Internal Medicine Correlations and Clinical Scenarios (CCS)
USMLE Step 3, 1st Edition
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Dedication
This book is dedicated to decreasing suffering.
Everyone who takes an action to ease the burden of suffering on our planet, no matter how small,
is my brother or sister. I send you my love.
CONTENTS
Preface
Introduction and How to Use This Book
List of Abbreviations and Acronyms
Chapter 1. Cardiology
Case 1. Pulmonary Edema
Case 2. Congestive Heart Failure
Case 3. Acute Coronary Syndrome
Case 4. Aortic Stenosis
Case 5. Mitral Stenosis
Case 6. Atrial Fibrillation
Case 7. Supraventricular Tachycardia, Ventricular Tachycardia, and Wolff-Parkinson-White
Syndrome
Case 8. Pericardial Tamponade
Case 9. Complete Heart Block
Case 10. Mitral Regurgitation
Case 11. Peripheral Arterial Disease
Case 12. Syncope
Chapter 2. Hematology
Case 1. Iron Deficiency Anemia
Case 2. Thalassemia
Case 3. Vitamin B12 Deficiency (Alcoholism, Peripheral Neuropathy)
Case 4. Sickle Cell
Case 5. Autoimmune Hemolysis
Case 6. Glucose-6-Phosphate Dehydrogenase Deficiency
Case 7. Paroxysmal Nocturnal Hemoglobinuria
Case 8. Hemolytic Uremic Syndrome and Thrombotic Thrombocytopenic Purpura
Case 9. Immune Thrombocytopenic Purpura
Case 10. Von Willebrand Disease
Case 11. Clotting Factor Deficiency
Case 12. Thrombophilia (Hypercoagulable States): Deep Venous Thrombosis and Heparin-Induced
Thrombocytopenia
Chapter 3. Endocrinology
Case 1. Diabetes—Initial Diagnosis and Treatment
Case 2. Diabetes—Prevention of Complications
Case 3. Diabetic Ketoacidosis
Case 4. Hypothyroidism
Case 5. Hyperparathyroidism
Case 6. Hypercortisolism
Case 7. Acromegaly
Case 8. Hyperaldosteronism
Case 9. Prolactinoma
Chapter 4. Neurology
Case 1. Stroke
Case 2. Parkinson Disease
Case 3. Myasthenia Gravis
Case 4. Subarachnoid Hemorrhage
Case 5. Guillain-Barré Syndrome
Case 6. Dementia
Case 7. Meningitis
Case 8. Head Trauma-Subdural
Chapter 5. Gastroenterology
Case 1. Gastrointestinal Bleeding
Case 2. Achalasia
Case 3. Gastroesophageal Reflux Disease
Case 4. Peptic Ulcer Disease
Case 5. Zollinger-Ellison Syndrome
Case 6. Inflammatory Bowel Disease
Case 7. Celiac Disease
Case 8. Hemochromatosis
Case 9. Pancreatitis
Chapter 6. Nephrology
Case 1. Acute Kidney Injury, Prerenal Azotemia (Dehydration)
Case 2. Acute Renal Failure (Rhabdomyolysis)
Case 3. Glomerulonephritis (Immunoglobulin A)
Case 4. Nephrotic Syndrome (Membranous)
Case 5. End-Stage Renal Failure and Dialysis
Case 6. Syndrome of Inappropriate Secretion of Antidiuretic Hormone
Case 7. Hypernatremia (Central Diabetes Insipidus)
Case 8. Hyperkalemia (Tumor Lysis Syndrome)
Case 9. Renal Tubular Acidosis
Case 10. Hypertension and Preventive Medicine
Chapter 7. Pulmonary
Case 1. Asthma
Case 2. Chronic Obstructive Pulmonary Disease
Case 3. Pneumonia
Case 4. Pneumocystis Pneumonia
Case 5. Tuberculosis
Case 6. Pulmonary Embolus
Case 7. Sarcoidosis
Case 8. Pulmonary Hypertension
Chapter 8. Rheumatology
Case 1. Rheumatoid Arthritis
Case 2. Ankylosing Spondylitis
Case 3. Sjögren Syndrome
Case 4. Gout
Case 5. Osteoarthritis
Case 6. Scleroderma
Case 7. Polymyositis-Dermatomyositis
Case 8. Systemic Lupus Erythematosus
Chapter 9. Oncology
Case 1. Breast Cancer
Case 2. Prostate Cancer
Case 3. Myeloma
Case 4. Polycythemia Vera
Chapter 10. Infectious Diseases
Case 1. Osteomyelitis
Case 2. Endocarditis
Case 3. Pyelonephritis
Case 4. Cellulitis
Case 5. Urethritis
Case 6. Syphilis
Case 7. Herpes Zoster: Shingles
Case 8. Infectious Diarrhea
Case 9. Malaria and Travel Medicine
Case 10. Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome
Chapter 11. Emergency Medicine
Case 1. Tricyclic Antidepressant Overdose
Case 2. Acetaminophen Overdose
Case 3. Aspirin Overdose
Case 4. Carbon Monoxide
Case 5. Ethylene Glycol and Methanol
Case 6. Organophosphates
Case 7. Spider Bite
Case 8. Digoxin Toxicity
Case 9. Drowning and Hypothermia
Case 10. Neuroleptic Malignant Syndrome
Index
PREFACE
Why did we go to medical school? What was the beautiful vision of yourself in the future, when you
set out to challenge obstacles, conquer barriers and commit yourself to medicine?
Hold On! You are ALMOST DONE!
The energy you need for your final push lies in the sacred vision you had of yourself when you
started. Go back. Go back in time and remember your MCAT and medical school application essay
and your personal statement for your residency application. I still have mine.
I wrote in flowery words about compressing all the desire of thousands of years of human history
in the single moment of cosmic understanding that allows us to heal the world, grow an immortal soul,
have a heart perfumed by love and bring into existence by our own constant work a better civilization
where there are no separate groups, and people live with hope, peace, art, music, science and
freedom from fear and pain.
My faculty advisor said, “Conrad, aren’t you weird enough already? Take that out of your
statement.”
I kept it in.
Go back to beginning. Don’t stop five minutes too soon. What you have in your hands will help
you.
Save the world. Save the world outside you with medicine. Save the world inside you with hard
work and eternally fragrant love.
Conrad Fischer, MD
