help students thrive and succeed academically during medical school. They meet with students on a regular basis to review material and draw connections between lectures, conduct lab demonstrations and prepare for exams.

Big Brother/Big Sister Mentoring Program

The Big Brother/Big Sister Mentoring Program is a student-run peer advising organization designed to smooth students' transition into medical school by matching members of the incoming class with a second-year student. These student mentors, who are referred to as "Bigs," supply support, answer questions and share information from a student's perspective. Students meet with their Bigs during the first week of school and periodically check in throughout the year.

Career Development Center

The Career Development Center provides career counseling and resources to guide medical students in making informed decisions and successfully plan their careers. Career advising is available on an individual basis and through a variety of programs, workshops and specialty interest groups. The Career Development Center also keeps students informed of research opportunities.

Academic Support for Graduate School Program Students

Students enrolled in Graduate School programs receive academic support through a variety of mentoring and advising resources. Our goal is to support graduate students in their academic studies and help guide them for success in their future careers.

Program Director

Program directors are available for each program in the Graduate School as a resource to students in their respective programs. They are available to students to assist with course selection, academic concerns related to courses, career advice, course requirements, thesis requirements and mentoring.

Principal Investigator

Graduate students who are performing research will be in direct contact with their principal investigator who may act not only as a research mentor but also as a resource for advice related to career planning, concerns regarding experiments, authorship and thesis preparation and defense.

Divisional and Departmental Offices

Each division in the Graduate School has its own divisional office with academic administrators who can assist students with academic concerns related to courses, course registration, program requirements, thesis preparation, fees, stipends and more.

The College of Medicine’s basic science departments have offices with administrators who can provide similar assistance. Department administrators are also uniquely available to assist students with questions regarding equipment, stipends and administration of funds from fellowships, awards and grants.

Center for Learning & Academic Success Services

The Center for Learning & Academic Success Services (CLASS), located on the first floor of the New College Building, provides a variety of academic support resources to students. They offer course-specific tutoring for students enrolled in the Graduate School of Biomedical Sciences and Professional Studies, as well as workshops on subjects such as study skills, time management and test-taking strategies.

The center also provides peer and professional academic coaches who provide one-on-one assistance for any student at Drexel. The CLASS has a computer lab, printing, anatomical models, supplemental texts and a study space you are welcome to use.

You can find more information about utilizing services or becoming a peer educator on the CLASS website.

Career Development

The Graduate School provides regular professional and career development series to inform graduate students about various career options. Graduate students should refer to the Professional and Career Development website of the Graduate School for more information.

 
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Fri, 14 Aug 2020 07:31:00 -0500 en text/html https://drexel.edu/medicine/student-life/mentoring-and-advising/

Getting into medical school is not easy. In 2018, only 41% of all applicants were accepted, with a low MCAT score listed as the “biggest application deal-breaker” in the application. For students who are applying to medical school with a lower-than-average GPA or MCAT score, they might be weighing their options to see if there are is another way to earn the title of “doctor.”  

There are dozens of medical specialties out there and various degrees associated with the medical field. There is more to the name “doctor” then you might realize. However, the terms “doctor” and “MD” are often used as synonyms, but this is not always the case. Licensed physicians can hold either an MD or DO degree. For students who are debating which path into medicine they want to take, they might be wondering why one is right for them and is one better than the other?

MD vs DO: Which is right for you?

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MD Vs. DO: Different Approaches

Both allopathic (MD) and osteopathic (DO) medical schools instruct their students in the necessary scientific foundations to become licensed physicians. However, the approaches the two schools take are very different. To obtain your medical doctor degree (MD), you must attend an allopathic medical school. Allopathic medicine uses science to diagnose and treat any medical conditions.

Osteopathic medicine is a little less-known and takes a more holistic approach.  Doctors who receive their DO degree study something called osteopathic manipulative treatment (OMT), a method that involves moving muscles and joints to promote healing. When OMT fits within a patient’s treatment plan, it can be used to complement drugs or surgery, adding another dimension to medical care.

Physicians with both an MD and a DO are licensed in all 50 states to practice medicine, perform surgeries and prescribe medication.

MD Vs. DO: Education

There are more than 152 accredited U.S. allopathic colleges, whereas there are just 35 accredited colleges of osteopathic medicine. Naturally, that means that there are more MDs than DOs, with roughly 25% of all doctors receiving their degree from an osteopathic medical school. The National Resident Matching Program surveyed all active medical school students who participated in the 2018 Main Residency Match. The number of seniors who attended allopathic medical school in 2018 numbered at 18,818 whereas the students of osteopathic medical schools numbered at just 4,275.

There is a stigma surrounding DOs and the level of work and academic success you must have achieved to be accepted. Years ago, it was believed that earning a degree in osteopathic medicine versus allopathic medicine was the more easily-accessible path to becoming a doctor.

As the gap has lessened, it can be just as difficult to be admitted into a DO program compared to an MD one. The average MCAT score for matriculants into a medical school was a 510.4, on the other hand, the average MCAT scores for matriculants into a college of osteopathic medicine averaged around 502.2.  

Once they enter into their respective medical schools, the path to becoming a doctor is very similar. Both MDs and DOs have earned bachelor’s degrees and then attend a four-year medical school. While in med school, they both learn the same basic knowledge regarding anatomy, physiology and pharmacology.

DOs spend an additional 200 hours learning about nerves, muscles, bones and how the connection between them will affect their patients’ overall health. When doctors of osteopathic medicine enter into the workforce, they can incorporate that training into their day-to-day patient interactions if they choose.

MD Vs. DO: Exams

The allopathic and osteopathic paths to becoming a doctor begin to split once the students take their licensing exams. Students at allopathic schools take the USMLE series, while osteopathic students often take the COMLEX sequence. Both of these exams are three-step exams and prospective doctors take them between the end of their second year of medical school and their first year of residency.

However, DOs can take the USMLE exam as well as the COMLEX sequence. While it does add considerably to the student’s workload, it is worth it if they are considering a residency program that requires the USMLE.

These two exams might cover similar topics, but they are a bit different in the testing style. In general, allopathic students are better prepared for taking the USMLE examinations and tend to do better than osteopathic students. The mean USMLE Step 1 Score for all matched U.S. allopathic seniors was 233 while the mean USMLE Step 1 Score for all matched US osteopathic seniors was 227.

Ultimately, the student needs to assess their own individual goals and interests when deciding if they should take the USMLE. The USMLE will increase the number of programs the student can apply to and will supply them greater access to more specialized programs. However, depending on the residencies the student is interested in, the USMLE might not be necessary for an osteopathic student.

Osteopathic students should be confident that they will do well on the USMLE before committing to taking it. According to the 2018 NRMP (National Resident Matching Program) Program Director, of the 1,333 programs surveyed, only 2% said that the USMLE was not required. Thirty percent of the program directors said they would never admit a student who failed the USMLE on their first attempts, and 58% said they would seldom admit a student who failed.

Of those schools, 46% of programs said that they do use the COMLEX-USA exam when considering which applicants to invite for an interview. Taking the USMLE helps put the students on an even playing field; the directors can compare the students more easily if they have all taken the same exam.  

MD Vs. DO: Residency

According to the National Resident Matching Program, allopathic seniors preferred the specialties of radiology, neurological surgery, orthopedic surgery, and plastic surgery. They least preferred to match with a residency in pathology, family medicine, or internal medicine.

On the other hand, osteopathic medical seniors preferred family medicine, pathology, physical medicine and rehabilitation, and psychiatry more than other specialties. They were less likely to apply for a residency in otolaryngology, plastic surgery, radiation oncology, and orthopedic surgery.

Overall, 91.8% of US allopathic seniors matched with their preferred specialty. 82.6% of US osteopathic seniors paired with their preferred specialty.

As of 2019, MD students could only match with programs that were accredited by the Accreditation Council for Graduate Medical Education (ACGME) and DO students could match with residencies that are accredited by either the ACGME or the American Osteopathic Association (AOA). However, this is all about to change. In July of 2020, the accreditation councils will merge to form a single GME Accreditation system, allowing MD and DO students to apply to any residencies.

The purpose of this merger is to create a more consistent method of evaluating residencies. It will affect both current and future DO students, who no longer will have a safe haven of residencies that only DO students can apply to. That means that allopathic students will have more opportunities open to them, perhaps at the expense of weaker DO students.

When choosing between DO and MD, you should consider what you want your future specialty to be, as your chances of matching with your desired program can increase depending on if you go to an allopathic or osteopathic medical school. Being a DO does not make you any worse or better of a doctor. Your residency and your action will determine that, not what letters follow your name.

Research for this article was contributed by Moon Prep college counselor, Lindsey Conger.

Sat, 15 Aug 2020 09:02:00 -0500 Kristen Moon en text/html https://www.forbes.com/sites/kristenmoon/2019/03/12/will-i-limit-my-career-path-by-pursuing-do-instead-of-md/

Getting quick results is important because pancreatic cancer patients usually do best if they undergo chemotherapy to shrink their tumor prior to surgery, explains Lyudmyla Demyan, a lead author of the study. Demyan is a research fellow in Tuveson's lab and a surgeon at Northwell Health. If the first round of chemotherapy is not effective, the patient may be switched to a different regimen. But, Demyan says, "you've already lost that critical window of opportunity to treat cancer. You're kind of losing grip on it—it's spreading very quickly."

The new study is part of an effort to expand organoids' role in improving clinical care. "Organoids enable us to recreate and recapitulate each patient's tumor," explains Amber Habowski, a postdoctoral fellow in the Tuveson lab and another lead author of the study. "We then have a model system for each individual patient that we can test drugs on. The idea behind personalized medicine is that if the organoid responds really well, we can maybe predict the patient would also."

Cold Spring Harbor Laboratory (CSHL) runs one of the largest cancer organoid facilities in the country, working on a wide range of cancers. Currently, it leads a clinical trial called Pancreatic Adenocarcinoma Signature Stratification for Treatment (PASS-01). It is evaluating personalized therapy based on how individual patients' organoids respond to different chemotherapy treatments. The new pilot test may further optimize personalized chemotherapy treatments. Demyan hopes she will be able to use the test one day soon to help her patients.

Source: Eurekalert

Sun, 24 Jul 2022 11:12:00 -0500 en-US text/html https://www.medindia.net/news/organoids-can-guide-pancreatic-cancer-therapy-208041-1.htm