CARDIOVASCULAR DISORDERS
Congestive Heart Failure
- Identify atrial fibrillation, and determine appropriateness for anticoagulation.
- Diagnose new onset congestive heart failure, and understand the most appropriate tests in the work up for heart failure.
- Identify indications and thresholds for transfusing packed red blood cells in the setting of congestive heart failure.
- Recognize the primary cause of sudden cardiac arrest and the associated EKG findings.
- Discuss contraindications to beta-blocker use in the setting of congestive heart failure.
- Recognize peripartum cardiomyopathy and understand its appropriate treatment.
- Recognize signs of advanced heart failure.
- Diagnose heart failure with preserved ejection fraction.
- Diagnose heart failure with preserved ejection fraction and understand associated medical treatment.
- Determine appropriate use of beta-blockers in heart failure with reduced ejection fraction.
- Understand significant physical examination findings in congestive heart failure.
- Identify medicines to be avoided in patients with heart failure.
- Recognize the risk factors for congestive heart failure.
- Compare risk factors between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).
- Treat acute decompensated heart failure.
- Treat for acute decompensated heart failure.
- Recognize signs and symptoms of respiratory failure.
- Assess pharmacologic treatment for heart failure with reduced ejection fraction in the African American population.
- Select the medication that provides the greatest mortality benefit in patients with HFrEF.
- Select the prognostic indicators for congestive heart failure.
Endocarditis
- Identify the most common pathogens responsible for acute prosthetic valve infective endocarditis.
- Discuss appropriate empiric antibiotic coverage of infective endocarditis.
- Recognize that neurologic complications of infective endocarditis may present before the diagnosis is established.
- List common etiologies of infective endocarditis in pediatric populations.
- Discuss the diagnostic utility and limitations of the modified Duke criteria.
- Classify a patient using the modified Duke criteria.
- Characterize the cardiac sequelae of rheumatic fever, echocardiographic characteristics of infective endocarditis, and limitations of echocardiography as an imaging modality in this setting.
- Define the indications for emergent cardiac surgery in the setting of infective endocarditis.
- Identify the preferred initial evaluation when infective endocarditis is suspected.
- Recognize that antibiotic prophylaxis for infective endocarditis (is reserved for high-risk procedures only in certain, high-risk patients.
Ischemic Heart Disease
- List the contraindications to stress testing.
- Recognize that folic acid and hormone replacement therapy are not indicated for primary and secondary coronary artery disease (CAD) prevention.
- Manage hypercholesterolemia according to treatment guidelines for high cholesterol.
- Recognize that a stress test is not indicated to screen for CAD in low-risk asymptomatic patients.
- Identify the benefits of smoking cessation on CAD risk.
- Recognize acute coronary syndrome, Prinzmetal angina, syndrome X, Wellens syndrome, an ST segment elevation myocardial infarction (STEMI), new left bundle branch block, and non-traditional CAD risk factors.
- Calculate Thrombolysis in Myocardial Infarction risk score.
- Identify patients who would benefit the most from coronary artery bypass grafting.
- Medically manage stable angina.
- Identify and manage unstable angina/non-STEMI.
- Describe the mechanical complications from myocardial infarction.
- List the contraindications to thrombolytics in patients with STEMI.
- Recognize the digitalis effect on electrocardiography.
- Identify the symptoms of Wellens syndrome.
- Describe the medical regimen for patients with non–ST elevation myocardial infarction (STEMI).
- Diagnose STEMI based on electrocardiographic findings.
- List the contraindications to thrombolytics.
- Record the treatment options for an elderly patient with cardiac problems and altered mental status.
- Recognize the symptoms of pulmonary embolism in elderly patients following surgery.
- Diagnose septal infarct in an elderly patient with comorbidities and shortness of breath.
Pediatric Cardiovascular Disorders
- Measure blood pressure in children.
- Evaluate patients with Kawasaki disease and identify the complications of the condition.
- Diagnose Kawasaki disease, ventricular septal defect, and myocarditis in pediatric patients.
- Recognize the sequelae of rheumatic fever.
- Evaluate pediatric patients for heart murmur, exertional syncope and causes of hypertension.
- Differentiate chest wall pain from cardiac chest pain in adolescents.
- Identify the symptoms of hypertrophic obstructive cardiomyopathy.
- Discuss blood pressure screening in children.
- Discuss the causes of pericarditis in children.
- Recognize the physical findings of endocarditis and the presentation of mitral valve prolapse in children.
- Describe mitral insufficiency in children with rheumatic heart disease.
- Manage lipids in children with type 1 diabetes mellitus.
- Characterize aortic root pathology in patients with Marfan syndrome.
Vascular Disease
- Determine first-line treatment for lower extremity deep venous thrombosis (DVT).
- Select the minimum duration of enoxaparin treatment in patients with DVT.
- Evaluate the cutoff for ankle-brachial index diagnostic of peripheral arterial disease (PAD)
- Identify supervised exercise as a first-line treatment for claudication from PAD.
- Diagnose high-risk limb ischemia and fibromuscular dysplasia.
- Distinguish neurogenic from vascular claudication.
- Identify neurogenic claudication from vascular claudication.
- Diagnose and provide medical treatment to patients with neurogenic claudication.
- Identify integumentary changes associated with PAD.
- Recognize the ethnic group with the highest genetic predisposition to thromboangiitis obliterans.
ALLERGY AND IMMUNOLOGY
Auto-Immune Collagen Vascular Disorders
- Identify and manage Raynaud phenomenon.
- Manage eosinophilic pneumonia and mastocytosis.
- Characterize and manage eosinophilic esophagitis.
- Identify allergic interstitial nephritis, vasculitic skin ulcers, and hypersensitivity pneumonitis.
- Recognize the most sensitive and specific tests for diagnosing systemic lupus erythematosus.
- Describe the drugs that can induce lupus.
- Identify eosinophilia granulomatosis with polyangiitis (Churg-Straus syndrome).
Food Allergy
- Identify the symptoms of lactose intolerance.
- Recognize the management of influenza vaccination in patients with a history of egg allergy.
- Describe the difference between IgE-mediated food reactions and non-IgE-mediated food reactions.
- Recognize that an egg allergy is a relative contraindication to receiving yellow fever vaccine.
- Recognize that it is safe to provide iodinated contrast media in patients with a history of anaphylaxis to shellfish.
- Characterize and manage anaphylaxis.
- List food allergies that may play a role in eosinophilic esophagitis.
- Recognize that food allergies can be associated with atopic dermatitis.
- Diagnose celiac disease and recognize that patients with celiac disease may benefit from a gluten-free diet.
RHEUMATOLOGY, MUSCULOSKELETAL DISORDERS, AND SPORTS MEDICINE
Bone and Joint Infections
- Describe appropriate evaluation and testing in a patient with suspected discitis.
- Examine the emerging trends in osteomyelitis.
- Decide on the appropriate course of treatment in an immunocompromised patient with suspected septic olecranon bursitis.
- Describe clinically relevant testing for diabetic osteomyelitis.
- Identify the clinical features associated with trauma-related osteomyelitis.
- Describe the key factors associated with joint aspiration.
- Characterize appropriate strategies for joint fluid analysis.
- Select the most appropriate test for detecting early osteomyelitis.
- Describe the most effective site to culture for gonococcal septic arthritis.
- Define typical characteristics for the clinical presentation of septic arthritis.
- List the key factors involved with joint fluid analysis.
- Identify risk factors for Pseudomonas-associated osteomyelitis.
- Recognize causative organisms of osteomyelitis by age group.
- Examine the most common pathogen observed in osteomyelitis.
Deep Soft Tissue Infections
- Differentiate between periorbital/orbital cellulitis.
- Identify clinical presentation of necrotizing fasciitis.
- Manage clostridial myonecrosis.
- Differentiate diabetic muscle infarct from infections.
Rheumatoid Arthritis
- Correctly use lab techniques to help diagnose rheumatoid arthritis.
- Explain why anemia develops in rheumatoid arthritis.
- Know what disease-modifying antirheumatic drugs (DMARDs) can be used in monotherapy for any degree of rheumatoid arthritis.
- Recognize and treat side effects of methotrexate.
- Describe the implications for methotrexate use in pregnancy.
- Express the pathophysiology of rheumatoid arthritis and its treatments.
- Define the role of nonsteroidal anti-inflammatory drugs (NSAIDs) in rheumatoid arthritis.
- Explain the ramifications of obesity in rheumatoid arthritis.
- Know the risk factors for rheumatoid arthritis.
ENDOCRINOLOGY, DIABETES, AND METABOLISM
Pediatric Endocrine Disorders
- Diagnose acute adrenal insufficiency.
- Differentiate primary adrenal insufficiency (Addison disease) from secondary adrenal insufficiency.
- Recognize volume depletion and its correction as priorities in diabetic ketoacidosis.
- Develop a treatment plan for adolescents with type 2 diabetes mellitus.
- Employ all indicated vaccines in children with diabetes.
- Identify causes for early morning hyperglycemia.
- Diagnose diabetes.
- Discuss recommendations for the routine supplementation of vitamin D in infants.
- Evaluate and treat neonatal hypoglycemia.
- Advise patients with type 1 diabetes mellitus on their risk of hypoglycemia.
- Identify the manifestations of transient neonatal hypoglycemia.
- Recognize symptoms of pediatric hyperthyroidism.
- Interpret laboratory studies in a patient with hyperthyroidism.
- Assess laboratory data in a patient with hypothyroidism.
- Recognize and treat the female athlete triad.
- Implement screening for hyperlipidemia in children.
PSYCHIATRIC DISORDERS
Mood Disorders
- Diagnose major depression.
- Select the initial therapy for moderate depression.
- Recognize seasonal affective disorder.
- Discuss the role of light therapy in the treatment of seasonal affective disorder.
- Diagnose bipolar disorder II.
- Discuss the role of electroconvulsive therapy in the treatment of bipolar disorder I.
- Recognize that medical conditions can present with psychiatric manifestations in elderly patients.
- Recognize remission in patients with depression.
- Recognize the contraindications to treatment with lithium.
- Recognize the risks associated with antidepressant medication.
- Recognize the risks associated with pharmacotherapy for depression in suicidal patients.
- Recognize that there is a medication that has been shown to prevent suicide in patients with depression.
EYE, EAR, NOSE, AND THROAT
Pediatric Eye, Ear, Nose and Throat Disorders
- Recognize the manifestations of and treat Kawasaki disease.
- Diagnose and select appropriate treatment for otitis externa.
- Employ the optimal tooth-saving approach to the pediatric avulsion of permanent teeth.
- Recognize peritonsillar abscess and identify definitive treatment with aspiration or incision and drainage.
- Fully evaluate the eye for foreign bodies in cases of corneal abrasion.
- Treat corneal abrasions in pediatric patients.
- Accurately diagnose acute otitis media.
- Implement appropriate follow-up care for otitis media with effusion.
- Diagnose and manage dacryocystitis.
- Recognize and treat nasolacrimal duct obstruction.
- Apply current guidelines for the treatment of acute otitis media.
- Describe orbital cellulitis and differentiate it from other conditions.
- Differentiate between different types of conjunctivitis.
- Identify and appropriately refer patients with contact lens–associated keratitis.
- Describe the treatment of group A beta-hemolytic streptococcal pharyngitis and examine its rationale.
- Suspect infectious mononucleosis as a cause of pharyngitis.
- Differentiate sinusitis from viral upper respiratory infection.
- Use appropriate therapy for tympanostomy tube–associated otorrhea.
CHILD AND ADOLESCENT CARE
Childhood Immunizations
- Discuss the contraindications and reasons for deferring scheduled vaccinations.
- Explain which vaccinations are indicated and contraindicated in immunocompromised individuals and their caregivers.
- Describe the indications, administration schedule, and contraindications for meningococcal vaccine.
- Explain the indications, administration, and catch-up schedule for pneumococcal vaccine.
- Define the indications for a booster dose of tetanus vaccine.
- List the common and rare complications of vaccinations.
- Characterize the difference between attenuated vs inactivated vaccines and dosing schedule for polio vaccine.
- Explain the schedule of administration and contraindication of the measles, mumps, rubella, and varicella vaccines.
- Describe the postexposure prophylaxis for measles.
- Examine the indications, contraindications, and dosing administration schedule for rotavirus, human papillomavirus, hepatitis A to C virus, diphtheria, tetanus, and acellular pertussis, and Haemophilus influenzae type B vaccines.
- List the vaccinations that may be required for international travels.
Sexuality and Emotional Development
- Recognize the developmental markers of early, middle, and late adolescence.
- Distinguish between appropriate and inappropriate sexual behavior in preadolescents and adolescents.
- Describe appropriate parental counseling during adolescence.
- Discuss expected changes in brain anatomy among adolescents.
- Discuss the timing of and the factors influencing the development of concrete thinking and abstract reasoning in adolescents.
- Characterize the role of puberty in the psychosocial development of adolescents.
GERIATRIC SYNDROMES
Common Issues in the Elderly
- List the adverse events of alprostadil.
- Recognize the appropriate checking testosterone levels.
- Appropriately treat erectile dysfunction.
- Evaluate and improve nutritional status.
- Describe the indications and contraindications for vitamin supplementation.
- Identify the manifestations of acoustic neuroma.
- Advise elderly patients on sexual activity after myocardial infarction.
- List the contraindications for cataract surgery.
- Describe the measures necessary to help prevent age-related macular degeneration.
- Recognize food impaction as a cause of dysphagia.
- Describe the management of presbycusis.
Other Primary Geriatrics
- Characterize the appropriate management of osteoarthritis in the setting of obesity.
- Manage terminal delirium and restless leg syndrome.
- Recognize indications for hospice referral.
- Manage end-of-life care issues.
- Recognize and manage the signs and symptoms of Morton neuroma.
- Differentiate calluses from warts.
- Identify the signs and symptoms of obstructive sleep apnea.
- Examine commonly used antibiotics that interact with warfarin.
- Recognize the signs of elder abuse.
- Demonstrate how to manage a case of suspected elder abuse.
- Recognize and manage carotid stenosis.
EMERGENT/URGENT CARE
Wound Management
- Characterize the process for wound preparation and suture closures of lacerations on the lower extremities.
- Describe appropriate management and treatment options for domestic animal and human bites.
- Describe the correct technique of incision and drainage.
- Recognize incision and drainage alone as adequate treatment for mild abscesses.
- Describe the appropriate staple techniques used in various types of skin lacerations.
- Identify the 3 methods of nail trephination.
- Describe the correct technique for trephination
- Describe the correct techniques for limb and chest escharotomy.
WOMEN'S HEALTH AND MATERNITY CARE
General Approach to the Pregnant Patient
- Discuss the development of human chorionic gonadotropin (hGC)
- Identify abnormal physical examination findings in pregnant patients
- Define anemia in pregnant patients
HEMATOLOGY AND ONCOLOGY
Gynecologic Cancer
- Stage ovarian cancer according to the Federation of Gynecology and Obstetrics (FIGO) staging system.
- Counsel a patient regarding pregnancy and breastfeeding being associated with a lower risk for ovarian cancer.
- Identify the most effective screening tool for finding early-stage ovarian carcinomas.
- Treat invasive epithelial ovarian carcinoma.
- Recall the guidelines for surgical staging of ovarian cancer.
- Evaluate abnormal vaginal bleeding.
- Recall the guidelines for surgical staging of endometrial carcinoma.
- Stage endometrial cancer.
- Treat endometrial cancer with adjuvant radiotherapy.
Sickle Cell Disease
- Identify the genetics of sickle cell disease
- Vaccinate people with sickle cell disease against encapsulated organisms
- Recognize salmonella as a cause of osteomyelitis in sickle cell disease
- Recognize the indications for hydroxyurea in sickle cell disease
- Recognize acute aplastic crisis in sickle cell disease
NEPHROLOGY AND UROLOGY
Chronic Kidney Disease
- Recognize the most significant cause of morbidity and mortality in chronic kidney disease (CKD).
- Identify the most common cause of CKD.
- Recognize proteinuria as a marker of CKD.
- Summarize the role of angiotension-converting enzyme inhibitors in the preservation of kidney function in patients with CKD beyond the protection conveyed by lowering of blood pressure.
- Examine the risks of erythropoietin-stimulating agent use.
- Analyze the role that sodium-glucose cotransporter 2 inhibitors have in reducing the progression of diabetic renal disease.
- Appreciate metabolic acidosis in CKD and the importance of correcting it.
- Recognize uremic encephalopathy as a medical emergency requiring emergency dialysis.
- Diagnose peritonitis in patients receiving peritoneal dialysis.
- List the various complications of CKD.
- Account for renal function when managing diabetes with sulfonylureas.
NEUROLOGIC DISORDERS
Seizures
- Recognize medications which can precipitate withdrawal seizures
- Differentiating syncope versus seizures by clinical presentation
- Discuss the emergent management of pre-eclampsia and eclampsia
DERMATOLOGY
Pediatric Dermatology
- Characterize the presentations of infantile hemangioma, benign course of pityriasis rosea, and verruca vulgaris.
- Differentiate tinea faciei from other facial dermatologic conditions.
- Diagnose tinea capitis.
- Identify the risk associated with large congenital nevi.
- Describe the management of milia in a neonate.
- Describe the management of neonatal herpes simplex virus infection.
- Recognize the physical manifestations of erythema toxicum neonatorum, the course of action of nevus simplex (salmon patch), and the clinical presentation and natural history of Mongolian spots.
- Manage eczema in children.
- Summarize the effective management of moderate to severe inflammatory acne.
POPULATION-BASED CARE
Prevention of Cardiovascular Disease
- Assess the risk factors for and apply current guidelines to prevent cardiovascular disease (CVD).
- Recognize the effect and mechanism of action of aspirin in preventing CVD.
- Describe the role of new medications on the secondary prevention of CVD.
- Discuss the guidelines for the use of statins after a cardiac event.
Prevention of Infectious Disease
- Recognize which populations are appropriate for screening for chlamydia and gonorrhea.
- Discuss the benefits of early detection and treatment of gonorrhea and chlamydia.
- Describe the 2-step screening process for syphilis and identify which populations should be screened.
- Identify specific populations for which screening for hepatitis B and C viruses is recommended.
- Determine populations at risk for HIV infection.
- Discuss the primary modes of HIV transmission and know when to offer screening.