Internal Medicine II Study Guide

CLINICAL YEAR 2005-2006
STUDY GUIDES

Jefferson College of Health Sciences
Roanoke, VA

Internal Medicine II

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 Endocrine System**
Diseases of the Thyroid Gland Hypothyroidism Neonatal (cretinism) Hashimoto’s thyroiditis Iatrogenic hypothyroidism Myxedema Hypothyroidism—Iatrogenic secondary to prior neck surgery Hyperthyroidism Graves’ disease Thyroid storm Toxic multinodular goiter Euthyroid goiter Thyroid cancer Primary hyperparathyroidism	Diseases of the Adrenal Glands Addison’s disease Cushing’s syndrome Pheochromocytoma Diseases of the Pituitary Gland Acromegaly, gigantism Dwarfism Diabetes insipidus Lipid Disorders Hypercholesterolemia Hypertriglyceridemia Strategies for prevention of chronic diseases	Diabetes Mellitus Type 1 Type 2 Hypoglycemia Nonketotic hypoglycemic hyperosmolar coma Complications (kidney, renal, vascular, etc.) Self management Insulin management Sundowning, other syndromes

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**Diseases and Disorders of the Hematology System**
Anemias Aplastic anemia Vitamin B₁₂ deficiency Folate deficiency Iron deficiency G6PD deficiency Hemolytic anemia Sickle cell anemia Thalassemia	Coagulation disorders Factor VIII disorders Factor IX disorder Thrombocytopenia Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpura Von Willebrand’s disease	Malignancies Acute and chronic lymphocytic leukemia Acute and chronic myelogenous leukemia Lymphoma Multiple myeloma

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 Glucose tolerance Complete metabolic profile Liver panel Fenitin Coombs test: direct and indirect Hemoglobin electrophoresis CT with and without contrast MRI Renal function test	HgbA1c Reticulocyte count B12 level Red-cell folate Iron level TIBC Dexamethasone suppression test ACTH stimulation test Thyroid function test	PT Activated PTT Bleeding time Serum protein electrophoresis Bence-Jones proteinuria Philadelphia chromosome HDL, LDL, total cholesterol Triglycerides

**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 Foley catheter insertion