ANSWERS cont’d

6.) C: Children with Down’s syndrome are at an increased risk for leukemia. A. One would expect a neutrophil predominance and elevated ESR with septic arthritis, as well as unilateral findings and a fever. The x-ray should show joint space widening. B. Toxic synovitis would have a normal WBC count and ESR. D. Pauciarticular juvenile rheumatoid arthritis should not cause WBC count elevation. E. Fussiness would not elevate the WBC count. 7.) D: This patient has porphyria cutanea tarda, characterized by blistering, increased hair on temples and cheeks, and no abdominal pain. The disease is transmitted via an autosomal dominant pattern, thus the similarity in her siblings. The urine of these patients fluoresces an orange-pink color under the Wood’s lamp as a result of increased uroporphyrins. A. A skin biopsy, often the gold standard for diagnosis in dermatology, would not be helpful in this case. B. Pemphigus vulgaris has immunofluorescence surrounding epidermal cells, showing a “tombstone” pattern; immunofluorescence in bullous pemphigoid shows a linear band around the basement membrane, with increased eosinophils in the dermis. Therefore, a skin biopsy with immunofluorescence would not be helpful. C. Although some dermatologic conditions have known chromosomal abnormalities, diagnosis usually is obtained clinically or through biopsy and only confirmed by chromosomal analysis. E. Urine porphyrobilinogen is the test for acute intermittent porphyria, which is associated with abdominal pain. 8.) E: Polycythemia vera is characterized by symptoms related to increased blood viscosity: headache, fatigue, and blurred vision. Pruritus classically occurs during showers and results from histamine release because of increased basophilia. Plethora, splenomegaly, and a high hematocrit level with normal morphology are also present in polycythemia vera. A. Hepatic failure may result in pruritus but would not be expected to result in the other findings. B. Chronic renal failure would result in a decreased hemoglobin and hematocrit. C. Idiopathic myelofibrosis results in a decreased hemoglobin level and abnormal morphology. Red cells are described as “teardrop cells.” D. An elevated platelet count is not present in this patient; therefore, this response is incorrect. 9.) D: Criteria for receiving influenza vaccine include age >50 years, presence of heart disease/lung disease, and those who work in high-risk environments such as health care workers. This patient fulfills both the age cutoff as well as the pulmonary disease criteria. A. This response fulfills none of the criteria. B. This patient is considered too young, and her controlled hypertension would not place her at risk. C. This patient would qualify if not for her allergy; the vaccine is made in eggs and is contraindicated in those with a chicken egg allergy. E. Well-controlled minor asthma would not call for a vaccine.

Too much to juggle?
Become more efficient with LWW Resources!

LOOK INSIDE FOR: I Tips from students who have been through it all I The best in review and rotations resources I Practice Q&A from Boards and Wards, Fourth Edition

For more information, contact your Lippincott Williams & Wilkins Publisher’s Representative. Available at your Health Science Bookstore.
Entire catalogue ©2009 Lippincott Williams & Wilkins

LWW has the Clerkship Resources to Cover All Your Needs.
See inside for resources in:
I INTERNAL MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8 I OBSTETRICS/GYNECOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 I PEDIATRICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,12 I PSYCHIATRY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 I SURGERY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-15 I EMERGENCY MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 I FAMILY/AMBULATORY MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 I INTRO TO CLINICAL MEDICINE/PATIENT INTERVIEWING . . . . . . . . . . . . . . . . . . . . . . 19 I NEUROLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 I RADIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 I FOR ALL ROTATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 I COMPREHENSIVE REVIEWS FOR USMLE STEPS 2 & 3 AND MCCQE PART 1 . . . . . . 23 I PRACTICE Q&A FROM BOARDS AND WARDS, FOURTH EDITION. . . . . . . . . . . . 24-28 You are about to embark on your clinical years after a lot of hard work in the classroom. The transition will be challenging, yet so rewarding! Take a look inside for some helpful advice directly from students who have been through it all. Get tips for interacting with patients and their families, being on rounds and on call, plus great studying strategies for your clerkship years! Contributors: Marissa Cohler NYU School of Medicine Class of 2010 Patrick Hanley Thomas Jefferson University-Jefferson Medical College Class of 2010 Edwin Ho University of Toronto Class of 2010 Arash Mozayan Isfahani Albert Einstein College of Medicine Class of 2009

INTERNAL MEDICINE
UNDERGROUND CLINICAL VIGNETTES STEP 2: INTERNAL MEDICINE I: CARDIOLOGY, ENDOCRINOLOGY, GI, HEMATOLOGY/ ONCOLOGY, 4E
Kim: 978-0-7817-6835-1 • 2007

IN A PAGE MEDICINE, 2E
Kahan: 978-0-7817-7035-4 • 2008 Quickly review etiology/pathophysiology, differential diagnosis, signs and symptoms, diagnostic evaluation, prognosis, and treatment options for over 250 diseases—all in an innovative 2-page spread.

UNDERGROUND CLINICAL VIGNETTES STEP 2: INTERNAL MEDICINE II: DERMATOLOGY, ID, NEPHROLOGY, UROLOGY, PULMONARY, RHEUMATOLOGY, 4E
Kim: 978-0-7817-6836-8 • 2007

IN A PAGE SIGNS & SYMPTOMS, 2E
Kahan: 978-0-7817-7043-9 • 2008 With its innovative design, you can review a detailed differential diagnosis and diagnostic workup for more than 175 of the most common clinical signs and symptoms— perfect for quick reference in the hospital!

BLUEPRINTS MEDICINE, 5E
Young: 978-0-7817-8870-0 • 2009 Concise, accurate, clinical high-yield content covers the essentials for rotation and USMLE review.

SOAP FOR INTERNAL MEDICINE
Uzelac: 978-1-4051-0436-4 • 2004 Features 75 clinical problems with each case presented in an easy-to-read, 2-page

BLUEPRINTS CLINICAL CASES IN MEDICINE, 2E
Li: 978-1-4051-0491-3 • 2006 Includes 60 symptom-based clinical cases— presents an efficient manner of cataloging symptoms, syndromes, and diseases.

“SOAP note” layout. HIGH-YIELDTM INTERNAL MEDICINE, 3E
Nirula: 978-0-7817-8169-5 • 2006 Provides a concise review in outline format of internal medicine for students during their rotation and while preparing for the USMLE Step 2.

IN A PAGE INPATIENT MEDICINE
Perkins: 978-0-7817-6499-5 • 2007 Provides a quick overview of diseases, “on call” complaints, and diagnostic procedures encountered in the inpatient setting.

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INTERNAL MEDICINE, cont’d
MEDICINE RECALL, 3E
Bergin: 978-0-7817-9414-5 • 2007 Two-column question and answer format with mnemonics and illustrations.

INTERNAL MEDICINE, cont’d
NMS MEDICINE CASEBOOK
Shah: 978-0-7817-8468-9 • Fall 2008 This case-based review covers all the core information medical students are expected to learn during their internal medicine clerkship and offers thorough preparation for end-of-rotation examinations.

GUIDE TO DIAGNOSTIC TESTING
Khan: 978-0-683-30725-2 • 2002

New!

ADVANCED MEDICINE RECALL
Bergin: 978-0-7817-7629-5 • 2008

KOCHAR'S CLINICAL MEDICINE FOR STUDENTS, 5E
Torre: 978-0-7817-6699-9 • 2008 Substantially revised, this text has been streamlined to focus on essential topics derived from the Clerkship Directors in Internal Medicine (CDIM) core curriculum guide and the USMLE™ Step 2 Clinical Knowledge (CK) content outline. New companion website offers access to the complete text plus 39 additional chapters, 300 board-format Q&As, physical examination videos and more!

THE 5-MINUTE CLINICAL CONSULT, 2010
Print, Website and PDA: 978-1-60547-013-9 • May 2009 Provides rapid-access information on the diagnosis, treatment, and follow-up of 715 medical conditions. This best-selling clinical reference is now packaged with a new, enhanced, quarterlyupdated Website and a quarterly-updated PDA version of the book.

POCKET MEDICINE, 3E
Sabatine: 978-0-7817-7144-3 • 2007 A handy summary of key clinical information designed to form the basis of an individual pocket notebook or to be integrated into one’s own notebook.

SAINT-FRANCES GUIDE TO INPATIENT MEDICINE, 2E
Saint: 978-0-7817-3728-9 • 2003 Problem-oriented approach: works from a symptom, sign, abnormal lab test or EKG forward, as opposed to working from the disease backward.

3E Available Fall 2009

BASIC ORTHOPEDIC EXAMS
Child: 978-0-7817-6333-2 • 2007 This pocket handbook for third- and fourth-year medical students and non-orthopedic clinicians is a quick, problem-focused tool for evaluating patients with musculoskeletal disorders. Includes online access to the fully searchable text.

HIGH-YIELD ACID BASE, 2E
Longenecker: 978-0-7817-9655-2 • 2006 This book provides a bridge between the acid-base physiology taught in the classroom and the evaluation of the patient on the wards.

TM

STEP-UP TO MEDICINE, 2E
Agabegi: 978-0-7817-7153-5 • 2008 Primary review tool to prepare students for both the internal medicine clerkship and the corresponding end-of-rotation examination. A wealth of illustrations, charts, tables, graphs, and mnemonics speed and supplement learning.

NMS MEDICINE, 6E
Wolfsthal: 978-0-7817-6975-4 • 2007 Offers a quick review of medicine in an outline format that allows rapid study and retention. Each chapter is followed by USMLE-style questions and answers. Includes online access to the complete text plus additional content and a comprehensive exam.

MEDICINE, 5E
Fishman: 978-0-7817-2543-9 • 2003 Crystal-clear and easy-to-read, this popular text focuses on the essential pathophysiology, diagnoses, and management of the most common clinical situations.

THE WASHINGTON MANUAL® OF MEDICAL THERAPEUTICS, 32E
978-0-7817-8125-1 • 2007 Gold Standard on current medical diagnosis and treatment.

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INTERNAL MEDICINE, cont’d
BLUEPRINTS CARDIOLOGY, 2E
Awtry: 978-1-4051-0464-7 • 2005 Covers the essentials that students need to know on cardiology and internal medicine rotations and while preparing for the USMLE.

IN A PAGE CARDIOLOGY
Prasad: 978-0-7817-6496-4 • 2006 Provides a quick overview of the most commonly seen cardiac diseases and disorders. Each disease is presented on a two-page spread in boxes with consistent headings.

Tips for working with other students, residents, attending physicians, and nurses
Marissa: Introduce yourself to everyone; including nurses with your name and say you're a medical student. It should always be the first thing you do when you step into the OR or need to ask for help with something. Arash: Respect your colleagues, try to learn from them and teach them when possible. Do not make other students look bad in front of residents or attendings. Be a team player. Always be positive and volunteer to make your resident’s life easier. They will love you for it, and it will be reflected in your evaluations. Be prepared to present cases in front of attendings. Make sure to do your homework beforehand. Show confidence, but with humility; arrogance is your enemy on wards. Patrick: You should try at all times to be nice to people during rotations. It seems pretty obvious, but in the craziness of the day it can be lost. A little bit of kindness can go a long way in making a good impression with the physicians, nurses, and other members of your team. You are being evaluated not just for your knowledge and skills but your interpersonal skills as well. It is a good idea to ask your residents and attendings what they want and expect from you in the beginning of a rotation that way you will not have any major surprises at the end of a rotation. Ask for feedback often if possible. Always volunteer to help and do procedures and answer questions with confidence. Edwin: My best advice for working with residents and attending physicians is to always know everything about your patients and do any work that you can handle yourself – aim to make their lives easier. When working with other students and staff on the wards, just play nice and remember your people skills.

SOAP FOR CARDIOLOGY
Awtry: 978-1-4051-0472-2 • 2006

DERMATOLOGY FOR THE BOARDS AND WARDS
Ayala: 978-0-632-04572-3 • 2001

HEMATOLOGY FOR MEDICAL STUDENTS
Schmaier: 978-0-7817-3120-1 • 2003 With its depth and concise format, this book serves as a thorough text, general reference, and is a valuable tool for the internal medicine clerkship rotation and exam.

ANTIBIOTIC BASICS FOR CLINICIANS: CHOOSING THE RIGHT ANTIBACTERIAL AGENT
Hauser: 978-0-7817-9464-0 • 2007 Designed for quick, easy comprehension, this handbook reference will assist medical students in understanding the rationale behind antibiotic selection for common bacterial pathogens and infectious disease presentations. Includes online access to the fully searchable text.

BLUEPRINTS INFECTIOUS DISEASES
Shah: 978-1-4051-0453-1 • 2005

INTERPRETATION OF DIAGNOSTIC TESTS, 8E
Wallach: 978-0-7817-3055-6 • 2006

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INTERNAL MEDICINE, cont’d
IN A PAGE INFECTIOUS DISEASE
McCue: 978-0-7817-6498-8 • 2006 Quickly scan this unique, visual reference for an instant overview of the most commonly seen infectious diseases.

OBSTETRICS/GYNECOLOGY
OBSTETRICS AND GYNECOLOGY, 6E
Beckmann: 978-0-7817-8807-6 • April 2009 Now published in collaboration with ACOG! Targets medical students needing information for the 6-8 week OB/GYN clerkship. All chapters have been thoroughly updated by a panel of Junior Fellows in the American College of Obstetricians and Gynecologists. A website offers access to the full text online and a question bank.

SOAP FOR OBSTETRICS AND GYNECOLOGY
Uzelac: 978-1-4051-0435-7 • 2004 Over 60 clinical problems with each case presented in an easy-to-read, 2-page “SOAP note” layout.

BLUEPRINTS POCKET GASTROENTEROLOGY
Grover: 978-1-4051-0470-8 • 2007

BLUEPRINTS UROLOGY
Zaslau: 978-1-4051-0400-5 • 2005

NMS OBSTETRICS AND GYNECOLOGY, 6E
Pfeifer: 978-0-7817-70712 • 2007 Offers a quick review of obstetrics and gynecology in an outline format that allows rapid study and retention. Includes online access to the complete text, case studies, and a comprehensive exam.

SOAP FOR UROLOGY
Zaslau: 978-1-4051-0451-7 • 2005

Tips for interacting with patients and their families
Marissa: If you don't know the answer, don't make it up. Tell the patient or patient's family that you will ask the resident and get back to them as soon as possible, and actually do it! Arash: Be respectful of your patients and their families. Try to be the best that you can be no matter how your patients act. Don't treat the disease; treat the person with the disease. Patrick: You should always approach the patient and their families with the utmost respect and honesty. If you do not know the answer to a question it is ok to simply say that. Especially in the inpatient setting realize that patients are pretty sick people and even though they may have a very interesting physical finding do not treat the patient like an exhibit on rounds. They are very aware of what is going on so recognize them and include the patient as much as possible. If you have the time take a few extra minutes each day to talk to and explain things to patients as they often have many questions, but their questions may not be answered by the resident or attending or they may not ask. Edwin: The most important part of interacting with patients and their families really is listening. Even if the issue is non-medical, good listening skills go a long way in helping you provide good care for your patients.

UNDERGROUND CLINICAL VIGNETTES STEP 2: OBSTETRICS AND GYNECOLOGY, 4E
Kim: 978-0-7817-6840-5 • 2007

BLUEPRINTS OBSTETRICS & GYNECOLOGY, 5E
Callahan: 978-0-78178249-4 • 2009 Concise, accurate, clinical high-yield content covers all you need to know for your rotation and USMLE review.

OBSTETRICS AND GYNECOLOGY RECALL, 3E
Bourgeois: 978-0-7817-7069-9 • 2007 Q&A format with questions on one side, answers on the other. Great for the wards.

HIGH-YIELDTM OBSTETRICS AND GYNECOLOGY, 2E
Sakala: 978-0-7817-9630-9 • 2005 This concise, outline formatted book serves as a preparation for USMLE examinations and for course review.

BLUEPRINTS CLINICAL CASES IN OBSTETRICS & GYNECOLOGY, 2E
Caughey: 978-1-4051-0490-6 • 2006

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Tips for pre-rounding, rounds

PEDIATRICS
UNDERGROUND CLINICAL VIGNETTES STEP 2: PEDIATRICS, 4E
Kim: 978-0-7817-6844-3 • 2007

Marissa: If you're asked about a patient's labs or physical exam findings and you didn't look them up or do the exam, just admit it and let the resident/attending know you will get back to them with the results right after rounds. Arash: Give yourself at least 30 minutes to pre-round. Print out an interesting paper regarding your patient's case to discuss during rounds. Volunteer to give a 5 minute presentation during next round. Try to learn as much as possible during rounds; the best way to remember a disease is to associate it with a person. Patrick: For rounds and pre-rounds make sure you “know” your patient. See the patient before and review all pertinent information or changes in their care. When presenting at rounds it is a good idea if you have time to practice beforehand. We accumulate a tremendous amount of information and it is a skill distilling the information down to what is pertinent to patient care. Many attendings and residents have different expectations on how they want patients presented so if you are unsure it is a good idea to ask. Edwin: Many physicians will round on patients differently, so ask for advice from other students or residents who have worked with your staff. If that information isn’t available, know your patients better than anyone else and try to have a good understanding of the major medical issues of each.

BLUEPRINTS PEDIATRIC INFECTIOUS DISEASES
Shah: 978-1-4051-0402-9 • 2004

IN A PAGE PEDIATRICS, 2E
Kahan: 978-0-7817-7045-3 • 2008 Featuring a uniquely visual two-page-spread design that is great for rapid reference or review, In a Page Pediatrics provides a quick overview of the diseases, symptoms, and injuries most commonly seen in children.

BLUEPRINTS PEDIATRICS, 5E
Marino: 978-0-7817-82517 • 2009 Concise, accurate, clinical high-yield content covers all you need to know for the USMLE and rotations.

BLUEPRINTS CLINICAL CASES IN PEDIATRICS, 2E
Londhe: 978-1-4051-0492-0 • 2006 60 symptom-based clinical cases present an efficient manner of cataloging symptoms, syndromes, and diseases.

IN A PAGE PEDIATRIC SIGNS & SYMPTOMS
Teitelbaum: 978-1-4051-0427-2 • 2004

SOAP FOR PEDIATRICS
Polisky: 978-1-4051-0434-0 • 2004 Features over 70 clinical problems with each case presented in an easy-to-read, 2-page “SOAP note” layout.

Tips for being on call
Marissa: Bring snacks and a book! Try to look busy. If you're sitting around, ask a resident if there's something you can help with. Just don't ask every 10 minutes...that's annoying. Arash: Find a quiet place to rest if you have time. Don't forget to bring a snack and a book to study. Patrick: Bring a book with you in case you have some down time. Always carry a few granola bars or snacks with you because you can never really be sure when you will have time to sit and eat. For overnight call find out what time the cafeteria closes if you plan on buying food so you do not miss dinner. Edwin: Take advantage of any learning opportunities that come up, such as assessing the change in a patient’s status or new consults. With that said, rest or study when you have free time!

BLUEPRINTS POCKET PEDIATRIC ICU
Schwarz: 978-1-4051-0485-2 • 2006 Introduces the care and management of patients as well as procedures and technology in a pediatric intensive care unit.

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PEDIATRICS, cont’d
PEDIATRICS FOR MEDICAL STUDENTS, 2E
Bernstein: 978-0-78172941-3 • 2002 Evaluative skills and a logical approach are honed in this problem-oriented approach to clinical practice designed to teach students the basics of pediatric clinical practice.

PSYCHIATRY
PEDIATRICS RECALL, 3E
McGahren: 978-0-78177118-4 • 2007 Rapid-fire Q&A review; perfect for the wards.

CLINICAL PSYCHIATRY ESSENTIALS
Roberts: 978-0-7817-7157-3 • Available June 2009 Easy to read and use, it provides an introduction to the field of psychiatry and features a wealth of learning tools to maximize comprehension. Each chapter integrates clinical case scenarios, clinical pearls, and study questions, making this an excellent resource for course study and exam preparation.

FIELD GUIDE TO PSYCHIATRIC ASSESSMENT & TREATMENT
Bauer: 978-0-7817-3758-6 • 2003 Field Guide to Psychiatric Assessment and Treatment is an invaluable diagnostic guide for the non-specialist practitioner.

BRS PEDIATRICS
Brown: 978-0-7817-2129-5 • 2004 This concise, outline formatted book serves as a preparation for USMLE examinations and for course review.

SCHWARTZ'S CLINICAL HANDBOOK OF PEDIATRICS, 4E
Zorc: 978-0-7817-7013-2 • 2008 Comprehensive, pocketsized clinical handbook covering all the information that a medical student would encounter during pediatric clinical rotation.

HIGH-YIELDTM PSYCHIATRY, 2E
Fadem: 978-0-7817-4268-9 • 2003 Provides a succinct review in outline format of psychiatry for students during their rotation and while preparing for the USMLE Step 2.

UNDERGROUND CLINICAL VIGNETTES STEP 2: PSYCHIATRY, 4E
Kim: 978-0-7817-6846-7 • 2007

PSYCHIATRY RECALL, 2E
Fadem: 978-0-7817-4511-6 • 2003

NMS PEDIATRICS, 5E
Dworkin: 978-0-7817-7075-0 • 2008 Presents material in a narrative outline with a concise yet comprehensive review. Study questions appear at the end of each chapter.

BLUEPRINTS PSYCHIATRY, 5E

NMS PSYCHIATRY, 5E
Thornhill: 978-0-7817-65145 • 2007 Offers a quick review of psychiatry in an outline format that allows rapid study and retention. Each chapter is followed by USMLE-style questions and answers. Includes online access to the complete text plus a comprehensive exam.

Order your Clerkship resources today!

Murphy: 978-0-7817-8253-1 • 2008 USMLE-style questions and answers with full explanations; Key Points in every section; and a color-enhanced design that increases the usefulness of figures and tables.

BLUEPRINTS CLINICAL CASES IN PSYCHIATRY, 2E
Hoblyn: 978-1-4051-0496-8 • 2007 60 symptom based clinical cases provide comprehensive USMLE review.

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SURGERY
STEP-UP TO SURGERY
McFadden: 978-1-60547-393-2 • 2008 The newest addition to the Step-Up series, Step-Up to Surgery serves as a premier resource for students preparing for both the surgery clerkship and the corresponding end-of-rotation examination.

SURGERY, cont’d
NMS SURGERY, 5E ESSENTIALS OF GENERAL SURGERY, 4E*
Lawrence: 978-0-7817-5003-5 • 2005 Provides the most need-to-know information about specific diseases and areas of surgery and meets all the guidelines of the Association of Surgical Educators.

BLUEPRINTS SURGERY, 5E
Karp: 978-0-7817-8868-7 • 2009 Concise, accurate, clinical high-yield content covering all you need to know for the USMLE and rotations.

Jarrell: 978-0-7817-5901-4 • 2007 Offers a quick yet thorough review of surgery in an outline format that facilitates rapid study and retention. It focuses on the essential information that students need to successfully complete their clerkship. Includes online access to the complete text plus a comprehensive exam.

ESSENTIALS OF SURGICAL SPECIALTIES, 3E*
Lawrence: 978-0-7817-5004-2 • 2006 Organized by specialty, the book explains the basic skills needed in nine core rotations and prepares students for their clerkship.

NMS SURGERY CASEBOOK
Jarrell: 978-0-7817-3219-2 • 2003 Presents a series format of surgical cases that begin with a clinical scenario and go through the decision-making process of patient management step-by-step. Great companion to NMS Surgery! *Both resources are available in a convenient package for students: 978-0-7817-7501-4

BLUEPRINTS ORTHOPEDICS
Cooper: 978-1-4051-0401-2 • 2005

BLUEPRINTS CLINICAL CASES IN SURGERY, 2E
Li: 978-1-4051-0493-7 • 2006

SOAP FOR ORTHOPEDICS
Gottlieb: 978-1-4051-0476-0 • 2005

BLUEPRINTS POCKET ANESTHESIOLOGY
Gaiser: 978-1-4051-0452-4 • 2006

SURGICAL RECALL, 5E
Blackbourne: 978-0-78177076-7 • 2008 Written in rapid-fire questionand-answer format, this popular resource enables quick study prior to surgical rounds. Purchasers of this edition will get both the print book and access to MP3 audio files of the entire text. All Q&A material will also be posted online in the form of electronic flashcards for self-quizzing.

BLUEPRINTS PLASTIC SURGERY
Taylor: 978-1-4051-0446-3 • 2004

ADVANCED SURGICAL RECALL, 3E
Blackbourne: 978-0-7817-7068-2 • 2007 Written in rapid-fire question-and-answer format with detailed illustrations of anatomic landmarks and surgical techniques.

IN A PAGE SURGERY
Kahan: 978-1-4051-0365-7 • 2003

UNDERGROUND CLINICAL VIGNETTES STEP 2: SURGERY, 4E
Kim: 978-0-7817-6847-4 • 2007

BRS GENERAL SURGERY
Crabtree: 978-0-683-30636-1 • 2000

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EMERGENCY MEDICINE
NMS CLINICAL MANUAL OF EMERGENCY MEDICINE, 2E
Biddinger: 978-0-7817-3551-3 • 2002 Contains condensed information that provides quick access protocols and extensive treatment modalities for ER medicine.

BLUEPRINTS CLINICAL CASES IN EMERGENCY MEDICINE, 2E
Silvers: 978-1-4051-0497-5 • 2006 Case-based learning presents an efficient manner of cataloging symptoms, syndromes, and diseases. 60 symptom-based clinical cases provide comprehensive USMLE review.

Reading/Studying Strategies
Marissa: There's much less free time to study than during the pre-clinical years. I recommend always having a book with you that you can read during down time, even if it's just 10 minutes. References that fit into your white coat are a plus! Arash: Read about each of your patients’ diseases right after you see them. Study as much as you can at the beginning of the rotation so you can be better prepared on the wards. Make a schedule to study everyday and stick to it. It is hard to study when you're tired from a long day on the wards, so give yourself a break, use the gym or see your friends, or take a nap so you can be refreshed. Don't forget to save some time to relax. You'll be more productive. Patrick: Always read about the diseases that are affecting the patients you are following. It helps you look good in rounds and improves patient care, and it will be easier to remember the information in the long term with a patient context. Try to read a little bit everyday, over time it adds up to a tremendous amount of information. Set a goal and try to stick to that goal whatever it is each day. Edwin: Reading around cases is a great way to remember information well, but won’t necessarily cover everything you need to know. It’s probably best to combine this with a core topics reading schedule. At the end of the day, go with what works best for you - you’ve already made it this far in school and probably have a good idea of how you study best.

NMS EMERGENCY MEDICINE, 2E
Plantz: 978-0-7817-8884-7 • 2006 Completely revised to reflect current research and the demands of today’s students, the second edition of NMS Emergency Medicine focuses on the most essential information that students need to successfully complete their emergency medicine clerkship.

ICU RECALL, 3E
Tribble: 978-0-7817-76530 • 2009 This edition includes new techniques for cardiac support, renal support, and immunosuppression and thoroughly updated information on pharmacology, radiology, and monitoring.

IN A PAGE EMERGENCY MEDICINE
Caterino: 978-1-4051-0357-2 • 2003

TOXICOLOGY RECALL BLUEPRINTS EMERGENCY MEDICINE, 2E
Mick: 978-1-4051-0461-6 • 2005 Covers the essentials of emergency medicine that students need to know during their rotation and while preparing for the USMLE. Provides the most common acute conditions first, followed by a systems-based approach to emergency medicine. Holstege: 978-0-7817-9089-5 • 2009 Offers a complete yet concise review of clinical toxicology.

Favorite resources
Marissa: Blueprints Obstetrics and Gynecology & Step-Up to Medicine Arash: The Washington Manual of Medical Therapeutics was essential during my medicine rotation. I took it everywhere, used it for my presentations and for the shelf. I started every rotation by reading the Blueprints series, as it is very easy to read and covers the main subjects. Surgical Recall was always in my pocket. The question and answer format make it very easy to use whenever you have a few minutes to study, ex: between cases in the OR. Patrick: For third year you should always have Pocket Medicine in your coat at all times it will save you on rounds especially with internal medicine. For review during clerkships the Blueprints series, the Underground Clinical Vignettes series, and the Step-Up series were really helpful for me for different rotations. Look at each and see which one fits your learning style best. It is always a good idea to have a question book and the NMS series was very helpful for board review questions. Edwin: I really like that the Pocket Medicine handbook is a concise and organized resource that you can have with you all the time. For the diagnostic and treatment approach to common chief complaints and referrals, I find The Washington Manual series extremely helpful.

INTRODUCTION TO EMERGENCY MEDICINE
Mitchell: 978-0-7817-3200-0 • 2005 Covers basic principles commonly found in the introduction to emergency medicine course. Comprised of five sections, diagnosis and management is presented from an emergency medicine perspective. Includes 75 case-based clinical vignettes.

UNDERGROUND CLINICAL VIGNETTES STEP 2: EMERGENCY MEDICINE, 4E
Kim: 978-0-7817-6834-4 • 2007

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FAMILY MEDICINE
ESSENTIALS OF FAMILY MEDICINE, 5E
Sloane: 978-0-7817-8188-6 2007 This updated Fifth Edition continues to serve as a comprehensive introduction to family medicine. Its user-friendly style makes the book a lasting companion tool to approaching diagnoses and treating common problems. Includes online access to the complete text plus a comprehensive exam.

SOAP FOR FAMILY MEDICINE
Maldonado: 978-1-4051-0437-1 • 2004 Features 90 clinical problems with each case presented in an easy-to-read, 2-page “SOAP note” layout.

INTRO TO CLINICAL MEDICINE/ PATIENT INTERVIEWING
BATES' GUIDE TO PHYSICAL EXAMINATION AND HISTORY TAKING, 10E
Bickley: 978-0-7817-8058-2 • 2009 Features a beautiful full-color art program and a clear, simple two-column format, with highly visual step-by-step examination techniques on the left and abnormalities with differential diagnoses on the right.

FIELD GUIDE TO THE DIFFICULT PATIENT INTERVIEW, 2E
Platt: 978-0-7817-4774-5 • 2004 Written by physicians skilled at coaching colleagues in physician-patient communication, this pocket guide presents practical strategies for handling difficult patient interviews.

NMS Q&A: FAMILY MEDICINE
Rudy: 978-0-7817-9188-5 • 2007 Contains about 500 review questions, answers, and explanations typical of those found on the USMLE Step 2 examination.

BLUEPRINTS CLINICAL CASES IN FAMILY MEDICINE, 2E
Chang: 978-1-4051-0495-1 • 2006 Each case consists of a clinical vignette followed by thought questions and discussion, and ends with a question-and-answer review and a listing of suggested additional reading.

BLUEPRINTS FAMILY MEDICINE, 2E
Lipsky: 978-1-4051-0456-2 • 2005 Covers the essentials of family medicine that students need to know during their rotation and while preparing for the USMLE.

FIELD GUIDE TO BEDSIDE DIAGNOSIS, 2E
Smith: 978-0-7817-8165-7 • 2006 Covers 139 chief complaints and signs and is organized to parallel the diagnostic reasoning process: a differential overview of probable causes, a diagnostic approach for each differential, and the specific clinical findings that point to diagnosis.

BATES' POCKET GUIDE TO PHYSICAL EXAMINATION AND HISTORY TAKING, 6E
Bickley: 978-0-7817-8066-7 • 2009

AMBULATORY MEDICINE
IN A PAGE AMBULATORY MEDICINE
Kahan: 978-0-7817-6495-7 • 2007 Provides a quick overview of the diseases, symptoms, and injuries most commonly seen in outpatient settings. Each disease is presented on a two-page spread in boxes with consistent headings.

BLUEPRINTS CLINICAL PROCEDURES
Marbas: 978-1-4051-0388-6 • 2004 Combines almost 300 color photos with clear, step-bystep instructions for nearly 100 commonly performed procedures.

PATIENT-CENTERED INTERVIEWING: AN EVIDENCEBASED METHOD, 2E
Smith: 978-0-7817-3279-6 • 2001 Provides practical, how-to guidance on every aspect of physician-patient communication.

SAINT-FRANCES GUIDE: CLINICAL CLERKSHIPS IN OUTPATIENT MEDICINE, 2E
Bent: 978-0-7817-6502-2 • 2007 Organized by chief complaint, this pocket-sized manual provides a concise approach to problems commonly encountered in an outpatient setting. Its practical outline format and user-friendly features guide students through diagnosis, history-taking, tests, treatment, and patient management.

THE WASHINGTON MANUAL® OF AMBULATORY THERAPEUTICS
Book: 978-0-7817-2361-9 • 2002 PDA Version: 978-0-7817-3866-8 • 2002

FUNDAMENTALS OF CLINICAL MEDICINE, AN INTRODUCTORY MANUAL, 4E
Chaudhry: 978-0-7817-5192-6 • 2004 This convenient handbook offers a crucial link between basic sciences years and the hospital experience. Includes concise disease pathophysiology reviews.

6E Available THE ONLY EKG Fall 2009 BOOK YOU’LL EVER NEED, 5E

Thaler: 978-0-7817-7315-7 • 2006 This popular and practical text presents all the information clinicians need to use the EKG in everyday practice.

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NEUROLOGY
BLUEPRINTS NEUROLOGY. 3E
Drislane: 978-0-78179685-9 • 2009 Key Points highlight the most important, high-yield information. 100 boardformat questions and answers with complete correct and incorrect answer explanations appearing at the end of the book.

RADIOLOGY
NEUROLOGY RECALL, 2E CLINICAL RADIOLOGY-THE ESSENTIALS, 3E
Daffner: 978-0-7817-99683 • 2007 Written for medical students by an experienced educator, this text covers the topics most often included in introductory radiology courses in an easy-to-read format. Organized by organ system, the text presents technical, anatomic, and pathologic aspects of each region, featuring high quality illustrations. Includes online access to the fully searchable text.

RADIOLOGY RECALL, 2E
Gay: 978-0-7817-6559-6 • 2007 Q&A format with questions on one side, answers on the other. Includes up-to-date info on CT, PET, interventional radiology and nuclear medicine

Miller & Fountain: 978-07817-4588-8 • 2003 The book is written by residents and clinicians and facilitates rapid review and memorization with a concise question-andanswer format covering the basic and specialized areas of neurology.

RADIOLOGY 101, 2E
Erkonen and Smith: 978-07817-5198-8 • 2004 Provides the basic groundwork necessary for interpreting imaging studies and understanding the functions of the various imaging modalities.

UNDERGROUND CLINICAL VIGNETTES STEP 2: NEUROLOGY, 4E
Kim: 978-0-7817-6837-5 • 2007 Presents 75 patient cases-each case proceeds from chief complaint through diagnostic workup and treatment and includes buzzwords in history taking, physical examination, laboratory tests, imaging, and pathology.

WEINER AND LEVITT'S NEUROLOGY, 8E
Rae-Grant: 978-0-78178154-1 • 2008 Succinct, symptomoriented pocket guide to the diagnosis, treatment, and management of common neurologic disorders. Each chapter opens with a clinical case study and proceeds to classification of symptoms, history, physical examination, laboratory tests, differential diagnosis, diagnosis, treatment, and management.

BLUEPRINTS RADIOLOGY, 2E
Uzelac: 978-1-4051-0460-9 • 2005 Covers the essentials that students need to know on rotations and while preparing for the USMLE.

BLUEPRINTS CLINICAL CASES IN NEUROLOGY, 2E
Sheth: 978-1-4051-0494-4 • 2006 Case-based learning presents an efficient manner of cataloging symptoms, syndromes, and diseases. 60 symptom-based clinical cases provide comprehensive USMLE review.

SOAP FOR NEUROLOGY
Lin: 978-1-4051-0457-9 • 2005 Be sure to see pages 24-28 for Practice Q&A from Boards and Wards, Fourth Edition

Order your Clerkship resources today!

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FOR ALL ROTATIONS
BOARDS AND WARDS: A REVIEW FOR USMLE STEPS 2&3, 4E
Ayala: 978-0-7817-8743-7 • 2009 This best-selling review book provides exactly what you need to navigate the clinical years of your medical training and Steps 2 and 3 of the USMLE. It is written in a consistent outline format designed to fit in your coat pocket.

Available July 2009!

COMPREHENSIVE REVIEWS FOR USMLE STEPS 2 & 3 AND MCCQE PART 1
Step 2 CK & CS
Clement: Blueprints Q&A for Step 2 • 978-0-7817-7820-6 Feibusch: Prescription for the Boards, 3E • 978-0-7817-3400-4 Ibsen: NMS Review for USMLE Step 2 CK, 3E • 978-0-7817-6522-0 Ryan: USMLE Step 2 Recall • 978-0-7817-8850-2 Van Kleunen: Step-Up to USMLE Step 2, 2E • 978-0-7817-7156-6 Zaslau: Board Buster Step 2 • 978-1-4051-0385-5 Arias: NMS Review for the USMLE Clinical Skills Exam, 2E • 978-0-7817-6693-7 Wahl: Blueprints USMLE Step 2 CS • 978-1-4051-0438-8 Kim: Underground Clinical Vignettes Step 2 Bundle, 4E • 978-0-7817-6363-9

P.I.M.P. PROTECTOR: A MEDICAL REFERENCE GUIDE FOR ROTATIONS
Holzheimer: 978-0-7817-6999-0 • 2007 Pocket-sized, quick reference to common diseases encountered during clerkship rotations in all specialties. For each condition, the book outlines the pertinent positives and negatives in the history and physical examination, so the student will know what to ask, what to look for on the patient, and what to order.

THE ANSWER BOOK, SAINT-FRANCES GUIDE TO THE CLINICAL CLERKSHIPS
Wiese: 978-0-7817-3754-8 • 2005 Concise, pocket-sized manual provides a guidebook for medical students entering their clinical clerkship years. Includes outline format, hot keys, mnemonics, and a wealth of useful tips from a prominent leader in clerkship education.

Steps 2 & 3
Ayala: Boards & Wards: A Review for USMLE Steps 2 & 3, 4E • 978-0-7817-8743- 7 Taylor: Board Buster Clinical Cases, Steps 2 & 3 • 978-1-4051-0465-4

Step 3
Clement: Blueprints Q&A for Step 3 • 978-0-7817-7821-3 Rosner: NMS Review for USMLE Step 3, 2E • 978-1-58255-833-2 Ryan: USMLE Step 3 Recall • Audio Only: 978-0-7817-6658-6
Print & Audio Package: 978-0-7817-8731-4

HOSPITAL SURVIVAL: LESSONS LEARNED IN MEDICAL TRAINING
Cooper: 978-0-7817-7952-4 • 2007 Written in familiar, personal language this unique book relates some of the countless colorful stories that have occurred during the first year of rotations. The anecdotes included are all either from the author's own experience or from peers who have shared their knowledge.

Van Kleunen: Step-Up to USMLE Step 3 • 978-0-7817-7963-0 Wahl: Blueprints Computer-Based Case Simulation Review, USMLE Step 3 • 978-1-4051-0445-6

STEDMAN’S MEDICAL DICTIONARY, 28E
Book: 978-0-7817-3390-8 PDA Version: 978-0-7817-8529-7 Book & PDA Bundle: 978-0-7817-6450-6 Includes over 107,000 total medical terms.

MCCQE Part 1
Chowdhury: Essentials for the Canadian Medical Licensing Exam: Review and Prep for MCCQE Part I • 978-0-7817-7650-9

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Questions
From BOARDS and WARDS: A Review for USMLE Steps 2 &3, Fourth Edition
4.) An overweight 48-year-old patient, who has had multiple incidences of vaginitis, presents with a global darkening of her skin color. The patient was previously on the Atkins diet but denies any abnormal eating habits now. You recommend: A. insulin B. steroids C. hydroquinone cream D. increased exposure to sunlight E. phlebotomy F. full disclosure of diet 5.) A 17-year-old boy presents to your office after being injured during a football game. He describes being blocked on the lateral aspect of the knee while his foot was planted in the ground. He heard a pop and felt significant pain that required him to limp off the field and stop playing. Plain radiographs were negative for fracture. On physical examination, the knee is swollen and the lower leg is easily pulled forward from the upper leg when the patient is supine. The patient is scheduled for an MRI of the knee. Based on the history and physical examination, which three structures are likely to have been damaged during this injury? A. Anterior cruciate ligament (ACL), medial collateral ligament (MCL), and medial meniscus B. ACL, posterior cruciate ligament (PCL), and medial meniscus C. ACL, lateral collateral ligament (LCL), and lateral meniscus D. MCL, LCL, and medial meniscus E. MCL, LCL, and lateral meniscus 6.) A 4-year-old with Down’s syndrome is brought to his primary care doctor by his parents because he has refused to walk. On physical exam, the patient is afebrile. There is no calor, rubor, or tumor on the legs. There is full range of motion passively and bilaterally, although the patient is irritable with the exam. No change is seen on x-ray. White count is elevated to 50,000. This is most likely: A. septic arthritis B. toxic synovitis C. leukemia D. pauciarticular juvenile rheumatoid arthritis E. a fussy child 7.) A 31-year-old patient comes in with complaints of blistering on her skin. On physical exam, you realize that the pattern of distribution is consistent with areas of sun exposure. When you ask about sun exposure, the patient shows a picture of her at the beach with her family. You observe that all of the siblings are hirsute. Which of the following tests would most likely aid in the diagnosis? A. Skin biopsy B. Skin biopsy with immunofluorescence C. Serum chromosomes D. Wood’s lamp of urine E. Urine porphyrobilinogen

1.) A 78-year-old man has a past medical history significant only for gastroesophageal reflux disease (GERD). He presents to the clinic complaining of mild abdominal pain, chronic fatigue, and increasing dyspnea on exertion. He denies hematemesis or black or bloody stools. Physical examination reveals generalized and conjunctival pallor. Stool is guaiac negative. Laboratory results are as follows: Hemoglobin: 8.4 g/dL MCV: 77.8 mm3 Ferritin: 5.2 mg/L Upper endoscopy reveals mild gastritis but is otherwise unremarkable. Which of the following is the most appropriate next course of action? A. Ferrous sulfate 325 mg PO qd and reassurance B. Ferrous sulfate 2 g IV ¥ 1 and reassurance C. Bone marrow biopsy D. Abdominal CT E. Colonoscopy 2.) A 25-year-old pregnant woman undergoes routine prenatal screening ultrasound. During the test, the technician incidentally notes the presence of multiple, small gallstones. The patient has never had any pain or other symptoms related to gallstones but seeks a surgical opinion on whether or not she should have her gallbladder removed. Which of the following would you advise? A. Her lifetime risk of developing biliary colic is approximately 5% B. Her lifetime risk of biliary colic is approximately 20% and she should not undergo cholecystectomy unless symptoms develop C. Her risk of developing biliary colic within the next year is approximately 20% D. She should wait until after pregnancy before undergoing elective laparoscopic cholecystectomy E. She should undergo immediate laparoscopic cholecystectomy to prevent acute cholecystitis 3.) The mother of a 3-year-old boy calls because her child’s temperature is 104°F. He has no rash or other symptoms. The past medical history is significant only for recent adoption from Romania. The mother is concerned about preventing febrile seizures. Which of the following could you tell her? A. Give acetaminophen right away B. Give ibuprofen right away C. Give aspirin right away D. As long as the child is not drowsy after a seizure, he will be fine E. Febrile seizures occur as the temperature is rising; therefore, now that the temperature is already high, the child is not at as great a risk

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Questions cont’d
8.) A 65-year-old nonsmoking man presents to the clinic complaining of itching and redness of his face and body. These symptoms worsen after he takes a warm shower. In addition, he has frequent headaches and occasional blurred vision. Physical examination reveals generalized plethora, engorged retinal veins, and splenomegaly. On peripheral blood smear, red cell morphology is normal, and many basophils are present. A CBC reveals the following: Hemoglobin: Hematocrit: Leukocytes: Platelets: 22.2 g/dL 64% 12,000/mL 221,000/mL

Answers
1.)E: Iron-deficiency anemia in adults must be assumed to result from occult gastrointestinal bleeding until proved otherwise. Colorectal cancer is an important cause of iron-deficiency anemia that should be ruled out by colonoscopy in this patient. Even if upper endoscopy reveals a possible source of bleeding, colonoscopy should also be performed to evaluate for iron-deficiency anemia. Because bleeding is likely to be intermittent, stool guaiac testing is insufficient to rule out colorectal cancer. A and B are incorrect because iron replacement alone does not evaluate the cause of bleeding. C. Bone marrow biopsy is unnecessary for the diagnosis of iron-deficiency anemia. D. Abdominal CT is insensitive for the detection of colorectal cancer unless it has metastasized to the liver or outside the bowel lumen. 2.) B: Asymptomatic gallstones are common, and the vast majority of patients with them will not develop pain or other symptoms. However, there is a 2% to 3% yearly risk and 20% lifetime risk of developing biliary colic. Surgical intervention is not necessary unless symptoms arise. A and C are incorrect because the lifetime risk of biliary colic is approximately 20%. D and E are incorrect because surgical intervention is not indicated unless symptoms arise. 3.) E: The explanation of why this answer is correct is stated in choice E: the child is not at risk A. Acetaminophen is a fine adjuvant and may make the child more comfortable, but it does not prevent febrile seizures. B. Answer A is also true for ibuprofen. C. Aspirin should only be given under doctor’s orders (as in the case of Kawasaki’s syndrome). D. Many children are drowsy after a seizure; this has no known prognostic value. 4.) A: This patient has bronze diabetes, or primary hemochromatosis, requiring early phlebotomy to improve patient survival. The classic triad indicating liver disease includes increased skin pigmentation, cirrhosis, and diabetes mellitus. Multiple bouts of vaginitis in a patient with acanthosis nigricans (skin darkening around the neck, flexor surfaces, and intertriginous areas) can be seen with diabetes. B. Steroids are used for patients with dermatomyositis. C. Hydroquinone cream can be used generically to lighten hyperpigmentation. D. Sunlight can alleviate pityriasis rosea or psoriasis (for which one therapy is PUVA [Psoralens and UV A light]). E. Patients can get an orangey appearance with excessive consumption of foods rich in b-carotene. 5.) A: These structures are known as the “unhappy triad” and often are injured during football games. High-impact force to the lateral knee stretches the structures that provide stability to the medial knee: the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and medial meniscus. The anterior drawer sign indicates likely ACL injury and is present in this patient. B. Posterior cruciate ligament is more often injured during bent-knee trauma such as motor vehicle accidents. The posterior drawer sign is present rather than the anterior drawer sign. C. The lateral collateral ligament and lateral meniscus are unlikely to be damaged by trauma to the lateral knee. They are injured less often than the medial structures. D and E are incorrect because damage to both collateral ligaments is rare during a single injury. The lateral collateral ligament is the least-injured knee ligament because it is under less tension than the MCL.

Of the following, which is the most likely diagnosis? A. Chronic hepatic failure B. Chronic renal failure C. Idiopathic myelofibrosis D. Essential thrombocythemia E. Polycythemia vera 9.) A patient presents to your office one autumn afternoon inquiring if she should receive an influenza vaccine. Which of the following profiles would indicate giving the vaccine to your patient? A. She is 25 years old, with no medical problems who works in a publishing office B. She is a 45-year-old federal judge with well-controlled hypertension C. She is a 25-year-old medical student, with a documented allergy to chicken eggs D. She is a 66-year-old retired teacher who has emphysema E. She is 17 years old, with mild, intermittent asthma who is about to enter college

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