The Ultimate Medical School Rotation Guide

Preface
Acknowledgments
Introduction
Contents
Contributors
	Faculty Reviewers
	Student Reviewers
	Fellow Reviewer
	Resident Reviewers
1: Interpersonal Skills
	1.1	 Introduction
	1.2	 Sections
		1.2.1	 The Medical Learning Environment
		1.2.2	 The AMIGAS Framework
		1.2.3	 Suggestion Tables for Various Relationships and Scenarios
	1.3	 Special Topics
2: Wellness
	Reference
3: What Attendings and Residents Look For
	3.1	 Overview
	3.2	 The Unaltered Answers
	3.3	 Dissecting the Answers
		3.3.1	 Interpersonal Skills
		3.3.2	 Knowledge Base
		3.3.3	 Clinical Reasoning
		3.3.4	 Curiosity
		3.3.5	 Reliability
		3.3.6	 Honesty
		3.3.7	 Enthusiasm
		3.3.8	 Proactivity
		3.3.9	 Teamwork
		3.3.10	 Professionalism
	3.4	 Example Evaluations
	3.5	 Dealing with Negative Evaluations
	3.6	 Mid-Rotation Feedback
	3.7	 Concluding Remarks
4: Clinical Tips and Pearls
	4.1 General Rotation Considerations
	4.2 Feedback and Learning
	4.3 Pre-rounding
	4.4 History-Taking
	4.5 Physical Exam
	4.6 Objective Data
	4.7 Oral Presentation
		4.7.1	 General Tips
		4.7.2	 One-Liner
		4.7.3	 History of Present Illness
		4.7.4	 All Other History (Medical, Surgical, Medications, Social, etc.)
		4.7.5	 Vitals
		4.7.6	 Physical Exam
		4.7.7	 Objective Data
		4.7.8	 Assessment/Plan
	4.8 Note-Writing
	4.9 Calling a Consult
	4.10 Logistical Tips
5: EMR Tips and Tricks
	5.1	 Overview
	5.2	 Prior to the Rotation
		5.2.1	 Create Patient Lists
		5.2.2	 Smart Phrases
		5.2.3	 Dot Phrases
	5.3	 Daily Workflow
		5.3.1	 Creating Notifications
		5.3.2	 Chart Search
		5.3.3	 Chart Review Filters
		5.3.4	 Time Mark Results
			5.3.4.1	 Compare Labs to Baseline/Prior Values
		5.3.5	 Summary Tab
		5.3.6	 Copy Note
6: Internal Medicine
	6.1	 Overview
		6.1.1	 Setting Goals
		6.1.2	 Rotation Structure
		6.1.3	 Team Structure
	6.2	 Practical Tips
		6.2.1	 External Resources
		6.2.2	 Shelf Prep
		6.2.3	 Pre-rounding
			6.2.3.1	 Sign-Out
			6.2.3.2	 Pre-rounding
				Prior to Seeing Your Patients
				Pre-rounding Chart Review Checklist
				With the Patient
				After Seeing the Patients
		6.2.4	 Oral Presentation
			6.2.4.1	 One-liner
			6.2.4.2	 History of Present Illness (HPI)
			6.2.4.3	 Past History
			6.2.4.4	 Medications
			6.2.4.5	 Vital Signs
			6.2.4.6	 Physical Exam
			6.2.4.7	 Objective Data
			6.2.4.8	 Assessment/Plan
		6.2.5	 Rounding
		6.2.6	 EMR Setup
		6.2.7	 Calling Consults
			6.2.7.1	 Why Consult?
			6.2.7.2	 What Makes an Effective Consult?
		6.2.8	 Road to Discharge
	6.3	 Fundamentals
		6.3.1	 Basic Metabolic Panel (BMP)
		6.3.2	 Complete Blood Count (CBC)
		6.3.3	 Physical Exam
		6.3.4	 Bowel Regimen
		6.3.5	 IV Fluids
			6.3.5.1	 Fluid Choice
			6.3.5.2	 Volume
			6.3.5.3	 Rate
		6.3.6	 DVT Prophylaxis
		6.3.7	 Insulin Management
		6.3.8	 Approach to Supplemental Oxygen
		6.3.9	 When to Provide Supplemental Oxygen
	6.4	 Common Cases
		6.4.1	 Pneumonia (Question-Based Approach)
		6.4.2	 Pneumonia
			6.4.2.1	 Goals of Admission
			6.4.2.2	 Presentation
				History
				Exam
			6.4.2.3	 Workup
				Differentiating the Differential
			6.4.2.4	 Management
				Goals
				Treating the Infection
				Contingencies
			6.4.2.5	 When to Discharge?
		6.4.3	 COPD Exacerbation
			6.4.3.1	 Goals of Admission
			6.4.3.2	 Presentation
				History
				Exam
			6.4.3.3	 Workup
				Differentiating the Differential
			6.4.3.4	 Management
				Goals
				Treat the Inflammation
				Correct Oxygen Requirements
				Reduce Future Exacerbations
				Smoking Cessation
				Contingencies
			6.4.3.5	 When to Discharge?
		6.4.4	 Urinary Tract Infection (UTI)
			6.4.4.1	 Goals of Admission
			6.4.4.2	 Presentation
				History
				Exam
			6.4.4.3	 Workup
				Urinalysis (UA)
				Urine Culture (UCx)
				Differentiating the Differential
			6.4.4.4	 Management
				Goals
				Empiric Antibiotics
				Reduce Future UTIs
				Contingencies
		6.4.5	 Acute Kidney Injury
			6.4.5.1	 Goals of Admission
			6.4.5.2	 Presentation
				History
				Exam
			6.4.5.3	 Workup
			6.4.5.4	 Management
				Goals
				Restore Intravascular Volume
				Stabilize and Improve Renal Function
				Contingencies
			6.4.5.5	 When to Discharge?
			6.4.5.6	 Oral Presentation Pearls
		6.4.6	 Chest Pain Rule-Out Myocardial Infarction (CPROMI)
			6.4.6.1	 Goals of Admission
				Presentation
				History
				Exam
				General: No Acute Distress
			6.4.6.2	 Workup
				Differentiating the Differential
			6.4.6.3	 Management
				Goals
				Contingencies
			6.4.6.4	 When to Discharge?
		6.4.7	 Syncope
			6.4.7.1	 Goals of Admission
			6.4.7.2	 Presentation
				History
				Exam
			6.4.7.3	 Differentiating the Differential
			6.4.7.4	 Workup
			6.4.7.5	 Management
				Contingencies
			6.4.7.6	 When to Discharge?
		6.4.8	 Other Cases
7: General Surgery
	7.1	 Introduction
		7.1.1	 The Surgeon’s Mindset
		7.1.2	 Establishing Objectives
		7.1.3	 Learning in the OR
	7.2	 Clinical Knowledge
		7.2.1	 Resources
		7.2.2	 Content Checklist
		7.2.3	 Studying for Shelf
		7.2.4	 Studying for the Rotation
	7.3	 What to Expect
		7.3.1	 Before the Rotation
		7.3.2	 Team Roles
			7.3.2.1	 Attending Surgeon
			7.3.2.2	 Senior Resident
			7.3.2.3	 Junior Resident/Intern
			7.3.2.4	 Nurse Practitioner, Physician Assistants (Floor)
			7.3.2.5	 OR Physician Assistants and Nurse Practitioners
			7.3.2.6	 Scrub Nurse/Tech
			7.3.2.7	 Circulator
			7.3.2.8	 Anesthesia
		7.3.3	 Getting Started
		7.3.4	 Schedule
			7.3.4.1	 Sample OR Day
			7.3.4.2	 Sample Clinic Day
	7.4	 A Practical Guide
		7.4.1	 The Floor
			7.4.1.1	 Preparing for Rounds
			7.4.1.2	 Presenting on Rounds
			7.4.1.3	 Progress Notes
			7.4.1.4	 Handoffs/Sign-Outs
			7.4.1.5	 Consults
			7.4.1.6	 Discharge
		7.4.2	 The Operating Room
			7.4.2.1	 General Considerations
			7.4.2.2	 Pre-op
		7.4.3	 In the OR
		7.4.4	 Post-op
			7.4.4.1	 Post-op Check
	7.5	 The Clinic
		7.5.1	 New Patients
		7.5.2	 Follow-Up Visits
	7.6	 The Emergency Department
		7.6.1	 Admissions
		7.6.2	 Trauma
			7.6.2.1	 General Tips
			7.6.2.2	 What to Expect
			7.6.2.3	 Primary Survey
			7.6.2.4	 Secondary Survey
			7.6.2.5	 ED to OR
	7.7	 Technical Skills
		7.7.1	 References/Resources
		7.7.2	 Bedside Procedures
			7.7.2.1	 Chest Tube Placement
				Equipment Required (See 7 Sect. 7.6)
				Positioning
				Placing the Tube
			7.7.2.2	 Nasogastric Tube Placement
			7.7.2.3	 Additional Procedures
		7.7.3	 Operating Room Skills
			7.7.3.1	 Knot-Tying
				Two-Handed
				One-Handed
			7.7.3.2	 Suturing
				Types of Sutures
				Basic Stitches
			7.7.3.3	 Basics of Laparoscopy
				Camera Driving
				Entry/Port Sites
	7.8	 Conclusion
	7.9	 Examples
8: Obstetrics and Gynecology
	8.1	 Introduction
		8.1.1	 Overview
		8.1.2	 An Introduction to the Specialty
		8.1.3	 Before Your Rotation: Resources to Download or Subscribe to
		8.1.4	 OB-GYN Fundamentals
	8.2	 Obstetrics
		8.2.1	 OB Fundamentals
		8.2.2	 Prenatal Care
			8.2.2.1	 Preparing for OB Clinic
				Introduce Yourself (1–3 Days Before Clinic)
				Prep Your List (0–24 Hours Before Clinic)
				Learn and Shine (in Clinic)
			8.2.2.2	 Prenatal Care: Important Content and Checklists
				The New OB Visit
				The Return OB Visit
				Key Points for Pregnancy Counseling
				Common Complaints and Diagnoses During Pregnancy
				In Summary, to Prepare for and Shine in OB Clinic
				Antenatal Testing: Indications and Interpretations
		8.2.3	 Labor and Delivery
			8.2.3.1	 Signout
			8.2.3.2	 OB Triage
			8.2.3.3	 Common CCs in OB Triage
			8.2.3.4	 Key Terms/Definitions for the Labor Floor
			8.2.3.5	 Normal Labor
			8.2.3.6	 Fetal Monitoring
			8.2.3.7	 Presenting the OB Triage Patient: Template
			8.2.3.8	 Presenting the OB Triage Patient: Example
			8.2.3.9	 Intrapartum Fever: Differentiating the Differential
			8.2.3.10	 Intra-amniotic Infection (IAI)
			8.2.3.11	 The Vaginal Delivery
			8.2.3.12	 The Cesarean Delivery
			8.2.3.13	 Postpartum Hemorrhage (PPH)
			8.2.3.14	 The L&D Handoff/Signout: Checklist and Example
		8.2.4	 MFM (High-Risk Pregnancy): Select Conditions
			8.2.4.1	 Hypertensive Disorders of Pregnancy
			8.2.4.2	 Gestational Diabetes (GDM)
			8.2.4.3	 Preterm Labor (PTL)
			8.2.4.4	 PPROM (Preterm Pre-labor ROM)
		8.2.5	 Postpartum Care
			8.2.5.1	 Postpartum Fever: Differentiating the Differential
			8.2.5.2	 The Postpartum Visit
			8.2.5.3	 Postpartum Visit Checklist
	8.3	 Gynecology
		8.3.1	 GYN Fundamentals
		8.3.2	 Outpatient GYN
			8.3.2.1	 GYN Clinic Checklist
			8.3.2.2	 Common Outpatient GYN Conditions
				Well-Person Care
				Vulvovaginitis
				Chronic Pelvic Pain
				Abnormal Uterine Bleeding (AUB)
				DDX by Age
				Uterine Fibroids
		8.3.3	 Inpatient GYN
			8.3.3.1	 GYN Consults
				GYN Consult Checklist
			8.3.3.2	 Common Conditions
				Acute Pelvic Pain (. Fig. 8.14)
				Differentiating the Differential: Acute Pelvic Pain in the Reproductive-Age Patient
				Ovarian Torsion
				Pelvic Inflammatory Disease (PID)
			8.3.3.3	 Early Pregnancy Complications
				Differentiating the Differential: Vaginal Bleeding in a Patient with a Positive Pregnancy Test
				Ectopic Pregnancy
				Spontaneous Abortion (SAB)
			8.3.3.4	 The OR
				Anatomy Checklists
				Checklist: Preparing for the OR
				Checklist: Entering the OR and Setting Up
				Common Questions and Pearls for the OR
				Procedure-Specific Tips and Pearls
		8.3.4	 Postoperative Care
			8.3.4.1	 Post-op Check and SOAP Note
			8.3.4.2	 Pre-rounding Checklist
			8.3.4.3	 Presentation Example
			8.3.4.4	 Post-op Milestones (Discharge Checklist)
		8.3.5	 Select Subspecialty Topics in Gynecology
			8.3.5.1	 Family Planning
				Contraception
				Contraceptive Counseling
				Pregnancy Options Counseling
				Abortion
			8.3.5.2	 Pediatric and Adolescent Gynecology (PAGS)
			8.3.5.3	 Reproductive Endocrinology and Infertility (REI)
			8.3.5.4	 Urogynecology
				Urinary Incontinence
				Pelvic Organ Prolapse (POP)
			8.3.5.5	 Menopause
			8.3.5.6	 Gynecologic Oncology (GYN ONC)
				Cervical Cancer
				Endometrial Cancer
				Ovarian Cancer
	Appendix (. Table 8.6)
		OB Triage Note Template
9: Neurology
	9.1	 Overview
	9.2	 The Neurological Examination
		9.2.1	 Overview
		Box 9.1 The Steps to Performing the Core Neurological Examination
			Mental Status
			CN II-XII
			Motor Examination
			Sensory Examination
			Reflexes
			Cerebellar Examination
			Gait
		9.2.2	 The Mental Status Examination
			9.2.2.1	 Arousal
			9.2.2.2	 Attention
			9.2.2.3	 Memory
			9.2.2.4	 Language
			9.2.2.5	 Spokes
		9.2.3	 The Cranial Nerve Examination
			9.2.3.1	 Visual Fields (CN II)
			9.2.3.2	 Extraocular Movements (CN III, IV, VI)
			9.2.3.3	 Nystagmus
			9.2.3.4	 Facial Nerve (CN V)
			9.2.3.5	 Glossopharyngeal (CN IX) and Vagus Nerves (CN X)
			9.2.3.6	 Hypoglossal Nerve (CN XII)
		9.2.4	 The Motor Examination
			9.2.4.1	 Hyperkinetic Motor Findings
			9.2.4.2	 Strength Testing
		9.2.5	 Sensory Examination
		9.2.6	 Reflexes
			9.2.6.1	 Tips for Getting It Right
			9.2.6.2	 The Pectoral Jerk
		9.2.7	 Cerebellar (Coordination) Examination
			9.2.7.1	 Overview
			9.2.7.2	 Spoke Movements
		9.2.8	 Gait Examination
		9.2.9	 Non-neurological Examination
	9.3	 The Oral Presentation
		Box 9.2 Steps for the Oral Presentation on Your Neurology Rotation
		9.3.1	 One-Liner
		9.3.2	 History
		9.3.3	 Examination
		9.3.4	 Objective Data
		Box 9.3 The Approach to Interpreting Neuroimaging
		9.3.5	 Assessment
		9.3.6	 Plan
	9.4	 Common Cases
		9.4.1	 Delirium
			9.4.1.1	 Does This Patient Actually Have Delirium?
			9.4.1.2	 Is There an Identifiable Cause for Delirium?
			Box 9.4 Mnemonic for Causes of Delirium
			9.4.1.3	 Is This Patient Generally at Risk for Delirium?
			9.4.1.4	 Examination
			9.4.1.5	 Work-Up and Treatment
			9.4.1.6	 Treatment
		9.4.2	 Headache
			Box 9.5 Mnemonic for Causes of Secondary Headache
			9.4.2.1	 Work-Up and Treatment Approach
		9.4.3	 First Seizure
			9.4.3.1	 Did This Patient Have a Seizure?
			9.4.3.2	 Why Did the Patient Have a Seizure?
			Box 9.6 Mnemonic for Causes of Seizure
			9.4.3.3	 Is This Patient at Risk for a Second Seizure?
			9.4.3.4	 Examination
			9.4.3.5	 Work-Up
		9.4.4	 Bacterial Meningitis
			9.4.4.1	 Diagnosis
			9.4.4.2	 Examination
			9.4.4.3	 Work-Up and Management
	9.5	 Evidence-Based Neurology
		9.5.1	 POINT [5] Trial: Dual Antiplatelet Therapy for Secondary Prevention of Ischemic Stroke
		9.5.2	 SPARCL Trial [6]: Statin Therapy for Secondary Prevention of Ischemic Stroke
			9.5.2.1	 Takeaway
		9.5.3	 NINDS Trial [7]: Stroke
			9.5.3.1	 Takeaway
		9.5.4	 FIRST Trial [8]: Seizures
			9.5.4.1	 Takeaway
		9.5.5	 The Optic Neuritis Treatment Trial (ONTT) [9]: Multiple Sclerosis
			9.5.5.1	 Takeaway
	References
10: Pediatrics
	10.1	 Overview
		10.1.1	 History Taking
		10.1.2	 Past Medical History
		10.1.3	 Medication Choice
		10.1.4	 Medications to Avoid
		10.1.5	 Labs and Imaging
		10.1.6	 Family-Centered Rounding
		10.1.7	 How to Really Shine
		10.1.8	 Well-Child Visits
	10.2	 6-Month-Old Well-Child Visit
		10.2.1	 Subjective
		10.2.2	 Previous Immunizations
		10.2.3	 Objective
		10.2.4	 Assessment/Plan
	10.3	 Sick vs Not Sick
	10.4	 Approach to Acute Fever from Infection
	10.5	 Diseases
	10.6	 Infectious Complaints
		10.6.1	 Meningitis
		10.6.2	 Urinary Tract Infections
		10.6.3	 Sepsis
		10.6.4	 Acute Otitis Media
		10.6.5	 Conjunctivitis
		10.6.6	 Bronchiolitis
		10.6.7	 Croup
		10.6.8	 Influenza
		10.6.9	 Pneumonia
	10.7	 Atopy
		10.7.1	 Asthma
		10.7.2	 Atopic Dermatitis
	10.8	 Food Allergies
		10.8.1	 Food Protein-Induced Colitis
	10.9	 Strep Throat and Complications
		10.9.1	 Strep Pharyngitis
		10.9.2	 Rheumatic Fever
		10.9.3	 Post-Streptococcal/Infectious Glomerulonephritis
	10.10	 Skin Rashes
		10.10.1	 Tinea Corporis
		10.10.2	 Tinea Versicolor
		10.10.3	 Pityriasis Alba
		10.10.4	 Impetigo
		10.10.5	 Erythema Toxicum Neonatorum and Neonatal Cephalic Pustulosis
			10.10.5.1	 Erythema Toxicum Neonatorum
			10.10.5.2	 Neonatal Cephalic Pustulosis
	10.11	 Gastrointestinal Complaints
		10.11.1	 Physiologic Reflux
		10.11.2	 Pyloric Stenosis
		10.11.3	 Lead Exposure
		10.11.4	 Foreign Bodies
			10.11.4.1	 Foreign Body Ingestion
			10.11.4.2	 Foreign Body Aspiration
		10.11.5	 Viral Gastroenteritis
		10.11.6	 Constipation
	10.12	 Acute and Chronic Knee Pain
		10.12.1	 Acute Knee Pain
		10.12.2	 Fractures
		10.12.3	 Knee Strains and Sprains
		10.12.4	 Transient Synovitis
		10.12.5	 Septic Arthritis
		10.12.6	 Chronic Knee Pain
	10.13	 Seizures
		10.13.1	 Diabetic Ketoacidosis (DKA)
	10.14	 Example Day in Clinic
	10.15	 Example Day on a General Inpatient Service
	10.16	 Review Questions
		10.16.1	 Answers
11: Radiology
	11.1	 Overview
	11.2	 Recommended Resources
	11.3	 The Rotation
	11.4	 Fundamentals
		11.4.1	 The Black and White Language
		11.4.2	 Systematic Reading of CXRs
		11.4.3	 Image Quality (Mainly Applicable to X-rays)
			11.4.3.1	 Lines/Tubes
			11.4.3.2	 Bones
	11.5	 Common Images
12: Psychiatry
	12.1	 Introduction
	12.2	 The Interview
		12.2.1	 The Biopsychosocial Formulation
		12.2.2	 History
			12.2.2.1	 History of Present Illness (HPI)
				Informational Cues
				Interrupting Patients
				Setting Boundaries
		12.2.3	 History Checklist
		12.2.4	 Sensitive Topics
		12.2.5	 Handling Displays of Emotion
		12.2.6	 Safety
	12.3	 Verbal Aggression
		12.3.1	 Mental Status Examination (MSE)
		12.3.2	 Other Sources of Information
	12.4	 Clinical Vignette and Note Template
	12.5	 Inpatient Psychiatry Initial Note
	12.6	 Differentiating the Differential
	12.7	 A Day in the Life
		12.7.1	 Daily Task List
	12.8	 The Team
	12.9	 Common Errors
	12.10	 How to Stand Out
13: Primary Care
	13.1	 Overview
	13.2	 Fundamentals
		13.2.1	 Checkup Visits
			13.2.1.1	 Before the Visit
				Establishing the Baseline
			13.2.1.2	 During the Visit
			13.2.1.3	 After the Visit
		13.2.2	 Follow-Up Visits
			13.2.2.1	 Before the Visit
			13.2.2.2	 During the Visit
			13.2.2.3	 After the Visit
		13.2.3	 New Complaint
			13.2.3.1	 Before the Visit
			13.2.3.2	 During the Visit
			13.2.3.3	 After the Visit
	13.3	 Common Cases
		13.3.1	 Diabetes
			13.3.1.1	 New Diagnosis
				Goals of Visit
				Presentation
				Key Symptom Checklist
				Exam
				Labs
				Treatment
				Diabetic Treatment Checklist
			13.3.1.2	 Follow-Up Visits
				Goals of Visit
				Checking for Complications of Diabetes
		13.3.2	 Hypertension
			13.3.2.1	 Compliance and Why Hypertension Matters
			13.3.2.2	 New Diagnosis
				Goals of Visit
				Presentation
				Treatment
			13.3.2.3	 Follow-Up Visits
				Goals of Visit
		13.3.3	 Chronic Obstructive Pulmonary Disease (COPD)
			13.3.3.1	 Diagnosis
			13.3.3.2	 Treatment
		13.3.4	 Congestive Heart Failure (CHF)
			13.3.4.1	 Goal-Directed Medical Therapy
		13.3.5	 CAD Primary Prevention
		13.3.6	 Musculoskeletal Complaints
			13.3.6.1	 Presentation
			13.3.6.2	 Exam
			13.3.6.3	 Treatment
	13.4	 Screening
	13.5	 Vaccinations
14: Emergency Medicine
	14.1	 Introduction
		14.1.1	 Emergency Medicine Settings
		14.1.2	 First Day of Your Rotation
	14.2	 Before the Shift
	14.3	 During the Shift
		14.3.1	 Preparing for the Patient Encounter
		14.3.2	 The Patient Encounter
		14.3.3	 History of Present Illness
		14.3.4	 Review of Systems
		14.3.5	 Past Medical/Surgical History, Family History, Medications, Allergies and Social History
		14.3.6	 Physical Exam
		14.3.7	 Managing Patient Expectations
		14.3.8	 After the Patient Encounter
		14.3.9	 The Oral Presentation
		14.3.10	 Assessment and Plan
		14.3.11	 After the Oral Presentation
		14.3.12	 The Patient Note
		14.3.13	 Follow-Up and Reassessment
	14.4	 End and Beyond
		14.4.1	 Calling Consults
		14.4.2	 The Discharge
		14.4.3	 Signing Out Your Patient to Another Team Member/Pass-off
		14.4.4	 Final Tips
	14.5	 Most Common Emergency Department Chief Complaints
		14.5.1	 Chief Complaint: Chest Pain
			14.5.1.1	 Acute Coronary Syndrome
			14.5.1.2	 Aortic Dissection
			14.5.1.3	 Cardiac Tamponade
			14.5.1.4	 Esophageal Rupture
			14.5.1.5	 Pulmonary Embolism
		14.5.2	 Chief Complaint: Dyspnea/Shortness of Breath
			14.5.2.1	 Asthma
			14.5.2.2	 COPD
			14.5.2.3	 Congestive Heart Failure
			14.5.2.4	 Pneumonia
		14.5.3	 CC: Abdominal Pain
			14.5.3.1	 Acute Cholecystitis
			14.5.3.2	 Cholangitis
			14.5.3.3	 Pancreatitis
			14.5.3.4	 Appendicitis
			14.5.3.5	 Diverticulitis
			14.5.3.6	 Ectopic Pregnancy
			14.5.3.7	 Ovarian Torsion
			14.5.3.8	 Testicular Torsion
	14.6	 Additional Skills/Procedures to Learn About
		14.6.1	 Trauma/Resuscitation
		14.6.2	 Important Procedures
		14.6.3	 Laceration Repairs
		14.6.4	 Incision and Drainage (I&D)
		14.6.5	 Splinting
		14.6.6	 Ultrasound-Guided IV Placement
15: Critical Care
	15.1	 Overview
	15.2	 ICU Design and Cast of Characters
		15.2.1	 Nursing
		15.2.2	 Respiratory Therapy
		15.2.3	 Pharmacy
		15.2.4	 Primary Team
		15.2.5	 Medical Students
		15.2.6	 Schedule
		15.2.7	 Medical Student Routines
	15.3	 The ICU Patient
	15.4	 Fundamentals
		15.4.1	 A Review of the Data
		15.4.2	 ICU Assessment of Fluid Status
		15.4.3	 Oxygen Delivery Systems and Noninvasive Positive Pressure Ventilation
		15.4.4	 Basics of Mechanical Ventilation
		Box 15.1 Lung Protective Ventilation
		15.4.5	 Pressors and Inotropes
		15.4.6	 ICU Sedation and Analgesia
		15.4.7	 ICU Prophylaxis
	15.5	 Common ICU Procedures
		15.5.1	 Central Venous Access
		15.5.2	 Arterial Access/Invasive Hemodynamics
		15.5.3	 Intubation
		15.5.4	 Bronchoscopy with Bronchoalveolar Lavage
		15.5.5	 Extracorporeal Membrane Oxygenation (ECMO)
		15.5.6	 Lumbar Puncture
		15.5.7	 Thoracentesis
		15.5.8	 Paracentesis
		15.5.9	 Thoracic Ultrasound in the ICU
	15.6	 Common Cases
		Box 15.2 Common ICU Conditions
	15.7	 Acute Respiratory Failure
		15.7.1	 Hypoxemic Respiratory Failure and Acute Respiratory Distress Syndrome (ARDS)
		15.7.2	 Hypercapnic Respiratory Failure
	15.8	 Septic Shock
	15.9	 Helpful Tables
	15.10	 Common ICU Equations
		15.10.1	 Alveolar Gas Equation
		15.10.2	 Alveolar–Arterial Gradient
		15.10.3	 Dead Space Ventilation
		15.10.4	 Alveolar Ventilation
		15.10.5	 Ideal Body Weight Equation
		15.10.6	 Mean Arterial Pressure
		15.10.7	 Acid/Base Compensations
16: Cardiology
	16.1 Overview
	16.2 Fundamentals
		16.2.1 Heart Rate
		16.2.2 Blood Pressure
			16.2.2.1 Systolic Pressure
			16.2.2.2 Diastolic Pressure
			16.2.2.3 Mean Arterial Pressure (MAP)
			16.2.2.4 Pulse Pressure
		16.2.3 Oxygen Saturation
		16.2.4 Chest Pain and/or Pressure
		16.2.5 Shortness of Breath (SOB)
		16.2.6 Volume Status
			16.2.6.1 Jugular Venous Pressure
			16.2.6.2 Lower Extremity Edema
		16.2.7 Heart Auscultation
		16.2.8 Normal Heart Sounds
		16.2.9 Extra Heart Sounds
			16.2.9.1 Concerning Extra Heart Sounds
			16.2.9.2 Describing Extra Heart Sounds
			16.2.9.3 Insufficiency (Regurgitation) Murmurs
			16.2.9.4 Ejection Murmurs
			16.2.9.5 Other Murmurs
			16.2.9.6 Mechanical Valves
			16.2.9.7 Bioprosthetic Valves
			16.2.9.8 Gallops
			16.2.9.9 Rub
			16.2.9.10 Grading Murmurs
		16.2.10 Cardiac Anatomy
			16.2.10.1 Coronary Vasculature
			16.2.10.2 Heart Structure
		16.2.11 EKGs
			16.2.11.1 Rate
			16.2.11.2 Rhythm
			16.2.11.3 Axis
		16.2.12 PQRSTU Approach
		16.2.13 Common EKG Findings
			16.2.13.1 Sinus Arrhythmia
			16.2.13.2 Non-ST Segment Elevation Myocardial Infarction (N/STEMI)
			16.2.13.3 T Wave Inversions (TWI)
			16.2.13.4 Nonspecific T Wave Changes
			16.2.13.5 Atrioventricular (AV) Blocks
			16.2.13.6 Bundle Branch Blocks (BBB)
			16.2.13.7 Left Anterior Fascicular Block (LAFB)
			16.2.13.8 Left Atrial Enlargement
			16.2.13.9 Ventricular Hypertrophy
			16.2.13.10 Atrial and Ventricular Arrhythmias
			16.2.13.11 Atrial Fibrillation (Afib)
			16.2.13.12 Atrial Flutter
			16.2.13.13 Monomorphic Ventricular Tachycardia (Vtach)
			16.2.13.14 Premature Atrial/Ventricular Contractions (PAC/PVCs)
		16.2.14 Telemetry
		16.2.15 Pacemakers
		16.2.16 Echo
	16.3 Practical Tips
		16.3.1 Pre-Rounding
		16.3.2 Rounds
		16.3.3 Cardiology-Specific Oral Presentations
		16.3.4 Tasks
			16.3.4.1 Tasks to Consider
		16.3.5 Admissions/Consults
		16.3.6 Sign-Out
		16.3.7 Discharges
	16.4 Approach to Cardiac Disease
		16.4.1 Mechanics
			16.4.1.1 Diastole
			16.4.1.2 Systole
			16.4.1.3 Valvular Function
		16.4.2 Electrical Activity
			16.4.2.1 Electrical Signal Origin
			16.4.2.2 Transmission Integrity
		16.4.3 Reacting to Stress
	16.5 Acute Coronary Syndrome
		16.5.1 Differentiating the Differential
		16.5.2 Chart Review
			16.5.2.1 Chart Review Checklist
		16.5.3 History
		16.5.4 Examination
			16.5.4.1 ACS Physical Exam Checklist
		16.5.5 Initial Management
		16.5.6 Goals of Admission (Management)
			16.5.6.1 Risk Stratification for Early Invasive Therapy
			16.5.6.2 Determination of Coronary Blockage
			16.5.6.3 Revascularization
			16.5.6.4 Post-MI Heart Remodeling Prevention
			16.5.6.5 Secondary Prevention
			16.5.6.6 Other
		16.5.7 When to Discharge
	16.6 Heart Failure
		16.6.1 Heart Failure Exacerbation
		16.6.2 Causes of Heart Failure Exacerbation
		16.6.3 Differentiating the Differential
		16.6.4 Chart Review
		16.6.5 History
		16.6.6 Exam
		16.6.7 Objective Data
		16.6.8 Goals of Admission
			16.6.8.1 Determining the Cause of Current Exacerbation
			16.6.8.2 Optimizing Hemodynamics
			16.6.8.3 Clinical Pearls and Exceptions
			16.6.8.4 Twice-Daily (Morning, Afternoon) ADHF Diuresis Checklist
			16.6.8.5 Common Knowledge Questions
			16.6.8.6 Assessment/Plan Examples
		16.6.9 Optimizing Guideline-Directed Medical Therapy (GDMT)
	16.7 Arrhythmias
		16.7.1 Atrial Fibrillation
		16.7.2 Chart Review Checklist
		16.7.3 History
		16.7.4 Exam
		16.7.5 Goals of Admission
		16.7.6 Determining the Afib Etiology
		16.7.7 Controlling the Afib
		16.7.8 Anticoagulation
		16.7.9 Atrial Flutter
		16.7.10 Monomorphic Ventricular Tachycardia
		16.7.11 Goals of Admission
		16.7.12 EP Recs
		16.7.13 Ventricular Fibrillation (VFib)
		16.7.14 Atrioventricular (AV) Blocks
	16.8 Valvular Disease
		16.8.1 Replacement Valve Types
			16.8.1.1 Mechanical Valves
			16.8.1.2 Bioprosthetic Valves
			16.8.1.3 Surgical Versus Minimally Invasive Methods
			16.8.1.4 Aortic Stenosis
	16.9 Note Examples
17: Gastroenterology
	17.1	 Overview
	17.2	 Gastroenterology-Focused History
	17.3	 Gastroenterology-Focused Abdominal Exam
		17.3.1	 Appearance
		17.3.2	 Auscultation
		17.3.3	 Percussion
		17.3.4	 Palpation
		17.3.5	 Additions for Liver Disease
	17.4	 Unique Vocabulary
		17.4.1	 Scoring Systems and Calculations
		17.4.2	 Endoscopy Terminology
	17.5	 Lab Interpretation
		17.5.1	 Liver Function Test (LFT) Abnormalities
		17.5.2	 Viral Hepatitis Antibody Interpretation
			17.5.2.1	 Hepatitis A
			17.5.2.2	 Hepatitis B
			17.5.2.3	 Hepatitis C
	17.6	 GI-Specific Diagnostic Testing
	17.7	 Chief Complaints and Diagnoses: Approach To …
		17.7.1	 Abdominal Pain
		17.7.2	 Biliary Pathology
		17.7.3	 Diagnosis and Treatment
			17.7.3.1	 Peptic Ulcer Disease (PUD)
			17.7.3.2	 Intestinal Ischemia
		17.7.4	 Diarrhea
			17.7.4.1	 Watery Diarrhea
			17.7.4.2	 Fatty Diarrhea (Steatorrhea)
			17.7.4.3	 Inflammatory Diarrhea
		17.7.5	 Dysphagia
		17.7.6	 Gastrointestinal Bleeding
		17.7.7	 Upper GI Bleeding (UGIB)
		17.7.8	 Lower GI Bleeding (LGIB)
			17.7.8.1	 Colorectal Cancer (CRC) Screening
		17.7.9	 Liver Pathophysiology
			17.7.9.1	 Cirrhosis
			17.7.9.2	 Acute Liver Failure (ALF)
			17.7.9.3	 Alcohol-Related Hepatitis
			17.7.9.4	 Viral Hepatitis
	17.8	 Procedures
		17.8.1	 Digital Rectal Exam (DRE)
		17.8.2	 Diagnostic Paracentesis
		17.8.3	 Therapeutic (Large Volume) Paracentesis
18: Nephrology
	18.1 Overview
	18.2 Fundamentals
		18.2.1 Big Picture
		18.2.2 Urine Output (UOP)
		18.2.3 Glomerular Filtration Rate (GFR)
		18.2.4 Creatinine (Cr)
		18.2.5 Blood Urea Nitrogen (BUN)
		18.2.6 Sodium
		18.2.7 Urine Electrolytes
		18.2.8 Volume Status
		18.2.9 Fluid Choice
		18.2.10 Renal Replacement Therapy (Dialysis)
	18.3 Practical Tips
		18.3.1 Foley Management
		18.3.2 Urine Sediment
	18.4 Common Cases
		18.4.1 Acute Kidney Injury
			18.4.1.1 Treatment
		18.4.2 Electrolyte Disorders
		18.4.3 Sodium Disorders
			18.4.3.1 Hyponatremia
			18.4.3.2 Hypernatremia
		18.4.4 Potassium Disorders
			18.4.4.1 Hypokalemia
			18.4.4.2 Hyperkalemia
		18.4.5 Calcium Disorders
			18.4.5.1 Hypocalcemia
			18.4.5.2 Hypercalcemia
		18.4.6 Diuresis
			18.4.6.1 Loop Diuretics
			18.4.6.2 Thiazide Diuretics
			18.4.6.3 Potassium-Sparing Diuretics
			18.4.6.4 Diuresis Principles
			18.4.6.5 Strategies for Diuresis-Refractoriness
			18.4.6.6 Adverse Effects
			18.4.6.7 Electrolyte Balance
			18.4.6.8 Sulfa Allergy
		18.4.7 Cardiorenal Syndrome (CRS)
		18.4.8 Hepatorenal Syndrome (HRS)
		18.4.9 Acid–Base
			18.4.9.1 Primary Disturbance
			18.4.9.2 Compensation
			18.4.9.3 Metabolic Acidosis
			18.4.9.4 Anion Versus Non-anion Gap Metabolic Acidosis
			18.4.9.5 Management
			18.4.9.6 Metabolic Alkalosis
		18.4.10 Glomerular Disease
			18.4.10.1 Nephrotic Syndrome
			18.4.10.2 Nephrotic Diseases
			18.4.10.3 Nephritic Syndrome
19: Infectious Diseases
	19.1	 Overview
	19.2	 Fundamentals
		19.2.1	 Fever
		19.2.2	 Other Vital Signs
		19.2.3	 White Blood Cell (WBC) Count
		19.2.4	 CBC with Differential
		19.2.5	 ESR/CRP
		19.2.6	 Antibiotics
		19.2.7	 Antibiotics Checklist
		19.2.8	 Sensitivities (Sensis)
		19.2.9	 ID-Specific History
		19.2.10	 Chart Review
	19.3	 Microbes
		19.3.1	 Gram Positives
			19.3.1.1	 S. aureus
			19.3.1.2	 Coagulase-Negative Staph (CoNS)
			19.3.1.3	 Streptococci
			19.3.1.4	 Enterococci
			19.3.1.5	 Clostridium difficile
		19.3.2	 Gram Negatives
			19.3.2.1	 Pseudomonas (aeruginosa)
			19.3.2.2	 E. coli
	19.4	 Antimicrobials Review
		19.4.1	 Spectrum of Coverage
		19.4.2	 Beta-Lactams
			19.4.2.1	 Penicillins (The “OG Gram-Positive” Antibiotic)
			19.4.2.2	 Aminopenicillins (“Penicillin 2.0” – More Gram-Positive and Gram-Negative Coverage)
			19.4.2.3	 Beta-Lactamase-Inhibitor Combinations (“Penicillin 3.0” – Not Only Do We Get More Gram-Positive and Gram-Negative Coverage, But Most Importantly Anaerobic Coverage!)
			19.4.2.4	 Semisynthetic Penicillins (“The MSSA Drug”: Semisynesthetic with Two S’s as in MSSA)
			19.4.2.5	 Cephalosporins
			19.4.2.6	 Carbapenems
			19.4.2.7	 Monobactams (The “Second-Line Gram-Negative Beta-Lactam”)
			19.4.2.8	 Glycopeptides (The “Gram-Positive King”)
			19.4.2.9	 Linezolid and Daptomycin (The “Evil Twins of Vancomycin”)
			19.4.2.10	 Clindamycin (The “Gram-Positive and Anaerobe Antibiotic”)
			19.4.2.11	 Fluoroquinolones
			19.4.2.12	 Macrolides
			19.4.2.13	 Tetracyclines (The “King of Atypicals”)
			19.4.2.14	 Aminoglycosides
			19.4.2.15	 Bactrim (Trimethoprim-Sulfamethoxazole) (MRSA and PJP Prophylaxis)
			19.4.2.16	 Metronidazole (The “King of Anaerobes”)
			19.4.2.17	 Other Antimicrobials
			19.4.2.18	 Antibiotic Interactions Worth Remembering
			19.4.2.19	 Key Antimicrobial Recap
	19.5	 Top Infectious Disease Consults
		19.5.1	 Bacteremia
			19.5.1.1	 Identifying the Organism
			19.5.1.2	 Identifying the Source
			19.5.1.3	 Assessing for Complications
			19.5.1.4	 Identifying the Treatment
		19.5.2	 Endocarditis
		19.5.3	 Meningitis
		19.5.4	 Skin and Soft-Tissue Infections (SSTIs)
			19.5.4.1	 Cellulitis
			19.5.4.2	 Necrotizing Fasciitis
			19.5.4.3	 Diabetic Foot Infections (DFI)
		19.5.5	 Osteomyelitis
		19.5.6	 HIV/AIDS
			19.5.6.1	 Common Knowledge Questions
		19.5.7	 Recap Questions
		19.5.8	 Answers for Common Empiric Antibiotic Regimens
20: Anesthesia
	20.1 Introduction
		20.1.1 Anesthesiologists’ Role
		20.1.2 Anesthesia Training
		20.1.3 Exceling on the Anesthesia Rotation
	20.2 Fundamentals
		20.2.1 Machine (. Table 20.2)
		20.2.2 Suction (. Table 20.3)
	20.3 NG and OG Tubes
		20.3.1 Noninvasive and Invasive Monitoring (. Table 20.4)
	20.4 Pulse Oximetry
	20.5 Blood Pressure
	20.6 EKG
	20.7 Anesthetic Depth Monitoring
	20.8 Temperature Monitoring
	20.9 Train of Four (TOF)
	20.10 Urinary Catheters
		20.10.1 Airway Management (. Table 20.5)
	20.11 Bag-Mask Ventilation
	20.12 Laryngeal Mask Airways (LMAs)
	20.13 Intubation
		20.13.1 IV Access (. Table 20.7)
			20.13.1.1 Central Venous Access
			20.13.1.2 Arterial Lines
		20.13.2 Regional Blockade
			20.13.2.1 Peripheral Nerve Blocks
			20.13.2.2 Spinal Anesthesia
			20.13.2.3 Epidural Anesthesia
	20.14 Drugs, Drugs, Drugs
		20.14.1 Preinduction
		20.14.2 Induction
		20.14.3 Maintenance of Anesthesia
		20.14.4 Emergence
		20.14.5 Summary (. Table 20.14)
	20.15 A Day in the Life
		20.15.1 The Schedule
		20.15.2 The Night Before
		20.15.3 The Day
		20.15.4 Summary
	20.16 Conclusion
21: Radiation Oncology
	21.1	 Introduction to Radiation Oncology
		21.1.1	 What Is Radiation Oncology?
		21.1.2	 What Is Radiation Therapy?
		21.1.3	 How Do RT and Fractionation Work?
		21.1.4	 How Is the RT Dose Measured?
		21.1.5	 What Are the Various Types of Ionizing Radiation?
		21.1.6	 What Are the Various Delivery Techniques for EBRT?
		21.1.7	 What Are the Side Effects of RT?
	21.2	 Steps of Radiation Therapy: Role of Medical Students
		21.2.1	 What Is the Workflow for Receiving RT?
			21.2.1.1	 Consultation: How to Prepare
			21.2.1.2	 The Night Before
				Essential Components of Chart Review
				Preparing the Note
				Review of Literature
			21.2.1.3	 Seeing the Patient
			21.2.1.4	 Assessment and Plan
			21.2.1.5	 Simulation
			21.2.1.6	 Contouring
			21.2.1.7	 Treatment Planning and Quality Assurance
				Plan Generation
				Plan Evaluation
			21.2.1.8	 Treatment
				Radiation Delivery
				On-Treatment Visits (OTVs)
				History
				Physical Exam
				Laboratory Order
	21.3	 Disease Site Overview
		21.3.1	 Central Nervous System
			21.3.1.1	 Glioblastoma
			21.3.1.2	 Low-Grade Glioma
			21.3.1.3	 Meningioma
			21.3.1.4	 CNS-Associated Radiation Toxicity
		21.3.2	 Head and Neck
			21.3.2.1	 Nasopharyngeal Cancer
			21.3.2.2	 Oropharyngeal Cancer (OPC)
			21.3.2.3	 Oral Cavity Cancer
			21.3.2.4	 Laryngeal and Hypopharyngeal Cancers
			21.3.2.5	 Post-op Radiation Therapy for Head and Neck Cancers
			21.3.2.6	 Head and Neck-Associated Radiation Toxicity
		21.3.3	 Thoracic
			21.3.3.1	 Early-Stage (I–II) Non-small Cell Lung Cancer (NSCLC)
			21.3.3.2	 Small Cell Lung Cancer
			21.3.3.3	 Thoracic-Associated Radiation Toxicity
		21.3.4	 Breast
			21.3.4.1	 Ductal and Lobular Carcinoma In Situ
			21.3.4.2	 Early-Stage (I–II) Breast Cancer
			21.3.4.3	 Breast-Associated Radiation Toxicity
		21.3.5	 Gastrointestinal
			21.3.5.1	 Esophageal Cancer
			21.3.5.2	 Gastric Cancer
			21.3.5.3	 Pancreatic Cancer
			21.3.5.4	 Rectal Cancer
			21.3.5.5	 Anal Cancer
			21.3.5.6	 Gastrointestinal-Associated Radiation Toxicity
		21.3.6	 Genitourinary
			21.3.6.1	 Prostate Cancer
			21.3.6.2	 Prostate-Associated Radiation Toxicity
		21.3.7	 Gynecology
			21.3.7.1	 Cervical Cancer
			21.3.7.2	 Cervix-Associated Radiation Toxicity
		21.3.8	 Palliative
			21.3.8.1	 Brain Metastases
			21.3.8.2	 Bone Metastases
			21.3.8.3	 Spinal Cord Compression
	References
		Other Resources
22: Dermatology
	22.1	 Introduction
		22.1.1 Skin Structure
			22.1.1.1 Epidermis
			22.1.1.2 Dermis
			22.1.1.3 Subcutis
	22.2	 Fundamentals of Dermatology
		22.2.1 How to Approach a Skin Lesion
		22.2.2 Fitzpatrick Skin Type
		22.2.3 Basics of Dermatologic Therapy
			22.2.3.1 Topical Steroids
			22.2.3.2 Cryotherapy
			22.2.3.3 Wound Care
		22.2.4 Basics of Dermoscopy
			22.2.4.1 How to Use a Dermatoscope
			22.2.4.2 How to Describe What You See
		22.2.5 Other Clinical Exam Techniques
			22.2.5.1 Nikolsky Sign
			22.2.5.2 Diascopy
			22.2.5.3 Wood’s Lamp Skin Exam
		22.2.6 Diagnostic Tests by Clinical Presentation
		22.2.7 Skin Biopsies
	22.3	 Patient Clinical Encounter
		22.3.1 Oral Presentations
		22.3.2 Note-Writing
	22.4	 Differentiating the Differential
		22.4.1 Pigmented Lesions
			22.4.1.1 Melanoma
			22.4.1.2 Seborrheic Keratosis
			22.4.1.3 Other Conditions to Consider
		22.4.2 Scaly Patch
			22.4.2.1 Atopic Dermatitis
			22.4.2.2 Contact Dermatitis
			22.4.2.3 Psoriasis
			22.4.2.4 Seborrheic Dermatitis
			22.4.2.5 Other Conditions to Consider
		22.4.3 Non-melanoma Skin Cancer and Other Discrete Scaly or Smooth Papules
			22.4.3.1 Basal Cell Carcinoma
			22.4.3.2 Squamous Cell Carcinoma
			22.4.3.3 Actinic Keratosis
			22.4.3.4 Other Conditions to Consider
		22.4.4 Follicular-Based Papules/Pustules
			22.4.4.1 Acne
			22.4.4.2 Hidradenitis Suppurativa
			22.4.4.3 Other Conditions to Consider
		22.4.5 Erythematous Cheeks
			22.4.5.1 Rosacea
			22.4.5.2	 Other Conditions to Consider
		22.4.6 Lighter Skin Patches
			22.4.6.1 Vitiligo
			22.4.6.2 Other Conditions to Consider
		22.4.7 Leg Conditions
			22.4.7.1 Cellulitis
			22.4.7.2 Other Conditions to Consider
		22.4.8 Ulcers
			22.4.8.1 Pyoderma Gangrenosum
			22.4.8.2 Other Conditions to Consider
		22.4.9 Urticaria and Angioedema
			22.4.9.1 Table of Urticaria vs. Angioedema
		22.4.10 Blistering Diseases
			22.4.10.1 Pemphigus Vulgaris
			22.4.10.2 Bullous Pemphigoid
			22.4.10.3 Other Conditions to Consider
		22.4.11 Target and Targetoid Lesions
			22.4.11.1 Other Conditions to Consider
		22.4.12 Red/Violaceous Papules and Plaques
			22.4.12.1 Other Conditions to Consider
		22.4.13 Viral Exanthems
			22.4.13.1 Table of Important Viral Exanthems
		22.4.14 Drug Reactions
			22.4.14.1 Table of Cutaneous Drug Reactions
		22.4.15	 Erythroderma
		22.4.16	 Nail Disorders
			22.4.16.1 Onychomycosis
			22.4.16.2 Pigmentation in the Nail
			22.4.16.3 Other Conditions to Consider
		22.4.17	 Hair Loss
			22.4.17.1 Telogen Effluvium
			22.4.17.2 Alopecia Areata
			22.4.17.3 Other Conditions to Consider
23: Orthopaedic Surgery
	23.1	 Introduction
	23.2	 What Is the Role of an Orthopaedic Surgeon?
		23.2.1	 Clinic Days
		23.2.2	 OR Days
		23.2.3	 Emergency Department
		23.2.4	 Practice Settings
	23.3	 Useful Resources
		23.3.1	 Web-Based Services
			23.3.1.1	 Orthobullets
			23.3.1.2	 AO Surgery Reference
			23.3.1.3	 Digital Anatomy Atlas
		23.3.2	 Textbooks
			23.3.2.1	 Netter’s Concise Orthopaedic Anatomy
			23.3.2.2	 Surgical Exposures in Orthopaedics: The Anatomic Approach (Hoppenfeld, Surgical Exposures in Orthopaedics)
			23.3.2.3	 Pocket Pimped: Orthopaedic Surgery
			23.3.2.4	 Other Textbooks
		23.3.3	 Surgical Technique Guides
		23.3.4	 Zuckerman and Koval’s (Handbook of Fractures)
		23.3.5	 Rockwood and Green’s Fractures in Adults, Rockwood and Wilkin’s Fractures in Children (Three Volume Set)
		23.3.6	 Miller’s Review of Orthopaedics
		23.3.7	 VuMedi and the Orthopaedic Video Theater (OVT) from AAOS
	23.4	 A Typical Day: OR
		23.4.1	 Introduction
		23.4.2	 General
			23.4.2.1	 A Typical Day: Morning Rounds (. Fig. 23.1)
			23.4.2.2	 The Night/Day Before
			23.4.2.3	 During the Case
			23.4.2.4	 Do’s and Don’ts on Orthopaedic Services
			23.4.2.5	 Pimping
			23.4.2.6	 Closing/After the Case
			23.4.2.7	 In Between Cases
			23.4.2.8	 Ending the Day
	23.5	 A Typical Day: Clinic
		23.5.1	 The Night Before
		23.5.2	 During Clinic
	23.6	 A Typical Night: Call Nights
	23.7	 Procedure Guide
		23.7.1	 Supplies
		23.7.2	 Splint Rolling and Application
	23.8	 Compartment Syndrome
		23.8.1	 Splint Takedown
		23.8.2	 Cast Application
		23.8.3	 Fracture Reduction
24: Neurosurgery
	24.1	 Neurosurgery Mentality
	24.2	 The Neurosurgical Neuro Exam
	24.3	 How to Look at Images
		24.3.1	 Tips for Being Pimped
		24.3.2	 How to Read a Head CT
		24.3.3	 How to Read a Head MRI
		24.3.4	 How to Present Images on Rounds
	24.4	 Rounding
		24.4.1	 Pre-Rounding
		24.4.2	 On Rounds
		24.4.3	 Patient Presentations (. Table 24.15)
	24.5	 OR
		24.5.1	 Night Before the Case
		24.5.2	 Before Rounds
		24.5.3	 Before the Patient Rolls In
		24.5.4	 When the Patient Rolls In
		24.5.5	 During the Case
		24.5.6	 Technical Skills
		24.5.7	 Instruments and Proper Handling (. Table 24.22)
		24.5.8	 Pterional Cranial Exposure
		24.5.9	 Open Posterior Lumbar Approach
		24.5.10	 Minimally Invasive (MIS) Posterior Lumbar Approach
		24.5.11	 Closure
		24.5.12	 After the Case
	24.6	 Neuro ICU Essentials
		24.6.1	 Management of Post-Op Neurosurgical Patients
		24.6.2	 Postoperative DVT Prophylaxis (. Table 24.34)
		24.6.3	 Paroxysmal Sympathetic Hyperactivity (Storming)
		24.6.4	 ICP Management
		24.6.5	 Procedures
	24.7	 Consults
		24.7.1	 Consult 1: Malignant Cerebral Edema ISO MCA Infarction (. Table 24.38)
		24.7.2	 Consult 2: Intracerebral Hemorrhage (ICH) (. Table 24.40)
		24.7.3	 Consult 3: Traumatic Brain Injury (TBI)
		24.7.4	 Consult 4: Spontaneous SAH
		24.7.5	 Consult 5: New Brain Tumor (. Table 24.46)
		24.7.6	 Consult 6: Pituitary Tumor (. Table 24.47)
		24.7.7	 Consult 7: Shunt Evaluation (. Table 24.48)
		24.7.8	 Consult 8: Cauda Equina (. Table 24.49)
		24.7.9	 Consult 9: Spinal Cord Injury (SCI) (. Table 24.51)
	24.8	 Essential Cases
		24.8.1	 Case 1: Decompressive Hemicrani (“Crash Case”)
		24.8.2	 Case 2: MCA Aneurysm Clipping
		24.8.3	 Case 3: ACDF
			24.8.3.1	 Anesthesia
			24.8.3.2	 Field Prep
		24.8.4	 Case 4: Open Posterior Lumbar Laminectomy
		24.8.5	 Case 5: Ventriculoperitoneal Shunt Insertion
	24.9	 Resources
25: Ophthalmology
	25.1	 Introduction
	25.2	 High-Yield Abbreviations
	25.3	 High-Yield Anatomy
		25.3.1	 Eyelids
		25.3.2	 EOMs and Cranial Nerves
		25.3.3	 Globe
		25.3.4	 Conjunctiva/Sclera
		25.3.5	 Cornea
		25.3.6	 Uvea
		25.3.7	 Lens
		25.3.8	 Vitreous
		25.3.9	 Retina
		25.3.10	 Optic Nerve/Disc
		25.3.11	 Orbit
	25.4	 History, Exam, and Presentation
		25.4.1	 External Structures
		25.4.2	 Lids and Lacrimation
		25.4.3	 Conjunctiva and Sclera
		25.4.4	 Cornea
		25.4.5	 Anterior Chamber
		25.4.6	 Iris
		25.4.7	 Lens
		25.4.8	 Vitreous
		25.4.9	 Retina
	25.5	 High-Yield Investigative Tools and Resources for In-Depth Orientation
		25.5.1	 Conditions by Subspecialty
	25.6	 Cornea and Refractive
		25.6.1	 DtDx: Corneal Abrasion vs Corneal Ulcer
		25.6.2	 High-Yield Trials
		25.6.3	 Procedures for Further Review
	25.7	 Cataract and Lens
		25.7.1	 Grading of Nuclear Sclerotic Cataracts in Clinic
		25.7.2	 Topics for Further Review
	25.8	 Glaucoma
		25.8.1	 Options for Management
		25.8.2	 High-Yield Trials
		25.8.3	 Visual Field Findings in Glaucoma
		25.8.4	 Topics for Further Review
	25.9	 Pediatric Ophthalmology
		25.9.1	 Differentiating the Differential: Leukocoria
		25.9.2	 High-Yield Trials
		25.9.3	 Topics for Further Review
	25.10	 Trauma
		25.10.1	 Topics for Further Review
	25.11	 Neuro-ophthalmology
		25.11.1	 Differentiating the Differential: Cause of a Third Nerve Palsy
		25.11.2	 DtDx: NAION vs AAION
		25.11.3	 High-Yield Trials
		25.11.4	 Topics for Further Review
	25.12	 Retina
		25.12.1	 DtDx: Floaters
		25.12.2	 High-Yield Trials
		25.12.3	 Surgical Techniques and Topics for Further Review
	25.13	 Infection and Inflammation
		25.13.1	 DtDx: Preseptal vs Orbital Cellulitis
		25.13.2	 Options for Management of Uveitis
		25.13.3	 High-Yield Trials
		25.13.4	 Topics for Further Review
	25.14	 Oculoplastics
		25.14.1	 Surgical Techniques for Further Review
Index