I.

Biostatistics
A. Meta-analysis is conducted by pooling the data from several studies to increase the
statistical power.
B. Effect modification is present when the effect of the main exposure on the outcome is
modified by the level of another variable. Separate measures of outcome should be
reported for each level of an effect modifier.
II. Cardiology
III. Dermatology
IV. ENT
A. Ingested batteries in the esophagus should be removed immediately under direct
endoscopic visualization. Batteries that have made it to the stomach usually pass
without complication and out-patient management is indicated.
B. Diphenhydramine is highly sedating and has anti-cholinergic properties. Because of the
effect of diphenhydramine on the level of alertness and coordination, use of the drug
must be discontinued before performing coordinated tasks such as driving, working on
machinery, flying planes or diving.
V. Electrolytes
VI. Endocrinology
A. Strict blood glucose control decreases the risk of developing a new neuropathy in
patients with type 1 and 2 diabetes. The effect of strict glycemic control on preexisting
neuropathy, although not entirely clear, appears to be beneficial.
VII. GI
VIII. GU
A. Dementia-associated urinary incontinence is a multi-factorial disorder that may not be
etiologically related to dementia itself. Care assessment of an individual patient and
revealing predisposing urinary tract and non-urinary tract conditions are important
because many of these conditions may be treatable.
B. Before considering peritoneal dialysis as a treatment option in patients with ADPKD, it is
important to rule out diverticulosis with colonoscopy.
IX. Heme-Onc
X. Hepatology
XI. ID
XII. Misc
XIII. Neurology
A. Vertebrobasilar insufficiency is typically secondary to emboli, thrombi, or arterial
dissection. The labyrinth and brainstem are commonly affected, and symptoms may
include vertigo, dizziness, dysarthria, diplopia, and numbness.
B. It is important to recognize vitamin B12 deficiency as a potential cause of delirium or
dementia in the elderly. Subtle lab findings, such as increased MCV and reticulocytes, or
pancytopenia, can help to identify this condition.
C. MS is best diagnosed with MRI. Findings on lumbar puncture support the diagnosis.
Evoked potentials are used to identify silent lesions.
D. Acute exacerbations of MS are treated with corticosteroids. Beta-interferon or glatiramer
acetate is used to decrease the frequency of exacerbations in patients with relapsing-
remitting or secondary progressive form of MS.
E. The best way of monitoring the disease activity of MS is with a repeat MRI 3 months
after the initial scan.
F. MS relapses are decreased during pregnancy and increased in postpartum.
Contraception is important if patients are taking disease-modifying agents; however,
therapeutic abortion is not indicated if they become pregnant with early exposure.
Vaccination with hepatitis B is not a risk for MS relapse.


G. The initial presentation of MS with optic neuritis or sensory symptoms carries a good
prognosis.
XIV. OBGYN
A. Inadequate (hypotonic) uterine contractions may lead to arrest disorders in the active
phase of labor. Contraction strength should be measured with an intrauterine pressure
monitor.
B. The clinical presentation of an acute abdomen (tenderness with rebound and guarding),
with a positive pregnancy test and no intrauterine pregnancy, is a surgical emergency.
The most likely diagnosis is a ruptured ectopic pregnancy with intraabdominal
hemorrhage.
XV. Ophthalmology
XVI. Pediatrics
A. GBS is a common and serious neonatal pathogen. Well-appearing infants at least 37
weeks gestational age born to mothers who did not receive adequate intrapartum
chemoprophylaxis may be observed for at least 48 hours without further investigation.
B. The diagnosis of herpes zoseter or varicella is made clinically. In immunosuppressed
patients (eg. HIV), the rash can be atypical and can be confused with herpes simplex. If
the patient is critical and antiviral therapy needs to be started, lesions can be scraped for
PCR or immunoflurescence studies.
C. RSV is the most important respiratory pathogen of early childhood and the major cause
of bronchiolitis and pneumonia in children < 1 year. RSV bronchiolitis occurs in annual
outbreaks, appearing in winter, with peaks in Jan-Mar.
XVII. Poisoning
XVIII. Preventive
XIX. Psychiatry
XX. Respiratory
XXI. Rheumatology
XXII. Surgery
A. CN III palsy is a typical finding in patients with a PCA aneurysm