Internal Medicine I Study Guide

CLINICAL YEAR 2005-2006
STUDY GUIDES

Jefferson College of Health Sciences
Roanoke, VA

Internal Medicine I

For the following medical conditions or disease processes, understand the

physiology and epidemiology

clinical presentation, acute and chronic

laboratory and diagnostic findings

treatment

management, pharmacological and non-pharmacological

prevention

Resources: first-year lectures, required reading, preceptor’s materials, PANCE review books, the Blueprint series, and Uptodate.com

**Diseases and Disorders of the Cardiovascular System**
Cardiomyopathies Dilated Hypertrophic Restrictive Conduction Disorders Atrial fibrillation and flutter Atrioventricular block Bundle branch block Paroxysmal supraventricular tachycardia Premature beats (PACs & PVCs) Ventricular tachycardia Ventricular fibrillation/flutter Congenital Heart Disease Atrial septal defect Ventricular septal defect Patent ductus arteriosis Congestive Heart Failure Left-sided vs. right-sided Hypertension Essential Secondary Malignant	Hypotension Cardiogenic shock Volume depletion Sepsis, anaphylaxis Obstructive shock Orthostatics, postural hypotension Ischemic Heart Disease (Coronary Artery Disease) Acute myocardial infarction Angina pectoris: Stable, unstable, Prinzmetal’s variant Primary prevention of risk factors Vascular Disease Acute rheumatic fever Aortic aneurysm and dissection Arterial embolism and thrombosis Chronic and acute arterial occlusion Temporal arteritis Peripheral vascular disease Phlebitis, thrombophlebitis Deep venous thrombosis (DVT) Varicose veins, venous insufficiency	Valvular Disease Aortic stenosis and insufficiency Mitral stenosis and insufficiency Mitral valve prolapse Tricuspid insufficiency Heart murmurs Other Forms of Heart Disease Acute, subacute bacterial endocarditis Acute pericarditis Cardiac tamponade Pericardial effusion

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**Diseases and Disorders of the Pulmonary System**
Infectious Disorders Acute bronchitis Influenza Pertussis Pneumonias Bacterial Community-acquired Hospital-acquired HIV-related (pneumocystic) Tuberculosis	Obstructive Pulmonary Disease Asthma Bronchiectasis Chronic bronchitis Cystic fibrosis Emphysema Neoplastic Disease of the Pulmonary System Lung Cancer Pleural Diseases Pleural effusion Pneumothorax	Pulmonary Circulation Pulmonary embolism Pulmonary hypertension Cor pulmonale Restrictive Pulmonary Disease Idiopathic pulmonary fibrosis Sarcoidosis Other Pulmonary Diseases Acute respiratory distress syndrome (ARDS) Hyaline membrane disease Foreign body aspiration (including aspiration pneumonia

Skills you need to have:

Perform the physical exam for the heart and lungs (review Bates).

Identify normal vs. abnormal findings on the physical exam.

Be familiar with antihypertensive medications, using the latest JNC guidelines.

Correct names for the commonly used antihypertensives

Class of medications to which they belong, mechanism of action, and side effects

Special considerations for prescribing antihypertensives for a patient with a coexisting illness

Be familiar with the following

Acid-base balance

Arterial blood gas analysis (ABGs)

Differential diagnosis of chest pain

Describe primary and secondary prevention, behavioral modification, and self-management of the above conditions.

**Be able to interpret the following:**
Laboratory Results CBC with differential Urinalysis w/ microscopic exam Sputum AFB Complete metabolic panel Culture and sensitivities Sedimentation rate D-Dimer PPD interpretation Ptt Pt INR Cardiac enzymes Sputum gram stain and CNS Liver panel Abdominal x-ray Chest x-ray Electrocardiograms Recognize common abnormalities caused by acute MI (inferior, anterior, posterior, anteroseptal, anterolateral.) Recognize common rhythm disturbances. EKG manifestations of hyper- and hypokalemia	Common Cardiac Tests Ultrasound for aneurysms Echocardiogram Cardiac stress test Cardiac catheterization Common Pulmonary Tests Doppler ultrasound of extremities VQ scan CT with and without contrast Pulmonary arteriogram Venogram Bronchoscopy MRI PFT

**Know how to maintain medical records, including the following:**
Complete physical examination Admission orders Progress notes in the SOAP format Complete medical history	Discharge summaries Prescription writing Patient education

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Know the indications, contraindications, and protocols for the following:
Nasogastric tube placement Intravenous line placement Parenteral medication administration Arterial blood collection	Venous blood collection Chest tube insertion Thoracentesis Foley catheter insertion