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3 PRE TEST Pathophysiology PreTest Self-Assessment and Review
4 Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
5 PRE TEST Pathophysiology PreTest Self-Assessment and Review Second Edition Maurice A. Mufson, M.D., M.A.C.P. Professor of Medicine Chairman Emeritus Department of Medicine Marshall University School of Medicine Huntington, West Virginia Student Reviewers Christopher A. Heck University of South Alabama College of Medicine Mobile, Alabama Class of 2001 Sara M. Nesler University of Iowa College of Medicine Iowa City, Iowa Class of 2002 McGraw-Hill Medical Publishing Division New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto
6 McGraw-Hill abc Copyright 2002 by The McGraw-Hill Companies. All rights reserved. Manufactured in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher The material in this ebook also appears in the print version of this title: All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill ebooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. For more information, please contact George Hoare, Special Sales, at george_hoare@mcgraw-hill.com or (212) TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc. ( McGraw-Hill ) and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms. THE WORK IS PROVIDED AS IS. McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WAR- RANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MER- CHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. DOI: /
7 Contents Contributors vii Introduction ix Acknowledgments xi High-Yield Facts High-Yield Facts in Pathophysiology Immune System Questions Answers, Explanations, and References Genetic Disease Questions Answers, Explanations, and References Neoplasia and Blood Disorders Questions Answers, Explanations, and References Infectious Disease Questions Answers, Explanations, and References Cardiovascular System Questions Answers, Explanations, and References Pulmonary System Questions Answers, Explanations, and References Renal System/Nephrology Questions Answers, Explanations, and References v Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
8 vi Contents Gastroenterology Questions Answers, Explanations, and References Liver Disease Questions Answers, Explanations, and References Thyroid and Pituitary Disorders Questions Answers, Explanations, and References Reproductive System Questions Answers, Explanations, and References Nervous System Questions Answers, Explanations, and References Bibliography Index
9 Contributors Shirley M. Neitch, M.D. Professor of Medicine Section Chief of Geriatrics Department of Medicine Marshall University School of Medicine Huntington, West Virginia Henry K. Driscoll, M.D. Professor of Medicine Department of Medicine Marshall University School of Medicine Huntington, West Virginia Jason Yap, M.D. Assistant Professor of Medicine Section Chief of Nephrology Department of Medicine Marshall University School of Medicine Huntington, West Virginia Paulette Wehner, M.D. Associate Professor of Medicine Director of Cardiology Fellowship Department of Cardiovascular Services Marshall University School of Medicine Huntington, West Virginia vii Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
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11 Introduction Testing your knowledge by answering the pathophysiology questions in this book serves as a competition in which you compete against yourself for the satisfaction of doing well. It s a great feeling when you know the answers to difficult medical questions. It reflects well on your ability to learn the material in medical school, and it s a signal that you re prepared for the certifying examinations. This competition also can increase your knowledge base, as any competition sharpens your skills. That is an important part of testing ourselves. When we don t know an answer, it s an opportunity to look it up in a big book of internal medicine and improve our understanding of the topic. Each answer includes a reference to that answer, as a starting point for reading more about the topic. Although knowing the answer to any individual question provides some measure of satisfaction, it does not, and should not, represent a stopping point. Importantly, it should encourage you to read further so that you can easily answer questions from any point of view on that topic. Consider using this book in the following manner: Read the question and then record your answer before you read the correct answer. Look at the correct answer and the explanation. Read the source reference citation. Also, read the High-Yield Facts, a synopsis of significant points presented as condensed summaries. These High-Yield Facts highlight key points in pathophysiology for rapid review. They serve also as a memory jog when reviewing the questions, and it is important to read the source reference citations accompanying them. The process of studying remains paramount, not necessarily whether you know the correct answer to one question or many questions. Don t fail to read the source reference citation listed for each question, especially the questions for which you do not readily know the answer. In this manner, you will increase the depth and breadth of your knowledge, which after all is the goal of testing yourself on these questions. ix Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
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13 Acknowledgments Mentors open doors for us in a way that only mentors can do. They promote our career and help us to see its direction. Their interest and understanding make the difference in the paths we take. Several mentors aided me throughout differing times of my career and I want to acknowledge them: Harold Heine, Ph.D., at Bucknell University, my first research mentor; the late Pinckney Jones Harman, Ph.D., at New York University School of Medicine; H. Sherwood Lawrence, M.D., also of New York University School of Medicine, who guided me into a career in infectious disease; Robert M. Chanock, M.D., at the National Institutes of Allergy and Infectious Diseases, who nurtured my research endeavors in virus diseases; Morton D. Bogdonoff, M.D., at the University of Illinois College of Medicine, who encouraged my becoming a Chair of a Department of Medicine; Erling Norrby, M.D., Ph.D., of the Karolinska Institute, Stockholm, Sweden, who opened his laboratory to me for my sabbatical and inspired me; and my wife, Deedee, who guides, encourages, nurtures, and inspires me in all my endeavors, and without whom my career would not have been the joy that it is. Maurice A. Mufson, M.D., M.A.C.P. Huntington, West Virginia xi Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
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15 PRE TEST Pathophysiology PreTest Self-Assessment and Review
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17 High-Yield Facts in Pathophysiology 1. Many diseases have an immunologic basis. Example: Graft versus host (GVH) disease can develop in an immunosuppressed individual who receives immunocompetent donor cells. The donor cells respond to histocompatibility antigens present on the recipient s cells that are NOT found on the donor cells. Bone marrow contains immunocompetent T cells. (Murray, 5/e, p 123.) 2. The following chart compares bacterial meningitis and viral meningitis. (McPhee, 2/e, pp ) Bacterial Meningitis Viral Meningitis Disease state Acute: significant mortality Acute: usually self-limited without antibiotic therapy Symptoms Fever Fever Worst headache of life Worst headache of life Meningismus Meningismus Mental status changes Mental status changes Physical exam Photophobia Photophobia findings Nausea Nausea Vomiting Vomiting Fever Fever Kernig s sign positive Kernig s sign positive Brudinski s sign positive Brudinski s sign positive Etiology Neonates Cocksackie A and B viruses Escherichia coli Poliovirus Group B Streptococcus Mumps virus Listeria monocytogenes Epstein-Barr virus Children Adenovirus Neisseria meningitidis Cytomegalovirus Streptococcus pneumoniae Haeophilus influenzae, nonimmunized 1 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
18 2 Pathophysiology Bacterial Meningitis Viral Meningitis Etiology (cont d) Adults (more than 18 years old) N. meningitidis S. pneumoniae L. monocytogenes Gram-negative bacilli Cerebrospinal Decreased glucose Normal glucose fluid results Increased protein Slightly increased protein Increased neutrophils Increased pressure Increased monocytes Normal or slightlly increased pressure Gram stain shows no bacteria Treatment IV antibiotics Supportive therapy Supportive therapy Complications Cerebral edema Deafness Deafness Death Weakness 3. Carcinomas undergo phenotypic transition from normal Æ hyperplasia Æ carcinoma in situ Æ invasive carcinoma Æ metastasis. Carcinomas occur as a result of a constellation of physiologic and genetic changes (e.g., APC, hmlh1, and hmsh2 colon carcinoma/brca1 and BRCA2 breast carcinoma). (McPhee, 2/e, pp ) 4. Colon carcinoma begins when cell cycle regulation loses control over growth, and a collection of rapidly multiplying cells (hyperplasia) form an adenoma. The adenoma can continue to develop into carcinoma in situ. The first evidence of disease may be occult rectal bleeding indicating the appearance of new friable vessels supplying the tumor. Next, the cancer cells invade the basement membrane of the colon (invasive carcinoma), gaining access to the body s transport systems (lymphatic and hematogenous). Metastasis to lymph nodes and distant body regions can occur. (McPhee, 2/e, pp ) 5. Many malignancies have characteristic indirect systemic effects via multiple mechanisms. In lung malignancies, excess adrenocorticotropic hormone (ACTH) production results in a Cushing-like syn-
19 High-Yield Facts 3 drome and excess antidiuretic hormone (ADH) production results in a syndrome of inappropriate antidiuretic hormone secretion (SIADH). Malignancies (e.g., squamous cell carcinoma) can produce peptides related to PTH, causing hypercalcemia. Carcinoid syndromes produce serotonin or prostaglandins that can cause flushing, restrictive lung symptoms, ascites, and hypotension. (McPhee, 2/e, p 96.) 6. Pernicious anemia occurs when antibodies to intrinsic factor and parietal cells attack the gastric mucosa, causing gastric atrophy. The disruption of the normal function of the gastric mucosa affects vitamin B 12 absorption on two levels: stomach acid deficiency (achlorhydria) prevents the release of vitamin B 12 from food digestion, and intrinsic factor is necessary for vitamin B 12 absorption in the terminal ileum. The chronic loss of vitamin B 12 results in abnormal RBC maturation without changes in hemoglobin synthesis leading to macrocytic anemia. (Fauci, 14/e, pp ; McPhee, 2/e, p 111.) 7. Pathophysiology of hearing loss (McPhee, 2/e, pp ) Type of Hearing Loss Etiology Testing Conductive Disruption of conduction Negative Rinne test deafness and amplification of Weber test: heard best in sound from the external the affected ear auditory canal to the Audiometry inner ear Sensorineural Impaired function of inner Positive Rinne test ear or cranial nerve VIII Weber test: heard best in the unaffected ear Audiometry Central deafness Damaged CNS auditory Audiometry pathways 8. Myasthenia gravis is an autoimmune disease characterized by antibodies to acetylcholine receptors, causing a deficiency in the number of acetylcholine receptors on the postsynaptic (muscle) terminal, resulting in reduced efficiency of neuromuscular activity. The disease commonly presents in small muscle groups, accompanied by intermittent fatigue and weakness relieved by rest. (McPhee, 2/e, pp )
20 4 Pathophysiology 9. Psoriasis is an inflammatory parakeratotic accumulation of skin cells that features erythematous, demarcated lesions with scaly patches commonly found on scalp, extensor surfaces of extremities, and fingernails. (McPhee, 2/e, pp ) 10. Asthma is an obstructive pulmonary disease characterized by airway narrowing as a result of smooth muscle spasms, inflammation, edema, and thick mucus production. The pathophysiologic response is mediated by local cellular injury, lymphocyte activation (antigen exposure, B cell activation, and cytokine activity), IgE-mediated mast cell (producing histamine, leukotrienes, and platelet-activating factor), and eosinophil activation. (McPhee, 2/e, pp ) 11. Pulmonary function tests: obstructive lung disease vs. restrictive lung disease. Obstructive Lung Diease Restrictive Lung Disease Pulmonary (e.g., Chronic Obstructive (e.g., Pulmonary Function Test Pulmonary Disease Fibrosis FVC FEV 1 FEV 1 % Normal / TLC RV Normal / 12. Pulmonary embolism occurs when a venous thrombi (usually from a deep vein thrombosis) lodges in the pulmonary circulation. The pathophysiology includes hemodynamic changes, increased alveolar dead space with increased ventilation/perfusion ratios, and decreased oxygen perfusion to body tissues. Common acute presentations include tachypnea, hemoptysis, tachycardia, fever, cough, and pleuritic pain. (McPhee, 2/e, pp ) 13. In normal individuals, as left ventricular end-diastolic pressure or preload increases, stroke volume will increase proportionately. In patients who suffer heart failure, increased left ventricular end-diastolic pressure is not met with increased stroke volume, because the contractility is depressed and is unable to function; thus, the patient ultimately experiences heart failure. Frank-Starling curves or ventricular function
21 High-Yield Facts 5 curves are diagrams that show the relationship between stroke volume or cardiac output and preload or left ventricular end-diastolic volume. (Lilly, p 150.) 14. Stable angina is caused by a fixed partial atherosclerotic plaque in one or more of coronary arteries. When at rest, blood flow is able to provide adequate oxygenation to the heart muscle. On exertion, oxygen demand increases. The partial occlusion prevents adequate oxygenation to the heart, resulting in chest discomfort. Unstable angina is caused by thrombus formation on a fissuring atherosclerotic plaque, which transiently prevents adequate oxygenation to the heart. The resulting ischemia causes chest discomfort whether at rest or during exertion. (McPhee, 2/e, pp ) 15. Chronic esophageal reflux (as a result of a transient weakened lower esophageal sphincter, alcohol use, and tobacco abuse) can result in Barrett s esophagus. In the disease, columnar epithelium replaces normal squamous epithelium. Individuals with Barrett s esophagus have an increased risk of developing adenocarcinoma of the esophagus. (McPhee, 2/e, p 306.) 16. Helicobacter pylori is a common bacteria that infects the gastric mucosa, providing an increased propensity for peptic ulcer disease through inflammatory mechanisms. Other risk factors for peptic ulcer disease are use of a nonsteroidal anti-inflammatory drug (NSAID), family history, smoking, and Zollinger-Ellison syndrome (gastrinoma). (McPhee, 2/e, p 307.) 17. Crohn s disease is a chronic inflammatory bowel disease that affects the whole gastrointestinal tract (from mouth to anus) and is distinguished by alternating regions ( skip lesions ) of normal bowel and full-thickness ulcerations and granuloma formation of the bowel wall. Common manifestations are bloody diarrhea, fistula, iritis, arthritis, abscess formation, and small bowel obstruction. (McPhee, 2/e, p 315.) 18. Ulcerative colitis is an inflammatory bowel disease that causes continuous, partial-thickness (mucosa only) ulcerations of all or part of the colon and is manifested by bloody diarrhea and abdominal pain. (McPhee, 2/e, pp ) 19. Type 1 diabetes mellitus (previously called insulin-dependent diabetes mellitus) and type 2 diabetes mellitus (previously called non-insulin-
22 6 Pathophysiology dependent diabetes) differ in multiple ways. Type 1 DM usually starts in young (less than 30 years old), nonobese individuals who sometimes have a family history (weak genetic component). Insulin production deficiency predominates, with rare insulin receptor resistance. Type 1 DM is always treated with exogenous insulin. Diabetic ketoacidosis is a common complication. Type 2 DM usually starts in older (more than 40 years old), obese individuals who often have a family history of disease (strong genetic component). Recently, type 2 DM has been seen in younger adults and children, probably due to a change in life style. Insulin resistance is a major feature. Type 2 DM is often treated with exogenous insulin. Hyperosmolar coma is a common complication. (McPhee, 2/e, pp ) 20. Hyperthyroidism is characterized by sweating, agitation, weight loss, heat intolerance, palpitations, irritability, and dyspnea. Triiodothyronine (T 3 ) and thyroxine (T 4 ) are elevated with concurrent depression of thyroid-stimulating hormone (TSH). Hypothyroidism is characterized by fatigue, depression, constipation, weight gain, decreased sweating, cold intolerance, and hoarseness. T 3 and T 4 are depressed with concurrent elevation of TSH. (McPhee, 2/e, pp ) 21. Cushing s syndrome (excessive cortisol production) is characterized by moon facies, neck/trunk obesity, weight gain, mental status changes, purple striae on abdomen, osteoporosis, and glucose intolerance. Often there is excess ACTH production from the pituitary (Cushing s disease) or from tumors (ectopic ACTH). (McPhee, 2/e, p 497.) 22. Conn s syndrome (excessive mineralocorticoid secretion) is characterized by hypokalemia, hypertension, metabolic alkalosis, glucose intolerance, and weakness. (McPhee, 2/e, p 497.) 23. Addison s disease (primary adrenal insufficiency) is characterized by weakness, fatigue, weight loss, hypotension, cold intolerance, abdominal pain, diarrhea, anorexia, hyperkalemia, hyponatremia, and hypoglycemia. (McPhee, 2/e, p 497.) 24. Preeclampsia-eclampsia is characterized by hypertension, proteinuria, and edema after week 20 of pregnancy. Without treatment, a pattern of complications occurs. Complications include bleeding, malignant hypertension, stroke, renal failure, seizures, disseminated intravascular coagulation, and death. (McPhee, 2/e, pp )
23 High-Yield Facts Minimal change disease is the most common cause of nephrotic syndrome in children and is characterized by isolated proteinuria (more than 3.5 g of protein in 24-h urine) and obliterated epithelial podocytes on the glomerular basement membrane. (Fauci, 14/e, pp ) 26. Human immunodeficiency infection (HIV) and acquired immunodeficiency disease (AIDS). HIV infection occurs worldwide. It is mainly a sexually transmitted disease that can be transmitted by blood and blood products contaminated with the virus. The diagnosis of AIDS is made when any AIDS defining illness occurs in a person with HIV, such as Pneumocystis carinii pneumonia (PCP), thrush due to Candida, or their CD4 lymphocyte count drops below 200 cells/µl. AIDS is the leading cause of death in persons years old in the United States. HIV infection begins with an acute HIV syndrome, latency ensues, and then early symptomatic illness and eventually fully symptomatic illness with a myriad of complicating infections and noninfectious diseases. The entire cycle occurs over a period of more than years, and possibly longer now that effective treatment regimens are available. The treatment of HIV and AIDS can alter this progression and provide long periods free of detectable viral loads, almost normal CD4 lymphocyte counts and good quality of life. Treatment changes rapidly on the basis of the introduction of new anti-hiv drugs and new protocols specifying their use. The standard of care now is three-drug regimens (triple therapy). (Fauci, 14/e, pp )
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25 Immune System Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 1. The major immunoglobulin class in normal adult human serum is a. IgA b. IgG c. IgM d. IgE e. IgD 2. The predominant antibody found in a primary immune response is a. IgA b. IgG c. IgM d. IgE e. IgD 3. Which immunoglobulin class is found on the surface of mast cells? a. IgA b. IgG c. IgM d. IgE e. IgD 4. Which immunoglobulin class is a major component of mucosal secretions? a. IgA b. IgG c. IgM d. IgE e. IgD 9 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
26 10 Pathophysiology 5. Which immunoglobulin class can cross the placenta? a. IgA b. IgG c. IgM d. IgE e. IgD 6. Which of the following cells are important in an innate immune response to extracellular bacteria? a. T lymphocytes b. B lymphocytes c. Neutrophils d. Eosinophils e. Mast cells 7. Which one of the following is the most potent and effective antigenpresenting cell (APC)? a. Monocytes-macrophages b. Mast cells c. T lymphocytes d. B lymphocytes e. Dendritic-Langerhans cells 8. Compared with a healthy individual, lymph nodes from a person with a deficiency in B lymphocytes would have a. Few or no primary follicles b. Enlarged germinal centers c. Few Howell-Jolly bodies d. No paracortex e. Increased number of Heinz bodies 9. A newborn infected with group B streptococcus would produce and secrete antibody of which of the following class(es)? a. IgM only b. IgG only c. IgM and IgG d. Neither IgM nor IgG e. IgA only
27 Immune System Eosinophils are associated with the defense against infections caused by a. Virus b. Intracellular bacteria c. Extracellular bacteria d. Invasive parasites e. Mycoplasma 11. To determine whether a fetus acquired an infection in utero, antigenspecific antibody to which of the following classes should be measured? a. IgA b. IgM c. IgG d. IgD e. IgE 12. During an immune response, antibodies are made against different structures (usually proteins) on an infectious agent. These structures are referred to as a. Adjuvants b. Allotypes c. Isotypes d. Epitopes e. Alleles 13. Which one of the following complement components enhances phagocytosis of bacteria by opsonization? a. C1 b. Factor B c. C3b d. C5a e. C5b Which one of the following complement components mediates cytolysis? a. C1 b. Factor B c. C3b d. C5a e. C5b6789
28 12 Pathophysiology 15. Which one of the following complement components is a chemoattractant for neutrophils? a. C1 b. Factor B c. C3b d. C5a e. C5b Which one of the following complement components binds to antibody to activate the classical pathway? a. C1 b. Factor B c. C3b d. C5a e. C5b A patient with a predisposition for disseminated infections by Neisseria bacteria may have a deficiency in a. Membrane attack complex formation (C5 to C9) b. Classical pathway activation c. C3 d. C1 inhibitor e. C4 18. Which one of the following complement component deficiencies is associated with individuals with frequent pyogenic bacterial infections? a. Membrane attack complex (C5 to C9) b. C1 inhibitor c. C2 d. C3 e. C4 19. A person with an abnormality in which one of the following early complement components would most likely experience the most serious clinical manifestations? a. C1 b. C2 c. C3 d. Factor B e. C1 inhibitor
29 Immune System A 6-year-old boy has received a deep puncture wound while playing in his neighbor s yard. His records indicate that he has had the standard DPT immunizations and a booster when he entered school. What is the most appropriate therapy for this child? a. Tetanus toxoid b. Tetanus antitoxin c. Both toxoid and antitoxin at the same site d. Toxoid and antitoxin at different sites e. No treatment 21. Toxic shock syndrome toxin-1 is produced by some strains of S. aureus and is thought to be responsible for the clinical manifestations of disease by this organism. This toxin is referred to as a superantigen because it can a. Activate T cells in an antigen-nonspecific manner b. Activate B cells without T cell help c. Become immunogenic when attached to a carrier protein d. Prolong the presence of antigen in a tissue e. Evoke IgE 22. Neutralizing antiviral antibody produced in response to infection by an enveloped virus acts on which one of the following components of the virus? a. Matrix proteins b. One or more surface glycoproteins c. Internal protein components d. Nucleic acid e. Internal nonprotein components 23. Direct killing of cells infected with virus is usually accomplished by a. CD8-positive T cells b. CD4-positive T helper 1 cells c. CD4-positive T helper 2 cells d. plasma cells e. CD19-positive B cells
30 14 Pathophysiology 24. Mycobacterium tuberculosis results in an intracellular bacterial infection that provokes which one of the following immune responses? a. Natural killer cytotoxic response b. CD8-positive cytotoxic T cell response c. T helper 1 delayed type hypersensitivity response d. Complement mediated lysis of infected cell e. Eosinophilia 25. Which one of the following is a B cell neoplasm? a. Non-Hodgkin s lymphoma b. Acute lymphoblastic leukemia c. Burkitt s lymphoma d. Hodgkin s disease e. Histiocytosis X 26. During an immune response to pathogens in the intestine, the primary function of M cells along the Peyer s patches is to a. Transport antigen to lymphocytes b. Produce antigen-specific IgA antibody c. Present antigen to lymphocytes d. Secrete cytokines to help in antibody production e. Secrete chemokines 27. Which one of the following tests is used for the determination of the titer of antihepatitis B antibody? a. Flow cytometry (FACS) b. Enzyme-linked immunosorbent assay (ELISA) c. Latex agglutination d. Coombs test e. Mixed lymphocyte reaction 28. Which one of the following tests is used for the detection of anti-rh antibody in blood? a. Flow cytometry (FACS) b. Enzyme-linked immunosorbent assay (ELISA) c. Latex agglutination d. Coombs test e. Mixed lymphocyte reaction
31 Immune System Which one of the following tests is used for the assessment of the level of CD4+ T lymphocytes in an HIV-infected patient? a. Flow cytometry (FACS) b. Enzyme-linked immunosorbent assay (ELISA) c. Latex agglutination d. Coombs test e. Mixed lymphocyte reaction 30. Which one of the following tests is used for the evaluating the degree of compatibility between donor and patient lymphocytes? a. Flow cytometry (FACS) b. Enzyme-linked immunosorbent assay (ELISA) c. Latex agglutination d. Coombs test e. Mixed lymphocyte reaction 31. Which one of the following tests is used for the detection of group A streptococci from a throat swab? a. Flow cytometry (FACS) b. Enzyme-linked immunosorbent assay (ELISA) c. Latex agglutination d. Coombs test e. Mixed lymphocyte reaction 32. Which hypersensitivity reaction is associated with Goodpasture s syndrome? a. Type I: immediate b. Type II: cytotoxic c. Type III: immune complex d. Type IV: cell mediated 33. Which hypersensitivity reaction is associated with serum sickness? a. Type I: immediate b. Type II: cytotoxic c. Type III: immune complex d. Type IV: cell mediated
32 16 Pathophysiology 34. Which hypersensitivity reaction is associated with a tuberculin reaction? a. Type I: immediate b. Type II: cytotoxic c. Type III: immune complex d. Type IV: cell mediated 35. Which hypersensitivity reaction is associated with poison ivy? a. Type I: immediate b. Type II: cytotoxic c. Type III: immune complex d. Type IV: cell mediated 36. Which hypersensitivity reaction is associated with an anaphylactic reaction after a bee sting? a. Type I: immediate b. Type II: cytotoxic c. Type III: immune complex d. Type IV: cell mediated 37. Which hypersensitivity reaction is associated with hemolytic disease of the newborn? a. Type I: immediate b. Type II: cytotoxic c. Type III: immune complex d. Type IV: cell mediated 38. Which hypersensitivity reaction is associated with poststreptococcal glomerulonephritis? a. Type I: immediate b. Type II: cytotoxic c. Type III: immune complex d. Type IV: cell mediated
33 Immune System A patient with recurrent infections with yeast and the incapacity to control viral infections may indicate a deficiency in a. Cellular immunity b. Complement c. Granulocytes d. Humoral immunity e. Eosinophils 40. Graft versus host disease can be a complication of which of the following kinds of transplantation? a. Kidney b. Bone marrow c. Liver d. Skin e. Cornea 41. Which cytokine promotes the proliferation of T and B lymphocytes? a. IFN-γ (interferon γ) b. IL-2 (interleukin 2) c. IL-4 (interleukin 4) d. TNF-α (tumor necrosis factor α) e. TGF-β (transforming growth factor β) 42. Which cytokine promotes various biologic actions associated with inflammation? a. IFN-γ (interferon γ) b. IL-2 (interleukin 2) c. IL-4 (interleukin 4) d. TNF-α (tumor necrosis factor α) e. TGF-β (transforming growth factor β) 43. Which cytokine antagonizes or suppresses many responses of lymphocytes? a. IFN-γ (interferon γ) b. IL-2 (interleukin 2) c. IL-4 (interleukin 4) d. TNF-α (tumor necrosis factor α) e. TGF-β (transforming growth factor β)
34 18 Pathophysiology 44. Which cytokine functions as a promotor of T helper 2 (T H 2) development and IgE synthesis? a. IFN-γ (interferon γ) b. IL-2 (interleukin 2) c. IL-4 (interleukin 4) d. TNF-α (tumor necrosis factor α) e. TGF-β (transforming growth factor β) 45. Which cytokine functions as an activator of macrophages and natural killer (NK) cells? a. IFN-γ (interferon γ) b. IL-2 (interleukin 2) c. IL-4 (interleukin 4) d. TNF-α (tumor necrosis factor α) e. TGF-β (transforming growth factor β)
35 Immune System Answers 1. The answer is b. (Murray, 5/e, p 93.) IgG makes up about 85% of the immunoglobulin in adult serum. 2. The answer is c. (Murray, 5/e, p 93.) Most of the antibody produced in a primary immune response is IgM. As time passes or at a second encounter with the same antigen, isotype (class) switching can occur. 3. The answer is d. (Murray, 5/e, p 93.) IgE is found on the surface of mast cells and basophils. When antigen binds to the IgE, the mast cell releases various mediators involved in allergic reactions and antiparasitic defense. 4. The answer is a. (Murray, 5/e, p 93.) IgA is the predominant immunoglobulin class in mucosal secretions such as saliva, colostrum, bronchial, and genitourinary tract secretions. It is often called secretory immunoglobulin. 5. The answer is b. (Murray, 5/e, p 93.) IgG can cross the placenta and confer passive immunity to the fetus and newborn. 6. The answer is c. (Murray, 5/e, p ) Innate immunity involves antigen-nonspecific immune defense. Neutrophils circulate in the blood and can migrate into tissue to ingest and kill bacteria. Although T and B cells can augment the innate immune response, they become inactivated in an antigen-specific manner. Eosinophils, also part of the innate immune response, are important in parasitic, rather than bacterial, infections. 7. The answer is e. (Fauci, 14/e, p 1767.) Dendritic/Langerhans cells are the most potent and effective antigen-presenting cells (APC). The other cells do not possess as effective an antigen-presenting capability. 8. The answer is a. (Murray, 5/e, p 86.) The major cell type within follicles is the B cell; a germinal center is a follicle where cells are undergoing 19
36 20 Pathophysiology active proliferation. A deficiency in B cells would result in decreased size and number of follicles. The paracortex is predominately a T cell area. Heinz bodies (red cell inclusion body of denatured hemoglobin) and Howell-Jolly bodies (red cell inclusion body of parasites) are found in the spleen. 9. The answer is a. (Roitt, 5/e, p 168.) A normal newborn can make IgM antibody in response to challenge with antigen. If IgG is detected in the newborn, it is most likely the result of placental transfer from the mother. 10. The answer is d. (Fauci, 14/e, p 358.) Eosinophils are associated with invasive parasitic infections. They localize near the parasite, degranulate, and release antiparasitic molecules. Eosinophils do not exhibit any effective function against intracellular bacteria or virus, which reside within host cells, or mycoplasma. Neutrophils are usually associated with extracellular bacterial infections. 11. The answer is b. (Roitt, 5/e, p 168.) The fetus and newborn infant can only produce measurable IgM antibody in response to infection. If IgG is detected, it is the result of an immune response by the mother and the antibody has crossed the placenta. 12. The answer is d. (Murray, 5/e, p 88, 121.) Usually an immunogen contains more than one molecule that can elicit an antibody response. These different molecules are called epitopes (or antigenic determinants) and are the structures with which antibodies react. Isotypes refer to the different classes of immunoglobulins (e.g., IgM, IgG, and IgA). Allotypes refer to isotypes that differ among individuals within a species. Adjuvants are substances that can enhance an immune response to antigen. Alleles are variations of a gene. 13. The answer is c. (Murray, 5/e, pp ) The cleavage component of C3, C3b, when bound to the surface of a cell, promotes the phagocytosis of that cell by a process referred to as opsonization. 14. The answer is e. (Murray, 5/e, pp ) Complement components C5b, 6, 7, 8, and 9 associate to generate the membrane attack complex (MAC) that disrupts the integrity of the cell membrane on which it is formed.
37 Immune System Answers The answer is d. (Murray, 5/e, pp ) Several complement cleavage products promote inflammatory responses: C3a, C4a, and C5a. They can also induce the degranulation of mast cells and so are also referred to as anaphylatoxins. C5a has the additional property whereby it is a neutrophil-chemoattracting substance. 16. The answer is a. (Murray, 5/e, pp ) The classical pathway is initiated by antigen-antibody complexes. Binding of C1 to the complex activates the complement cascade. 17. The answer is a. (Fauci, 14/e, pp ) Patients with a familial deficiency in the terminal complement components fail to assemble the membrane attack complex (C5 C9), and they are at risk for disseminated Neisseria infections, including attacks of recurrent meningococcal disease. The other components of the complement system do not play a role in this unique susceptibility. 18. The answer is d. (Fauci, 14/e, p 1771.) Individuals with C3 deficiency have recurrent serious pyogenic bacterial infections that can be fatal. The absence of C3 leads to the inability to generate the opsonin, C3b, which, when deposited on the surface of the bacteria, promotes phagocytosis. Membrane attack complex deficiencies can lead to disseminated Neisseria infections. A deficiency in C1 inhibitor is associated with hereditary angioneurotic edema (HANE). Individuals with C2 deficiency have a predisposition for immune complex disease such as systemic lupus erythematosus. 19. The answer is c. (Murray, 5/e, p 98.) C3 plays a central role in both the classical and alternate pathways. An abnormality in this component would disrupt both pathways. C1 and C2 are used only by the classical pathway; therefore, an abnormality in either one or both of these components would leave the alternate pathway intact. Likewise, a defect in factor B (a component of the alternate pathway) would still permit the activation of the classical pathway. 20. The answer is e. (Murray, 5/e, pp ) Because the boy received his booster within the last 2 years, his level of immunity should be adequate. If an individual has no history of immunization, both antitoxin (passive immunization with tetanus immune globulin) for temporary and
38 22 Pathophysiology fast protection and toxoid (toxin detoxified with formaldehyde) for future and long-lasting protection should be given at different sites. 21. The answer is a. (Fauci, 14/e, p 877.) A superantigen can activate T cells without binding to the T cell receptor in an antigen-specific manner. Therefore, the superantigen can stimulate a large number of T cells, which can result in massive cytokine release, causing shock and tissue damage. An antigen that can activate B cells without T cell help is called a T-independent antigen. Haptens, usually small molecules, can become antigenic when attached to carrier proteins. Adjuvants can help in maintaining antigen at a tissue site. It does not evoke IgE, which is found in allergic reactions. 22. The answer is b. (Fauci, 14/e, p 1070.) During infection by enveloped viruses, antibody is produced, which reacts with the surface glycoproteins to neutralize the virus. Neutralizing antibody does not react with the other components of the virus. Usually, neutralizing (or protective) antibody is formed to surface components of the virus and not internal components. 23. The answer is a. (Murray, 5/e, p 119.) CD8-positive T cells are cytolytic T cells that can respond to viral peptides/mhc class I complexes on infected cells. CD4-positive T helper 1 cells usually function by releasing cytokines that promote an inflammatory response. CD4-positive T helper 2 cells produce cytokines important in generating antibody production. Plasma cells secrete antibody. CD19-positive B cells regulate B cell activation. 24. The answer is c. (Murray, 5/e, p 114.) Delayed type hypersensitivity (DTH) responses are important in protection against intracellular bacteria. In this type of response, macrophages and other inflammatory processes are activated to kill the infected cell. NK cells, cytotoxic T cells, and complement do not seem to provide adequate protection against intracellular bacteria. Eosinophilia occurs in allergy reactions. 25. The answer is c. (Fauci, 2/e, pp , ) Burkitt s lymphoma is a B cell neoplasm associated with Epstein-Barr virus (EBV) infection in about 15% of the disease in the United States and about 90%
39 Immune System Answers 23 of the disease in Africa. Hodgkin s disease and histiocytosis X are monocyte neoplasms, and non-hodgkin s lymphoma and acute lymphoblastic leukemia are T cell neoplasms. 26. The answer is a. (Murray, 5/e, p 87.) M cells deliver antigen to Peyer s patches, but they do not act as antigen-presenting cells to lymphocytes. Antibody is made by B cells within the Peyer s patch. T helper 2 cells are the main source of cytokines functioning in helping B cells make and secrete antibody. 27. The answer is b. (Murray, 5/e, pp 147, 149.) ELISA can be used to determine the relative antibody concentration to a specific antigen (titer); the assay can also be used to quantitate antibody. 28. The answer is d. (Roitt, 5/e, pp ) An indirect Coombs test is used to detect circulating anti-rh antibody: anti-rh antibody reacts with Rh+ erythrocytes causing agglutination of the erythrocytes. The direct Coombs tests for cell-bound anti-rh antibody. 29. The answer is a. (Murray, 5/e, pp 146, 147.) In flow cytometry, cells in suspension tagged with fluorescent-labeled antibody can be identified and quantitated. 30. The answer is e. (Roitt, 5/e, pp ) A mixed lymphocyte reaction assays the histocompatibility between two individuals. Donor cells are treated to prevent DNA synthesis and proliferation. The recipient s cells are mixed with the donor s cells. If the donor s cells express foreign MHC antigens, the recipient s lymphocytes will proliferate. Proliferation can be measured by the uptake of radioactive thymidine. 31. The answer is c. (Murray, 5/e, pp 145, 195.) In a latex agglutination test, antigen-specific antibody is attached to latex beads. When the beads are mixed with a specimen containing antigen, the beads agglutinate, which can be detected visually. 32. The answer is b. (Murray, 5/e, pp ) The hypersensitivity reaction in Goodpasture s syndrome is type II in which antibody mediates cell lysis. Antiglomerular basement membrane antibody is cytotoxic. In
40 24 Pathophysiology Goodpasture s syndrome, antibody forms to lung and kidney basement membranes causing damage to the tissue. 33. The answer is c. (Murray, 5/e, pp ) Serum sickness results from the injection of serum made in non-human species into humans. Antibody to the soluble nonhuman proteins are generated and immune complexes form. The complexes are trapped in capillaries and initiate an inflammatory response that causes damage to tissue. 34. The answer is d. (Murray, 5/e, p 125.) Antigen injected intradermally into a previously sensitized individual elicits a delayed type hypersensitivity response. This involves the recruitment of CD4+ T lymphocytes and macrophages to the site. 35. The answer is d. (Murray, 5/e, p 125.) Poison ivy, an allergic contact dermatitis, is a delayed hypersensitivity reaction mediated by CD4+ T lymphocytes in the skin. 36. The answer is a. (Murray, 5/e, p 123.) Anaphylaxis is a severe immediate hypersensitivity response. IgE, produced at the time of initial exposure to antigen (bee venom), binds to mast cells. On subsequent exposure, the antigen (bee venom) reacts with the mast cell-bound IgE, leading to the release of mediators from the mast cells. The mediators produce the symptoms associated with the anaphylactic reaction. 37. The answer is b. (Murray, 5/e, pp ) This is a cytotoxic hypersensitivity reaction in which IgG anti-rh antibody, produced in a previous pregnancy, crosses the placenta and binds to Rh+ fetal red blood cells. This triggers the classical complement pathway leading to the lysis of the fetal red cells. 38. The answer is c. (Murray, 5/e, pp , 195.) Complexes of bacterial antigen and antibody form and become trapped in the renal vasculature. Complement is activated and neutrophils are recruited to the site. During the process of removal of the immune complexes, tissue damage may occur. 39. The answer is a. (Murray, 5/e, pp ) Individuals with T cell deficiencies are susceptible to infections with microbes that reside within
41 Immune System Answers 25 host cells (virus, Mycobacterium species, and fungi). Humoral immune deficiency or complement deficiency usually results in recurrent bacterial, rather than viral, infections. Granulocyte deficiency may also result in bacterial and yeast infections. Because the statement indicates that the patient has problems with viral infections, the best answer is a deficiency in T cell immunity. 40. The answer is b. (Murray, 5/e, p 123.) Graft versus host (GVH) disease can develop in an immunosuppressed individual who receives immunocompetent donor cells. The donor cells respond to histocompatibility antigens present on the recipient s cells, which are NOT found on the donor cells. Bone marrow contains immunocompetent T cells; liver, kidney, and skin do not have a sufficient number of immunocompetent T cells to elicit GVH reactions. Corneal transplants do not evoke GVH. 41. The answer is b. (Murray, 5/e, p 81.) IL-2 acts on T cells to induce their progression through the cell cycle; it also acts as a growth factor for B cells. 42. The answer is d. (Murray, 5/e, p 81.) TNF-α activities depend partly on the quantity of cytokine produced. TNF-α is also associated with the production of IL-1 and IL-6. At low levels, it induces a local inflammatory effect by stimulating leukocyte recruitment. At moderate levels, it can have systemic effects, inducing fever and acute-phase protein synthesis within the liver. At high quantities, TNF-α (in conjunction with IL-1 and IL-6) can produce septic shock syndrome. 43. The answer is e. (Murray, 5/e, p 81.) TGF-β seems to be a signal that turns off inflammatory or immune responses. 44. The answer is c. (Murray, 5/e, p 81.) IL-4 promotes the development of the T helper 2 subset of CD4+ T lymphocytes. It also is important for class switching to IgE. 45. The answer is a. (Murray, 5/e, p 81.) IFN-γ acts on macrophages to enhance killing of ingested microbes. It also stimulates the cytolytic activity of NK cells.
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43 Genetic Disease Questions DIRECTIONS: Each item contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 46. A patient who has the autosomal dominant gene for type I osteogenesis imperfecta has blue scleras and slightly reduced height, whereas his brother has multiple fractures and deformities. This is an example of a. Polymorphism b. Mutation c. Variable expressivity d. Fitness 47. Your patient has an autosomal dominantly inherited disease. The patient and his grandfather show evidence of disease, but the patient s father is asymptomatic. This is an example of a. Polymorphism b. Mutation c. Variable expressivity d. Reduced penetrance 48. Two patients have the same eye color. They have the same a. HLA type b. Phenotype c. Haplotype d. Mutation 49. A patient has an X-linked disease. His three sisters do not have the disease. He most likely has a. A mutant recessive gene on the X chromosome b. A mutant dominant gene on the X chromosome c. A mutant recessive gene on the Y chromosome d. A mutant dominant gene on the Y chromosome 27 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
44 28 Pathophysiology 50. The fact that type IV osteogenesis imperfecta can be caused by defects on COLIA 1 and COLIA 2 is an example of a. Gonadal mosaicism b. Genetic heterogeneity c. Allelic heterogeneity d. Polymorphism 51. In genetics, fitness refers to a. Strong healthy chromosomes b. Genes fitting together on a single chromosome c. Absence of mutations d. Likelihood of reproduction by the individual with the mutant allele 52. The increased frequency of the recessive gene for sickle cell anemia in the African population is an example of a. Hypomorphism b. Hypermorphism c. Heterozygote advantage d. Phenotypic heterogeneity 53. Mutations that cause a gain in function of the mutated allele are a. Hypermorphic b. Neomorphic c. Amorphic d. Hypomorphic 54. When two copies of a mutant allele produce a phenotype more severe than one mutant and one normal copy, we have a. Dominant inheritance b. Recessive inheritance c. Semidominant inheritance d. Double dominant inheritance 55. Cystic fibrosis a. Occurs mainly in African Americans b. Causes endocrine problems with the pancreas gland c. Is an autosomal recessive disorder d. Is caused by loss of function mutations in a sodium channel
45 Genetic Disease Your patient presents with multiple café au lait spots and neurofibromas. His father and mother do not have neurofibromas. This may be an example of a. A new mutation b. Hypermorphism c. A dominant negative mutation d. Antimorphism 57. A patient has muscular weakness. His parents and sister do not have weakness, but his mother s brother has weakness. You suspect Duchenne s muscular dystrophy. This is an example of a. Autosomal recessive inheritance b. X-linked recessive inheritance c. Semidominant inheritance d. Autosomal dominant inheritance 58. Which of the following conditions is known to be multifactorial in etiology and not due to a single gene disorder? a. Neurofibromatosis b. Osteogenesis imperfecta c. Atherosclerosis d. Cystic fibrosis 59. A 13-year-old child with blue scleras, mildly short stature, and no deformity with a history significant for 10 fractured bones most likely has a. Type I osteogenesis imperfecta b. Type II osteogenesis imperfecta c. Type III osteogenesis imperfecta d. Type IV osteogenesis imperfecta 60. An infant with multiple fractures, bony deformity, blue scleras, wormian bones in the skull, and beaded ribs died of respiratory difficulties. He most likely had a. Type I osteogenesis imperfecta b. Type II osteogenesis imperfecta c. Type III osteogenesis imperfecta d. Type IV osteogenesis imperfecta
46 30 Pathophysiology 61. Fragile X-associated mental retardation syndrome a. Is transmitted from father to son b. Affects females and males equally c. 20% of carrier males show no sign of the syndrome d. Involves a nonrepetitive segment of DNA 62. Which is true regarding CpG islands? a. They are less than 100 base pairs in length b. They contain few sites for DNA methylation c. The island at Xq27.3 is normally unmethylated in male cells but methylated in one of the two X chromosomes in female cells d. Unmethylation of the CpG island in males correlates with expression of the fragile X-associated mental retardation syndrome 63. A patient has fragile X-associated mental retardation syndrome phenotype. Diagnostic testing of 10 7 lymphocytes reveals repetition of (5 CGG-3 ) n segment of DNA where n > 200, but variable in number. This variation in number is described as a. Genetic mosaicism b. Genetic anticipation c. Fitness d. Dosage compensation 64. The FMR1 protein a. Is expressed in fragile X-associated mental retardation b. Is normally found in brain and ovaries c. When defective, is not sufficient to cause the fragile X-associated mental retardation syndrome d. Is coded by the FMR1 gene which has the (5 -CGG-3 ) n repeat segments 65. A premutation allele a. If transmitted by a female expands to a full mutation with a likelihood proportionate to the size of the repeat segment b. If transmitted by a male usually expands to a full mutation regardless of the length of the repeat sequence c. Causes a change in phenotype d. Is present in the carrier males
47 Genetic Disease Fragile X, spinocerebellar ataxia 1, spinobulbar muscular atrophy, and Huntington s chorea a. All involve synthesis of an altered protein with an expanded polyglutamine region b. All involve failure to synthesize a protein c. All involve amplification of an unstable triplet repeat d. Involve mutation of the FMR1 gene 67. In the case of a dominant allele a. Two copies of the allele are needed to produce the altered phenotype b. One copy of the allele is sufficient to produce the phenotype c. An offspring with one parent having a dominant allele has a 25% chance of inheriting the dominant allele d. If two parents have a dominant allele, the offspring has a 50% chance of inheriting the dominant allele 68. The human genome is estimated to contain about how many genes? a. 25,000 b. 50,000 to 100,000 c. 200,000 d. 225, Which one of the following genetic diseases is a chromosomal disorder? a. Cystic fibrosis b. Hemochromatosis c. Klinefelter s syndrome d. Hemophilia e. Fragile-X 70. Most children with Down s syndrome are a. Born to women under 35 b. Born to women over 35 c. Tall d. Underweight
48 32 Pathophysiology 71. In Down s syndrome, life expectancy is characterized as a. 90% survive to age 30 regardless of the presence of congenital heart disease b. 60% survive to age 10 and 50% survive to age 30 if congenital heart disease is present c. It is the same as unaffected individuals if congenital heart disease is absent d. 90% die of Alzheimer s disease by age Which is true of Down s syndrome? a. 50% of cases are caused by an extra maternal chromosome b. 25% of nondysjunction occur in meiosis I c. Maternal and paternal nondysjunction events are associated with advanced maternal age d. It is impossible to tell whether the extra gene came from the mother or the father 73. The dietary treatment of phenylketonuria must be initiated when? a. Before the child is 3 weeks of age b. The child is 4 to 6 weeks of age c. The child is 7 to 10 weeks of age d. Between 3 and 6 months of age 74. Newborn screening for phenylketonuria a. Occurs at 7 days after birth b. Confirms the diagnosis in about 5% of those screened c. Has a false-negative rate of 1:70 d. Shows a prevalence in the general population of 1:50, Which treatment regimen is appropriate for phenylketonuria? a. Infants are fed a semisynthetic formula low in phenylalanine b. Breast feeding is prohibited c. Infants are fed a diet totally devoid of phenylalanine d. It can be discontinued at age The neurologic deficits of phenylketonuria are due to a. Primarily the metabolites of phenylalanine b. A direct effect of phenylalanine on energy production, protein synthesis, and neurotransmitter homeostasis c. Phenylalanine causing an increased transport of neutral amino acids across the blood-brain barrier d. The increased action of phenylalanine hydroxylase
49 Genetic Disease In phenylketonuria, phenylalanine is a competitive inhibitor of which enzyme that, when blocked, contributes to the hypopigmentation of hair and skin? a. Cystathionase b. Tyrosinase c. 4-Hydroxyphenylpyruvate dioxygenase d. Sarcosine dehydrogenase e. Histidine ammonia lyase 78. The different genetic forms of phenylketonuria illustrate two different pathophysiologic mechanisms by which inborn errors of metabolism cause disease. These are a. End-product overproduction and substrate accumulation b. End-product deficiency and substrate accumulation c. End-product overproduction and substrate deficiency d. End-product deficiency and substrate deficiency 79. Regarding the centimorgan a. The human genome is composed of approximately 6000 centimorgans in recombination distance b. It is a measure of genetic distance that reflects the probability of a crossover between two loci during meiosis c. One centimorgan approximates a 5% chance of a crossover during meiosis d. The average chromosome contains about 500 centimorgans of genetic material 80. The likelihood of two parents producing two offspring with identical chromosomes (other than by twinning) is a. 1:540,000 b. 1:1,200,000 c. 1:5,800,000 d. 1:8,400, A mutation in which the base replacement changes the codon for one amino acid to another is called a a. Missense mutation b. Nonsense mutation c. Silent mutation d. Frameshift mutation
50 34 Pathophysiology 82. Southern blotting a. Was developed in southern U.S. b. Was named after E.M. Southern c. Is not useful for detecting gross rearrangements of DNA d. Cleaves DNA into large fragments 83. Polymerase chain reaction technique for DNA amplification a. Is slow and cumbersome b. Can be used to detect nucleotide sequences of infectious agents c. Is not very specific d. Must be performed on a fresh whole blood sample 84. Sickle cell anemia a. Is due to a single base change in the gene that codes for the β chain of hemoglobin b. Is an example of aneuploidy c. Involves substitution of glutamic acid for valine in the sixth amino acid position d. Is inherited as an X-linked recessive disorder 85. Anticipation refers to a. Waiting for a disease to manifest itself in an individual such as in Huntington s chorea b. Worsening of a disease phenotype over generations within a family c. Birth of a fetus with positive prenatal tests for genetic abnormalities d. Expression of a premutation 86. Which method is used to detect unique genomic DNA fragments from an individual starting with DNA from peripheral leukocytes? a. Northern blot b. Southern blot c. Eastern blot d. Western blot
51 Genetic Disease In autosomal recessive genetic disease, the responsible gene must located on a. The X chromosome b. The Y chromosome c. Any one of the 22 autosomes d. The X chromosome and one autosome e. Both X and Y chromosomes 88. A key feature of all X-linked inheritance a. Male offspring of carrier females have 0% chance of being affected b. Affected males do not transmit the disease to their sons c. Affected homozygous females occur when any male mates with a carrier female d. 50% of female offspring of affected males are carriers e. Vertical distribution occurs 89. Regarding X inactivation a. It occurs late in embryonic development b. Each female is a mosaic with about half of her cells expressing the maternal X and half expressing the paternal X c. The nonfunctional X chromosome cannot be identified d. There is more methylation of DNA in the activated compared with the inactivated X chromosome 90. A 21-year-old black man comes to your office complaining of joint pains and swelling of both knees of several months duration. He has had frequent similar episodes beginning before he was 10 years old. His father had similar complaints of joint pains and suffered from anemia. However, his mother did not have any of these symptoms and signs. The patient is also anemic. His hemoglobin gene makeup is likely to be a. AA b. SA c. SS d. CC e. AC
52 36 Genetic Disease Answers 46. The answer is c. (McPhee, 2/e, p 6.) The phenomenon of different phenotypes in individuals with the same genotype is known as variable expressivity. Polymorphism is an allele that is present in 1% or more of the population. Mutation refers to an event such as a nucleotide change, deletion, or insertion that produces a new allele. Fitness refers to the ability of an affected individual to reproduce. 47. The answer is d. (McPhee, 2/e, p 5.) Given a set of defined criteria, recognition of the condition in individuals known to carry the mutated gene is described as penetrance. Reduced penetrance is commonly seen in dominantly inherited conditions that have relatively high fitness such as Huntington s disease or polycystic kidney disease. 48. The answer is b. (McPhee, 2/e, p 5.) A phenotype is any characteristic that can be described by an observer. HLA type refers to human leukocyte antigens that are coded by chromosome 6 and are especially important for transplant candidates. Haplotype refers to a set of closely linked alleles that are not easily separated by recombination. Mutation refers to an event such as a nucleotide change, deletion, or insertion that produces a new allele. 49. The answer is a. (McPhee, 2/e, p 6.) In males, only one copy of a mutant recessive gene on the X chromosome is sufficient to cause the genetic disease. Females, on the other hand, require two copies of the recessive gene. If this had been a dominantly inherited condition, chances are that at least one of his sisters would be affected. 50. The answer is b. (McPhee, 2/e, p 13.) Genetic heterogeneity is defined as a situation in which mutations of different genes produce similar or identical phenotypes. Gonadal mosaicism refers to mutation affecting some of the germ cells (sperm or eggs). Allelic heterogeneity refers to the state in which multiple alleles at a single locus can produce a disease phenotype or phenotypes.
53 Genetic Disease Answers The answer is d. (McPhee, 2/e, p 17.) A mutant allele that causes death in utero has low fitness. One in which the affected individual lives to reproductive age and allows the individual to pass on the mutant allele has high fitness. 52. The answer is c. (McPhee, 2/e, p 18.) When heterozygotes for a disease have a selective advantage compared with homozygous nonaffected individuals, this is called heterozygote advantage. This may account for the high incidence of certain mutant alleles in a population. One example is the high incidence of sickle cell anemia in persons of African descent. The heterozygous state for sickle cell anemia confers protection against malaria and offers a survival advantage. 53. The answer is a. (McPhee, 2/e, p 6.) Hypermorphic mutations cause a gain of function. Neomorphic mutations cause the acquisition of a new property. Amorphic mutations cause a complete loss of function. Hypomorphic mutations cause a partial loss of function. 54. The answer is c. (McPhee, 2/e, p 7.) Semidominant inheritance probably occurs in most dominantly inherited conditions, but homozygous mutant individuals are rarely observed. One example is when two people with achondroplasia have children. They have a 25% chance of producing a homozygous offspring. Unfortunately, these children usually die in the perinatal period. 55. The answer is c. (McPhee, 2/e, p 7.) Cystic fibrosis is inherited as an autosomal recessive disorder that derives from multiple mutations of a gene residing on chromosome 7. It occurs most frequently in whites (1 in 3000 live births). It can cause exocrine problems with the pancreas gland. The mutation responsible for cystic fibrosis most commonly is a deletion of 3 base pairs that code for phenylanaline at amino acid position 508 of the cystic fibrosis transmembrane regulator (CFTR), which functions as a chloride ion channel and other ion channels regulator. 56. The answer is a. (McPhee, 2/e, p 7.) About 50% of cases of neurofibromatosis are due to new mutations. Hypermorphism is a mutation that produces an increase in function. A dominant negative mutation gives rise
54 38 Pathophysiology to a protein that interferes with the function of the normal allele. One copy of the dominant negative allele has the same effect as two copies of the allele. This effect is called antimorphic. 57. The answer is b. (McPhee, 2/e, p 7.) Duchenne s muscular dystrophy is an X-linked recessive disorder. The patient s mother carries one copy of the recessive gene. It is not expressed in the patient s sisters who may also carry one copy of the recessive gene. Because women possess two X chromosomes, the terms X-linked dominant and X-linked recessive apply only to women. Men, because they possess only one X chromosome, will likely express the full phenotype irrespective of whether the mutation is a dominant or recessive allele in women. 58. The answer is c. (McPhee, 2/e, p 8.) Atherosclerosis is believed to be multifactorial. The effects of both genes and the environment play a role in its etiology. The other disorders listed are all single gene disorders. 59. The answer is a. (McPhee, 2/e, p 9.) Type I osteogenesis imperfecta is mild. Type II is severe and usually lethal in the perinatal period. Type III is considered progressive and deforming. Type IV is deforming, but with normal scleras. 60. The answer is b. (McPhee, 2/e, p 9.) Wormian bones are isolated islands of mineralization in the skull. Type II osteogenesis imperfecta usually results in death in infancy. 61. The answer is c. (McPhee, 2/e, p 14.) X-linked disorders are passed on from mother to son. Males are affected more than females in this disorder. One-third of carrier females have a significant degree of mental retardation; 20% of carrier males are nonpenetrant and manifest no signs of the disorder. The mutation involves a highly repetitive area of DNA. Fragile X, the most common cause of inherited mental retardation, results from a trinucleotide repeat expansion of CGG or CCG. 62. The answer is c. (McPhee, 2/e, p 16.) CpG islands are several hundred base pairs in length. They have many potential sites for DNA methylation. The CpG island at Xq27.3, the fragile site, is normally unmethylated in male cells, but methylated on one of the two X chromosomes in female
55 Genetic Disease Answers 39 cells. The CpG island at Xq27.3 is methylated in affected males and is methylated on both X chromosomes of affected females. 63. The answer is a. (McPhee, 2/e, p 16.) Patients with CGG repeat segments of greater than 200 show the fragile X-associated mental retardation syndrome. The fact that in an individual, the actual number of repeats can vary from cell to cell is called genetic mosaicism. Genetic anticipation is shown when a phenotype for a disease is more severe in successive generations. Fitness is the ability of affected individuals to reach the reproductive age and transmit the mutation to offspring. Dosage compensation is the mechanism by which a difference in gene dosage between two cells is equalized. For example, in XX cells, one of the X chromosomes is inactivated, thereby providing a genetic dosage equal to an XY cell. 64. The answer is d. (McPhee, 2/e, pp ) The family mental retardation (FMR1) protein is normally expressed in brain and testes. It is encoded by the FMR1 gene. Amplification of the CGG region to a repeat number greater than 200 causes methylation of the CpG island and prevents the FMR1 protein from being expressed. This defect is sufficient to cause the fragile X-associated mental retardation syndrome. 65. The answer is a. (McPhee, 2/e, p 17.) A premutation allele transmitted by a female expands to a full mutation with a likelihood proportionate to the length of the premutation. Premutation alleles with a repeat number between 52 and 60 rarely expand to a full mutation, whereas those with a repeat number greater than 90 nearly always expand. A premutation allele transmitted by a male rarely if ever expands to a full mutation regardless of the length of the repeat number. A premutation does not cause a change in phenotype. Carrier males have the mutation in their genes. About 20% of carrier males do not show evidence of the disease. 66. The answer is c. (McPhee, 2/e, p 17.) Spinocerebellar ataxia 1, spinobulbar muscular atrophy, and Huntington s disease are caused by expansion of a (5 -CAG-3 ) n repeat rather than the (5 -CFF-3 ) n repeat seen in fragile X. The first three diseases involve synthesis of a protein with an expanded polyglutamine region rather than failure to synthesize a normal protein as in fragile X-associated mental retardation syndrome. Only fragile X involves the FMR1 gene mutation.
56 40 Pathophysiology 67. The answer is b. (Cecil, 20/e, p 134.) One copy of the allele is sufficient to produce the phenotype in dominant inheritance. In recessive inheritance, two copies of the allele are necessary to produce the phenotype. An offspring with one parent having the dominant allele has a 50% chance of inheriting the allele. An offspring with both parents having the dominant allele has a 75% chance of inheriting the gene. 68. The answer is b. (Fauci, 14e, pp ) The human genome contains about 50,000 to 100,000 genes. Genes comprise linear strands of DNA that, together with the proteins of chromatin, make up the chromosomes. 69. The answer is c. (Fauci, 14e, pp and ) Klinefelter s syndrome is a chromosomal disorder and the most frequent major abnormality of sexual differentiation. The chromosome complement is 47,XXY or 46XY/47,XXY. Hemochromatosis and cystic fibrosis are monogenic autosomal recessive disorders, and hemophilia and fragile X are X- linked disorders. Fragile X results from a trinucleotide repeat expansion of CGG or CCG. 70. The answer is a. (McPhee, 2/e, pp ) Women over 35 years of age are at increased risk of giving birth to a child with Down s syndrome. However, screening programs for mothers over age 35 detect most Down s syndrome pregnancies in women of this age group. Because of this fact and the lower total numbers of births to women over age 35, most children with Down s syndrome are born to women under age 35. Individuals with Down s syndrome have statures two to three standard deviations below the average. Weight in affected individuals is mildly increased compared with the general population. 71. The answer is b. (McPhee, 2/e, p 20.) Survival depends on the presence or absence of congenital heart disease. Of those with heart disease, 60% survive to age 10 and 50% to age 30. Premature onset of Alzheimer s disease neuropathic changes is present in 100% of affected individuals by age 35. Frank dementia, however, is not detectable in all of these patients and may not play a large role in mortality. 72. The answer is c. (McPhee, 2/e, p 20.) It is of interest that both maternal and paternal nondysjunction events are associated with advanced
57 Genetic Disease Answers 41 maternal age. It is possible to use molecular markers to tell whether the extra chromosome came from the mother or the father. In studies using these markers, it was found that 75% of the extra chromosome 21 came from the mother and 75% of the nondysjunction events occurred during meiosis I. 73. The answer is a. (Fauci, 14e, pp ) Phenylketonuria must be treated before the child is 3 weeks old. Some children may exhibit modest CNS dysfunction with more deleterious mutations or excessive protein intake. Women who have the disease may bear children with congenital anomalies due to maternal transfer of elevated levels of phenylketonuria to the fetus. 74. The answer is c. (McPhee, 2/e, p 24.) Newborn screening for PKU is done at 24 to 72 h after birth. The diagnosis is confirmed in about 1% of those screened. The false-negative rate is 1:70. These children are picked up later when they exhibit developmental delays or seizures. Phenylketonuria has a prevalence of 1:10, The answer is a. (McPhee, 2/e, p 24.) Infants with phenylketonuria are fed a semisynthetic formula low in phenylalanine. This formula can be combined with regular breast feeding. Because phenylalanine is an essential amino acid, infants do require a minimal amount of phenylalanine in their diet. Dietary restriction should be continued indefinitely because even adults with hyperphenylalaninemia develop neuropsychologic and cognitive deficits. 76. The answer is b. (McPhee, 2/e, p 24.) The neurologic defects of phenylketonuria are due primarily to phenylalanine itself and not the metabolites. Phenylalanine has a direct effect on energy production, protein synthesis, and neurotransmitter homeostasis. It causes decreased transport of neutral amino acids across the blood-brain barrier. Phenylalanine hydroxylase, which converts phenylalanine to tyrosine, is decreased in action. 77. The answer is b. (Fauci, 14/e, pp ) Phenylalanine competitively inhibits tyrosinase and, together with the reduced availability of tyrosine, a melanin precursor, results in the hypopigmentation of hair and skin.
58 42 Pathophysiology A defect in histidine ammonia lysase occurs in histidinemia with hearing and speech deficits; a defect in cystathionase occurs in cystathioninuria; a defect in sarcosine dehydrogenase occurs in sarcosinemia; and a defect in 4-hydroxyphenylpyruvate dioxygenase occurs in tyrosinemia type III. 78. The answer is b. (McPhee, 2/e, p 27.) In phenylketonuria, there is a deficiency in the end products of phenylalanine metabolism, which are catecholamines and neurotransmitters. There is also a buildup of the substrate phenylalanine, which has its own adverse effects. 79. The answer is b. (Harrison, 14/e, p 366.) The centimorgan is a measure of genetic distance that reflects the probability of crossover between two loci during meiosis. The human genome is composed of approximately 3000 centimorgans in recombination distance. One centimorgan approximates a 1% chance of crossover during meiosis. The average chromosome contains about 130 centimorgans of genetic material. 80. The answer is d. (Harrison, 14/e, p 367.) The likelihood of two parents producing two offspring with identical chromosomes (other than by twinning) is 2 23 or 1 in 8.4 million. 81. The answer is a. (Harrison, 14/e, p 369.) A missense mutation is one in which the base replacement changes the codon for one amino acid to another. A nonsense mutation is one in which the base replacement changes the codon to one of the termination codons. A silent mutation is one in which the base replacement does not lead to a change in the amino acid but only to the substitution of a different codon for the same amino acid. A frameshift mutation is one in which deletion or insertion of one or two bases occurs in a coding region and causes every codon distal to the mutation in the same gene to be read in the wrong triplet frame. 82. The answer is b. (Harrison, 14/e, p 372.) Southern blotting was named after E.M. Southern. It is a technique for analyzing DNA where DNA is cleaved into small fragments, fractionated by electrophoreses onto agarose gels, and processed so that specific sequences can be identified. Southern blotting can detect gross rearrangements in DNA and some point mutations.
59 Genetic Disease Answers The answer is b. (Harrison, 14/e, p 372.) Polymerase chain reaction (PCR) is a technique for amplifying DNA. It can be performed on a fresh blood sample or isolated from dried blood filters, mouthwash, or even old tissue sections. One use is in detecting nucleotide sequences of infectious agents. PCR is a rapid technique that takes a single day. It is automated and extremely specific. 84. The answer is a. (Harrison, 14/e, p 377.) Sickle cell anemia is due to a single base change in the gene that codes for the β chain of hemoglobin. The change causes substitution of valine for glutamic acid in the sixth amino acid position in the protein sequence of the β chain. It is inherited as an autosomal recessive disorder. Aneuploidy refers to an abnormal number of chromosomes such as that seen in trisomy The answer is b. (Harrison, 14/e, p 381.) In genetics, anticipation refers to the worsening of a disease phenotype over generations within a family. The phenomenon of anticipation is due to increasing size of repeats in premutations that cause earlier onset of disease or a more severe phenotype. The mere presence of premutations does not cause changes in phenotype. 86. The answer is b. (Harrison, 14/e, p 372.) This is the definition of Southern blot. Southern blot, named after E.M. Southern, who developed it, is an electrophoresis procedure for separating and identifying DNA. The sensitivity of a Southern blot can be increased by treating whole genomic DNA with restriction endonucleases to produce small fragments that can be separated on an agar gel and identified, e.g., by nucleic acid hybridization. Northern blot is an electrophoresis procedure that starts with RNA and can be used to detect the absence or presence of a particular mrna. Western blot or immunoblot is an electrophoresis procedure for separation of proteins; the separated proteins can be identified by immunologic procedures, e.g., binding to a radioactive antibody and exposure to a radiographic film for localizing radioactivity. 87. The answer is c. (Harrison, 14/e, p 383.) In autosomal recessive disease, males and females are affected in equal proportions so that the gene must be located on any one of the autosomes. Conversely, it cannot be located on the X or Y chromosomes.
60 44 Pathophysiology 88. The answer is b. (Harrison, 14/e, p 385.) In X-linked inheritance, male-to-male transmission is absent because the male contributes the Y chromosome to his son and not the X chromosome. All female offspring of affected males are carriers, male offspring of female carriers have a 50% chance of being affected, transmission tends to be oblique and not vertical, and affected homozygous females occur only when an affected male mates with a carrier female. 89. The answer is b. (Harrison, 14/e, p 386.) X inactivation occurs early in embryonic development. Because the X chromosome that is selected for inactivation occurs independently and randomly in each cell, it would be expected that females are mosaic with about half of their cells expressing the maternal X and half expressing the paternal X. The nonfunctional X chromosome can be identified as a condensed clump of chromatin called a Barr body. There is more methylation of DNA in the inactivated X chromosome compared with the activated X chromosome. 90. The answer is c. (Harrison, 14/e, p 648.) The young man is homozygous SS and exhibits the signs and symptoms of sickle cell disease. Because his father shows the same symptoms and signs, he is likely to be SS also. The mother, who is asymptomatic, is likely heterozygous AS or sickle cell trait, which is a very mild form, mainly with signs and symptoms, as is heterozygous AC. Homozygous CC also is very mild with minimal anemia but not any joint pains or swelling of the joints.
61 Neoplasia and Blood Disorders Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 91. A 48-year-old white woman has what she believes is a suspicious lump in her breast, but a mammogram does not reveal any suspicious lesions. Truthful statements concerning potential pitfalls in management and diagnosis include a. Assuming that mammography is diagnostic b. Assuming that a radiographic lesion seen on mammography is the same as a palpable lesion c. Letting a negative or nonsuspicious mammogram influence the judgment of whether a palpable mass needs to be biopsied d. Assuming that a benign aspiration cytology is definitive 92. A 55-year-old man has lung cancer in the right middle lobe. Which paraneoplastic syndrome is associated with GHRH secretion and lung cancer? a. Hypocalcemia b. Hypocortisolemia c. Hypophosphatemia d. Acromegaly e. Gynecomastia 93. A 30-year-old man has pain in the left scrotum. What is currently valid concerning types of tumor? a. Alpha fetoprotein (AFP) is only elevated in seminomas. b. The half-life of AFP is 24 to 36 h. c. Lactate dehydrogenase (LDH) is an important marker to follow tumor progression or regression. d. Human chorionic gonadotropin-β subunit (β-hcg) is only elevated in seminoma. 45 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
62 46 Pathophysiology 94. In a patient with multiple enlarged lymph nodes, which should be biopsied? a. Groin nodes b. Nodes in the axilla c. Superficial cervical nodes d. Periaortic lymph node with CT guidance 95. The etiology of chronic lymphocytic leukemia (CLL) is a. Due to radiation b. Due to a retrovirus c. A familial disease d. Unknown 96. Which of the following is not a major example of inherited susceptibility to cancer? a. Li-Fraumeni syndrome b. Familial polyposis coli c. Familial retinoblastosis d. Peutz-Jeghers syndrome 97. A 22-year-old man comes to the emergency room of your hospital because he has a diffuse, erythematous rash involving nearly all of his body. His total WBC count is greater than 100,000 cells/mm 3. He also complains of bone pain, severe irritability, weakness, fatigue, nausea and vomiting, constipation, photophobia, and polyuria. His electrocardiogram (ECG) shows shortening of the QT interval, prolongation of the PR interval, and nonspecific T wave changes. The most likely cause of his symptoms is a. Hypercalcemia b. Hypocalcemia c. Hypophosphatemia d. Hyperkalemia
63 Neoplasia and Blood Disorders A 45-year-old white man with a limited small cell lung cancer presents to the emergency room of a local hospital and exhibits agitation and confusion, ataxia, nystagmus, peripheral sensory loss, and generalized weakness. The most likely etiology of this disorder is a. Hypercalcemia b. Paraneoplastic syndrome c. Cerebral vascular accident d. Myasthenia gravis 99. A 52-year-old white woman with breast cancer receiving adjuvant therapy presents with back pain that intensifies on movement and pain over the L1 vertebral body when she coughs and that radiates down her left lower extremity to her leg and foot. The most likely etiology of this disorder is a. Paraneoplastic disorder b. Trauma to the lumbar disk c. Muscular spasm of the intercostal muscles d. Possible spinal cord compression 100. In the aforementioned patient, the most effective initial treatment is a. Intravenous Decadron (dexamethasone) b. Orthopedic consultation c. Physical therapy techniques d. Intravenous narcotics 101. A 66-year-old white woman with a known history of small cell lung cancer comes to your office because of engorgement of her neck veins on the right side and over her chest wall. She also has cyanosis of the extremities, facial edema, and difficulty with her mentation. Her diagnosis is most likely a. Congestive heart failure b. Lymphatic obstruction of the upper body c. Superior vena cava syndrome d. Deep venous thrombosis
64 48 Pathophysiology 102. The multistep theory of carcinogenesis can be applied to what form of cancer? a. Head and neck cancer b. Breast cancer c. Lung cancer d. Colorectal cancer 103. Platelet production (thrombopoiesis) is affected by more than one cytokine. Which of the following sets seems to be the most important in platelet development? a. IL-3, granulocyte colony-stimulating factor (G-CSF), and granulocytemacrophage colony-stimulating factor (GM-CSF) b. IL-4, IL-6, and thrombopoietin c. Erythropoietin, thrombopoietin, and IL-6 d. IL-6 and thrombopoietin e. IL-3, IL-4, and IL Which of the following factors complexes with factor VIII, which is activated to factor VIIIa when released from the complex? a. Factor XIII b. High molecular weight kininogen c. Von Willebrand factor (vwf) d. Thromboplastin e. Plasminogen 105. Which of the following factors depends on platelets for synthesis? a. Factor II (prothrombin) b. Factor VII (proconvertin) c. Protein S d. Factor XIII (fibrin-stabilizing factor) e. Factor X (Stuart-Prower factor) 106. Which of the following causes of anemia is associated with microcytosis? a. Folic acid deficiency b. Therapy with zidovudine (AZT) c. Hypothyroidism d. Alcohol e. Thalassemia
65 Neoplasia and Blood Disorders Which of the following causes of an elevated hemoglobin concentration in the blood is characterized by a LOW level of erythropoietin in the blood? a. Chronic tobacco smoking b. Dwelling at high altitudes, such as in the Andes c. Erythrocytosis associated with renal tumors d. Primary polycythemia (polycythemia vera) e. Erythrocytosis secondary to chronic pulmonary insufficiency 108. Which of the following causes a leukocytosis without an increase in the number of circulating polymorphonuclear neutrophil leukocytes? a. Acute infection b. Release of epinephrine c. Tissue necrosis d. Myelocytic leukemia e. Collagen vascular disease 109. In a typical case of iron deficiency, which of the following molecular forms that contains or can bind to iron increases in the patient s serum? a. Hemoglobin b. Ferritin c. Hemosiderin d. Myoglobin e. Transferrin 110. Which of the following disorders is associated with thrombocytosis? a. Disseminated intravascular coagulation b. A plastic anemia c. Postsplenectomy d. Hypersplenism e. Prosthetic valves
66 50 Pathophysiology 111. A 47-year-old man walks into the emergency room because of feeling very weak, tired, short of breath, and dizzy. He has numbness and tingling of his fingers. He appears pale and sallow. On examination, his heart rate is 132. His sclerae and nailbeds are pale. His heart is enlarged and he has dependent edema of his ankles. Laboratory findings include a negative Coombs test and a hemoglobin of 4 g/dl. The likely diagnosis is a. Traumatic hemolytic anemia b. Autoimmune anemia c. Blood loss d. Pernicious anemia e. Iron-deficiency anemia 112. Most drugs induce thrombocytopenia by which mechanism? a. Marrow-depressing effect b. Directly cytotoxic of platelets c. Depress megakaryoctye production d. Immune response in which the platelet is damaged by complement activation e. Impair megakaryoctye production 113. Which of the following statements related to circulating erythrocytes (red cells) is untrue? a. The nuclei of the precursor cells to erythrocytes are extruded from their cells shortly before the red cells leave the bone marrow. Consequently, the presence of nucleated red cells in the peripheral blood should be regarded as abnormal and may indicate an underlying disease state. b. In a thin blood smear stained with Romanowsky s stain (such as Wright s stain), the youngest cells (reticulocytes) can be recognized by a blue coloration (basophilia) as different from most of the red cells present. c. The average diameter of erythrocytes is about 8 µm; consequently, they cannot flow through the smaller capillaries that have a diameter of 2 to 4 µm. d. The protein of hemoglobin, which is the principal constituent of the red cell contents, is in tetrameric form, with two α and two β subunits. e. The iron atom of the hemoglobin molecule, which is essential to its function of carrying oxygen, is an intrinsic part of the heme complex attached to each subunit of protein.
67 Neoplasia and Blood Disorders Which of the following statements concerning the relationship of the neutrophil polymorphonuclear leukocyte (PMN) to infection with bacterial pathogens is incorrect? a. The principal functions of the PMN are expressed in the tissues and not usually in the bloodstream, which is simply the transport path of the cells to their required site of action. b. The cytoplasmic granules of PMN are essentially inert, but metabolically have only a vegetative role in maintaining cell viability. c. When the cell numbers of PMN are reduced significantly, the probability of severe bacterial infection can be greatly increased. d. The average duration of the period of circulation of PMN after entering the bloodstream is about 6 to 8 h. e. An increasing need for PMN produced by infection is met in part by large numbers of immature cells (especially band cells) being released from the marrow pool into the bloodstream Which pathologic cells in a stained blood film have appearances very similar to those of normal mature white cells or their precursors? a. Chronic lymphocytic leukemia (B cell type) b. Chronic myelocytic leukemia c. Lymphoblastic leukemia d. Hodgkin s disease e. Non-Hodgkin s disease 116. On karyotyping, a well-defined chromosomal abnormality is pathognomonic of which condition? a. Chronic lymphocytic leukemia (B cell type) b. Chronic myelocytic leukemia c. Lymphoblastic leukemia d. Hodgkin s disease e. Non-Hodgkin s disease 117. Which condition customarily terminates by transition to a blast cell phase with similarities to acute leukemia? a. Chronic lymphocytic leukemia (B cell type) b. Chronic myelocytic leukemia c. Lymphoblastic leukemia d. Hodgkin s disease e. Non-Hodgkin s disease
68 52 Pathophysiology 118. The principal complication of which condition is susceptibility to infection? a. Chronic lymphocytic leukemia (B cell type) b. Chronic myelocytic leukemia c. Lymphoblastic leukemia d. Hodgkin s disease e. Non-Hodgkin s disease 119. Which disorder presents mainly as a localized new mass or group of superficial lymph nodes? a. Chronic lymphocytic leukemia (B cell type) b. Chronic myelocytic leukemia c. Lymphoblastic leukemia d. Hodgkin s disease e. Non-Hodgkin s disease 120. Which mechanism is responsible for thrombocytopenia in vitamin B 12 deficiency? a. Decreased production b. Maldistribution c. Accelerated destruction d. Decreased survival e. Inherited 121. Which mechanism is responsible for thrombocytopenia in disseminated intravascular coagulation (DIC)? a. Decreased production b. Maldistribution c. Accelerated destruction d. Decreased survival e. Inherited 122. Which mechanism is responsible for thrombocytopenia in immune (idiopathic) thrombocytopenic purpura (ITP)? a. Decreased production b. Maldistribution c. Accelerated destruction d. Decreased survival e. Inherited
69 Neoplasia and Blood Disorders Which mechanism is responsible for thrombocytopenia in any increase in spleen size? a. Decreased production b. Maldistribution c. Accelerated destruction d. Decreased survival e. Inherited 124. Which mechanism is responsible for thrombocytopenia in thrombotic thrombocytopenic purpura (TTP)? a. Decreased production b. Maldistribution c. Accelerated destruction d. Decreased survival e. Inherited 125. Which mechanism is responsible for thrombocytopenia in von Willebrand s syndrome? a. Decreased production b. Maldistribution c. Accelerated destruction d. Decreased survival e. Inherited 126. Which is a protein cofactor that exposes the inactivation site of activated coagulation factor V, which can then be cleaved by a protease? a. Protein C b. Protein S c. Antithrombin III (ATIII) d. Plasminogen e. Prekallikrein 127. Which is a factor capable of inhibiting the serine protease factors II, IX, X, XI, and XII, a process accelerated by heparin or similar molecules. a. Protein C b. Protein S c. Antithrombin III (ATIII) d. Plasminogen e. Prekallikrein
70 54 Pathophysiology 128. Which is a vitamin K dependent factor, activated in the presence of thrombin to cleave activated factors V and VIII. a. Protein C b. Protein S c. Antithrombin III (ATIII) d. Plasminogen e. Prekallikrein
71 Neoplasia and Blood Disorders Answers 91. The answer is c. (Fauci, 14/e, p 363.) Any suspicious palpable mass should be biopsied despite a negative mammogram. Negative mammograms can occur in 10 to 15% of instances of a palpable breast mass. 92. The answer is d. (Fauci, 14/e, p 620.) Ectopic acromegaly is a paraneoplastic endocrine disorder related to small cell lung cancer and secretion of growth hormone releasing hormone (GHRH). Hypercalcemia is a paraneoplastic endocrine syndrome associated with non-small cell cancers which is caused by secretion of parathyroid hormone related peptides (PTHrP); hypercortisolism caused by ACTH release occurs with small cell lung cancers, and cellular release of phosphorus causes hyperphosphatemia associated with lung cancer; gynecomastia caused by human chorionic gonadotropin secretion (hcg) also occurs with lung cancers. 93. The answer is c. (Fauci, 14/e, p 603.) LDH is an important marker to follow in any germ cell tumor. AFP elevation is seen only in nonseminoma, whereas β-hcg is seen in both nonseminoma and seminoma. The half-life of AFP is 5 to 7 days. 94. The answer is c. (Fauci, 14/e, pp 346 and 347.) Cervical nodes are more likely to yield an etiology of disease than those in the axillae and supraclavicular region. Nodes in the inguinal/femoral (groin) area much less often provide diagnosis of disease because they often are nonspecifically enlarged because of repeated infections of the lower extremities. 95. The answer is d. (Fauci, 14/e, p 699.) Chronic lymphocytic leukemia (CLL), a common chronic leukemia, has no known etiology. B cell CLL is the most common chronic leukemia/lymphoma. Often it presents as an asymptomatic lymphocytosis in patients about 60 years old. 55
72 56 Pathophysiology 96. The answer is d. (Fauci, 14/e, p 513.) Li-Fraumeni syndrome, familial polyposis coli, and familial retinoblastosis are known genetic disorders associated with familial malignancies. Peutz-Jeghers syndrome, a familial disorder of multiple gastrointestinal polyps, rarely occurs as a familial cancer disorder. 97. The answer is a. (Fauci, 14/e, pp ) Hypercalcemia of malignancy is the most common paraneoplastic syndrome. It accounts for about 40% of all hypercalcemia. The signs and symptoms of hypercalcemia include bone pain, irritability, weakness, fatigue, constipation, nausea, and vomiting, as this patient manifests. Symptoms begin at a serum calcium of about 2.6 mmol/l. Hypercalcemia of malignancy is common in cancers with squamous cell histology. 98. The answer is b. (Fauci, 14/e, pp ) The paraneoplastic syndromes include endocrine syndromes and hematologic syndromes. The paraneoplastic endocrine syndromes include hypercalcemia of malignancy, inappropriate vasopressin secretion (SIADH), Cushing s syndrome, acromegaly, and gynecomastia. The paraneoplastic hematologic disorders include erythrocytosis, granulocytosis, thrombocytosis, eosinophilia, and thrombophlebitis. 99. The answer is d. (Fauci, 14/e, pp ) Any back pain in a patient with a known history of carcinoma should be evaluated for the possibility of spinal cord compression. It occurs in 5 to 10% of patients with cancer. Lung cancer is the most common primary malignancy causing spinal cord compression. Localized back pain and tenderness are the most common initial complaints The answer is a. (Fauci, 14/e, pp ) Intravenous Decadron is the choice for initial treatment in this situation because it will decrease swelling of the tumor mass. It may provide some relief of the compression by reducing the edema. It should be given immediately on making the diagnosis The answer is c. (Fauci, 14/e, p 627.) The definitive diagnosis is superior vena cava syndrome until proven otherwise with scans. It means that the superior vena cava is obstructed. Ninety percent of these cases are
73 Neoplasia and Blood Disorders Answers 57 due to malignant tumors such as carcinoma of the lung, lymphoma, and various metastatic tumors. The findings described in this patient are not due to the other diagnoses The answer is d. (Fauci, 14/e, p 517.) Colon cancer is one cancer in which the multistep theory of carcinogenesis has been studied. In the multistep theory, the cancer develops from multiple somatic mutational steps that change normal epithelium to adenoma to carcinoma. An accumulation of somatic mutations is necessary for cancer to develop The answer is d. (McPhee, 2/e, pp ) Platelet production is stimulated by multiple cytokines, the most important being IL-6 and the peptide thrombopoietin. IL-3, IL-6, and GM-CSF also affect megakaryocytes, whereas erythropoietin and G-CSF are almost exclusively related to erythropoiesis and granulocyte production, respectively. IL-4 is also predominantly granulocyte related The answer is c. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) VWF complexes with factor VIII, which is activated by release from the complex to produce factor VIIIa. Together with factor IXa, calcium, and platelet phospholipid, factor VIIIa activates factor X. Factor XIII is activated to XIIIa by thrombin and improves the tensile properties of fibrin by chemical cross-linking. High molecular weight kininogen is the activator of factor XII. Thromboplastin is the lipid-rich protein material released on tissue injury that activates factor VII. Plasminogen is the precursor of plasmin, which is the serum protease that cleaves fibrin The answer is d. (McPhee, 2/e, p 104; Fauci, 14/e, p 739.) Factor XIII is produced by platelets. Factors II, VII, IX, and X are all dependent for synthesis on γ-carboxylase, a liver enzyme dependent on vitamin K. The two anticoagulant proteins S and C are also vitamin K dependent. Vitamin K is a necessary cofactor in the posttranslational synthesis of γ-carboxyglutamic acid groups in precursors of these factors The answer is e. (McPhee, 2/e, p 105; Fauci, 14/e, pp 338 and 643.) Microcytic anemia results from abnormal hemoglobin production of the quantity of molecules or the type, as in thalassemia. Macrocytic anemia results either from abnormal nuclear maturation (nuclear cytoplasmic
74 58 Pathophysiology asynchrony) with megaloblastic changes in the bone marrow precursor cells or a high proportion of reticulocytes in the red cell population. The causes of abnormal nuclear maturation include vitamin B 12 deficiency, folic acid deficiency, drugs that interfere with DNA synthesis, and alcohol. A high proportion of reticulocytes in the red cell population will also increase the average mean volume of red cells, because reticulocytes are larger than more mature red cells. This occurs when there is an active marrow proliferative response in compensation for active red cell destruction (hemolysis) or an active response to therapy for anemia such as vitamin B The answer is d. (McPhee, 2/e, p 105; Fauci, 14/e, pp ) The relative hypoxia of the tobacco smoker, the mountain dweller, and the patient with pulmonary insufficiency is a stimulus to erythropoietin production, which results in increased red cell production and circulating red cell mass. Likewise, some tumors, including renal tumors, uterine myomata, and cerebellar hemangiomas, may synthesize erythropoietin. Primary polycythemia is an abnormality of the bone marrow, leading to increased circulating red cell mass and feedback suppression of erythropoietin production The answer is b. (McPhee, 2/e, p 106; Fauci, 14/e, pp 352 and 355.) The leukocytosis associated with release of epinephrine, including conditions of stress (endogenous) and in therapy (exogenous), arises by demargination of neutrophils from the blood vessel walls. The apparent increase in the leukocyte count results from redistribution of the neutrophils, the marginated cells normally flowing close to the periphery of the blood vessels being relocated throughout the full volume of flowing blood. Leukocytosis associated with acute infection, tissue necrosis, myelocytic leukemia, and collagen vascular disease is due to the proliferative stimulus increasing the true numbers of circulating cells The answer is e. (McPhee, 2/e, p 109; Fauci, 14/e, pp 337 and 640.) Transferrin is the principal iron-binding protein present in plasma and carries the greater part of the iron in transport between the gut, storage sites, and the bone marrow. In iron deficiency, the total iron-binding capacity of serum increases as the serum iron falls. The iron-binding capacity is principally dependent on the quantity of transferrin. Hemoglobin and myoglobin contain iron in the oxygen-carrying molecule heme. This binds oxygen
75 Neoplasia and Blood Disorders Answers 59 reversibly, which permits transport by hemoglobin in red cells and storage by myoglobin in muscle The answer is c. (McPhee, 2/e, p 107; Fauci, 14/e, p 683.) Thrombocytosis occurs in the myeloproliferative disorders (especially essential thrombocythemia), in the hyposplenic states, including postsplenectomy, mainly because of redistribution of the excess platelets normally present in the spleen and anemias. The anemias include iron-deficiency anemia and hemolytic anemias, reflecting the increased proliferative activity of the affected bone marrow. Thrombocytopenia occurs because of decreased production as in aplastic anemia, vitamin B 12, and folate deficiencies or because of decreased survival as in hypersplenism, prosthetic valves, and disseminated intravascular coagulation The answer is d. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Pernicious anemia, a megaloblastic anemia, results from a complex cascade of events that is autoimmune in origin. Antibodies against gastric parietal cell components and intrinsic factor are common, and antibody-generating B lymphocytes are found in the gastric mucosa. The signs of vitamin B 12 (cobalamin) deficiency are delayed by the liver storage of cobalamin, provided that the patient s intake has previously been normal. Cobalamin deficiency is almost always due to malabsorption. Normal diets usually provide adequate intake of cobalamin; however, in vegetarians the intake is inadequate. Persons suffering from pernicious anemia can develop very low hemoglobin levels, as low as 4 g/dl, unlike other anemias. Multiple neurologic findings (due to demyelination at first and then axonal degeneration) include numbness and paresthesias, weakness, ataxia, difficulties with mentation, and abnormal deep tendon reflexes and pathological reflexes, high output failure, sallow color are consistent with pernicious anemia. In autoimmune hemolysis, the Coombs test is positive The answer is d. (McPhee, 2/e, pp ; Fauci, 14/e, pp 731 and 744.) Drugs induce thrombocytopenia by an immune response. The platelet is damaged by complement activation as a consequence of the formation of drug-antibody complexes. The incidence of thrombocytopenia is high in patients treated with heparin. The pathogenesis involves binding of heparin to platelet factor 4 (PF4), and the released heparin PF4 combination acts as an antigen provoking the production of an IgG antibody. The
76 60 Pathophysiology complex IgG heparin PF can bind to platelets by the platelet Fc receptor and lead to thrombocytopenia by destruction of the sensitized platelets in the spleen. However, the complex can also form bridges between platelets and induce aggregation with platelet activation and the potential for thrombus formation. Heparin-induced thrombosis is sometimes known as the white clot syndrome. Alcohol ingested in large quantities depresses the marrow, and chemotherapeutic drugs are cytotoxic and depress megakaryocyte production The answer is c. (McPhee, 2/e, pp ) The presence of nucleated red cells in the peripheral blood is abnormal: it may be pathologic as in the leukoerythroblastosis that accompanies bone marrow infiltration, or with extramedullary erythropoiesis as in primary (agnogenic) myeloid metaplasia. Occasionally, it accompanies a brisk therapeutic correction of anemia. The earliest red cells (reticulocytes) still contain some ribosomes, mitochondria, and RNA and appear faintly basophilic (blue) in a Wright s stained blood smear. Hemoglobin is a tetrameric protein, and each subunit is associated with a heme complex containing the iron atom of the molecule, which is related to the locus of the carried oxygen atoms. The red cell is, in fact, normally a highly flexible body, capable of considerable modification of shape in traversing small capillaries. The flexibility may be compromised by increased intracellular viscosity or rigidity of the cell membrane, as in various hemolytic anemias The answer is b. (McPhee, 2/e, p 101; Fauci, 14/e, p 351.) The neutrophils (PMNs) are the predominant form of the WBCs, but their major function is in the tissues where they accumulate at sites of infection or inflammation, after transient passage through the bloodstream. Decreased available numbers (neutropenia) can result in a high incidence of bacterial infections. The granules contain enzymes with bactericidal properties, such as myeloperoxidase and NADPH oxidase The answers are 115: b; 116: b; 117: b; 118: a; 119: d. (McPhee, 2/e, p 106; Fauci, 14/e, pp and ) The chronic lymphocytic and myelocytic leukemias are characterized by proliferation of lymphoid and myeloid cells, which are usually present in excessive numbers in the peripheral blood: their appearances in the peripheral blood smear are usually close to those of the related normal forms, although other
77 Neoplasia and Blood Disorders Answers 61 properties of the cells may be abnormal. Precursor forms are often prominent in myeloid leukemias. A characteristic chromosomal translocation t(9:22) results in the Philadelphia chromosome: although not exclusively restricted to chronic myelocytic leukemia, its presence in a chronic leukemia makes the diagnosis highly probable. The myelocytic leukemia commonly terminates following transition to an accelerated phase with transformation of the principal malignant cell to a blastlike form. The lymphocytic leukemia involves impaired antibody production and other immune functions, resulting in susceptibility to severe infections. Both forms of leukemia lead to increasing accumulation of malignant cells, leading to organ enlargement, especially of the spleen, liver, lymph nodes, and bone marrow. Hodgkin s disease often presents with superficial nodes found as a new mass The answers are 120: a; 121: c; 122: c; 123: b; 124: c; 125: e. (McPhee, 2/e, p 107; Fauci, 14/e, pp 344 and ) Thrombocytopenia is most commonly produced by processes that reduce the survival of circulating platelets significantly below the normal average life span of 10 days. In disseminated intravascular coagulation, activation of the coagulation sequence by infection, release of thromboplastins from malignant cells, hypoxia, or hemorrhage leads to a consumption coagulopathy that depletes the components of coagulation mechanisms, including the platelets. In vitamin B 12 (cobalamin) deficiency, the number of megakaryocytes in the bone marrow are depleted. In ITP, autoimmune antibodies attack the platelet surface and initiate phagocytosis by attachment to the receptors of macrophages, especially in the spleen. A proportion, often about 10%, of the circulating platelets is normally present in a platelet pool in a normal spleen. With splenic enlargement (splenomegaly), the pool accommodates a higher proportion of the total and reduces the platelet count. Von Willebrand s syndrome is an inherited disorder in which affected persons lack the carrier protein for factor VIII, the von Willebrand factor, and it is necessary for formation of the platelet plug in the coagulation cascade The answers are 126: c; 127: c; 128: a. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Control of the coagulation system depends in large part on the activity of negative control factors that impede the excessive development of active coagulation. Protein C, which exposes
78 62 Pathophysiology the inactivation site of activated coagulation factor V, is an anticoagulation factor requiring vitamin K for its synthesis. Thrombin generated by the coagulation process and modified by thrombomodulin activates protein C, which cleaves factors Va and VIIIa and inhibits coagulation. Platelet phospholipid, calcium, and a cofactor, protein S, are also required. Antithrombin III (ATIII) is also an inhibitor of coagulation not only of thrombin but of activated IX, X, XI, and XII. It acts by binding to the factor and not by enzymatic action. Its activity is very dependent on its accelerator cofactor, heparin. Activated factor XIII is involved in cross-linking fibrin, and prekallikrein is involved in activating factor XII.
79 Infectious Disease Questions DIRECTIONS: Each item contains a question or incomplete statement followed by suggested responses. Select the one best response to each question Acute bacterial infections of the bone characteristically show which one of the following? a. Necrotic bone b. Prolonged clinical course c. Predominantly mononuclear cells d. Congested and thrombosed blood vessels e. Granulation tissue 130. Which one of the following organisms accounts for at least 50% of cases of acute hematogenous and contiguous focus osteomyelitis? a. Group A streptococci b. Group B streptococci c. Mycoplasma d. S. aureus e. Pseudomonas aeruginosa 131. Bacteria can infect the skin through accidental or deliberate breaks in it or through the hair follicle. Which one bacteria causes one of several differing infections of the skin including necrotizing fasciitis, erysipelas, impetigo contagiosa, and necrotizing myositis? a. Clostridium spp. b. S. pyogenes c. S. aureus d. Anaerobic bacteria e. Pseudomonas aeruginosa 63 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
80 64 Pathophysiology 132. Which one of the following does not contribute to injection drug users becoming infected? a. Unsterile injection technique b. Immune defects induced by drug use c. Contaminated needles and syringes d. Nonuse of antibiotics e. Poor dental hygiene 133. Infective endocarditis frequently occurs in injection drug users. The valve most often involved is a. Mitral b. Aortic c. Tricuspid d. Pulmonic 134. Which one of the following types of bites is more likely to become infected? a. Human b. Dog c. Cat d. Rat 135. Among nosocomial (hospital acquired) infections, which one occurs most commonly and also causes the least sequelae? a. Pneumonia b. Urinary tract c. Surgical wound d. Bacteremia 136. Gram-negative and gram-positive bacteria each possess which one of the following structures? a. Peptidoglycan b. Lipopolysaccharide c. Matrix protein d. Pili e. Flagella
81 Infectious Disease Which organism is not a likely cause of left-sided infective endocarditis? a. Clostridium spp. b. S. aureus c. Streptococcus viridans d. Enterococcus e. Streptococcus bovis 138. The subarachnoid space inflammation of bacterial meningitis, which is caused by a gram-negative bacteria, is induced by which one component of the bacteria? a. Matrix protein b. Lipopolysaccharide (LPS) c. Pili d. Inner membrane e. Peptidoglycan 139. Which one of the following microorganisms is the most common cause of meningitis in children under 1 month of age? a. Neisseria meningitidis b. Streptococcus pneumoniae (pneumococcus) c. Gram-negative bacilli d. Staphylococci e. Hemophilus influenzae 140. Which one of the following microorganisms is the most common cause of community acquired pneumonia? a. Mycoplasma pneumoniae b. Streptococcus pneumoniae c. Staphylococcus aureus d. Hemophilus influenzae e. Legionella spp.
82 66 Pathophysiology 141. Which one of the following microorganisms is not a likely cause of pneumonia among persons with human immunodeficiency virus (HIV) infection and AIDS? a. Mycoplasma pneumoniae b. Streptococcus pneumoniae c. Pneumocystis carinii d. Hemophilus influenzae e. Mycobacterium tuberculosis 142. Which one of the following bacteria is deposited directly into the lower airways? a. Mycoplasma pneumoniae b. Streptococcus pneumoniae c. Pneumocystis carinii d. Hemophilus influenzae e. Mycobacterium tuberculosis 143. Which microorganism is likely to cause pneumonia in a person with late stages of HIV and AIDS? a. Legionella spp. b. Pneumocystis carinii c. Chlamydia psittaci d. Klebsiella pneumoniae e. Moraxella catarrhalis 144. Which microorganism is likely to cause pneumonia in a person who abuses alcohol? a. Legionella spp. b. Pneumocystis carinii c. Chlamydia psittaci d. Klebsiella pneumoniae e. Moraxella catarrhalis
83 Infectious Disease Which one of the following microorganisms that cause pneumonia is acquired from exposure to an infected animal? a. Legionella spp. b. Pneumocystis carinii c. Chlamydia psittaci d. Klebsiella pneumoniae e. Moraxella catarrhalis 146. Persons with chronic pulmonary disease are more likely to develop pneumonia due to infection which one of the following pathogens? a. Legionella spp. b. Pneumocystis carinii c. Chlamydia psittaci d. Klebsiella pneumoniae e. Moraxella catarrhalis 147. Which one of the following groups of microorganisms more commonly causes diarrhea in the United States? a. Bacteria b. Fungi c. Protozoa d. Viruses 148. The single most important bacteria that causes diarrhea worldwide is: a. Helicobacter pylori b. Staphylococcus aureus c. Salmonella spp. d. Shigella spp. e. E. coli 149. In the pathogenesis of acute diarrhea, which microorganism characteristically penetrates intestinal mucosa of the distal small bowel, multiplies in Peyer s patches, and then disseminates by the bloodstream? a. Vibrio cholerae b. Enterotoxigenic E. coli c. Salmonella typhi d. Rotavirus e. Clostridium difficile
84 68 Pathophysiology 150. Which one of the endogenous mediators of sepsis is most likely to be the mediator of shock? a. Cytokines b. Endorphins c. Arachidonic acid metabolites d. Complement C5a e. Nitric oxide 151. The principal CD lymphocyte affected in HIV and AIDS is: a. CD28 b. CD27 c. CD8 d. CD4 e. CD The destruction of CD4 lymphocytes in HIV and AIDS involves all of the following except which one feature? a. Direct viral destruction of CD4 lymphocytes b. Apoptosis c. Autoimmunity d. Syncytium formation e. Bone marrow stimulation 153. Typically HIV progresses from the onset of infection to evidence of immunosuppression over what period of time? a. 1 to 3 months b. 1 to 3 years c. 4 to 5 years d. 5 to 10 years e. 11 to 15 years 154. Which one of the following causes a lung infection, the most common opportunistic infection, in HIV-infected persons? a. Kaposi s sarcoma b. Pneumocystis carinii c. Mycobacterium tuberculosis d. Mycobacterium avium complex (MAC) e. Toxoplasma gondii
85 Infectious Disease Which one of the following causes esophagitis, with substernal pain and dysphagia, in HIV-infected persons? a. Candida albicans b. Cytomegalovirus c. Cryptococcus neoformans d. Herpesvirus varicellae e. Cryptosporidium 156. Which one of the following causes biliary tract infection, including sclerosing cholangitis, in HIV-infected persons? a. Candida albicans b. Cytomegalovirus c. Cryptococcus neoformans d. Herpesvirus varicellae e. Cryptosporidium 157. Which one of the following causes painful and crusted lesions that follow the path of an intracostal nerve in persons infected with HIV? a. Candida albicans b. Cytomegalovirus c. Cryptococcus neoformans d. Herpesvirus varicellae e. Cryptosporidium 158. Which one of the following causes headache, seizures, altered mental status, and a space-occupying lesion in persons infected with HIV? a. Kaposi s sarcoma b. Pneumocystis carinii c. Mycobacterium tuberculosis d. Mycobacterium avium complex e. Toxoplasma gondii
86 70 Pathophysiology 159. Which one of the following causes localized skin lesion or disseminated visceral lesion characterized by mixed cell population that includes vascular endothelial cells in persons infected with HIV? a. Kaposi s sarcoma b. Pneumocystis carinii c. Mycobacterium tuberculosis d. Mycobacterium avium complex e. Toxoplasma gondii 160. Which one of the following causes retinitis, with patient complaints of blind spots, and retinal hemorrhages and exudates in persons infected with HIV? a. Candida albicans b. Cytomegalovirus c. Cryptococcus neoformans d. Herpesvirus varicellae e. Cryptosporidium 161. Which one of the following causes a wasting disease and cachexia in persons infected with HIV? a. Kaposi s sarcoma b. Pneumocystis carinii c. Mycobacterium tuberculosis d. Mycobacterium avium complex e. Toxoplasma gondii 162. A 45-year-old woman veterinarian who is a faculty member at the nearby veterinary school comes to your office with complaints of a flulike syndrome of 9 days duration including persistent fever for all 9 days, extreme fatigue, and severe headache. She has a dry cough, an increased white count, and thrombocytopenia. Which one of the following is the likely cause of her infection? a. Influenzavirus b. Mycoplasma pneumoniae c. Chlamydia psittaci d. Coxiella burnetii e. Chlamydia pneumoniae
87 Infectious Disease Pneumococcal vaccine is a. Comprised of purified capsular polysaccharides from 23 serotypes b. Precipitated with alum to improve its antigenicity c. Inactivated with formaldehyde d. Prepared by recombinant techniques e. Revised annually based on the predominant serotypes in the U.S A 22-year-old college student comes to your office because of a cold and respiratory symptoms of about 12 days duration that do not seem to be lessening in intensity. He is anorexic and tired. His respiratory rate is 24/min, and he has a cough productive of small amounts of white sputum, but no hemoptysis or pleuritic chest pain. He chest x-ray shows infiltration in the right lower lobe. He has a leukocytosis of 18,000 and his cold agglutinin titer is elevated. The organism that is the likely cause of this illness is a. Leptospira b. Influenzavirus c. Mycoplasma pneumoniae d. Legionella spp. e. Coxiella burnetti 165. In clinical infection with E. histolytica, the main finding concerning immunity is a. Clinical infection induces immunity to recurrent colonization b. Repeated episodes of colitis are usual c. Antibody is protective d. Antibody titers correlate with the length of illness e. Antibody titers correlate with the severity of disease 166. The recommendation for poliovirus vaccine in infants and children was changed to inactivated vaccine [Salk inactivated vaccine (IPV)] from live attenuated vaccine [Sabin oral vaccine (OPV)] for which reason? a. Inactivated vaccine is cheaper than attenuated vaccine b. Injection of vaccine is easier than oral administration c. The antibody response is more long lasting with inactivated vaccine d. The chance of vaccine-induced polio illness is unlikely with inactivated vaccine e. Mothers prefer injections for their children
88 72 Pathophysiology 167. INH prophylaxis is recommended for which person? a. A man teacher with HIV and a PPD of 4 mm b. A well man truck driver age 25 years with a PPD of 8 mm c. A well woman clerk age 45 years with a PPD of 9 mm d. A well man medical student age 30 years with a PPD of 11 mm e. A well woman actress age 40 years with a PPD of 12 mm 168. Among intravenous drug abusers, which is most often the source of the pathogens of infective endocarditis? a. Urine b. Lungs c. Gastrointestinal tract d. Skin e. Contaminated drugs 169. Which is the best approach to confirm the diagnosis of an acute cytomegalovirus infection (CMV)? a. Clinically with fever and rash b. Isolation of the virus from urine c. Isolation of virus from saliva d. Isolation of the virus from blood e. Isolation of virus from stool 170. The complications of severe infections of falciparum malaria can include anemia that is due predominantly to a. Significant bleeding with disseminated intravascular coagulation b. Accelerated erythrocyte destruction and removal by the spleen c. Inadequate iron storage d. Increased Kuppfer cells in the liver e. Lactic acidosis 171. Which one feature characterizes cat-scratch disease? a. 60% of cases occur in adults b. Fever and rash occur within 3 to 5 days of a cat scratch in most cases c. Anorexia, malaise, and weight loss are common d. Painless lymphadenopathy e. Culture of lymph nodes usually is positive for the infecting organism
89 Infectious Disease A 12-year-old boy is brought to your office by his mother because he developed a painless rash on his face and legs. The rash began as red papules and then became vesicular and pustular and finally it coalesced in honeycomb-like crusts. The boy does not have fever, but he does have several insect bites and he is unwashed and dressed in dirty clothes. This rash is likely to be a. Herpes simplex b. Shingles c. Impetigo d. Scarlet fever e. Erysipelas
90 74 Infectious Disease Answers 129. The answer is d. (Fauci, 14e, p 824.) Acute osteomyelitis shows bacteria, polymorphonuclear leukocytes, and congested and thrombosed blood vessels. Its course is not prolonged, as is the course of chronic osteomyelitis. Necrotic bone, presence of granulation and fibrous tissues, very few bacteria, and the absence of living osteocytes characterize chronic osteomyelitis The answer is d. (Fauci, 14e, pp ) In acute hematogenous osteomyelitis, S. aureus accounts for about 50% of infections, likely as the single organism. In contiguous focus osteomyelitis, S. aureus also occurs in more than 50% of cases, except it likely occurs together with other organisms as a polymicrobial infection The answer is b. (Fauci, 14e, p 828.) S. pyogenes causes these differing skin infections because they infect the dermis and can spread laterally by the lymphatics to deeper and superficial areas. Pseudomonas aeruginosa causes hot tub folliculitis especially in tubs that fail to maintain high water temperature, for example between 37 and 40 C, and sufficient chlorination. S. aureus causes bullous impetigo, furunculosis, and pyomyositis. Clostridium species causes gas gangrene The answer is d. (Fauci, 14e, p 831.) Usually, intermittent antibiotic usage by injection drug users alters normal microbial flora, leading to increased risk of infection, and the nonuse of antibiotics would prevent it. All other factors contribute to the increased of infection in injection drug users The answer is c. (Fauci, 14e, p 832.) The tricuspid valve is more frequently involved than the other valves, perhaps because of its nearness to the injection sites. However, in an individual patient any of the heart valves may become infected. Left-sided infective endocarditis usually develops when underlying valvular defect exists The answer is a. (Fauci, 14e, p 837.) Of the common animal bites, human bites more often become infected than other animal bites. They
91 Infectious Disease Answers 75 occur as occlusional injuries: actual biting and clenched-fist injuries sustained by striking the teeth of another individual. Infections caused by human bites reflect the multiple microorganisms that can be present in the mouth The answer is b. (Fauci, 14e, p 848.) Urinary tract infections acquired in hospital develop more commonly than any other nosocomial infection and have the fewest severe sequelae. The other nosocomial infections, especially pneumonia and bacteremia, are life threatening and much more difficult to treat and can lead to severe sequelae The answer is a. (Fauci, 14e, p 853.) Gram-positive and gramnegative bacteria each have a peptidoglycan layer. All other structures are features of gram-negative bacteria only The answer is a. (Fauci, 14e, pp ) The most common bacteria causing infective endocarditis of the left side of the heart are viridans streptococci (including Streptococcus sanguis, Streptococcus mutans, and Streptococcus mitis), less often Streptococcus bovis and other streptococci, S. aureus and Enterococcus. Clostridium spp. and other fungi are pathogens of endocarditis in persons who are injection drug abusers, but rarely in other persons. S. aureus also is common in injection drug users, and then it infects the right side of the heart The answer is b. (Fauci, 14e, p 2422.) The pathogenesis of meningitis involves subarachnoid space inflammation caused by the invading bacterial pathogen. Individual component(s) of the bacteria induce subarachnoid space inflammation. In the case of the gram-negative bacteria, the lipopolysaccharide (LPS or endotoxin) induces subarachnoid space inflammation, but in the pneumococcus, it s the cell wall components, namely, teichoic acid and peptidoglycan. Both bacteria do this through the release of inflammatory mediators The answer is c. (Fauci, 14e, p 2419.) Among children 1 month of age and younger, the gram-negative bacilli, mainly E. coli and other enteric bacilli, are the most common cause of meningitis. Group B streptococci and Listeria monocytogenes also cause meningitis in this age of group of children, but not as often as do the gram-negative bacilli. Group B streptococci
92 76 Pathophysiology septic infections that occur very early do so as a result of spread of the organism to the newborn from the maternal genital tract. N. meningitidis is a common cause of meningitis in children older than 1 month of age, and among older children, adolescents, and adults, N. meningitidis and S. pneumoniae are the two most common pathogens of meningitis. H. influenzae is a common cause of meningitis among older children and adolescents The answer is b. (McPhee, 2e, p 64.) S. pneumoniae is the most common cause of community acquired pneumonia, accounting for about twothirds of pneumonias, especially among adults. Mycoplasma pneumoniae occurs mainly in young adults during the second and third decades. H. influenzae is a frequent cause of community acquired, but not the most frequent. S. aureus and Legionella spp. are minor causes of community acquired pneumonia The answer is a. (McPhee, 2e, p 65.) Mycoplasma pneumoniae shows no more predilection for HIV and AIDS patients than it does for persons with intact immune systems. Pneumocystis carinii pneumonia occurs almost exclusively in persons with HIV and AIDS and not in persons with intact immune systems, usually when the CD4 lymphocyte count falls below about 450 cells/µl. However, prophylaxis with trimethoprimsulfamethoxazole or pentamidine aerosols now prevents most of the cases of PCP. Mycobacterium tuberculosis occurs at a high rate in persons with AIDS; they can become infected and spread drug-resistant strains of Mycobacterium tuberculosis that are very difficult to treat especially if they exhibit resistance to both isoniazid and rifampin. S. pneumoniae and H. influenzae occur at high rates in persons with HIV and AIDS The answer is e. (McPhee, 2e, p 65.) Mycobacterium tuberculosis is an airborne microorganism that is deposited directly into the lower airways. The large microorganisms are caught in the nose and pharynx and colonize these structures, and the smaller microorganisms are deposited on the mucociliary blanket of the respiratory tree The answer is b. (McPhee, 2e, p 65.) Pneumocystis carinii, a common cause pneumonia in persons with late stage HIV and AIDS, was the most common cause of pneumonia in this group of persons until prophylaxis
93 Infectious Disease Answers 77 either with trimethoprim-sulfamethoxazole or pentamidine aerosol became a routine feature of their care The answer is d. (McPhee, 2e, p 65.) Persons with acute and chronic alcoholism become infected with Klebsiella pneumoniae, most often by aspiration. K. pneumoniae pneumonia often localizes in the upper lobe, sometimes the minor fissures bows downward, reflecting the bogginess of the upper lobe involved with this infection The answer is c. (McPhee, 2e, p 65.) Psittacine birds transmit Chlamydia psittaci to humans who come in contact with them or keep them as pets. The pneumonia appears as an atypical pneumonia (patchy, interstitial infiltrate) on chest roentgenogram, similar to other atypical pneumonias such as Mycoplasma pneumoniae pneumonia. It also responds to treatment with a broad spectrum antibiotic, such as a macrolide or doxycycline The answer is e. (McPhee, 2e, p 65.) Persons suffering from chronic lung disease develop pneumonia due to Moraxella catarrhalis, and also to S. pneumoniae and H. influenzae. Very often, their sputum is colonized by one or more of the microorganisms that gains entrance to the lower respiratory tract because of damage to the respiratory tract cilia and the mucociliary blanket The answer is d. (McPhee, 2e, p 67.) Viruses account for 30 to 40% of the cases of infectious diarrhea in the U.S.; rotavirus is the predominant virus, especially in infants and children. The main bacterial pathogens are Helicobacter pylori and various E. coli serotypes. Crytposporidium causes a particularly severe diarrhea in persons with HIV and AIDS and a very low CD4 lymphocyte count, usually less than 100 cells/µl The answer is e. (McPhee, 2e, p 68.) On a worldwide basis, the single most important bacteria that causes diarrhea is E. coli, of which several main types play important roles in diarrhea illnesses. These include the following types: enteroaggregative, enteropathogenic, enterotoxigenic, enteroinvasive, and enterohemorrhagic. Enterotoxigenic occur more widely
94 78 Pathophysiology in acute diarrhea than the other types. They produce two enterotoxins that adversely affect the mucosal cells of the small intestine, resulting in a watery diarrhea. Enterohemorrhagic E. coli of serotype O157:H7 is associated with the severe hemolytic-uremia syndrome, as well as nonbloody diarrhea, noninflammatory diarrhea, and thrombotic thrombocytopenia purpura. It also produces toxins that are Shiga-like, called verotoxins, composed of one large protein unit (the A subunit) and five small subunits (the B subunit) that bind the toxin to the intestinal cell, stop intracellular protein synthesis, and eventually kill the intestinal cells The answer is c. (Fauci, 14e, p 797.) Certain bacteria can aggregate at the mucosal wall as a mechanism of producing diarrhea, but an antigenantibody reaction is involved. Enterotoxin, cytotoxin, and invasion of the mucosal wall are mechanisms of bacterial diarrhea in differing bacterial pathogens. Salmonella typhi and Yersinia enterocolitica are two pathogens that penetrate mucosal wall, multiply in lymph nodes and Peyer s Patches, and then spread to the bloodstream, causing enteric fever. Characteristically, these two microorganisms cause destruction of mucosal cells, unlike the other pathogens of acute diarrhea The answer is e. (Fauci, 14e, pp ) The chemicals listed are mediators of sepsis, and additional mediators include platelet-activating factor, endothelium-derived relaxing factor, kinin, coagulation, and myocardial depressant substance. However, it is only nitric oxide, produced by inducible nitric oxide synthetase (inos), that has been shown to be the mediator of septic shock The answer is d. (McPhee, 2e, p 44.) CD4 T lymphocyte is the main CD antigen involved in HIV and AIDS. HIV infection destroys the CD4 lymphocytes. The CD8 lymphocytes increase in a reciprocal manner in HIV The answer is e. (McPhee, 2e, p 44.) Bone marrow stimulation is not involved; viral proteins show toxicity not only for the CD4 lymphocytes but also for the marrow, suppressing its function. Apoptosis (programmed cell death), autoimmune destruction of CD4 lymphocytes, and syncytium formation contribute to the decrease in CD4 lymphocytes.
95 Infectious Disease Answers The answer is d. (McPhee, 2e, p 44.) Usually, HIV progresses slowly, and the beginning of immunosuppression is about 5 to 10 years after the onset of infection. Infection begins with an acute, brief, febrile viral syndrome, followed by a long symptom-free period until the CD4 T lymphocyte begins to decline, providing evidence of immunosuppression The answer is b. (McPhee, 2e, pp ) Pneumocystis carinii pneumonia is a common complication of HIV and AIDS, and it is the most common opportunistic infection in HIV and AIDS. It can be prevented in most persons by prophylaxis with trimethoprim-sulfamethoxazole or pentamidine aerosols. A serious lung infection, it can be life threatening. All persons with HIV and AIDS experience one or more of the complications discussed in questions 170 to 177, especially as their immune system progressively fails The answer is a. (McPhee, 2e, pp ) Candida albicans causes thrush of the mouth and a severe esophagitis characterized by severe pain and dysphagia The answer is e. (McPhee, 2e, pp ) Biliary tract disease of differing types can be caused by Cryptosporidium, a protozoa that infects the gastrointestinal tract in many patients with HIV and AIDS The answer is d. (McPhee, 2e, pp ) Herpesvirus infections are common in persons with HIV and AIDS. Many of them experience reactivation of latent Herpesvirus varicellae infections or shingles that are very painful. Until the lesions crust over, they potentially can communicate chickenpox to susceptible persons The answer is e. (McPhee, 2e, pp ) Toxoplasmosis, acquired from infected cats, causes space occupying lesions, accompanied by central nervous system symptoms The answer is a. (McPhee, 2e, pp ) Kaposi s sarcoma typically causes purplish, dense, localized skin lesions of varying size and also visceral organ involvement. The lesions progress slowly but can become large
96 80 Pathophysiology and fulminant. Kaposi s sarcoma in AIDS occurs mainly in homosexual men The answer is b. (McPhee, 2e, pp ) Cytomegalovirus, also a herpesvirus, causes retinitis that leads progressively to complete blindness without treatment The answer is d. (McPhee, 2e, pp ) Wasting and cachexia are caused by a bloodstream infection with Mycobacterium avium complex (MAN), which includes M. avium and M. intracellulare. MAN organisms occur widely in nature soil and animals and spread to humans. However, almost only immunosuppressed persons become infected, especially persons with AIDS who possess few CD4 lymphocytes The answer is d. (Fauci, 14e, pp ) Infection with Coxiella burnetii (or Q fever) represents an occupational hazard of veterinarians. Q fever is characterized by fever, extreme fatigue, and headache, and about one-fourth of persons with the infection develop thrombocytopenia, unlike in the other infections. Mycoplasma pneumoniae infection is insidious and causes pneumonia as does Chlamydia pneumoniae infection; thrombocytopenia is not a characteristic of these infections. Influenza develops rapidly, in 2 to 3 days from exposure The answer is a. (Fauci, 14e, p 1445.) Pneumococcal polysaccharide vaccine is composed of purified polysaccharides from 23 serotypes of the pneumococcus that account for about 90% of infections. The polysaccharides are purified from the capsule of the organism grown in broth. The formulation remains unchanged from introduction of the vaccine in By comparison, the components of the influenza vaccine, the only other vaccine for prevention of respiratory tract disease, change annually because of antigenic drift and shift that occurs in the virus in nature. Additionally, a second pneumococcal vaccine was licensed recently for use in children under 2 years of age composed of 7 polysaccharides conjugated to a protein carrier to provide a superior antibody response in this age group compared with the 23-valent vaccine The answer is c. (Fauci, 14e, p 1053.) Mycoplasma pneumoniae pneumonia occurs predominantly in adolescents and young adults and
97 Infectious Disease Answers 81 also in elderly adults. It begins insidiously with fever, cough, and scant white sputum, but not hemoptysis. The cold agglutinin antibodies are elevated in this infection, usually in about one-half of cases and not in the other infections. The chest x-ray is usually positive and the infiltrate is interstitial, mainly in the lower lobe on one side; occasionally, it involves both lungs The answer is d. (Fauci, 14e, pp ) In E. histolytica clinical infection, antibody is not protective, and titers correlate with the duration of illness and not the severity. Clinical infection fails to induce immunity to recurrent colonization. Episodes of recurrent colitis are unusual nonetheless The answer is d. (Fauci, 14e, pp ) Because of the real, but very small, risk of paralysis associated with the administration of live oral poliovirus (OPV) vaccine, especially in adults, inactivated poliovirus vaccine (IPV) is now the recommended vaccine for use in children and adults The answer is d. (Fauci, 14e, p 1013.) Adults younger than 35 years of age with PPD skin test reactivity (meaning induration, not redness) of 10-mm diameter or more and at risk of tuberculosis should be given INH prophylaxis for 6 months. HIV-infected adults with PPD induration of 5 mm or more should be given INH prophylaxis. INH prophylaxis is not recommended for persons in the other three groups listed The answer is d. (Fauci, 14e, pp ; 832.) Injection drug abusers usually contaminate their bloodstream from the skin. However, much less commonly than skin, contaminated drug serves as the source of the pathogen. The other organ systems do not serve as a source of the pathogens of endocarditis in drug abusers The answer is d. (Fauci, 14e, p 1094.) Isolation of virus from blood or demonstration of a fourfold or greater rise in antibody is the most reliable means of diagnosis of an acute infection of CMV. Excretion of CMV in the urine or the saliva can persist for months. Clinical findings alone are insufficient to differentiate CMV infection from other acute virus infections.
98 82 Pathophysiology 170. The answer is b. (Fauci, 14e, p 1094.) The anemia that develops in severe infections of falciparum malaria results from accelerated erythrocyte destruction and removal by the spleen. Few patients show significant bleeding with disseminated intravascular coagulation. Lactic acidosis occurs in severe malaria in part due to lactate production by the parasites. Increased Kuppfer cells in the liver and inadequate iron storage do not account for the anemia The answer is c. (Fauci, 14e, p 985.) About 60% of cases occur in children and do not cause fever in most cases, but patients usually develop systemic systems including weight loss, anorexia, and fatigue. Painful regional lymphadenopathy persists for weeks, and occasionally the involved nodes can become suppurative. However, cultures of lymph nodes or other tissues are rarely positive. Cat-scratch disease uncomplicated by central nervous sytem disease is a self-limiting disease of several weeks or months The answer is c. (Fauci, 14e, p 985.) The rash is impetigo, which is caused by group A streptococci, occasionally by other streptococci, and also by Staphylococcus aureus. It occurs in children who have poor hygiene, and the streptococci, which colonize the skin, gain entrance through a break in the skin, such as a scratch or an insect bite. The rash is painless, unlike herpes simplex or shingles, which is due to Herpesvirus varicellae. Herpes simplex occurs on the face and mouth and genitals; shingles follows the distribution of a nerve, mainly the temporal nerve and the intracostal nerves. Scarlet fever, also due to streptococci, characteristically covers the trunk and extremities with a fine papular rash, sparing the palms and soles. Erysipelas is a streptococcal cellulitis.
99 Cardiovascular Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question Which one of the following ECG components varies with heart rate? a. PR interval b. QRS duration c. ST segment d. QT interval e. QRS voltage 174. Which of the following cardiac parameters decreases during pregnancy? a. Cardiac output b. Stroke volume c. Heart rate d. Blood volume e. Systemic vascular resistance 175. Which of the following occurs during systole? a. Blood passes from atria into the ventricles b. The atrioventricular (AV) valves are open c. Rapid ventricular filling occurs d. The ventricles contract e. Atrial contraction propels final proportion of blood into ventricles 176. Cardiac output, the volume of blood ejected from the ventricles in 1 minute, is equal to which of the following? a. The product of heart rate and stroke volume b. The product of contractility and preload c. The difference between preload and afterload d. The product of heart rate and preload e. The difference between contractility and afterload 83 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
100 84 Pathophysiology Review the Frank-Starling curve to answer questions Stroke volume (or cardiac output) A B C Left ventricular end-diastolic pressure (or end-diastolic volume) 177. Curve A corresponds to which of the following? a. A patient in congestive heart failure b. A patient with normal left ventricular function who is receiving intravenous dobutamine as part of a diagnostic study for ischemia c. A patient in congestive heart failure due to diastolic dysfunction d. A normal person whose stroke volume increases as preload increases e. A patient with congestive heart failure treated with a positive inotrope 178. Curve B corresponds to which of the following? a. A patient in congestive heart failure treated with a positive inotrope b. A patient in congestive heart failure due to systolic function c. A normal person whose stroke volume increases as preload increases d. A patient with normal left ventricular function who is receiving intravenous dobutamine as part of a diagnostic study for ischemia e. A patient in congestive heart failure due to diastolic dysfunction 179. Curve C corresponds to which of the following? a. A patient in congestive heart failure due to systolic dysfunction b. A normal person whose stroke volume increases as preload increases c. A patient with normal left ventricular function who is receiving intravenous dobutamine as part of a diagnostic study for ischemia d. A patient in congestive heart failure due to diastolic function e. A patient in congestive heart failure treated with a positive inotrope
101 Cardiovascular 85 Review the left ventricular pressure volume loop to answer questions d c Pressure, mm Hg a SV b Volume, ml 180. Which of the following represent the mitral valve opening? a. Point A b. Line A B c. Point B d. Line B C e. Point C 181. Which of the following represent the mitral valve closing? a. Line A B b. Point B c. Point C d. Line B C e. Point D 182. Which of the following represent the aortic valve opening? a. Point A b. Line B C c. Point C d. Line C D e. Point D
102 86 Pathophysiology 183. Which of the following represent left ventricular ejection? a. Point A b. Point B c. Line B C d. Line C D e. Point C Review the diagram of an ECG tracing for questions QRS P wave T wave U wave J point 184. Which of the following would represent left or right atrial enlargement on a surface electrocardiogram? a. Wide or tall P wave b. Wide or tall T wave c. A prominent U wave d. An elevated J point e. A large QRS voltage 185. Which of the following is often noted during hypokalemia? a. Prominent P wave b. Prominent QRS complex c. Long Q T interval d. Prominent U wave e. J point elevation 186. Which of the following represent repolarization of the ventricles? a. P wave b. QRS complex c. T wave d. J point e. U wave
103 Cardiovascular Which of the following would widen if a bundle branch block were present? a. P wave b. QRS complex c. T wave d. J point e. U wave 188. A normal frontal plane QRS axis is a. +90 to +180 b. 30 to 90 c. 30 to +90 d. 0 to +150 e. 0 to Which of the following associations is correct? a. Hypokalemia: shortened Q T interval b. Hypercalcemia: long Q T interval c. Hypercalcemia: flattened T waves d. Hypocalcemia: U waves e. Hyperkalemia: peaked T waves
104 88 Pathophysiology Review the diagram of electrolyte flux and the phase of the action potential for questions Membrane potential, mv Influx of sodium ions a. Phase 0 b. Phase 1 c. Phase 2 d. Phase 3 e. Phase May involve chloride ion movement a. Phase 0 b. Phase 1 c. Phase 2 d. Phase 3 e. Phase Resting state a. Phase 0 b. Phase 1 c. Phase 2 d. Phase 3 e. Phase Mediated via slow conduction channels a. Phase 0 b. Phase 1 c. Phase 2 d. Phase 3 e. Phase 4
105 Cardiovascular Rapid potassium exit a. Phase 0 b. Phase 1 c. Phase 2 d. Phase 3 e. Phase Which of the following arterial pulse waveforms is consistent with severe left ventricular impairment? a. Parvus et tardus pulse b. Bisferiens pulse c. Pulsus alternans d. Hyperkinetic pulse e. Dicrotic pulse 196. Which of the following arteriole pulse waveforms is consistent with aortic stenosis? a. Pulsus alternans b. Pulsus tardus c. Bisferiens pulse d. Dicrotic pulse e. Parvus et tardus pulse 197. Which of the following conditions is consistent with a hypokinetic arterial pulse? a. Left ventricular failure b. Hypovolemia c. Restrictive pericardial disease d. Mitral stenosis e. All of these 198. Which of the following statements is true of a reversed splitting of the first heart sound? a. The mitral component follows the tricuspid component b. It may be present in severe mitral stenosis c. It may be present with a left atrial myxoma d. It may be present with a left bundle branch block e. All of these
106 90 Pathophysiology Items Match the following heart sounds with the appropriate description: 199. Which of the following heart sounds is produced by closure of the AV valves? a. S3 b. Opening snap c. S1 d. S2 e. S Which of the following heart sounds is produced by closure of the semilunar (aortic and pulmonic) valves? a. S3 b. Opening snap c. S1 d. S2 e. S Which of the following heart sounds is low pitched and produced in the ventricle at the termination of rapid filling, heard in normal children and in patients with increased cardiac output? a. S3 b. Opening snap c. S1 d. S2 e. S Which of the following heart sounds is low pitched, presystolic sound of ventricular filling produced by atrial contraction? a. S1 b. Opening snap c. Midsystolic click d. S3 e. S4
107 Cardiovascular Which of the following heart sounds is high pitched, early diastolic sound, usually due to mitral stenosis? a. S1 b. Opening snap c. Midsystolic click d. S3 e. S Which of the following heart sounds is often caused by mitral or tricuspid valve prolapse? a. S1 b. Opening snap c. Midsystolic click d. S3 e. S The onset of the QRS complex on surface ECG corresponds to which action potential phase? a. Phase I b. Phase II c. Phase III d. Phase IV e. Phase The isoelectric ST segment on surface ECG corresponds to which action potential phase? a. Phase I b. Phase II c. Phase III d. Phase IV e. Phase The T wave on the surface ECG corresponds to which action potential phase? a. Phase I b. Phase II c. Phase III d. Phase IV e. Phase 0
108 92 Pathophysiology 208. Which of the following is represented by a prolonged PR interval and is due to delayed AV conduction? a. Asystole b. Third-degree AV block type c. Second-degree AV block type I d. First-degree AV block e. Second-degree AV block type II 209. Which of the following AV blocks is characterized by progressive PR interval prolongation prior to loss of AV conduction? a. First-degree AV block b. Second-degree AV block type I c. Second-degree AV block type II d. Third-degree AV block 210. Which of the following is the correct sequence for myocardial depolarization? a. AV node bundle of His atria b. Bundle of His AV node left ventricle c. Sinoatrial (SA node) AV node bundle of His right and left ventricles d. SA node left ventricle bundle of His 211. Which ECG leads represent the inferior cardiac wall? a. V 1, V 2 b. V 3, V 4 c. avr d. I, avl e. II, III, avf
109 Cardiovascular Which of the following produces a diastolic murmur? a. Aortic regurgitation b. Aortic stenosis c. Mitral regurgitation d. Supravalvular aortic stenosis e. Tricuspid regurgitation 213. Loss of P waves on surface ECG is consistent with a. First-degree AV block b. Atrial flutter c. Atrial fibrillation d. Sinus bradycardia e. Second-degree AV block type I 214. The arrow indicates a. R wave b. S wave c. QS wave d. Q wave e. T wave 215. Cardiac output is the product of a. Preload stroke volume b. Afterload heart rate c. Heart rate stroke volume d. Contractility preload e. Preload heart rate
110 94 Pathophysiology 216. Which of the following is true regarding right ventricular hypertrophy? a. The hypertrophy may result from aortic valve stenosis b. The hypertrophy is characterized by poor R wave progression in leads V 1 to V 3 c. The hypertrophy is usually associated with left axis deviation d. There are no associated ST-T wave changes e. The hypertrophy is secondary to an atrial septal defect
111 Cardiovascular Answers 173. The answer is d. (Fauci, 14/e, p 1238.) The standard surface ECG is divided into various intervals and segments. The small horizontal boxes on a standard ECG each equal 0.04 s, five small boxes comprise one large box, measuring 0.20 s. The P wave represents atrial depolarization. The PR interval is measured from the beginning of the P wave to the beginning of the QRS complex and represents AV conduction. A normal PR interval measurement is 0.12 to 0.20 s. A PR interval greater than 0.20 s is referred to as a first-degree AV block. The QRS complex on a standard surface ECG represents ventricular depolarization. Normal QRS duration is less than 0.10 s. If the QRS duration is greater than 0.10 s, a bundle branch block is most likely present. The ST segment is the most usual site evaluated for the presence of ischemia or injury. The ST segment is elevated in acute myocardial injury and depressed in the presence of myocardial ischemia. The QT interval varies with heart rate. This interval represents both ventricular 95
112 96 Pathophysiology depolarization and repolarization. The QT interval increases with bradycardia and decreases as the heart rate increases. The normal QT interval depends on heart rate, but a corrected QT interval may be calculated as the QT interval divided by the square root of the R R interval. The normal corrected QT interval is less than 0.44 s. Prolongation of the QT interval is clinically important, because it can lead to fatal dysrhythmias such as torsades de pointes The answer is e. (Fauci, 14/e, p 26.) Normal cardiovascular changes that occur with pregnancy include decreased systemic vascular resistance, increased blood volume, increased stroke volume, increased heart rate, and increased cardiac output. These changes are quite well tolerated during normal pregnancy but, with preexisting cardiac disease, these changes may not be well tolerated. Because of these normal cardiovascular changes during pregnancy, new systolic murmurs may develop, as well as the presence of a third heart sound. In a physiologically normal heart, these developments are considered normal during pregnancy The answer is d. (Lilly, pp ) The cardiac cycle consists of both systole and diastole. During diastole, the AV valves are open and the atrial and ventricular pressures are essentially equal. Left atrial contraction occurs in late diastole, causing a small increase in pressure in the left atrium and left ventricle. Left ventricular systole initiates left ventricular contraction. The mitral valve closes as left ventricular pressure overcomes left atrial pressure; this represents the mitral component of the first heart sound. As left ventricular pressure continues to increase, the aortic valve opens and blood is ejected. As the ventricles then begin to relax, the pulmonic and aortic valves close, causing the second heart sound. As left ventricular pressure continues to drop, the aortic valve opens. The contraction of both ventricles initiates systole and does not occur during diastole The answer is a. (Lilly, pp ) Cardiac output, which is the volume of blood ejected from the ventricle in 1 min, changes regularly as the body s needs change and is the product of stroke volume and heart rate.
113 Cardiovascular Answers 97 Therefore, for instance, when an individual begins to exercise and heart rate increases, the cardiac output will increase as well. Stroke volume is merely the volume of blood ejected from the ventricle during systole. Preload is the ventricular wall tension present at the end of diastole. Afterload is the ventricular wall tension present during contraction and is a function of aortic pressure and volume and thickness of the ventricular cavity. Contractility is actual measurement of the strength of contractile force. Contractility and preload contribute positively to stroke volume, whereas increased afterload decreases stroke volume. Thus, ultimately contractility, preload, afterload, stroke volume, and heart rate are all contributors to cardiac output. Contractility + Preload + Afterload Heart rate + + Stroke volume Cardiac output The answers are 177: b; 178: c; 179: a. (Lilly, p 150.) Frank- Starling curves or ventricular function curves are diagrams that show the relationship between stroke volume or cardiac output and preload or left ventricular end-diastolic volume. In normal individuals, as left ventricular end-diastolic pressure or preload increases, stroke volume will increase proportionately. In patients who suffer heart failure, increased left ventricular end-diastolic pressure is not met with increased stroke volume, because the contractility is depressed and is unable to function; thus, the patient ultimately experiences heart failure. If an individual with normal contractility is administered a positive inotropic agent, such as dobutamine, the contractility will increase without a necessary increase in preload. This is reflected by curve (A) on the Frank-Starling curve. The middle curve (B) represents a normal individual whose stroke volume will increase as preload increases. The bottom curve (C) represents a patient with congestive heart failure in that increasing this individual s preload will not be met with an increase in stroke volume and will result in pulmonary edema.
114 98 Pathophysiology Stroke volume (or cardiac output) A B C Left ventricular end-diastolic pressure (or end-diastolic volume) The answers are 180: a; 181: b; 182: c; 183: d. (Lilly, p 151.) A normal left ventricular volume loop is represented here. The mitral valve opens at point A. Diastolic filling ensues, represented by the line A B, at which point ventricular contraction begins and the mitral valve closes at point B. Isometric contraction (the aortic valve is not yet open) is represented by the line B C, indicating the increase in pressure in the left ventricle. As the left ventricular pressure maximizes, the aortic valve opens at point C. Line C D thus corresponds with left ventricular ejection, and the aortic valve closes at point D. Line D A thus represents isometric relaxation and subsequent reopening of the mitral valve at point A. d c Pressure, mm Hg a SV b Volume, ml
115 Cardiovascular Answers The answer is a. (Fauci, 14/e, pp ) The waveforms on a standard surface ECG include the P wave, which precedes the QRS complex. It is usually a rather small upward deflection that represents atrial depolarization. Thus, if right or left atrial enlargement were present, the P wave would reflect these changes. During right atrial enlargement, the P wave is tall, as seen in lead II. During left atrial enlargement, the P wave tends to become widened and biphasic, which is best seen in leads V 1 and V 2. Electrolyte abnormalities are common causes of changes on surface ECG. Hypokalemia results in the presence of U waves, which is a relatively low-devoltage deflection after the T wave. U waves are nonspecific and may be present for other reasons, but they are a classic finding in hypokalemia. The QRS complex is usually the largest complex on the surface tracing. This complex represents depolarization of the left and right ventricles. Normal QRS duration is less than 0.1 s. If a right or left His bundle is blocked, this results in a widened QRS complex representing abnormal ventricular depolarization. The third waveform on a standard surface ECG is the T wave, which represents repolarization of the ventricles. The T wave may show changes during myocardial ischemia, as well as electrolyte abnormalities, and may be altered by many pharmacologic agents The answer is d. (Fauci, 14/e, pp ) The waveforms on a standard surface ECG include the P wave, which precedes the QRS complex. It is usually a rather small upward deflection that represents atrial depolarization. Thus, if right or left atrial enlargement were present, the P wave would reflect these changes. During right atrial enlargement, the P wave is tall, as seen in lead II. During left atrial enlargement, the P wave tends to become widened and biphasic, which is best seen in leads V 1 and V 2. Electrolyte abnormalities are common causes of changes on the surface of an ECG. Hypokalemia results in the presence of U waves, which is a relatively low-devoltage deflection after the T wave. U waves are nonspecific and may be present for other reasons, but they are a classic finding in hypokalemia. The QRS complex is usually the largest complex on the surface tracing. This complex represents depolarization of the left and right ventricles. Normal QRS duration is less than 0.1 s. If a right or left His bundle is blocked, this results in a widened QRS complex representing abnormal ventricular depolarization. The third waveform on a standard surface ECG is the T wave, which represents repolarization of the ventricles. The T wave may show changes during myocardial ischemia, as well as
116 100 Pathophysiology electrolyte abnormalities, and may be altered by many pharmacologic agents The answer is c. (Fauci, 14/e, pp ) The waveforms on a standard surface ECG include the P wave, which precedes the QRS complex. It is usually a rather small upward deflection that represents atrial depolarization. Thus, if right or left atrial enlargement were present, the P wave would reflect these changes. During right atrial enlargement, the P wave is tall, as seen in lead II. During left atrial enlargement, the P wave tends to become widened and biphasic, which is best seen in leads V 1 and V 2. Electrolyte abnormalities are common causes of changes on the surface of an ECG. Hypokalemia results in the presence of U waves, which is a relatively low-devoltage deflection after the T wave. U waves are nonspecific and may be present for other reasons, but they are a classic finding in hypokalemia. The QRS complex is usually the largest complex on the surface tracing. This complex represents depolarization of the left and right ventricles. Normal QRS duration is less than 0.1 s. If a right or left His bundle is blocked, this results in a widened QRS complex representing abnormal ventricular depolarization. The third waveform on a standard surface ECG is the T wave, which represents repolarization of the ventricles. The T wave may show changes during myocardial ischemia, as well as electrolyte abnormalities, and may be altered by many pharmacologic agents The answer is b. (Fauci, 14/e, pp ) The waveforms on a standard surface ECG include the P wave, which precedes the QRS complex. It is usually a rather small upward deflection that represents atrial depolarization. Thus, if right or left atrial enlargement were present, the P wave would reflect these changes. During right atrial enlargement, the P wave is tall, as seen in lead II. During left atrial enlargement, the P wave tends to become widened and biphasic, which is best seen in leads V 1 and V 2. Electrolyte abnormalities are common causes of changes on the surface of an ECG. Hypokalemia results in the presence of U waves, which is a relatively low-devoltage deflection after the T wave. U waves are nonspecific and may be present for other reasons, but they are a classic finding in hypokalemia. The QRS complex is usually the largest complex on the surface tracing. This complex represents depolarization of the left and right ventricles. Normal QRS duration is less than 0.1 s. If a right or left His bun-
117 Cardiovascular Answers 101 dle is blocked, this results in a widened QRS complex representing abnormal ventricular depolarization. The third waveform on a standard surface ECG is the T wave, which represents repolarization of the ventricles. The T wave may show changes during myocardial ischemia, as well as electrolyte abnormalities, and may be altered by many pharmacologic agents The answer is c. (Lilly, pp ) The standard surface ECG is recorded from 12 leads. Leads V 1 through V 6 are placed on the anterior chest and are referred to as the chest leads. Leads avr, avf, and avl are unipolar limb leads and are averaged together to create a standard reference. The avr selects the right arm as the positive electrode, the avf selects the left leg as the positive electrode, and the avl selects the left arm as the positive electrode. Leads I, II, and III are also limb leads but are bipolar. Lead I designates the left arm as the positive electrode and the right arm as negative. Lead II has the left leg designated as the positive electrode and the right arm as the negative electrode. Lead III has the left arm designated as the negative electrode and the left leg as the positive electrode. When the six limb leads are interposed, a reference system is devised. The main QRS electrical axis may be determined by averaging the forces created during ventricular depolarization. The normal frontal plane QRS axis is 30 to approximately +90. An axis more negative than 30 indicates left axis deviation, and an axis greater than +90 indicates right axis deviation. The axis is determined by the positive or negative direction of the QRS complex in each of the limb leads The answer is e. (Lilly, p 79.) Electrolyte abnormalities affect various portions of the surface ECG. Both hypercalcemia and hypocalcemia affect ventricular repolarization and are thus represented by changes in the QT interval. Hypercalcemia results in a shortened QT interval, whereas hypocalcemia results in a prolonged QT interval. Calcium does not affect the T wave; it specifically changes the ST portion of the QT interval. Hyperkalemia may be represented by very tall peaked T waves as potassium affects ventricular repolarization. Hypokalemia may be represented by U waves, which are small deflections following the T wave The answers are 190: a; 191: b; 192: e; 193: c; 194: d. (Lilly, p. 12.) Myocardial contraction ultimately results from electrical impulses. An action potential is created by ion fluxes through certain chan-
118 102 Pathophysiology nels in the cellular membranes. Various cardiac cells are capable of electrical activity including the pacemaker cells of the SA and AV nodes, the Purkinje fibers, and the cardiac muscle cells. The action potential consists of phases I to IV and of phase 0. Phase 0 is caused by the rapid influx of sodium ions. This is the rapid depolarization phase of the action potential. Phase I is not well understood but is the first stage of repolarization. This phase is thought to include chloride ion movement. Phase II is controlled by the slow calcium channels and is commonly referred to as the plateau. The slow calcium influx is an important factor in myocyte contraction. Phase III consists largely of the exiting of potassium and returning of the resting potential to approximately 90 mv. Phase IV is simply the resting state prior to stimulation. Membrane potential, mv Ca 2+ 2 influx Na + influx 3 K + efflux The answers are 195: c; 196: b; 197: e. (Fauci, 14/e, p 1232.) The arterial pulse may be palpitated in the periphery, or evaluation of the carotid may occur. Certain changes in the arterial pressure pulse occur with various pathologic conditions. Pulsus parvus, defined as a small weak pulse, is present when left ventricular stroke volume is decreased. A hypokinetic or weak pulse is commonly present due to conditions such as hypovolemia, heart failure, restrictive pericardial disease, or mitral stenosis. In pulsus tardus (late pulse) the systolic peak is delayed. It is common in aortic stenosis, because the left ventricular ejection is impeded because of the stenotic valve. A bisferiens pulse has two peaks and is common with aortic regurgitation. Pulsus alternans is a unique pattern during which the amplitude of the pulse changes or alternates in size with a stable heart rhythm. This is common in severe left ventricular dysfunction. In summary, examination of the arterial pressure pulse may lead to clues of existing pathology.
119 Cardiovascular Answers The answer is e. (Fauci, 14/e, p 1234.) The first heart sound consists of a mitral and tricuspid component. Normally, the mitral valve closes first, thus contributing to the first component of S 1. When there is reverse splitting of S 1, the mitral component follows the tricuspid component. This finding may be present in severe mitral stenosis and may be due to the presence of a left atrial myxoma, which often mimics mitral stenosis. Splitting may be present also with a left bundle branch block The answers are 199: c; 200: d; 201: a; 202: e; 203: b; 204: c. (Fauci, 14/e, pp ) The first heart sound is produced by closure of the mitral and tricuspid valves (the AV or atrioventricular valves). Normally, the mitral valve closure precedes the tricuspid valve closure; thus, the mitral valve contributes to the first component of S 1. The second heart sound is caused by the aortic and pulmonic valve closure. The aortic component is generally louder than the pulmonic component. The fixed splitting of the second heart sound is caused by atrial septal defect. Normally, the splitting of S 2 representing the difference in closure between the aortic and pulmonic valves varies with respiration. If an atrial septal defect is present, this variation does not occur, and the two components of S 2 are fixed. A third heart sound is present in individuals with increased cardiac output. It is a low-pitched sound produced in the ventricle. In adults, this is a pathologic finding, but an S 3 is quite normal in young children. A fourth heart sound may be present and is produced by atrial contraction. The S 4 is a low-pitched sound produced during ventricular filling. It may be a normal finding in the elderly, because the left ventricle tends to stiffen with age. Obviously, because the sound is due to atrial contraction, it is absent in patients with atrial fibrillation. A classic finding of mitral stenosis is an opening snap that is a high-pitched early diastolic sound. An opening snap may be noted with tricuspid stenosis. Midsystolic clicks usually result from mitral or tricuspid prolapse and are due to unequal chordae tendineae The answers are 205: e; 206: b; 207: c. (Fauci, 14/e, p 1238.) The surface ECG tracing, which is a representation of the electrical activity of the heart, corresponds to the various phases of the ventricular action potential. The QRS complex on surface ECG represents ventricular depolarization. The intracellular activity during ventricular repolarization is a rapid influx of sodium and corresponds to phase 0 of the action potential. The isoelectric ST segment corresponds to contin-
120 104 Pathophysiology ued ventricular depolarization and repolarization. This corresponds to the plateau phase or phase II. This phase is mediated via slow calcium channels. The T wave on surface ECG represents ventricular repolarization. Intracellularly, this corresponds to phase III, during which potassium rapidly exits the cells Ventricular action potential 0 4 QRS ECG ST T 400 ms 208. The answer is d. (Fauci, 14/e, p 1256.) First-degree AV block is represented by a prolonged PR interval. This is due to delayed AV conduction. Second-degree AV block is divided into two types: I and II. Type I is an AV block above the level of the His bundle and is characterized by gradually prolonging PR intervals followed by a P wave that is not conducted to the ventricle. Second-degree AV block type II is generally due to disease of the His Purkinje system. The PR interval does not gradually prolong, and there is sudden loss of a QRS complex following a P wave. Third-degree block is present when no AV conduction occurs. The atrium is depolarizing independently of the ventricle The answer is b. (Fauci, 14/e, p 1256.) First-degree AV block is represented by a prolonged PR interval. This is due to delayed AV conduction.
121 Cardiovascular Answers 105 Second-degree AV block is divided into two types: I and II. Type I is an AV block (Wenkebach heart block) above the level of the His bundle and is characterized by gradually prolonging PR intervals followed by a P wave that is not conducted to the ventricle. Second-degree AV block type II (classical heart block) is generally due to disease of the His Purkinje system. The PR interval does not gradually prolong, and there is sudden loss of a QRS complex following a P wave. Third-degree block is present when no AV conduction occurs. The atrium is depolarizing independently of the ventricle The answer is c. (Fauci, 14/e, pp ) The SA node, which is the site of initiation of a depolarization that results in a normal heartbeat, consists of pacemaker cells that fire spontaneously. The impulse then proceeds to the conduction tissues in the AV node in the His bundle, both of which are in the AV junction. The bundle of His then divides into the right bundle and left bundle, and the impulse is then conducted to the right and left ventricular myocardium through the Purkinje fibers. The left bundle bifurcates into the left anterior fascicle and left posterior fascicle. The depolarization then continues through both ventricular walls, and ventricular contraction is triggered. Depolarization occurs from endocardium to epi- Sinoatrial (SA) node AV junction AV node His bundle RA LA LV Ventricular myocardium RV Purkinje fibers Right bundle branch Ventricular septum Left bundle branch
122 106 Pathophysiology cardium. Thus, the correct sequence for myocardial depolarization is SA node through AV node through bundle of His and proceeding to both ventricles The answer is e. (Lilly, p 76.) The lead system on a standard surface ECG is designed so that certain leads represent specific segments of the left ventricle. The chest (or precordial) leads represent the anterior wall of the left ventricle with leads V 3 and V 4, the septal portion of the left ventricle with leads V 1 and V 2, and the low lateral portion of the left ventricle with leads V 5 and V 6. The high lateral wall is represented by the limb leads I and avl. The inferior wall is represented by II, III, and avf. Lead avr does not represent a specific portion of the left ventricular muscle, because its positive electrode is the right arm The answer is a. (Fauci, 14/e, p 1236.) Systole is represented by left ventricular contraction and rapid ejection. Left ventricular systole must occur when the aortic valve is open. If the aortic valve is stenosed significantly, a systolic murmur will ensue as the blood flows through the constricted valve. If the mitral valve is incompetent or weakened during systole or left ventricular ejection, there will be backflow into the left atrium through the incompetent valve, and mitral regurgitation will result. As the backflow continues into the left atrium during systole, mitral regurgitation will result in a systolic murmur. Supravalvular aortic stenosis occurs when there is obstruction above the aortic valve structure proper and, again, the flow constriction will occur during ventricular systole, thus resulting in a systolic murmur. Tricuspid regurgitation, similar to mitral regurgitation, will also result in a systolic murmur due to backflow into the right atrium during right ventricular systole. In contrast, aortic regurgitation results in backflow into the left ventricle during relaxation. If the aortic valve is incompetent, as opposed to being stenosed, as the ventricle relaxes and the aortic valve is closed there will be regurgitation resulting in a diastolic murmur The answer is c. (Lilly, p 71.) Atrial depolarization is represented on the surface ECG as a P wave. Left or right atrial enlargement that exists is represented with increased voltage of the P wave. Atrial fibrillation occurs when there is chaotic, intermittently conducted atrial activity. Because there is no organized atrial contraction, no P wave is represented on the surface ECG.
123 Cardiovascular Answers The answer is d. (Fauci, 14/e, p 1238.) The QRS complex on a surface ECG represents ventricular depolarization. If the initial force of this complex is in a negative direction, this is referred to as a Q wave. The subsequent upward deflection is an R wave, and the final downward deflection is an S wave. A Q wave need not necessarily be present, if the initial force of the QRS complex is positive, then a Q wave by definition is not present. Pathologic Q waves occur when a myocardial infarction has occurred. Small Q waves are usually nonpathologic The answer is c. (Lilly, pp ) Cardiac output, which is defined as the volume of blood expelled from the ventricle per minute, is the product of heart rate and stroke volume. In turn, stroke volume (or the volume of blood that the ventricle ejects in systole) is determined by contractility, preload, and afterload The answer is e. (Fauci, 14/e, p 1241.) A cardiac hypertrophy of the various chambers is manifested on the surface ECG. If pulmonic valve stenosis is present, right ventricular pressure is significantly increased as the ventricle must contract against a stenotic valve. This results in hypertrophy of the right ventricle. The classic surface ECG findings include a prominent R wave in leads V 1 to V 3. Ventricular hypertrophy also often leads to ST depression and T wave changes in the precordial leads. This is often referred to as secondary repolarization changes or strain pattern. If an atrial septal defect is present, the right ventricle is significantly volume overloaded, again resulting in right ventricular hypertrophy.
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125 Pulmonary Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question Which one of the following hemodynamic findings is the main derangement of primary pulmonary hypertension? a. Increased cardiac output early b. Increased resistance to pulmonary blood flow c. Decreased resistance to pulmonary blood flow d. Decreased pulmonary capillary wedge pressure early e. Normal diastolic filling of the left ventricle 218. Transudative pleural effusion is caused by which one of the following diseases? a. Bacterial pneumonia b. Malignancy c. Cirrhosis d. Sarcoidosis e. Viral infection 219. When the exudative pleural effusion contains less than 60 mg/dl of glucose, which one of the following diseases is the most likely cause? a. Eosophageal rupture b. Cirrhosis c. Malignant pleural effusion d. Pancreatic pleural effusion e. Diaphragmatic hernia 109 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
126 110 Pathophysiology 220. A 76-year-old man comes to your office in January with complaints of abrupt onset of cough, with small amounts of green sputum, worse in the morning, without any blood in it. He also has fever as high as 103 F, very rapid respirations (32/min), and chest pain on his right side, worsened with coughing. He exhibits some difficulty remembering the details of his illness. On the basis of these clinical findings, you consider a diagnosis of pneumonia. Which one choice would you make? a. Obtain a chest x-ray and schedule him to return tomorrow b. Treat his symptoms with antipyretics and cough syrup c. Prescribe an oral antibiotic and also antipyretics and cough syrup and schedule him to return in 2 days d. Admit him to the hospital in the intensive care unit for parenteral antibiotic treatment e. Administer a tuberculin skin test (PPD), treat his symptoms with antipyretics and cough syrup, obtain a chest x-ray, and schedule him to return in 2 days for interpretation of the skin test 221. Which one of the following is true about silicosis? a. Mesothelioma is a complication of silicosis b. It is caused by exposure to asbestos fibers c. An increased risk exists of developing tuberculosis in patients with silicosis d. Silicosis generally presents as a pneumothorax on chest x-ray e. Patients with silicosis should not receive any antituberculous therapy 222. Obstructive airway defect is characterized on pulmonary function testing by which one of the following? a. Reduced FEV 1 /FVC ratio b. Decreased total lung capacity (TLC) c. Reduced residual volume (RV) d. Decreased residual volume/total lung capacity (RV/TLC) e. Decrease in diffusing capacity (DLCO) 223. Which one of the following is the first-line therapy in the management of an acute asthma attack? a. Steroids b. β 2 -agonists c. Theophylline d. Antibiotics e. Magnesium sulfate
127 Pulmonary Which one of the following pathogens is a main cause of bronchiectasis? a. Influenza virus b. Rhinovirus c. Mycoplasma pneumoniae d. Enterovirus e. Necrotizing fungal infections 225. The most frequent inherited disorder of hypercoagulability leading to pulmonary thromboembolism is a. Deficiency in protein C b. Deficiency in protein S c. Deficiency in antithrombin III d. Disorders of plasminogen e. Activated protein C resistance (factor V Leiden) 226. ARDS is differentiated from acute lung injury (ALI) on the basis of which one of the following? a. Presence of bilateral interstitial infiltrates on chest x-ray b. Severity of hypoxemia with PaO 2 /FiO 2 ratio of less than 200 mmhg c. Increased pulmonary capillary wedge pressure d. Reduced compliance e. Systemic inflammatory response 227. Which one disease is the single most common indication for single lung transplantation? a. Chronic obstructive pulmonary disease (COPD) either smoking induced or secondary to α-1-antitrypsin deficiency b. Cystic fibrosis c. Lung cancer d. Idiopathic pulmonary fibrosis (IPF) e. Primary pulmonary hypertension (PPH) 228. Which of the following statements is true about sarcoidosis? a. The first manifestation is an accumulation of B lymphocytes b. The giant cells in the granuloma lack inclusions c. It is characterized by hypoglobulinemia d. Sarcoid fails to clear spontaneously e. It results from an exaggerated immune response
128 112 Pathophysiology 229. A 30-year-old male presents to the emergency room with shortness of breath and right-sided pleuritic chest pain. His chest x-ray in the emergency room is normal. An arterial blood gas is obtained while the patient is breathing room air. The results show a ph of 7.48, PaCO 2 of 35, PaO 2 of 68, and an oxygen saturation of 92%. What is his A-a gradient? a. 20 b. 30 c. 40 d. 50 e Which one of the following eosinophilic pulmonary syndromes may present without any peripheral eosinophilia? a. Loeffler s syndrome b. Acute eosinophilic pneumonia c. Chronic eosinophilic pneumonia d. Allergic granulomatosis of Churg-Strauss e. Hypereosinophilic syndrome 231. Exposure to asbestos fibers causes which one of the following x-ray findings? a. Pulmonary vascular prominence b. Pleural blebs c. Enlarged right ventricle d. Acute bronchopneumonia e. Diffuse interstitial pulmonary fibrosis with irregular or linear opacities 232. In patients with COPD, long-term oxygen supplementation is prescribed if PaO 2 is a. 55 mmhg or below b. 65 mmhg c. 70 mmhg d. 75 mmhg e. 80 mmhg or higher
129 Pulmonary The most common cause of mass in the posterior mediastinum is a. Vascular b. Esophageal diverticula c. Neurogenic tumors d. Lymphomas e. Bronchogenic cysts 234. In obstructive sleep apnea (OSA) which one of the following contributes to the negative oropharyngeal pressure characteristic of OSA? a. Pleural blebs b. Laryngeal muscles hyperactivity c. Occlusion of the upper airway at the level of the oropharynx d. Low pharyngeal resistance e. Low upstream (nasal) resistance 235. Mycobacterium tuberculosis is spread most effectively by which one of the following persons? a. Persons whose sputum smear is negative for Mycobacterium tuberculosis, but whose culture is AFB-positive b. Persons who are close contacts of tuberculosis patients c. Persons recently infected who are culture-negative d. Persons with proven extrapulmonary tuberculosis e. Persons infected with Mycobacterium tuberculosis whose sputum smear is positive for AFB on microscopy 236. In which one of the following diseases would the occurrence of hemoptysis prompt a search for another disease as the cause of the hemoptysis? a. Bronchogenic carcinoma b. Acute bronchitis c. Goodpasture s syndrome d. Emphysema e. Bronchiectasis
130 114 Pulmonary Answers 217. The answer is b. (Fauci, 14e, pp ) The cardinal hemodynamic feature of primary pulmonary hypertension is increased resistance to blood flow. The pulmonary artery pressure becomes elevated, and in time, the cardiac output decreases, and late in the course, the pulmonary capillary wedge pressure increases because of impaired diastolic filling of the left ventricle Answer is c. (Fauci, 14e, 1473.) Transudative and exudative effusions can be distinguished by measuring the lactate dehydrogenase (LDH) and protein levels in the pleural fluid. Exudative effusions show a pleural fluid protein/serum protein greater than 0.5, pleural fluid LDH/serum LDH greater than 0.6, or pleural fluid LDH more than two-thirds normal upper limit for serum by these criteria. Only cirrhosis causes transudative effusions. Local factors contribute to exudative effusions in bacterial pneumonia, viral infections, malignancy, and sarcoidosis The answer is c. (Fauci, 14e, pp ) Exudative pleural effusions that contain less than 60 mg/dl of glucose are caused by malignancy, bacterial infections, and rheumatoid pleuritis. The other exudative effusions do not show low glucose levels. However, exudative effusions caused by esophageal rupture, pancreatic pleural effusion, and also malignancy show elevated amylase levels Answer is d. (Fauci, 14e, 1441.) Elderly patients and patients with other comorbid illnesses have a higher chance of complications following a community-acquired pneumonia, and they need to be admitted to the hospital for parenteral antibiotic treatment and close monitoring. Elderly patients with tachypnea and acute alteration in mental status are at high risk of adverse outcomes from pneumonia and need to treated in the hospital Answer is c. (Fauci, 14e, p 1432.) Workers exposed through sand blasting, tunneling through rock with high quartz content, or manufacture
131 Pulmonary Answers 115 of abrasive soaps can develop silicosis. Chest x-ray findings include reticular pattern of irregular densities mostly in the upper lung zones. The nodular fibrosis may be progressive with formation of irregular masses of greater than 1 cm each. These masses can become quite large and coalesce to progressive massive fibrosis (PMF). Calcification of hilar lymph nodes may occur in as little as 20% of cases and can produce the characteristic egg shell calcification. Patients with silicosis are at greater risk of acquiring mycobacterium tuberculosis and atypical mycobacterial infections. Treatment or prophylaxis for tuberculosis is indicated in patients with silicosis and a positive tuberculin test The answer is a. (Fauci, 14e, p 1412.) Pulmonary function tests are divided into two subgroups: obstructive and restrictive defects. The hallmark of obstructive defect is a decrease in the expiratory flow rate, as manifested by a decrease in FEV 1 /FVC ratio. Total lung capacity is normal or increased. Residual volume (RV) is elevated owing to the air trapping during expiration, which results in an increase of RV/TLC ratio. Vital capacity is frequently decreased in obstructive defects because of striking elevations in RV with only minor changes in TLC The answer is b. (Fauci, 14e, p 1425.) The most effective treatment for acute episodes of asthma is administration of aerosolized β 2 -agonists. In emergency situations, they can be given every 20 min until the attack has subsided or the patient develops any side effects. Thereafter, the frequency can be reduced to every 2 to 4 h until the attack has totally subsided. Other drugs have some role in asthma but are not the first-line therapeutic agents for an acute attack The answer is a. (Fauci, 14e; p 1446.) Bronchiectasis is a consequence of inflammation and destruction of the bronchial walls. The main virus causes are influenza virus and adenovirus. Rhinovirus, Mycoplasma pneumoniae, and necrotizing fungal infections rarely cause bronchiectasis. Noninfectious causes include immune mediated inflammation, e.g., in allergic bronchopulmonary aspergillosis The answer is e. (Fauci, 14e, p 1469.) Activated protein C resistance is the single most common inherited predisposition to hypercoagulability. Its phenotype is associated with a single-point mutation, designated factor
132 116 Pathophysiology V Leiden, which is more common than all other inherited hypercoagulable conditions combined. These include deficiencies in protein C, protein S, antithrombin III, and disorders of plasminogen The answer is b. (Fauci, 14e, 1483.) Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) are both characterized by bilateral interstitial infiltrates, normal pulmonary capillary wedge pressure, and low compliance. Both develop in response to infectious or systemic inflammatory conditions. However, the severity of hypoxemia, as defined by PaO 2 /FiO 2 ratio, distinguishes the two syndromes from each other. In ARDS, patients have a refractory hypoxemia with a PaO 2 /FiO 2 ratio of less than 200 mmhg, whereas in patients with ALI, this ratio is higher than The answer is a. (Fauci, 14e, p 1491.) COPD accounts for about 60% of all single lung transplants and about 30% of bilateral lung transplant. Cystic fibrosis accounts for approximately 36% of bilateral lung transplants and rests are miscellaneous reasons for lung transplant including idiopathic pulmonary fibrosis, primary pulmonary hypertension, and several other rarer lung diseases. Cancer in the lungs or outside the lungs would preclude patients from undergoing lung transplantation The answer is e. (Fauci, 14e, 1922.) Sarcoidosis is a chronic, multisystem disorder of unknown cause with an exaggerated immune response. It affects both sexes, although females seem to be slightly more susceptible than males. There is a remarkable diversity of the prevalence of sarcoidosis among certain ethnic and racial groups. The prevalence is from 10 to 40 per 100,000 in the U.S. In the U.S., most patients with sarcoidosis are black, with a ratio of blacks to whites ranging from 10:1 to 17:1. The therapy of choice for sarcoidosis is oral glucocorticoids. The disease responds well to steroids; however, the treatment for symptomatic sarcoid patients is administered usually over several months Answer is c. (Fauci, 14e, p 1415.) The patient most likely has a pulmonary embolism because of shortness of breath, right-sided pleuritic chest pain, a normal chest x-ray, and abnormal blood gases. A useful calculation is the assessment of Alveolar oxygenation and calculating the gradient between Alveolar and arterial partial pressures of the oxygen. At room air,
133 Pulmonary Answers 117 the PaO 2 (Alveolar) can be calculated by the following formula. PaO 2 = PaCO 2. Once PaO 2 is determined, the A-a gradient is simply the difference between PaO 2 and arterial PaO 2. In a healthy young person breathing room air, the PaO 2 PaO 2 is normally less than 15 mmhg; this value increases with age and may be as high as 30 mmhg in elderly patients The answer is b. (Fauci, 14e, p 1429.) The group of idiopathic eosinophilic pneumonias consists of diseases of varying severity. Loeffler s syndrome was originally reported as migratory pulmonary infiltrates. In some patients, these may be secondary to parasites or drugs. Acute eosinophilic pneumonia is a recently described syndrome characterized by an acute febrile illness of less than 7 days in duration and may or may not present with peripheral eosinophilia. Chronic eosinophilic syndrome presents with significant systemic symptoms of weeks or months in duration and presents with peripheral eosinophilia. Allergic angiitis and granulomatosis of Churg-Strauss is a multisystem vasculitis that frequently involves skin, kidneys, and nervous system in addition to the lungs. This is also manifested by peripheral eosinophilia. The hypereosinophilic syndrome is characterized by the presence of more than 1500 eosinophils/µl of peripheral blood for 6 months or longer The answer is e. (Fauci, 14e, p 1431.) On x-ray examination, asbestos exposure causes diffuse interstitial pulmonary fibrosis that is slowly evolving and characterized by linear or irregular opacities of the lungs. Usually, about 10 years elapse since first exposure to asbestos and the development of asbestosis. Benign pleural effusions occur and these may resolve without treatment. However, pleural blebs, enlargement of the right ventricle, and increased prominence of the pulmonary vascular are not features of asbestosis on x-ray The answer is a. (Fauci, 14e, p 1457.) If PaO 2 is persistently below 55 mmhg, supplemental oxygen should be prescribed. However, if room air PaO 2 is between 55 and 60 mmhg, supplemental oxygen may still be prescribed if the patient has signs of cor pulmonale, secondary erythrocytosis, or signs of right heart failure. In patients with severe hypoxemia, supplemental oxygen improves exercise tolerance and neurophysiologic functions and alleviates pulmonary hypertension. It tends to improve survival if used greater than 15 to 19 h a day.
134 118 Pathophysiology 233. The answer is c. (Fauci, 14e, p 1475.) The most common tumor in the posterior mediastinum are the neurogenic tumors. Other masses found in the posterior mediastinum are meningoceles, gastroenteric cysts, and esophageal diverticula. The most common masses in the middle mediastinum are vascular masses, lymph node enlargement from metastases or granulomatous disease, and pleuropericardial and bronchogenic cysts. In the anterior mediastinum, the most common lesions are thymomas, lymphomas, teratomas, and thyroid masses Answer is c. (Fauci, 14e, p 1480.) Occlusion of the upper airway at the level of the oropharynx leading to negative oropharyngeal pressure represents the underlying mechanism in obstructive sleep apnea (OSA). Other contributing factors can be a small pharyngeal cavity, high pharyngeal compliance, and high upstream (nasal) resistance. Obesity contributes to OSA by increasing fat deposition in the soft tissues of the pharynx or by compressing the pharynx by superficial fat masses in the neck. In a few patients, structural compromise, such as adenotonsillar hypertrophy, retrognathia, or macroglossia, can contribute to the development of OSA also The answer is e. (Fauci, 14e, p ) Mycobacterium tuberculosis is most effectively spread by persons whose acid-fast bacilli (AFB) in their sputum is visible on microscopy, which means that the sputum contains about 100,000 organisms/ml or more. These persons usually have cavitary lung disease or endobronchial or laryngeal tuberculosis. Persons whose sputum smear is negative, but culture positive are much less infectious, and persons with extrapulmonary tuberculosis are not usually infectious The answer is d. (Fauci, 14e, p ) Hemoptysis is not a feature of emphysema. In patients with emphysema who present with hemoptysis, physicians must search for other causes. The most common cause of mild hemoptysis in the U.S. is acute bronchitis. Hemoptysis can occur because of a tracheobronchial source, pulmonary parenchymal source, primary vascular disease, coagulopathy, or immune mediated diseases, e.g., Goodpasture s syndrome.
135 Renal/Nephrology Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question Which is a common finding in acute glomerulonephritis? a. Pulmonary congestion due to volume expansion b. Hypovolemia due to tubular dysfunction c. Uniformly progresses to chronic renal failure if untreated d. Urine showing leukocytes and eosinophils 238. Which finding is fairly specific for chronic renal failure? a. Anemia b. Hyaline casts c. Broad casts in urinalysis d. Proteinuria e. Hypocalcemia 239. Nephrotic syndrome is associated with a. Excessive renal salt and water loss b. Hyperlipidemia due to lipoprotein excess c. Bleeding due to loss of clotting factors d. Hypothyroidism due to loss of thyroid-binding globulin 240. A patient with chronic renal failure will be expected to have which of the following findings due to the mechanisms described? a. Hypercalcemic due to elevated PTH hormone b. Prolonged bleeding due to decreased synthesis of clotting factors c. Anemia due to increased red cell destruction d. Hypermagnesemia due to decreased renal excretion 119 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
136 120 Pathophysiology 241. A high fractional excretion of sodium is typically found in a. Heart failure b. Urinary tract obstruction c. Acute tubular necrosis d. Acute glomerulonephritis e. Hepatorenal syndrome 242. Which of the following nephron segment is correctly paired with its function? a. Distal tubule and bicarbonate reclamation b. Loop of Henle and potassium regulation c. Proximal tubule and urinary concentration d. Collecting tubule and water regulation 243. Which of the following statements is true in the management of acute renal failure? a. Metabolic acidosis is fully corrected with bicarbonate b. Hyperphosphatemia is primarily managed with dialysis c. Low-dose dopamine is used to shorten the duration of renal failure d. Hypervolemia is managed with high-dose loop diuretics e. Hyponatremia is corrected by administration of sodium salts 244. Which of the following describes bone abnormalities in patients with chronic renal failure? a. Osteitis fibrosis cystica is a result of oversuppression of PTH b. Adynamic bone disease is associated with myopathy c. Osteomalacia is due to excessive accumulation of magnesium d. Hyperparathyroidism responds well to 1,25 dihydroxyvitamin D e. Amyloidosis is similar in etiology to patients who are not on dialysis 245. Which one of the following statements is true concerning hematologic disorders in CRF? a. Resistance to erythropoietin is most commonly due to aluminum overload b. Erythropoietin administration is associated with worsening hypertension c. The major cause of death in CRF is sepsis d. Abnormal bleeding responds best to platelet transfusion e. Leukocyte function is generally unimpaired
137 Renal/Nephrology Which of the following measures has not been shown to retard progression of renal failure? a. Aggressive BP control b. Decrease in protein intake c. ACE inhibitors above other antihypertensives d. Erythropoietin for anemia 247. In patients with chronic renal failure, which of the following adaptations are normal? a. Fractional excretion of sodium increases due to suppression of aldosterone b. Metabolic acidosis due to loss of bicarbonate in the urine c. Increased potassium loss through extrarenal mechanisms d. Decreased fractional excretion of water due to ADH resistance 248. Which of the following serologic finding is associated with linear staining of the glomerulus on immunofluorescence? a. Anti-GBM antibody b. Low complement immune complex glomerulonephritis c. ANCA associated renal disease d. Membranoproliferative glomerulonephritis 249. Antineutrophil cytoplasmic antibody (ANCA) is typically present in which systemic disease? a. Goodpasture s syndrome b. Wegener s granulomatosis c. Systemic lupus erythematosus d. Thrombotic thrombocytopenic purpura 250. Postinfectious glomerulonephritis is characterized by which of the following? a. Most cases in an epidemic are subclinical b. Hematuria typically develops within a week of infection c. More common with pharyngeal than cutaneous strep infection d. Focal proliferative glomerulonephritis seen on renal biopsy e. Children are often left with residual renal impairment
138 122 Pathophysiology 251. Which of the following is true of anti-gbm (glomerular basement membrane) syndrome? a. The clinical presentation is largely the same in different age groups b. The target antigen in the glomerulus is elastin c. Complement levels are typically normal d. Plasmapheresis enables dialysis-dependent patient to recover renal function e. Transplantation is contraindicated because of disease recurrence 252. Prerenal azotemia is associated with a. High fractional excretion of sodium b. Granular casts in the urine c. Use of angiotensin-converting enzyme (ACE) inhibitors in unilateral renal artery stenosis d. Evolution to acute tubular necrosis if untreated 253. The pathologic findings of predominant small artery involvement with intimal proliferation and sometimes with thrombosis, also termed thrombotic microangiopathy, is found in which renal disease? a. Membranoproliferative glomerulonephritis b. Hemolytic uremic syndrome c. Microscopic polyarteritis d. Analgesic nephropathy 254. Leukocytes and white cell casts in the urine are typically seen in a. Radiocontrast nephropathy b. Methicillin-induced renal insufficiency c. Aminoglycoside nephrotoxicity d. Rhabdomyolysis 255. Elevated anion gap and osmolar gap in a patient with renal failure suggests a. ethylene glycol ingestion b. isopropanol ingestion c. mannitol infusion d. radiocontrast administration
139 Renal/Nephrology Which may cause acute renal failure in patients with nephrotic syndrome? a. Dietary protein restriction b. ACE inhibitors c. Lipid-lowering agents d. Loop diuretics 257. Hyponatremia with a low urine sodium is associated with a. SIADH b. congestive heart failure c. recent thiazide use d. hypothyroidism 258. Which disease presents with predominantly tubulointerstitial involvement? a. Systemic lupus erythematosus b. Sjögren s syndrome c. Rheumatoid arthritis d. Essential mixed cryoglobulinemia 259. Which disease presents with predominantly glomerular involvement? a. Analgesic nephropathy b. Uric acid nephropathy c. Lead nephropathy d. Light chain deposition disease 260. Which of the following patients would be better served by undergoing continuous ambulatory peritoneal dialysis rather than intermittent hemodialysis as treatment of chronic renal failure? a. Patient with poor vision due to diabetic retinopathy b. Patient with cardiomyopathy sensitive to fluid overload c. Patient with severe COPD d. Very obese patient
140 124 Pathophysiology 261. A patient on long-term lithium comes into your office complaining of polyuria; you would expect his serum sodium to be a. Elevated because he has central diabetes insipidus b. Elevated because he has nephrogenic diabetes insipidus c. Nearly normal because he is drinking increased amounts of water d. Low because he is suffering from psychogenic polydipsia 262. Concerning the association between potassium and bicarbonate abnormalities, which of the following is true? a. The regulation of potassium excretion occurs largely in the loop of Henle, and this is why loop diuretics cause hypokalemia b. Metabolic alkalosis is associated with volume depletion caused by diuretics c. Hypokalemia generally results in the increased production of aldosterone d. Volume depletion inhibits reabsorption of bicarbonate in the proximal tubule 263. Which of the following is characterized by normotension, hypokalemia, and metabolic alkalosis? a. Sjögren s syndrome b. Hyperaldosteronism c. Liddle s syndrome d. Barrter s syndrome 264. A 25-year-old man with flank pain is found to have three cysts in each kidney, normal hepatic and renal function, and family history is not clear. He is most likely to have a. Autosomal dominant polycystic kidney disease b. Autosomal recessive polycystic kidney disease c. Acquired cystic disease d. Medullary sponge kidney 265. Growth retardation, hypophosphatemia, and glycosuria may be associated with a. Type 1 RTA b. Type 2 RTA c. Type 4 RTA d. Diabetic nephropathy
141 Renal/Nephrology Which is an accurate statement concerning diabetic nephropathy? a. Most patients with type 2 diabetes will develop this problem b. It is almost always associated with retinopathy in type 1 diabetes c. ACE inhibition is only indicated for patients with hypertension d. Routine dipstick urine should be performed to screen for early disease 267. Which of the following is a secondary cause for focal segmental sclerosis? a. Hodgkin s disease b. Colon cancer c. HIV disease d. Hepatitis C infection 268. A patient with Crohn s disease passes a kidney stone; the most likely composition is a. Calcium phosphate b. Uric acid c. Struvite d. Calcium oxalate 269. The metabolic disorder induced by diarrhea and by acetazolamide are best differentiated by a. Serum anion gap b. Blood gas analysis c. Urine anion gap d. Urine ph e. Serum potassium 270. Which of the following would be a characteristic finding in obstructive nephropathy due to benign prostatic hypertrophy? a. Hyperkalemia b. Polyuria and nocturia c. Hematuria d. Suprapubic discomfort 271. Cirrhosis is a cause of a. Hypervolemic hyponatremia b. Isovolemic hyponatremia c. Hypovolemic hyponatremia d. Pseudohyponatremia
142 126 Pathophysiology 272. Which of the following statements characterizes minimal change disease? a. It is associated with renal insufficiency despite treatment b. It is associated with selective proteinuria c. It is the most common cause of nephrotic syndrome in adults d. It is diagnosed on light microscopy after kidney biopsy 273. Which of the following findings would favor essential hypertension over secondary hypertension? a. Presence of hypokalemia and alkalosis b. Presence of hyperinsulinemia and obesity c. Presence of grade III fundoscopic findings d. Presence of aortic aneurysm 274. A patient with long-standing COPD who develops vomiting would have which of the following blood gas and electrolyte patterns? Sodium Chloride Bicarbonate pco 2 ph a b c d A patient with cardiomyopathy on chronic diuretics suffers acute respiratory arrest from aspiration has which of the following patterns? Sodium Chloride Bicarbonate pco 2 ph a b c d A patient with diabetic ketoacidosis along with a bout of viral gastroenteritis resulting in diarrhea has which of the following patterns? Sodium Chloride Bicarbonate pco 2 ph a b c d
143 Renal/Nephrology Hyperkalemia may be caused by a. Trimethoprim b. Albuterol c. Licorice d. Cisplatin 278. A middle-aged patient with an elevated serum creatinine, hypertension, and mild anemia comes to you for evaluation. Urine dipstick shows trace protein without red cells or cellular casts. A 24-h urine collection reveals 5 g of protein. The most likely etiology is a. Focal segmental sclerosis b. Hypertensive nephrosclerosis c. Amyloidosis d. Multiple myeloma 279. Which of the following is a common cause of isolated hematuria with isomorphic red cells in the urine? a. Alport s syndrome (hereditary nephritis) b. Thin basement membrane disease c. Idiopathic hypercalciuria d. IgA nephropathy 280. A 26-year-old woman with a history of mitral valve prolapse comes in with 1 week of fever that started 3 days after a dental procedure. Her urine contains red cells and her rheumatoid factor is elevated. Which of the following serologic abnormalities is expected to be present? a. Anti-GBM antibody b. Low serum complement levels c. Antineutrophil cytoplasmic antibody d. Elevated IgA levels
144 128 Pathophysiology 281. A 70-year-old man presents to you because he has not been feeling well for several months. He mainly complains of malaise and achiness. He takes ibuprofen occasionally for these symptoms. His urine shows protein and erythrocyte casts. A 24-h urine shows 1 g of protein per day. His creatinine clearance is 24 ml/min. About 4 months ago, his serum creatinine was normal. The most likely diagnosis is a. Amyloidosis b. Light chain deposition disease c. Nonsteroidal induced interstitial nephritis d. Vasculitis
145 Renal/Nephrology Answers 237. The answer is a. (Fauci, 14/e, p 1495.) Pulmonary congestion due to fluid overload is a common finding in acute glomerulonephritis, which can resolve spontaneously as in postinfectious GN or lead to chronic renal failure as in lupus nephritis. Urinary findings consists of hematuria, red cell casts, and proteinuria. Leukocytes and eosinophils are seen in tubulointerstitial nephritis The answer is c. (Fauci, 14/e, p 1496.) The finding of broad casts reflects compensatory dilatation of surviving nephrons. Hyaline casts are a nonspecific finding. Proteinuria can be present in various stages of renal disease. Anemia and hypocalcemia can be present in acute renal failure and are usually multifactorial The answer is b. (Fauci, 14/e, p 260.) In nephrotic syndrome, the renin angiotensin system is activated, leading to salt and water retention and edema. Hyperlipidemia results from increased lipoprotein synthesis. Hypercoagulability results from loss of antithrombin III and reduced levels of proteins C and S. Although thyroid-binding globulin is lost, most patients are euthyroid when free T4 is measured The answer is d. (Fauci, 14/e, p 1495.) Hypocalcemia is due to decreased calcitrol synthesis and secondary hyperparathyroidism results. Bleeding time is prolonged due to uremic platelet inhibitors. Anemia is due to decreased erythropoietin synthesis. Hyperkalemia and hypermagnesemia is due to decreased excretion The answer is c. (Fauci, 14/e, p 1508.) In acute tubular necrosis, tubular damage prevents reabsorption of filtered sodium. In the other disorders listed, renal hypoperfusion causes avid sodium retention. Creatinine is not reabsorbed, hence leading to a low fractional excretion of sodium The answer is d. (Fauci, 14/e, p 1500.) Reabsorption of sodium and bicarbonate takes place largely in the proximal tubule. The loop of Henle is 129
146 130 Pathophysiology responsible for creating the hypertonicity of the medullary interstitium allowing for urinary concentration. Potassium regulation takes place in the distal tubule through the action of aldosterone and water regulation through ADH action in the collecting tubule The answer is d. (Fauci, 14/e, p 1512.) Metabolic acidosis is usually corrected if ph is less than 7.2. Hyperphosphatemia is managed initially with phosphate binders. Dopamine has not been shown to impact renal recovery. Hyponatremia is managed with water restriction. Hypervolemia is managed by decreasing salt and water intake and loop diuretics The answer is d. (Fauci, 14/e, p 1516.) Osteitis fibrosa is due to hyperparathyroidism and is associated with myopathy. Adynamic bone disease is associated with oversuppression of PTH. Osteomalacia is due to excessive aluminum accumulation. Amyloidosis in dialysis patients is due to β 2 -microglobulin and not the amyloid proteins seen in usual amyloidosis. 1,25 dihydoxyvitamin D suppresses PTH production The answer is b. (Fauci, 14/e, p 1518.) Resistance to erythropoietin is most commonly due to iron deficiency despite oral iron intake. In a third of patients, the rise in hematocrit with erythropoietin therapy worsens with hypertension. Abnormal bleeding is treated with intensive dialysis, vasopressin, and estrogens among other measures but not with platelets. Although leukocyte function is impaired, sepsis is the second leading cause of death after cardiovascular disease The answer is d. (Fauci, 14/e, p 1519.) Erythropoietin is used to correct anemia of chronic renal failure. Most evidence suggests it does not hasten decline of renal function but is not protective. The other measures are recommended although protein restriction should be carefully monitored to avoid malnutrition The answer is c. (Fauci, 14/e, p 1502.) Adaptations to chronic renal insufficiency include increased fractional excretion of sodium due to hydraulic pressure, atrial natriuretic peptide, and vasodilatory prostaglandin; increased water excretion due to solute loss (osmotic diuresis); and metabolic acidosis due to retention of organic anions and decreased generation of ammonia. Potassium excretion is increased through augmented aldosterone production and extrarenal (i.e., colonic) losses.
147 Renal/Nephrology Answers The answer is a. (Fauci, 14/e, p 1537.) Anti-GBM disease is characterized by linear staining of the basement membrane. Immune complex disease, such as lupus or membranoproliferative glomerulonephritis is characterized by granular staining. ANCA-associated renal diseases were formerly called pauci-immune due to absence of staining by immunofluorescence The answer is b. (Fauci, 14/e, p 1537.) Goodpasture s syndrome consists of pulmonary hemorrhage and renal failure. The latter alone is called anti-gbm disease. ANCA is typically present in vasculitic disorders such as Wegener s, microscopic polyangiitis, and Churg-Strauss syndrome. SLE may have ANCA positivity if vasculitis is a prominent feature. TTP is primarily due to endothelial injury The answer is a. (Fauci, 14/e, p 1539.) Most cases of postinfectious GN are subclinical and found among contacts of the index case. Hematuria typically occurs 10 days or more after the infection, compared with IgA nephropathy in which the hematuria follows very closely thereafter. It is more common after cutaneous infection, unlike rheumatic fever, and the lesion is a diffuse proliferative glomerulonephritis. The prognosis in children is usually excellent The answer is c. (Fauci, 14/e, p 1539.) Complement levels are normal because it is not consumed in anti-gbm disease. Anti-GBM disease in the older age group is characterized by absence of pulmonary hemorrhage compared with the younger age group. The antigen is the NC1 domain of α-3 chain of type IV collagen. Although plasmapheresis is the treatment of choice, dialysis-dependent patients rarely recover renal function. Transplantation can be performed after seronegativity for a defined period with disease recurring only rarely The answer is d. (Fauci, 14/e, p 1504.) In prerenal azotemia, the renal dysfunction is initially reversible on restoration of renal perfusion but may evolve to tubular necrosis if the insult is not corrected. The urine sediment is bland and fractional excretion of sodium is low. Use of nonsteroidals or ACE inhibitors in predisposed patients, such as those with hypovolemia, heart failure, liver failure, or bilateral renal artery stenosis, may lead to prerenal azotemia.
148 132 Pathophysiology 253. The answer is b. (Fauci, 14/e, p 1560.) Thrombotic microangiopathy, which reflects predominantly endothelial injury in the small renal arterioles, is the hallmark of a group of diseases that includes hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, scleroderma, sickle cell nephropathy, and malignant hypertension. This is the case because the primary process is endothelial damage The answer is b. (Fauci, 14/e, p 1507.) White cells and their casts are typically seen in pyelonephritis or acute interstitial nephritis such as seen with methicillin. Radiocontrast causes vasoconstriction and so the urinary sediment is bland. Aminoglycosides and rhabdomyolysis causes tubular necrosis and are associated with granular casts and renal tubular epithelial cell shedding in the urine The answer is a. (Fauci, 14/e, p 1510.) Only ethylene glycol and methanol ingestion present with an osmolar gap and metabolized to acids that cause an osmolar gap. Isopropanol and mannitol do not present with an anion gap The answer is d. (Fauci, 14/e, p 1544.) High-dose diuretics can precipitate acute renal failure in nephrotics because the intravascular volume cannot be defended by the hypoalbuminemia. The other three measures are generally considered helpful in nephrosis although dietary protein restriction needs monitoring to guard against malnutrition The answer is b. (Fauci, 14/e, p 268.) Hyponatremia associated with congestive heart failure is associated with low urine sodium due to decreased cardiac output and renal perfusion. Euvolemic hyponatremia, such as due to SIADH, hypothyroidism, or glucocorticoid deficiency, does not present with sodium retention. The main defect is free water excretion. Thiazide diuretics increase urine sodium loss The answer is b. (Fauci, 14/e, p 1549.) Sjögren s syndrome presents as a tubulointerstitial nephritis. Lupus may present with proliferative or membranous changes along with interstitial involvement. Rheumatoid arthritis usually presents with amyloidosis, whereas cryoglobulinemic nephropathy is a membranoproliferative lesion.
149 Renal/Nephrology Answers The answer is d. (Fauci, 14/e, p 1555.) Light chain deposition disease, found in paraproteinemias, presents with proteinuria and nephrotic syndrome due to glomerular deposition. The other diseases are examples of tubulointerstitial renal disease characterized by low albumin excretion in urine The answer is b. (Fauci, 14/e, p 1523.) Peritoneal dialysis is a daily treatment, and the gradual fluid removal is better tolerated by patients with poor cardiac reserve than hemodialysis. It requires adequate vision to be done independently. The abdominal distention may not be well tolerated by patients with COPD due to interference with lung expansion and the calories absorbed from dextrose-containing fluids may cause weight gain and obesity The answer is c. (Fauci, 14/e, p 270.) Lithium therapy results in nephrogenic diabetes insipidus. These patients maintain a high normal serum osmolarity unless water intake is restricted because the thirst center is intact and able to regulate serum osmolarity by water intake. They develop hypernatremia if they are hospitalized or develop CNS problems The answer is b. (Fauci, 14/e, p 273.) Potassium regulation takes place in the distal tubule and is regulated by aldosterone. Hypokalemia suppresses aldosterone production. Volume contraction increases proximal tubule bicarbonate reabsorption and leads to metabolic alkalosis The answer is d. (Fauci, 14/e, p 273.) Hyperaldosteronism (Conn s syndrome) is associated with hypertension, alkalosis, and hypokalemia due to increased aldosterone action. Liddle s syndrome, which is due to a mutation in the sodium channel, results in a similar picture. Sjögren s syndrome causes renal tubular acidosis and hypokalemia. Barrter s syndrome is due to a defect in a transporter in the loop of Henle and simulates a patient taking loop diuretics; because volume expansion does not occur, the patient is normotensive The answer is a. (Fauci, 14/e, p 1563.) Autosomal dominant PKD is diagnosed by ultrasound by the finding of three to five cysts in each kidney, especially in a young individual who is not expected to have acquired cystic disease (generally found in older individuals commonly with renal
150 134 Pathophysiology insufficiency). The recessive form leads to renal failure and hepatic fibrosis early in life. Medullary sponge kidney is autosomal dominant and diagnosed by IVP. It does not lead to renal failure The answer is b. (Fauci, 14/e, p 1566.) Type 1 RTA is a distal nephron disorder of acid excretion; nongap metabolic acidosis and hypokalemia ensues. Common causes include Sjögren s syndrome and hypergammaglobulinemia. Type 2 RTA is a proximal disorder of bicarbonate reclamation; it may be associated with Fanconi s syndrome (phosphate, amino acid, and glucose loss in the urine). Type 4 RTA presents with hyperkalemia and is caused by diabetes and tubulointerstitial nephropathy The answer is b. (Fauci, 14/e, p 2076.) About one-third of patients with diabetes will develop nephropathy. It is the most common cause of end-stage renal failure. It is nearly always associated with retinopathy in type 1 DM, but not in type 2 DM. Detection of microalbuminuria depends on 24-h urine collection or specialized urine dipsticks; the routine dipsticks are too insensitive. ACE inhibition may have a role in patients with microalbuminuria even before hypertension sets in The answer is c. (Fauci, 14/e, p 1541.) Glomerular lesions can be associated with systemic diseases. Common associations include minimal change with Hodgkin s disease and nonsteroidals; focal sclerosis with HIV infection, reflux nephropathy, and obesity; membranous nephropathy with hepatitis B, lupus, and solid tumors; and membranoproliferative lesions with hepatitis C and endocarditis The answer is d. (Fauci, 14/e, p 1572.) Inflammatory bowel disease causes fat malabsorption. The fat binds calcium, allowing oxalate absorption, leading to calcium oxalate stone formation. Calcium phosphate stones are formed by patients with renal tubular acidosis or hyperparathyroidism. Uric acid stones are associated with myeloproliferative syndromes or Lesch-Nyhan syndrome. Struvite stones are associated with infection The answer is c. (Fauci, 14/e, p 1526.) Both diarrhea and acetazolamide induce a nongap acidosis and hypokalemia. The urine ph is acidic (5.0) in diarrhea but is alkaline in acetazolamide administration only if the serum bicarbonate is above the threshold for complete reabsorption of
151 Renal/Nephrology Answers 135 bicarbonate (16 to 18 meq/l) The urine anion gap reliably differentiates renal from nonrenal causes of nongap acidosis The answer is b. (Fauci, 14/e, p 1575.) Chronic obstruction commonly results in polyuria and nocturia due to impaired urinary concentrating ability. Hyperkalemia is due to distal tubular damage. Hematuria should never be passed over as being due to BPH without further investigation. Because the process develops gradually, although the patient may complain of frequency and urgency, suprapubic discomfort is uncommon The answer is a. (Fauci, 14/e, p 268.) Congestive heart failure, cirrhosis, and nephrotic syndrome are causes of hypervolemic hyponatremia. Addison s disease and diuretic use lead to the hypovolemic form and SIADH is euvolemic. Pseudohyponatremia is associated with elevated lipids, glucose, or plasma proteins The answer is b. (Fauci, 14/e, p 1541.) Minimal change is the most common cause of nephrotic syndrome in children, but membranous nephropathy is more common in adults. The diagnosis is made by identifying foot process effacement on electron microscopy. By light microscopy, all findings are normal, hence the name minimal change. Clinically, it is characterized by selective proteinuria principally due to loss of albumin and minimal amounts of higher molecular weight proteins, unlike in other diseases such as membranous glomerulopathy or focal sclerosis. It carries an excellent prognosis because remissions are typically obtained with steroid therapy The answer is b. (Fauci, 14/e, p 1985.) Secondary hypertension may be suggested by certain clues such as abrupt onset before the age of 25 years or after 50 years of age; abdominal bruits or signs of vascular disease such as an aneurysm; palpitations and tachycardia as in pheochromocytoma; hypokalemia and alkalosis as seen in hyperaldosteronism; and accelerated hypertension such as occurs in renal artery stenosis The answer is b. (Fauci, 14/e, p 278.) COPD produces a chronic respiratory acidosis that is compensated by a rise in serum bicarbonate. The vomiting introduces a metabolic alkalosis that further increases the serum bicarbonate. The relatively low bicarbonate in choices a. and c. sug-
152 136 Pathophysiology gests a preexisting metabolic acidosis, the former having a normal, and the latter an elevated anion gap. Choice d. suggests a combined metabolic and respiratory alkalosis The answer is d. (Fauci, 14/e, p 278.) This patient has an acute respiratory acidosis superimposed on a metabolic alkalosis caused by diuretics. Choice b. lacks the metabolic alkalosis, whereas choice c. lacks the respiratory acidosis; choice a. is more compatible with a chronic respiratory acidosis with the higher serum bicarbonate and nearly normal ph. The best choice is d The answer is a. (Fauci, 14/e, p 278.) This patient has a combined high anion gap and nongap metabolic acidosis, resulting in a fall in serum bicarbonate greater than the rise in the anion gap. The most compatible picture is a. Choice b. shows a nongap acidosis alone, and choice c. shows a gap acidosis alone. Choice d. shows a preexisting chronic respiratory acidosis The answer is a. (Fauci, 14/e, p 275.) Trimethoprim impairs potassium secretion in the distal nephron. Heparin, ACE inhibitors, and nonsteroidals are other examples of drugs that can cause hyperkalemia. The other three answers cause hypokalemia by cellular shifts (albuterol) or increased urinary loss (licorice, cisplatin) The answer is d. (Fauci, 14/e, p 1549.) Urine dipstick cannot detect light chains and Bence Jones proteins found in paraproteinemias. So there is a discrepancy between dipstick values and the 24-h urine collection. The sulfosalicylic acid test (SSA) can precipitate all proteins and can be diagnostic as well. Focal sclerosis and amyloidosis would not have this discrepancy. Hypertensive nephrosclerosis presents with milder degrees of proteinuria The answer is c. (Fauci, 14/e, p 1544.) Glomerular diseases cause hematuria with dysmorphic red cells in the urine and sometimes red cell casts. Isomorphic red cells indicate nonglomerular bleeding including that from the urinary bladder. Hypercalciuria is a common cause of hematuria in young individuals even without renal stone formation.
153 Renal/Nephrology Answers The answer is b. (Fauci, 14/e, p 1543.) This clinical description is classic for membranoproliferative glomerulonephritis, which is associated with bacterial endocarditis. Choice a. describes anti-gbm antibody disease or Goodpasture s syndrome when the lung is involved. Choice c. describes pauci-immune glomerulonephritis, such as Wegener s. Choice d. describes IgA nephropathy. Low complement levels are typically found in membranoproliferative glomerulonephritis, but not in the other disorders listed The answer is d. (Fauci, 14/e, p 1547.) All of these diseases are common in older persons. Amyloidosis and light chain deposition disease are related to paraprotein deposition in the kidney and typically present with nephrotic syndrome. The subacute presentation and erythrocyte casts in the urine along with the rapid decline in renal function are most consistent with vasculitis. A positive antineutrophil cytoplasmic antibody (ANCA) would be supportive. Erythrocyte casts are not seen in the other diseases.
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155 Gastroenterology Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question A 55-year-old man who is a longtime alcoholic comes to the emergency room after vomiting small amounts of bright red blood four times today. Your differential diagnosis is constructed around causes of bleeding from the a. Colon b. Liver and pancreas c. Kidneys d. Lungs e. Upper gastrointestinal (GI) tract 283. A patient in your office tells you that he had an episode of vomiting bright red blood twice in 1 day about 1 week ago, followed the next day by three or four episodes of vomiting material that looked like coffee grounds. He could not afford to seek medical help then and he said that it got better except for the pain. The past 3 days he noticed black sticky stools and he finally came to see you. What is your first concern? a. Bleeding colon cancer b. Bleeding from lung cancer c. Crohn s disease d. Cirrhosis e. Bleeding peptic ulcer 284. A 60-year-old patient has epigastric pain and weight loss of a few pounds. The consulting gastroenterologist s evaluation includes upper GI endoscopy, and he discovers a gastric ulcer. Now, the gastroenterologist should a. Biopsy the area of the ulcer b. Cauterize the ulcer c. Do nothing further d. Consult a surgeon to do a partial gastrectomy e. Repeat the upper GI endoscopy in 6 months 139 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
156 140 Pathophysiology 285. A 50-year-old woman executive has for the past 3 months experienced abdominal pain that often is relieved by antacids. Because of the persistent abdominal pain, she consults a gastroenterologist. He does an upper GI endoscopy and visualizes a duodenal ulcer. Now, the gastroenterologist should a. Biopsy the ulcer b. Arrange for a surgeon to operate on the ulcer c. Suggest medical treatment of the ulcer d. Cauterize the ulcer e. Order an abdominal CT scan 286. A 70-year-old woman is evaluated with colonoscopy for anemia and intermittently hemoccult-positive stools. A diagnosis of multiple arteriovenous malformations (AVMs) is made by which diagnostic procedure? a. Biopsy b. Visual inspection c. Arteriography d. Venography e. Lymphangiography 287. A 55-year-old alcoholic man has been losing weight for about 6 months and begins to complain of difficulty swallowing. An upper GI endoscopy reveals an esophageal ulcer. The gastroenterologist should a. Biopsy the ulcerated area b. Cauterize the ulcer c. Do nothing further d. Consult a surgeon to do an esophagectomy e. Observe the patient and repeat the upper GI endoscopy in 6 months 288. A patient complaining of chest pain, regurgitation, and dysphagia for several months is thought to have achalasia. The gastroenterologist should a. Order a chest CT scan to rule out tracheoesophageal fistula b. Do an endoscopy to biopsy the lower esophageal sphincter c. Do an endoscopy to dilate the esophagus d. Do an endoscopy to inject botulinum toxin into the lower esophageal sphincter e. Order an abdominal CT scan to make the diagnosis of achalasia
157 Gastroenterology Hepatitis C virus is most commonly transmitted by a. Parenteral routes including intravenous drug abuse and promiscuous sex b. Fecal-oral route c. Ingestion of contaminated food or water d. Living in the same household as an infected person e. Inhalation of infected airborne particles 290. The percentage of patients with acute hepatitis C who go on to have chronic disease is a. 5 to 10 b. 15 to 20 c. 25 to 30 d. 40 to 50 e. 60 to The extent of liver damage done by chronic hepatitis B or C infection can best be gauged by evaluating a. Symptoms b. Elevation of serum transaminases c. Duration of infection d. Liver biopsy e. Presence or absence of ascites 292. A 45-year-old obese woman with cholelithiasis presents to the emergency room complaining of nausea and vomiting for 2 days, along with severe continuous midabdominal pain. She has a low-grade fever and the ER physician finds that she has a slightly elevated WBC count (12,000) and an elevated serum amylase. The most likely diagnosis is a. Ruptured abdominal aortic aneurysm b. Hepatitis c. Peptic ulcer disease d. Early phase of acute appendicitis e. Acute pancreatitis
158 142 Pathophysiology 293. Chronic pancreatitis may be reliably diagnosed in a patient presenting with a. Calcification in the pancreas detected on a flat plate x-ray of the abdomen b. Abdominal pain c. Diarrhea d. Nausea and vomiting e. Jaundice 294. Acute pancreatitis is caused by a variety of disorders. Which of the following pairs of disorders account for 80 to 90% of cases? a. Diabetes and viral illness b. Trauma and hyperlipidemia c. Trauma and gallstones d. Hyperlipidemia and alcohol e. Alcohol and gallstones 295. A 70-year-old man with progressive painless jaundice is referred to your office. You order liver function tests that show an abnormal pattern consistent with obstruction. Which procedure will you now suggest? a. Laparoscopic cholecystectomy b. Endoscopic retrograde cholangiopancreatography (ERCP) c. Modified barium swallow d. Laparoscopic abdominal exploration e. Upper GI endoscopy 296. In which of the following disorders will esophageal manometry reveal a high-pressure nonrelaxing LES and poor motility in the rest of the esophagus? a. Hypertensive LES b. Esophageal spasm c. Obstructive lower esophageal lesion d. Nonspecific motility disorders e. Achalasia
159 Gastroenterology A 70-year-old man complains of a sensation of food sticking in his lower chest area. This happens when he eats either liquids or solids. He also has a slight weight loss. The most likely diagnosis is a. Achalasia b. Esophageal spasm c. Hypertensive LES d. Hiatal hernia with GERD e. Barrett s esophagus 298. A 45-year-old woman has chest pain for which a cardiac cause has been ruled out. Her esophageal motility study shows pressure waves of a very high amplitude lasting 2 to 3 s. The most likely diagnosis is a. Esophageal web b. Esophageal spasm c. Achalasia d. GERD (gastroesophageal reflux disease) e. T-E (tracheoesophageal) fistula 299. A 40-year-old man with occasional dysphagia and who otherwise feels well undergoes esophageal motility studies that show an LES amplitude of approximately 60 mmhg. The esophagus relaxes completely when he swallows. The most likely diagnosis is a. GERD (gastroesophageal reflux disease) b. Achalasia c. Hypertensive LES d. Barrett s esophagus e. Esophageal spasm 300. The presence of gastroesophageal reflux is best diagnosed by a. Computed tomographic (CT) scan of the chest b. Physical examination c. Laboratory evaluation d. Barium swallow e. Medical history
160 144 Pathophysiology 301. The most common location for a gastric ulcer is a. Fundus b. Greater curvature c. Cardia d. Body e. Antrum 302. Helicobacter pylori is associated with a. Nearly all duodenal ulcers and most gastric ulcers b. Few peptic ulcers c. Most esophageal ulcers, but not many gastric ulcers d. Nearly all gastric ulcers, but very few duodenal ulcers e. Most cases of erosive gastritis 303. When nonsteroidal anti-inflammatory drugs cause ulcers, they are usually a. Esophageal b. Jejunal c. Duodenal d. Gastric e. Anal 304. A 40-year-old man comes to your office complaining of epigastric pain that is unrelieved by several weeks of antacid therapy. Endoscopy reveals a duodenal ulcer. You recommend a course of treatment. What is the most likely outcome? a. The ulcer may heal but scarring will cause outlet obstruction b. Eventually the patient will require surgery for control of his symptoms c. The ulcer may heal completely after 8 weeks of H2-blocker therapy d. The symptoms will improve with H2-blocker therapy, but the ulcer won t heal e. The ulcer may heal completely after 6 months of H2-blocker therapy 305. Which one of these ulcers has the lowest incidence of malignancy? a. Duodenal b. Esophageal c. Gastric d. Colon e. Gastroesophageal junction
161 Gastroenterology Osmolality of bowel contents under normal circumstances is a. Isotonic in the jejunum, ileum, and colon and variable in the duodenum b. Variable throughout the small and large intestines c. Isotonic in the colon and hypertonic in the small intestine d. Hypertonic throughout the small and large intestines e. Variable in the jejunum, ileum, and colon and isotonic in the duodenum 307. The digestive enzymes amylase and lipase begin to be secreted and begin to act on ingested food a. In the duodenum, after they are secreted by the pancreas b. In the ileum, after they are secreted by the small intestine c. In the duodenum, after they are secreted from the liver d. In the mouth, after secretion from the salivary and lingual glands e. In the stomach, after they are secreted from the pancreas 308. A 72-year-old woman complains of fatigue, dyspepsia, and shortness of breath. Her daughter tells you that her mother also has some slight memory loss and occasionally complains of numbness in her legs. The laboratory tests you ordered show a hemoglobin of 10.2 g/dl and an MCV of 110. The most likely cause is a. Autoantibodies to thyroglobulin b. Autoantibodies to histones c. Autoantibodies to gastric parietal cells d. Autoantibodies to dsdna (double-stranded DNA) e. Autoantibodies to ribosomal P protein 309. A 45-year-old man complains of frequent heartburn and a mild chronic cough. On examination, he has gastroesophageal reflux disease (GERD). In addition to prescribing medications, which one of the following dietary recommendations would you make? a. Avoid high-protein meals because they would increase lower esophageal sphincter (LES) pressure b. Avoid fats, chocolates, and alcohol because they would decrease LES pressure c. Eat high-carbohydrate food to increase overall GI motility d. Eat high-protein meals to decrease LES pressure e. Avoid concentrated carbohydrates to decrease dopamine secretion
162 146 Pathophysiology 310. A 32-year-old man is admitted with a bleeding ulcer. This is his fifth episode of bleeding from gastric ulcers and he also has moderate diarrhea. Each time, his ulcers have been difficult to resolve. Which neoplastic lesion is most likely to be found in this man? a. Small cell carcinoma of the lung b. Gastric adenocarcinoma c. Small intestinal carcinoid d. Prostate adenocarcinoma e. Gastrinoma 311. Which clinical or laboratory finding is most consistently seen in malabsorption syndromes? a. Hypercalcemia b. Iron overload c. Elevated zinc levels in serum d. Normal small bowel biopsy e. Steatorrhea 312. In which disorder is malabsorption due to diminished or absent digestive enzymes? a. Chronic pancreatitis b. Crohn s disease c. Gastric surgery d. Small bowel ischemia e. Sigmoid resection 313. A 35-year-old woman has had episodes of abdominal pain and bloody diarrhea for 4 to 5 years. Recently, the episodes became increasingly common, and she noted a weight loss of about 10 pounds. She tells you that two of her uncles have had similar symptoms for years and recently one of them had colon cancer. On examination, there are no abdominal masses and no fistulas. The most likely findings on colonoscopy with biopsy are a. Normal mucosa b. Patchy inflammatory lesions that extend throughout the bowel wall c. Granulomas and fibrosis d. Continuous inflammatory changes mostly confined to the mucosa e. Patchy inflammation of the mucosa with inflamed mesenteric fat and fibrosis
163 Gastroenterology A 20-year-old man has complaints of diarrhea and abdominal pain. He often sees some blood in his stool, but not with every episode of diarrhea. He also complains of easy fatigue and weight loss and for 2 days he has had nausea and vomiting. Two years ago he was treated for a rectal fissure. On examination, he has a modestly tender mass in the right lower quadrant. The most likely diagnosis is a. Ulcerative colitis b. Appendicitis c. Diverticulitis d. Irritable bowel syndrome e. Crohn s disease 315. You suspect a patient may have gallstones as a cause of her chronic nausea and mild RUQ pain. The best imaging study would be a. Upper abdominal ultrasound b. Abdominal CT scan c. Abdominal MRI d. Barium swallow e. KUB (flat-plate x-ray of the abdomen) 316. A patient with jaundice complains of RUQ pain. Liver function tests show a bilirubin of 3.0 mg/dl, alkaline phosphatase about four times normal and both AST and ALT increased about 50% above normal. The best imaging test to order first in evaluating this patient would be a. Ultrasound b. Abdominal CT scan c. Abdominal MRI d. Barium swallow e. KUB (flat-plate x-ray of the abdomen) 317. A patient with colon cancer diagnosed about 2 years ago presents with slight jaundice, nausea, and weight loss. An abdominal CT scan is read as lesions in the liver; unable to distinguish vascular from possible metastatic areas. What is the best imaging study for this patient? a. Upper abdominal ultrasound b. Repeat CT scan with spiral technique c. Abdominal MRI d. Laparoscopy e. Open abdominal exploration
164 148 Pathophysiology 318. A 65-year-old man complains of trouble swallowing. He is unsure whether his trouble swallowing occurs with both liquids and solids because it is intermittent. Sometimes he chokes and gets food in his windpipe. The best imaging study is a. Ultrasound of the neck b. CT scan of the chest c. MRI of the mediastinum d. Barium swallow e. KUB (flat-plate x-ray of the abdomen) 319. Symptoms due to Clostridium difficile infection can be accurately diagnosed by a. Presence of diarrhea b. Stool positive for WBCs c. History of recent antibiotic usage d. Pseudomembranes noted on a sigmoidoscopy e. KUB (flat-plate x-ray of the abdomen) 320. Which term characterizes the frequency of chronic disease following hepatitis A infection? a. Rare b. Infrequent c. Common d. Typical e. Nonexistent 321. Which of the following laboratory patterns is most consistent with the diagnosis of hemochromatosis? a. Increased iron, increased TIBC (total iron-binding capacity), and increased ferritin b. Low iron, low TIBC, and low ferritin c. Low iron, low TIBC, and increased ferritin d. Low iron, increased TIBC, and decreased ferritin e. Increased iron, normal TIBC, and low ferritin
165 Gastroenterology Which of the following is seen most commonly in association with primary biliary cirrhosis (PBC)? a. Positive antinuclear antibody (ANA) b. Increased ceruloplasmin c. Increased ferritin d. Positive hepatitis B surface antigen e. Positive antimitochondrial antibody (AMA) 323. Previously, you treated a 44-year-old man, a former intravenous drug abuser, for acute hepatitis C infection. Several months later, it is clear that the patient has chronic hepatitis and may need therapy with interferon. Which long-term complications of hepatitis C infection must you discuss so that the patient can make an informed decision about treatment? a. Hepatoma and cirrhosis b. Hepatic adenoma c. Sclerosing cholangitis d. Hemochromatosis e. Lymphoma or leukemia 324. Fatigue, anorexia, orange/brown-colored urine, and an ALT level greater than 10 times normal are clinical features of a. Hepatitis A b. Any viral hepatitis c. Hepatoma d. Hepatitis B and hepatitis C e. Hepatitis B, but not hepatitis C 325. Protective vaccines are available for which of the following hepatitis viruses? a. A and B b. A and D c. A and C d. B and C e. C and D
166 150 Pathophysiology 326. A man known to be an alcoholic for at least 15 years presents with fever, elevated serum bilirubin, elevated WBC count, and an AST/ALT ratio greater than 2. A liver biopsy shows Mallory bodies, WBCs, and degenerating cells. You should tell this patient that the biopsy findings are a. Consistent with cirrhosis b. Essentially normal c. Consistent with alcoholic hepatitis that may revert to normal if he stops drinking alcohol d. Consistent with alcoholic hepatitis that will progress to cirrhosis e. Not interpretable because of the presence of degenerating cells and it will need to be repeated
167 Gastroenterology Answers 282. The answer is e. (Fauci, 14/e, p 246.) Hematemesis or vomiting of blood represents an upper gastrointestinal (GI) source of blood loss. Bleeding from the colon will be manifested by either by no change in the color of the stools or by black, tarry-like stools (melena). Bleeding from the lungs results in blood in the sputum (hemoptysis) and from the kidneys as blood in the urine (hematuria), mainly microscopic hematuria The answer is e. (Fauci, 14/e, p 1607.) Vomiting of blood or hematemesis can be either fresh, bright red blood or dark blood (similar to coffee grounds in appearance), which results from the action of gastric chemicals on the blood. Blood that appears as coffee grounds signals bleeding from the stomach or duodenum. Tarry or black stools occur with bleeding from the colon. It can occur also with substantial amounts of bleeding from the upper gastrointestinal tract, such as bleeding from a peptic ulcer The answer is a. (Fauci, 14/e, pp 518, 1607.) Gastric ulcers should be biopsied to rule out malignancy. The other approaches are not appropriate The answer is c. (Fauci, 14/e, pp 568, 1607.) The incidence of malignancy in duodenal ulcer is low, so a biopsy of the ulcer is not indicated. Surgery or other procedures are not necessary in uncomplicated ulcers The answer is b. (Fauci, 14/e, pp 568, 1607.) AVMs are recognized visually and no biopsies are necessary. This is so particularly because of the increased incidence of bleeding The answer is a. (Fauci, 14/e, pp 568, 1607.) Like gastric ulcers, esophageal ulcers should always be biopsied because ulcerating lesions of the esophagus on contrast radiographs can be cancer. Esophageal cancers are mainly squamous cell carcinomas. Although uncommon, esophageal cancer is particularly aggressive and less than 5% of persons survive 5 years. 151
168 152 Pathophysiology 288. The answer is d. (Fauci, 14/e, pp 1590.) In achalasia, the esophagus is dilated, sometimes significantly so to the point of mimicking the sigmoid. Endoscopy with injection of botulinin toxin into the LES may be useful, and it would provide a direct view of the dilation. Biopsy is not necessary unless the mucosal surface is irregular The answer is a. (Fauci, 14/e, pp 1686.) Hepatitis C requires parenteral exposure for transmission. It is most commonly spread through intravenous drug abuse. It also spread by sexual contact; however, this occurs very infrequently The answer is e. (Fauci, 14/e, pp 1690.) Up to 75% of patients infected with hepatitis C subsequently may become carriers and develop chronic disease. Interferon and ribavirin in combination cure about 40% of persons with HCV serotype 1a and about 60% of persons with HCV serotype 3a The answer is d. (Fauci, 14/e, pp 1700.) Obtaining a piece of liver tissue is the only means to judge the histologic damage caused by chronic viral infection. A poor correlation exists between symptoms and transaminase elevation, as well as the duration of infection and liver damage The answer is e. (Fauci, 14/e, pp 1581.) The characteristics of acute pancreatitis include nausea and vomiting, abdominal pain, low-grade fever, and an elevated serum amylase. The pain is located primarily in the epigastrium and radiates into the back and usually is continuous and boring in quality. Fever may or may not be present. Serum amylase and lipase are usually elevated in the acute stages The answer is a. (Fauci, 14/e, pp 1741.) Jaundice, abdominal pain, diarrhea, and nausea and vomiting all occur in patients suffering from chronic pancreatitis, but these findings are nonspecific. The finding of calcification on the KUB (kidneys, ureters, and bladder) or flat-plate x-ray is diagnostic of chronic pancreatitis The answer is e. (Fauci, 14/e, pp 1741.) Gallstones and alcoholinduced disease account for 80 to 90% of the cases of acute pancreatitis. Less common causes include trauma, viral illnesses, hypercalcemia, and medications. Diabetes is not a cause of acute pancreatitis.
169 Gastroenterology Answers The answer is b. (Fauci, 14/e, pp 1584.) Therapeutic ERCP is used most commonly for complicated gallstone disease, as well as for an evaluation of obstructive jaundice. It can nonsurgically relieve obstructive jaundice. When needed, during ERCP sphincterotomy can be performed or stents usually can be placed very safely, with an approximately 5% complication rate. Most complications are not serious The answer is e. (Fauci, 14/e, pp 1741.) Achalasia shows a highpressure nonrelaxing LES with absent motility in the body of the esophagus. Hypertensive LES has a high-pressure reading at the LES. Esophageal spasm shows high-amplitude prolonged pressure waves. Nonspecific disorders include repetitive swallows and dropped waves that do move through the whole esophagus. Obstructive causes of dysphagia are best diagnosed on barium swallow or endoscopy The answer is a. (Fauci, 14/e, pp 1741.) Patients with achalasia present with a history of dysphagia or sensation of food sticking, which includes both liquids and solids. They have a long history of these symptoms and might come for treatment at an older age The answer is b. (Fauci, 14/e, pp 1741.) Patients with esophageal spasm usually have more severe pain than patients with hypertensive (hypercontracting) LES (and the other disorders). The symptoms of esophageal spasm often are confused with the pain of cardiac origin. Patients with esophageal spasm and hypertensive (hypercontracting) LES usually present at an earlier age than patients with achalasia The answer is c. (Fauci, 14/e, pp ) Patients with hypertensive (hypercontracting) LES experience less dysphagia than patients with esophageal spasm, and they do not complain of food sticking as do patients with achalasia. The pain associated with hypertensive LES does not have the characteristic of cardiac origin The answer is e. (Fauci, 14/e, pp 1593.) The diagnosis of gastroesophageal reflux is best diagnosed by a medical history because of its typical presentation of retrosternal burning, usually postprandially and sometimes nocturnally. It may be exacerbated by certain foods. In simple reflux disease, the results of a physical examination and laboratory tests are unremarkable. CT findings of the chest are normal in reflux disease. Gastroesophageal reflux
170 154 Pathophysiology can be elicited on barium swallow, but often it is only an incidental and unrelated finding in patients who have no symptoms of heartburn The answer is e. (Fauci, 14/e, pp 1593.) Eighty-five to 90% of gastric ulcers are found in the prepyloric and antral areas. An ulcer in a different location is unusual, but it is not indicative of a higher incidence of malignancy The answer is a. (Fauci, 14/e, pp 1605.) Helicobacter pylori is associated as a cause of approximately 95% of duodenal ulcers and 75% of gastric ulcers. It is also universally associated with antral gastritis. About one-half of the adult population in the U.S. harbors Helicobacter pylori. However, in adults it rarely causes symptoms The answer is d. (Fauci, 14/e, pp 1605.) Nonsteroidal antiinflammatory drugs primarily cause gastric ulcers. They also can cause duodenal disease. Because of the concern for malignancy in gastric ulcers, biopsies are performed of gastric ulcers to search for malignant changes The answer is c. (Fauci, 14/e, pp 1605.) After only 8 weeks of H2- blocker therapy, the ulcer may heal. Six months of H2-blocker will not prove more beneficial than 6 weeks of such therapy and it is not indicated. Symptoms lessen because the ulcer heals. Surgery is rarely indicated for the control of symptoms, considering the high efficacy of the medications currently available. Duodenal ulcers are at exceedingly low risk for any malignancy; therefore, biopsies of them are not routinely performed The answer is a. (Fauci, 14/e, pp 1605.) Duodenal ulcers are at exceedingly low risk for any malignancy, unlike the other ulcers. Gastric ulcers especially show malignancy The answer is a. (McPhee, 2/e, p 293.) The duodenum has the highest fluid flow rate and the most variable osmolality of any area in the intestinal tract. Its flow rate exceeds any area in the small and large intestine The answer is d. (McPhee, 2/e, p 293.) Digestion begins in the mouth with the action of chewing. Amylase from the salivary glands and lipase from the lingual glands start to act in the mouth.
171 Gastroenterology Answers The answer is c. (McPhee, 2/e, pp 290; Fauci, 14/e, pp 655, 656, 1875, 2018.) The syndrome described is most consistent with pernicious anemia, a macrocytic anemia, in which 90% of persons with this disease have antibodies to gastric parietal cells and about 60% of persons possess anti-intrinsic factor antibody. The antiparietal cell antibody destroys parietal cells and leads to malabsorption of cobalamin and a macrocytic anemia. Antibodies to histones, dsdna, and ribosomal P protein occur in systemic lupus erythematosus (SLE). Autoantibodies to thyroglobulin are characteristic of Hashimoto s disease The answer is b. (McPhee, 2/e, pp 296.) The goal for improving the symptoms of GERD is to increase or maintain the LES pressure. Highprotein meals generally increase LES pressure and should be encouraged. Fats, chocolate, and alcohol decrease LES pressure and these foods should be avoided. Carbohydrate content does not affect motility The answer is e. (McPhee, 2/e, p 240; Fauci, 14/e, p 1614.) The clinical findings in this patient are consistent with a diagnosis of Zollinger- Ellison syndrome (multiple peptic ulcers due to a gastrin-secreting tumor). Diarrhea accompanies the symptoms of peptic ulcer frequently. The patient is a young adult and lacks other symptoms of a gastric adenocarcinoma. Carcinoid causes diarrhea, but not often does it cause the ulcerative symptoms this patient exhibits. Also, this patient s symptoms are inconsistent with lung or prostate carcinoma The answer is e. (Fauci, 14/e, pp ) The presence of steatorrhea is diagnostic for malabsorption particularly when more than 6 g of fat is excreted per day. Villous atrophy on small bowel biopsy specimens is consistent also with changes leading to malabsorption. Calcium and iron are not absorbed well in the upper small intestine, and their levels are low. Similarly, the zinc level should be low The answer is a. (Fauci, 14/e, p 1621.) The causes of malabsorption include the absence of digestive enzymes (as occurs in chronic pancreatitis) or injured or absent small bowel mucosa (as occurs in Crohn s disease, various gastric surgeries, and ischemia resulting in bowel resection.) Sigmoid resection or removal of all or part of the colon should not impair absorption of nutrients.
172 156 Pathophysiology 313. The answer is d. (Fauci, 14/e, p ) Ulcerative colitis usually shows continuous inflammatory changes mostly confined to the mucosa of the colon without skip lesions. Granulomas are not seen in biopsy specimens. Clinically, diarrhea, frequently bloody, characterizes ulcerative colitis. After 10 years of total colonic involvement, an increased risk exists of colon malignancy The answer is e. (McPhee, 2/e, p 315; Fauci, 14/e, p ) Crohn s disease can present confined to the small bowel or colon or more commonly with a combination of ileocolonic involvement. It frequently has skip lesions throughout the small bowel and colon, with abnormal mucosa separated by normal mucosa. It can present with nausea and vomiting, secondary to obstruction due to fibrosing disease, stricture, or abscess The answer is a. (Fauci, 14/e, pp , 1664.) An upper abdominal ultrasound is the ideal test to examine the gallbladder for stones. CT scan is very helpful in evaluating obstructive jaundice, particularly when a pancreatic source is suspected. For subtle lesions for which the differential diagnosis includes metastatic disease, vascular problems, or parenchymal disease, MRI is very helpful if the CAT scan is not diagnostic. Barium swallow is the initial study favored in the evaluation of patients with dysphagia. A KUB can show radiopaque stones only The answer is b. (Fauci, 14/e, pp , 1664.) CT scan is very helpful in evaluating obstructive jaundice, particularly when a pancreatic source is suspected. For subtle lesions for which the differential diagnosis includes metastatic disease, vascular problems, or parenchymal disease, MRI is very helpful if the CAT scan is not diagnostic. An upper abdominal ultrasound is the ideal test to examine the gallbladder for stones, and a barium swallow is the initial study favored in the evaluation of patients with dysphagia. A KUB might show an enlarged liver, but contribute to the evaluation of jaundice, especially when the pancreas is involved The answer is c. (Fauci, 14/e, pp , 1664.) For subtle lesions for which the differential diagnosis includes metastatic disease, vascular problems, or parenchymal disease, MRI is very helpful if the CAT scan is not diagnostic. An upper abdominal ultrasound is the ideal test to examine
173 Gastroenterology Answers 157 the gallbladder for stones. CT scan is very helpful in evaluating obstructive jaundice, particularly when a pancreatic source is suspected The answer is d. (Fauci, 14/e, pp , 1664.) Barium swallow is the initial study favored in the evaluation of patients with dysphagia. An ultrasound of the neck will not provide information on dysphagia with difficulty swallowing liquids and solids because the lesion causing this symptom is in the esophagus The answer is d. (Fauci, 14/e, p 909.) The diagnosis of Clostridium difficile infection can be made accurately by the presence of pseudomembranes on sigmoidoscopy and also by identifying C. difficile toxins in the stools. The presence of diarrhea and WBCs in the stool are not specific and not diagnostic of C. difficile, which usually are seen with prior antibiotic usage, but these findings are not totally reliable The answer is e. (Fauci, 14/e, p 1684.) Patients with acute hepatitis A do not progress to chronic disease, unlike those patients infected with hepatitis B or hepatitis C viruses. In acute hepatitis A, the case fatality rate is less than 1%, and there is no chronic disease secondary to it The answer is a. (Fauci, 14/e, p 1251.) The findings of an increased serum iron, slightly increased TIBC, and increased ferritin level is consistent with the diagnosis of hemochromatosis. The increased ferritin level is usually greater than 500. Low iron, low TIBC, and low ferritin are not characteristic of hemochromatosis The answer is e. (Fauci, 14/e, p 1621.) Positive AMA is seen in approximately 95% of primary biliary cirrhosis (PBC) patients. ANA is seen in a few patients. Decreased ceruloplasmin and increased ferritin levels are usually seen in Wilson s disease and hemochromatosis, respectively. There is no association between Hepatitis B surface antigen and PBC The answer is a. (Fauci, 14/e, p 1699.) The most serious consequences of chronic hepatitis B and C infections are hepatoma and cirrhosis. Complications of cirrhosis may occur, resulting in liver failure. Chronic hepatitis is not a risk factor for adenoma, cholangitis, lymphoma, or hemochromatosis.
174 158 Pathophysiology 324. The answer is b. (Fauci, 14/e, p 1677.) Acute viral hepatitis, no matter what the etiology, usually presents in a similar manner with fatigue and anorexia, malaise, and dark-colored urine, if jaundice is present. The transaminases, AST and ALT, are usually elevated 10 times above normal levels The answer is a. (Fauci, 14/e, p 1705.) Currently, protective vaccines are available for hepatitis A (2 doses 6 months apart) and hepatitis B (3 doses; second dose follows the first by 1 month and third dose follows the second dose by 5 months). No vaccines exist for other hepatitis viruses The answer is c. (Fauci, 14/e, p 1705.) Acute alcoholic hepatitis is characterized by the presence of Mallory bodies and WBCs in the liver biopsy specimen. Frequently, it shows fat and degenerating cells in the liver. Usually, with abstinence from alcohol, this will revert to a normal histologic pattern. However, on occasion, liver disease can progress despite abstinence.
175 Liver Disease Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question Serum alkaline phosphatase may be elevated in the diseases of which organ? a. Liver b. Salivary glands c. Spleen d. Heart e. Bladder 328. In parenchymal liver disease, which one of the following tests of liver function likely will be decreased from normal? a. AST (aspartate aminotransferase) and ALT (alanine aminotransferase) b. Alkaline phosphatase c. Albumin d. Prothrombin time e. γ-glutamyl transpeptidase (GGT) 329. In obstructive liver disease, which one of the following tests of liver function likely remains normal? a. AST and ALT b. Alkaline phosphatase c. Albumin d. 5 -Nucleotidase e. γ-glutamyl transpeptidase (GGT) 330. Which one of the following enzymes is found primarily in the liver? a. AST b. ALT c. Alkaline phosphatase d. 5 -Nucleotidase e. γ-glutamyl transpeptidase (GGT) 159 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
176 160 Pathophysiology 331. A 43-year-old woman comes to your office complaining of pruritus, mainly of the soles and palms, and fatigue. She has minimal jaundice and steatorrhea. Laboratory tests show a slightly elevated bilirubin, an elevated alkaline phosphatase, and a positive IgG antimitochondrial antibody test. The likely diagnosis is a. Extrahepatic biliary tract obstruction b. Alcoholic hepatitis c. Viral hepatitis d. Primary biliary cirrhosis e. Carcinoma of the liver 332. Transmission of hepatitis A is almost exclusively by a. Blood transfusion b. Intravenous drug abuse c. Fecal-oral route d. Sexual 333. Which one of the hepatitis viruses is a DNA virus? a. HAV b. HBV c. HCV d. HEV e. HGV 334. In hepatitis B virus infection, which one of the following antibodies is the protective antibody? a. Anti-HBe b. Anti-HBc c. Anti-HBs d. Anti-polymerase e. Anti-HBV DNA
177 Liver Disease A 51-year-old man health care worker whom you examine for the first time feels well. You do a complete physical examination, which is normal except for slight overweight and borderline hypertension. It is interesting that his laboratory studies show the following hepatitis B virus profile: positive HBsAg, negative anti-hbs, low levels of IgG anti-hbc, positive anti-hbeag, and negative anti-hbe. The likely diagnosis is a. Acute HBV infection, high infectivity b. Late-acute HBV, low infectivity c. Recovered from HBV infection d. Chronic HBV infection, high infectivity e. Immunization with HBsAg vaccine 336. A 55-year-old woman manager of a regional long-distance telephone office whom you examine for the first time feels well. You do a complete physical examination, which is normal except for a few very small palpable and moveable, nontender nodes in both cervical chains and occasional wheezes in the lungs. However, her laboratory studies show the following hepatitis B virus profile: negative HBsAg, positive anti-hbs, low levels of IgG anti-hbc, negative anti-hbeag, and positive anti-hbe. The likely diagnosis is a. Acute HBV infection, high infectivity b. Late-acute HBV, low infectivity c. Recovered from HBV infection d. Chronic HBV infection, high infectivity e. Immunization with HBsAg vaccine 337. The most common cause of fulminant hepatitis is hepatitis a. A b. B c. C d. E e. G 338. Mallory bodies found on biopsy of the liver are highly suggestive of which disease? a. Alcoholic fatty liver b. Alcoholic hepatitis c. Alcoholic cirrhosis d. Viral hepatitis e. Primary biliary cirrhosis
178 162 Pathophysiology 339. A 26-year-old man comes to your office for an examination because of tremors, spasticity, and drooling. He has headaches and fatigue. On physical examination, he is very slightly icteric, the liver is not palpable, and no spider angiomata are present, but he has resting and intention tremors and spasticity. Laboratory tests show elevated AST and ALT and a ceruloplasmin level of 70 mg/l. The diagnosis is a. Hemochromatosis b. Gaucher s disease c. Biliary cirrhosis d. Wilson s disease e. Type III glycogen storage disease 340. Which of these liver diseases results from a copper disorder? a. Hemochromatosis b. Gaucher s disease c. Biliary cirrhosis d. Wilson s disease e. Type III glycogen storage disease 341. Which of these liver diseases results from an iron disorder? a. Hemochromatosis b. Gaucher s disease c. Biliary cirrhosis d. Wilson s disease e. Type III glycogen storage disease 342. Which feature characterizes acetaminophen-induced liver damage? a. Fatal fulminant disease usually is associated with ingestion of 25 g or more of acetaminophen b. Blood levels of acetaminophen fail to correlate with severity of hepatic injury c. Glutathione levels in the liver are increased d. Aminotransferase levels are normal e. N-Acetylcysteine increases renal excretion of acetaminophen
179 Liver Disease Which feature is characteristic of chronic hepatitis due to HBV? a. It is more likely to occur if infection occurs in adults. b. Seroconversion from HBeAg positive to HBeAg negative after 4 months of interferon-α therapy is 40% c. Long-term therapy with steroids is also effective d. The likelihood of responding to interferon is greater in patients with high levels of HBV DNA 344. The most sensitive indicator of infection with hepatitis C virus (HCV) is a. Anti-HCV, first-generation assay against C100-3 b. Anti-HCV, second-generation assay against C200 and C22-3 c. Anti-HCV, third-generation assay against C200, C22-3, and NS5 d. Antienvelope proteins E2/NS1 e. HCV RNA 345. Which of the hepatitis viruses most commonly progresses to chronic infection and chronic hepatitis? a. HAV b. HBV c. HCV d. HEV e. HGV 346. The clinical symptoms, signs, and outcomes following acute liver injury associated with viral hepatitis are as a consequence of the a. Virus directly cytopathic for liver cells (hepatocytes) b. Virus directly cytopathic to lymphoid cells in the liver c. Immunologic response of the host (the person infected), involving cytolytic T cells d. Primary action of viral polymerase on hepatocytes e. Virus antibody acting on hepatocytes and lymphoid cells
180 164 Pathophysiology 347. A 30-year-old man comes to your office with complaints of fatigue, anorexia, nausea, and vomiting. He does not have fever. His urine is dark. On physical examination, his liver is slightly enlarged and minimally tender. He does not have edema or spider angiomata. Laboratory tests show the following: negative HBsAg, negative IgM anti-hav, positive IgM anti- HBc, and negative anti-hcv. The most likely diagnosis is a. Acute hepatitis A b. Acute hepatitis B c. Acute hepatitis A and B d. Chronic hepatitis B e. Acute hepatitis C 348. A 35-year-old woman comes to your office with complaints of fatigue, anorexia, nausea, and vomiting. She does not have fever. Her urine is dark and her stool is clay colored. On physical examination, her liver is slightly enlarged and minimally tender. She does not have edema or spider angiomata. Laboratory tests show the following: negative HBsAg, positive IgM anti-hav, positive IgM anti-hbc, and negative anti-hcv. The most likely diagnosis is a. Acute hepatitis A b. Acute hepatitis B c. Acute hepatitis A and B d. Chronic hepatitis B e. Acute hepatitis C 349. The most common cause of portal hypertension is a. Hepatic vein thrombosis b. Hepatic venoocclusive disease c. Noncirrhotic portal fibrosis d. Portal vein obstruction e. Cirrhosis 350. Ascites forms in patients with cirrhosis when a. Portal hypertension alone is present b. Hepatic lymph flow is decreased c. Hypoalbuminemia alone is present d. Portal hypertension and hypoalbuminemia are present e. Hepatic lymph flow and aldosterone secretion are decreased
181 Liver Disease Which is the most common precipitating event of hepatic encephalopathy? a. Constipation b. Hyperkalemia c. Gastrointestinal bleeding d. Hypernatremia e. Acidosis 352. A serum ascitic fluid albumin gradient of more than 1.1 g/dl is consistent with ascites caused by a. Tuberculosis b. Peritoneal metastases c. Cirrhosis of the liver d. Trauma 353. Which one of the following disorders of bilirubin metabolism shows increased unconjugated bilirubin, normal conjugated bilirubin, and lack of bilirubin in the urine? a. Neonatal jaundice b. Crigler-Najjar syndrome, types I and II c. Hepatitis d. Partial extrahepatic obstruction e. Intravascular and extravascular hemolysis 354. Which one of the following disorders of bilirubin metabolism shows increased unconjugated bilirubin, increased conjugated bilirubin, and positive bilirubin in the urine? a. Neonatal jaundice b. Crigler-Najjar syndrome, types I and II c. Hepatitis d. Gilbert s syndrome e. Ineffective erythropoiesis
182 166 Pathophysiology 355. In the treatment of persons with hepatic encephalopathy, which one of the following acts decreases ammonia absorption? a. Sucrose b. Lactulose c. Protein d. Glucose e. Galactose 356. Which one of these drugs is of proven benefit in the treatment of persons with hepatic encephalopathy? a. Levodopa b. Bromocriptine c. Keto analogues of essential amino acids d. Branched-chain amino acids e. Tetracycline 357. In spontaneous bacterial peritonitis (SBP) typically a. Pneumococcus or other gram-positive bacteria commonly cause this infection b. Ascitic fluid usually has a high concentration of albumin c. Persons with normal livers and persons with advanced liver disease are equally likely to develop SBP d. As many as 70% of patients will experience at least one recurrence within 1 year of the first episode e. The leukocyte count in ascitic fluid is usually low, less than 100 cells/µl 358. In the hepatorenal syndrome typically a. Urinary sodium is greater than 5 mmol/l b. A precipitating factor occurs infrequently c. Azotemia, hyponatremia, progressive oliguria, and hypotension are usually present d. The urinary sediment contains a high concentration of RBC casts e. The leukocyte count in ascitic fluid is usually low, less than 100 cells/µl
183 Liver Disease Chronic infection with which virus is a risk factor for the development of hepatocellular carcinoma? a. HAV b. HBV c. HDV d. HEV e. HGV 360. Which disease is a major risk factor for development of hepatocellular carcinoma? a. Alcoholism b. Coombs positive hemolytic anemia c. Cholelithiasis d. Cirrhosis e. Amyloidosis 361. Which protein synthesized by the liver is commonly and significantly elevated in hepatocellular carcinoma? a. Albumin b. α-fetoprotein c. Thyroxine-binding globulin d. Protein C e. C-reactive protein 362. A 21-year-old college student and varsity football player comes to the emergency room with complaints of nausea, fatigue, mild right upper quadrant pain, and anorexia of several days. He has been at practice with the football team this spring and summer at a substitute practice field near the campus and he drank from a faucet of cold water at the edge of the field and near a farm. He does not use drugs. He drinks an occasional beer. Two other team members were examined recently for similar symptoms. On examination, his liver is minimally enlarged and tender. His serum bilirubin is 2.5 mg/dl and his AST and ALT are elevated. Which disease is he likely to have? a. Cirrhosis b. Wilson s disease c. Hepatitis due to HAV d. Hepatitis due to HBV e. Hepatitis due to HCV
184 168 Pathophysiology 363. A 31-year-old man with HIV comes to your office because of nausea, fatigue, mild right upper quadrant pain, and anorexia of 3 weeks duration. He uses intravenous illicit drugs and does so regularly. However, he previously received three doses of hepatitis B vaccine on the appropriate schedule, and he regularly takes his three-drug regimen for the treatment of his HIV. He drinks alcohol to excess, mainly for the past 2 years. On examination, he is slightly icteric and his liver is minimally enlarged and tender. His serum bilirubin is 3.0 mg/dl and his AST and ALT are significantly elevated. Which disease does he likely have? a. Cirrhosis b. Wilson s disease c. Hepatitis due to HAV d. Hepatitis due to HBV e. Hepatitis due to HCV 364. Which hepatitis virus is transmitted almost exclusively by the fecaloral route? a. HAV b. HBV c. HCV d. HDV e. HGV 365. Primary biliary cirrhosis (PBC) typically a. Is characterized by a circulating IgG antimitochondrial antibody present in more than 90% of patients b. Occurs predominantly (90%) in men between the ages of 50 and 70 years with symptomatic disease c. Can be effectively treated with glucocorticoids d. Occurs rarely with pruritus e. Have normal serum lipids 366. Hepatocellular adenomas a. Have multiple hepatocellular adenomas associated with glycogen storage disease type I b. Are mostly malignant c. Do not have hormones playing a role in their pathogenesis d. Occur predominantly in the left lobe of the liver e. Occur predominantly in men
185 Liver Disease Answers 327. The answer is a. (Fauci, 14/e, pp ) Alkaline phosphatase originates from bone, liver, intestine, and placenta. Elevated levels of alkaline phosphatase occur in persons with parenchymal liver diseases (slight to moderate increases in many of these cases). Impaired biliary function also shows elevated levels of alkaline phosphatase in the absence of bone disease and pregnancy. Alkaline phosphatase is not increased in diseases of the salivary glands, spleen, heart, or bladder The answer is c. (Fauci, 14/e, pp ) In parenchymal liver disease, serum albumin decreases. Albumin is synthesized in the liver and it has a half-life of 14 to 20 days. In moderate to severe parenchymal disease, the serum level of albumin decreases moderately to significantly. AST, alkaline phosphatase, prothrombin time, and GGT all increase in parenchymal liver disease The answer is c. (Fauci, 14/e, pp ) In obstructive liver disease, unlike parenchymal liver disease, the albumin level remains normal. Unlike albumin, the AST, alkaline phosphatase, prothrombin time, and GGT all increase slightly or significantly in obstructive liver disease. Of these enzymes, 5 -nucleotidase increases more in obstructive liver disease than in parenchymal liver disease The answer is b. (Fauci, 14/e, p 1664.) The aminotransferase ALT is found primarily in the liver. AST is found in many tissues. They are indicators of hepatocellular damage. In the hepatocyte, ALT is located only in the cytosol. Because AST occurs in many tissues, it is less specific than ALT for hepatocellular damage The answer is d. (Fauci, 14/e, pp , 1666.) The signs and symptoms in this patient suggest primary biliary cirrhosis (PBC), especially pruritus, a disease that occurs predominantly in women ages 35 to 60. The slightly elevated bilirubin and the elevated alkaline phosphatase are common in cirrhosis, and in particular, elevated alkaline phosphatase occurs in 169
186 170 Pathophysiology PBC. However, a positive IgG antimitochondrial antibody is detected in more than 90% of patients with PBC and provides an important diagnostic finding The answer is c. (Fauci, 14/e, p 1684.) Hepatitis A virus (HAV) is transmitted solely by the fecal-oral route. Person-to-person spread of HAV is enhanced by poor personal hygiene and overcrowding. Large outbreaks, as well as sporadic cases, have been traced to consuming contaminated food, water, milk, and shellfish. Intrafamily and institutional spread are common also. It is not spread by blood transfusion and sexual contact The answer is b. (Fauci, 14/e, p 1679.) HBV is a DNA belonging to the Hepadnaviridae. It possesses partially single-stranded and partially double-stranded DNA and a double-shelled virion. Its major antigens are HBsAg, a surface protein, and HBcAg and HBeAg, both core proteins. The other hepatitis viruses are RNA viruses belonging to different genera and species The answer is c. (Fauci, 14/e, pp 1680, 1688.) Anti-HBs is the protective antibody in hepatitis B virus infection. Persons with anti-hbs are protected against reinfection with the virus. None of the other antibodies are protective. However, anti-hbe and HBC are commonly measured to gauge the progress of the infection or determine the status of a patient with a viral hepatitis The answer is d. (Fauci, 14/e, p 1688.) The positive HBsAg in hepatitis B virus infection, together with low levels of IgG anti-hbc, positive HBeAg, and negative anti-hbe, fit the picture of chronic HBV infection with high infectivity. In chronic or late-acute HBV of low infectivity, the HBeAg would be negative. Persons immunized with HBV vaccine show only anti-hbs. Persons who have recovered from HBV infection are negative for HBsAg The answer is c. (Fauci, 14/e, p 1688.) The serologic pattern in this case is a person who has recovered from HBV infection. They possess anti- HBs, the protective antibody in HBV infection, IgG anti-hbc, and anti- HBc. The anti-hbc may be positive or negative in persons who recover from HBV.
187 Liver Disease Answers The answer is b. (Fauci, 14/e, p 1689.) Hepatitis B virus accounts for more than 50% of fulminant hepatitis cases. Also, many fulminant hepatitis cases are associated with hepatitis D virus (HDV) infection. The other hepatitis viruses are not associated with fulminant hepatitis The answer is b. (Fauci, 14/e, p 1705.) Mallory bodies are clumps of perinuclear, deeply eosinophilic material, or alcoholic hyaline. Their presence in hepatocytes strongly suggests alcoholic hepatitis. Similar material can be seen in hepatocytes in Wilson s disease, morbid obesity, and diabetes mellitus, but not viral hepatitis, biliary cirrhosis, or alcoholic fatty liver, or cirrhosis The answer is d. (Fauci, 14/e, pp 1719, , 2174, ) This patient s clinical and laboratory findings suggest Wilson s disease. These patients manifest neurologic findings, including tremors, spasticity, drooling, and dysphagia. The Babinski response may be present. The eyes show deposits of copper in Descemet s membrane of the cornea; the lack of them excludes the diagnosis. Also, the ceruloplasmin level is less than 200 mg/l The answer is d. (Fauci, 14/e, pp 1719, 2149, , 2174, ) Wilson s disease is an inherited copper metabolism disorder that leads to accumulation of copper in the liver, brain, and other organs. Gaucher s disease is a lipid storage disorder with a deficiency in the enzyme acid β-glucosidase. Type III glycogen storage disease is a defect in the branching enzyme. Hemochromatosis is an iron storage disorder The answer is a. (Fauci, pp 1719, 2149, , 2174, ) Hemochromatosis is an autosomal recessive disorder of iron storage, with impaired function of the liver. Wilson s disease is an inherited copper metabolism disorder that leads to accumulation of copper in the liver, brain, and other organs. Gaucher s disease is a lipid storage disorder with a deficiency in the enzyme acid β-glucosidase. Type III glycogen storage disease is a defect in the branching enzyme The answer is a. (Fauci, 14/e, p 1694.) Acetaminophen causes severe hepatic necrosis when ingested in large amounts in suicide attempts and accidentally by children. Fatal fulminant disease is usually, but not
188 172 Pathophysiology invariably, associated with ingestion of 25 g or more of the drug. Therapy should begin within 8 h of ingestion but may be effective when given as late as 24 to 36 h after the overdose. N-Acetylcysteine appears to act by providing a reservoir of sulfhydryl groups to bind to toxic metabolites or by stimulating synthesis and repletion of hepatic glutathione The answer is a. (Fauci, 14/e, pp ) The likelihood of chronicity after acute HBV infection varies as a function of age. Infection at birth is associated with a 90% chance of chronic infection; infection in young adulthood in immunocompetent persons is associated with an approximately 1% risk of chronicity. The likelihood of responding to interferon is greater in patients with moderate to low levels of HBV DNA and in patients with substantial elevations of aminotransferase activity. In patients with HBV, long-term therapy with glucocorticoids is ineffective and detrimental The answer is e. (Fauci, 14/e, pp , ) The most sensitive indicator of HCV infection is measurement of HCV RNA. The antibodies to HCV do not provide a certain measure of infection because they do not identify all persons infected with the virus The answer is c. (Fauci, 14/e, p 1684.) HCV progresses to chronic infection commonly. About 50 to 70% of persons infected develop chronic hepatitis. About 80 to 90% develop chronic infection. HBV progresses to chronic infection in children and adults in less than 10% of cases; however, neonates do so commonly. HAV and HEV do not progress to chronic infection The answer is c. (Fauci, 14/e, p 1683.) In viral hepatitis, the liver injury is due to the immunologic response of the host the person infected. Hepatitis viruses are not directly cytopathic for hepatocytes or lymphoid cells in the liver. The viral polymerase and virus antibody acting on the hepatocytes do not play a role in liver injury in viral hepatitis The answer is b. (Fauci, 14/e, p 1688.) In this case, the patient has acute HBV infection signaled by the positive IgM anti-hbc. Because the HBsAg is negative, it likely is below the threshold for detection. The IgM response reflects recent infection. This serologic pattern does not fit with infection with any of the other hepatitis viruses. The symptoms and signs,
189 Liver Disease Answers 173 lack of fever, and minimal abnormal findings on examination of the liver are consistent with the diagnosis of acute HBV The answer is c. (Fauci, 14/e, p 1688.) This patient has both hepatitis A and B virus infections. Both viruses can infect the same person. Clinical findings are consistent with an acute hepatitis; they are not specific for one virus. The positive IgM anti-hav and the positive IgM anti-hbc are evidence of acute infection with both viruses. The negative HBsAg is consistent with this antigen being below the threshold of detection The answer is e. (Fauci, 14/e, p 1710.) The most common cause of portal hypertension is cirrhosis. About 60% of persons with cirrhosis have portal hypertension. Portal vein obstruction is the second most common cause of portal hypertension. The other diseases cause portal hypertension much less often than cirrhosis and portal vein obstruction The answer is d. (Fauci, 14/e, p 1713.) Ascites forms in persons with cirrhosis who suffer from both portal hypertension and hypoalbuminemia. Hepatic lymph flow is increased in cirrhosis and contributes to the ascites. Aldosterone secretion also increases ascites The answer is c. (Fauci, 14/e, p 1715.) Gastrointestinal bleeding is the single most important precipitating event of hepatic encephalopathy. It leads to an increase in ammonia and other nitrogenous substances that are absorbed. Other factors that can precipitate hepatic encephalopathy include hyperkalemia, hypernatremia, and constipation; however, constipation is a much less important precipitating event than gastrointestinal bleeding The answer is c. (Fauci, 14/e, p 1713.) The serum ascites albumin gradient provides a better classification than total protein count or other parameters. Ascites accompanying cirrhosis of the liver typically has a high serum ascites albumin gradient (greater than 1.1 g/dl), reflecting indirectly the abnormally high hydrostatic pressure gradient between the portal bed and the ascitic compartment The answer is e. (Fauci, 14/e, p 1676.) This pattern of bilirubin in icterus is consistent with intravascular and extravascular hemolysis. In this
190 174 Pathophysiology condition, bilirubin turnover is increased. In partial hepatic obstruction and hepatitis, the conjugated bilirubin is increased, and in Crigler-Najjar syndrome and neonatal jaundice, the conjugated bilirubin is low The answer is c. (Fauci, 14/e, p 1676.) This case shows the laboratory findings in hepatitis. In Crigler-Najjar syndrome and neonatal jaundice, the conjugated bilirubin is low and no bilirubin is found in the urine. In Gilbert s syndrome and ineffective erythropoiesis, the conjugated bilirubin is low and normal, respectively, and no bilirubin is found in the urine The answer is b. (Fauci, 14/e, p 1716.) Lactulose, a nonabsorbable disaccharide, acts as an osmotic laxative. It works to decrease ammonia absorption. The other sugars and protein are not indicated in the treatment of hepatic encephalopathy The answer is e. (Fauci, 14/e, p 1716.) In addition to lactulose, antibiotics decrease ammonia production by intestinal bacteria. Tetracycline is effective, as is ampicillin and metronidazole. Neomycin is effective, but it is absorbed some and can cause renal toxicity. The role of the other drugs in the treatment of hepatic encephalopathy is unproven The answer is d. (Fauci, 14/e, pp ) Patients with cirrhosis and ascites develop SBP without any obvious primary source of infection. The ascitic fluid in these patients typically has a low concentration of albumin. An ascitic fluid count of more than 250 polymorphonuclear cells is suggestive of SBP. Empirical therapy with cefotaxime should be initiated when the diagnosis is first suspected, because enteric gram-negative bacteria are found in most cases. Recurrent episodes are relatively common; as many as 70% of the patients will experience at least one recurrence within 1 year of the first episode The answer is c. (Fauci, 14/e, pp ) Worsening azotemia, hyponatremia, progressive oliguria, and hypotension signal the hepatorenal syndrome. It may be precipitated by severe GI bleeding, sepsis, or overly vigorous attempts at diuresis. Also, it may occur without any obvious cause. Typically, the urine sodium concentration is less than 5 mmol/l. The urinary sediment is unremarkable.
191 Liver Disease Answers The answer is b. (Fauci, 14/e, pp ) HBV is a clear risk factor for development of hepatocellular carcinoma. HCV also is a risk factor for hepatocellular carcinoma. Except for HBV and HCV, the other hepatitis viruses apparently play no role as risk factors in this carcinoma The answer is d. (Fauci, 14/e, pp ) Cirrhosis is a major risk factor for development of hepatocellular carcinoma. The risk of hepatocellular carcinoma in a cirrhotic liver is about 3% a year. The other diseases play no role The answer is b. (Fauci, 14/e, p 579.) α-fetoprotein levels greater than 500 µg/l are found in about 70 to 80% of patients with hepatocellular carcinoma. The other proteins are synthesized in the liver but do not increase in carcinoma of the liver. Persistence of high levels of α-fetoprotein over 500 to 1000 µg/l in an adult with liver disease and without an obvious gastrointestinal cancer should be investigated for hepatocellular carcinoma The answer is c. (Fauci, 14/e, pp 1684.) In this case, the likelihood is that the college student drank contaminated water. The clinical and laboratory findings fit hepatitis due to HAV. He drinks too little and for too few years to have cirrhosis. HBV and HCV are parenterally spread and he has no evidence of that. Wilson s disease is an inherited disorder of copper metabolism for which this patient has no findings The answer is e. (Fauci, 14/e, pp 1684.) Hepatitis C virus occurs in persons with HIV and it is transmitted parenterally. The clinical and laboratory findings are consistent with this diagnosis. His heavy drinking is for too short a time for cirrhosis to develop, although he might have fat deposits in the liver. He had received HBV vaccine, thus protecting him from this infection The answer is a. (Fauci, 14/e, pp 1684.) HAV is transmitted exclusively by the fecal-oral route. The other hepatitis viruses, HBV, HCV, HDV, and HGV, are transmitted parenterally The answer is a. (Fauci, 14/e, pp ) The cause of PBC remains unknown. A circulating IgG antimitochondrial antibody is detected
192 176 Pathophysiology in more than 90% of the cases. Among patients with symptomatic disease, 90% are women between the ages of 35 and 60 years. In the treatment of PBC, glucocorticoids are ineffective and may actually worsen the bone disease The answer is a. (Fauci, 14/e, p 578.) Hepatocellular adenomas are benign tumors that occur predominantly in women and are influenced by hormones, mainly oral contraceptives. They occur mostly in the right lobe of the liver. Multiple adenomas in the liver have been associated with glycogen storage disease type I.
193 Thyroid and Pituitary Disorders Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question In a patient with iodine-deficiency goiter who moves from an iodinedeficient area to an iodine-replete area, the occurrence of hyperthyroidism most likely represents a. Graves disease b. Jod-Basedow phenomenon c. Choriocarcinoma d. Struma ovarii e. Toxic multinodular goiter 368. Thyrotoxicosis and uniformly increased radioactive iodine uptake in the thyroid can occur without any thyrotropin receptor antibodies or any thyroid autoimmunity in a. Graves disease b. Jod-Basedow phenomenon c. Choriocarcinoma d. Struma ovarii e. Toxic multinodular goiter 369. Pretibial myxedema is associated with a. Graves disease b. Jod-Basedow phenomenon c. Choriocarcinoma d. Struma ovarii e. Toxic multinodular goiter 177 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
194 178 Pathophysiology 370. Infiltration of orbital soft tissue and extraocular muscles with lymphocytes, mucopolysaccharides, and fluid is seen with a. Graves disease b. Jod-Basedow phenomenon c. Choriocarcinoma d. Struma ovarii e. Toxic multinodular goiter 371. Thyrotoxicosis with a low uptake of iodine in the thyroid bed but uptake in the pelvis can be seen with a. Graves disease b. Jod-Basedow phenomenon c. Choriocarcinoma d. Struma ovarii e. Toxic multinodular goiter 372. The most common cause of spontaneous hypothyroidism in the U.S. is a. Iodine deficiency b. Lithium c. Hashimoto s thyroiditis d. Propylthiouracil e. Toxic multinodular goiter 373. The most common cause of goiter in developing nations is a. Iodine deficiency b. Lithium c. Hashimoto s thyroiditis d. Propylthiouracil e. Toxic multinodular goiter 374. Endemic goiter results from a. Iodine deficiency b. Lithium c. Hashimoto s thyroiditis d. Propylthiouracil e. Toxic multinodular goiter
195 Thyroid and Pituitary Disorders The conversion of T 4 to T 3 is inhibited by a. Iodine deficiency b. Lithium c. Hashimoto s thyroiditis d. Propylthiouracil e. Toxic multinodular goiter 376. High levels of thyroidal peroxidase antibody are found with a. Iodine deficiency b. Lithium c. Hashimoto s thyroiditis d. Propylthiouracil e. Toxic multinodular goiter 377. A patient without symptoms and without a recent illness is found to have a normal free T 4 and elevated TSH which are confirmed on repeated measurements. The most likely explanation is a. Hyperthyroidism b. Nonthyroidal illness (sick euthyroidism) c. Estrogen therapy d. Subclinical hypothyroidism e. Familial (euthyroid) dysalbuminenic hyperthyroxinemia 378. The pattern of normal TSH, normal T 4, and low T 3 is most consistent with a. Hyperthyroidism b. Nonthyroidal illness (sick euthyroidism) c. Estrogen therapy d. Subclinical hypothyroidism e. Familial (euthyroid) dysalbuminenic hyperthyroxinemia 379. A low TSH, high T 4, and high T 3 suggests a. Hyperthyroidism b. Nonthyroidal illness (sick euthyroidism) c. Estrogen therapy d. Subclinical hypothyroidism e. Familial (euthyroid) dysalbuminenic hyperthyroxinemia
196 180 Pathophysiology 380. The pattern of normal TSH, high T 4, and high T 3 is seen often with a. Hyperthyroidism b. Nonthyroidal illness (sick euthyroidism) c. Estrogen therapy d. Subclinical hypothyroidism e. Familial (euthyroid) dysalbuminenic hyperthyroxinemia 381. A patient with a low TSH and high T 3 most likely has a. Hyperthyroidism b. Nonthyroidal illness (sick euthyroidism) c. Estrogen therapy d. Subclinical hypothyroidism e. Familial (euthyroid) dysalbuminenic hyperthyroxinemia 382. The most common variety of thyroid cancer is a. Thyroid lymphoma b. Medullary thyroid carcinoma c. Papillary thyroid carcinoma d. Anaplastic thyroid carcinoma e. Follicular thyroid carcinoma 383. A patient with thyroid cancer is told that he has a life expectancy of less than 6 months from diagnosis. The variety of thyroid cancer with this prognosis is a. Thyroid lymphoma b. Medullary thyroid carcinoma c. Papillary thyroid carcinoma d. Anaplastic thyroid carcinoma e. Follicular thyroid carcinoma 384. A patient with chronic autoimmune (Hashimoto s) thyroiditis develops a rapidly enlarging thyroid mass. Most likely this is a. Thyroid lymphoma b. Medullary thyroid carcinoma c. Papillary thyroid carcinoma d. Anaplastic thyroid carcinoma e. Follicular thyroid carcinoma
197 Thyroid and Pituitary Disorders Psammoma bodies are a histologic feature of a. Thyroid lymphoma b. Medullary thyroid carcinoma c. Papillary thyroid carcinoma d. Anaplastic thyroid carcinoma e. Follicular thyroid carcinoma 386. Elevated plasma calcitonin is seen with a. Thyroid lymphoma b. Medullary thyroid carcinoma c. Papillary thyroid carcinoma d. Anaplastic thyroid carcinoma e. Follicular thyroid carcinoma 387. A 40-year-old patient with a recent viral infection presents with a significantly tender gland, low radioiodine uptake, and signs and symptoms of thyrotoxicosis. This presentation is most likely a. Graves disease b. Subacute thyroiditis c. Toxic multinodular goiter d. Hashimoto s thyroiditis e. Toxic adenoma 388. A 65-year-old man presents with signs and symptoms of thyrotoxicosis. His radioiodine scan and 24-h uptake show a patchy pattern but normal amount of radioiodine uptake. This presentation is most consistent with a. Graves disease b. Subacute thyroiditis c. Toxic multinodular goiter d. Hashimoto s thyroiditis e. Toxic adenoma
198 182 Pathophysiology 389. A 30-year-old woman with thyrotoxicosis has a diffusely enlarged gland on palpation of the neck. Her thyroid scan and 24-h uptake show uniformity of uptake and an increased percentage uptake. This patient has a. Graves disease b. Subacute thyroiditis c. Toxic multinodular goiter d. Hashimoto s thyroiditis e. Toxic adenoma 390. A 45-year-old man presents for frontal bossing and enlarged nose, tongue, and jaw. He has doughy palms and spadelike fingers. The best screening test to establish the diagnosis is a. Random growth hormone b. Insulin-like growth factor type 1 (IGF-1) c. TSH d. Prolactin e. Fasting blood sugar 391. On the basis of physical findings, you suspect a 48-year-old woman has acromegaly. The definitive diagnostic test for acromegaly is measurement of growth hormone in which of the following settings? a. Random b. TRH stimulation test c. Insulin tolerance test d. Oral glucose tolerance test e. LHRH stimulation test 392. You confirm acromegaly in a 58-year-old woman, and a MRI of the pituitary shows a microadenoma. The best choice for treatment is a. Transsphenoidal surgery b. Medical therapy with somatostatin agonist c. Irradiation d. Medical therapy with bromocriptine e. Transfrontal surgery
199 Thyroid and Pituitary Disorders Untreated acromegaly results in decreased life expectancy from a. Prognathism b. Renal hypertrophy c. Skin tags d. Colon carcinoma e. Cervical arthropathy 394. A 30-year-old woman presents with a 6-month history of amenorrhea. Your initial evaluation should include measurement of a. Prolactin b. Estradiol c. Progesterone d. Testosterone e. DHEA-S 395. A 28-year-old woman develops galactorrhea without amenorrhea. Your evaluation should include a. Estradiol b. Progesterone c. Prolactin d. Testosterone e. DHEA-S 396. A 47-year-old man presents with headache, impotence, and galactorrhea for the past 2 months. A likely hormonal profile on this patient would be a. Low testosterone, high LH, and low prolactin b. Low testosterone, low LH, and low prolactin c. Low testosterone, high LH, and high prolactin d. Normal testosterone, normal LH, and normal prolactin e. Low testosterone, low LH, and high prolactin 397. A 28-year-old woman presents with amenorrhea and galactorrhea, after beginning a new medication recently. The most likely medication is a. Haloperidol b. Lisinopril c. Fluoxetine d. Amitriptyline e. Buspirone
200 184 Pathophysiology 398. A 25-year-old woman presents with amenorrhea and galactorrhea. Thyroid function tests are normal. The prolactin level is 350 µg/l (normal is less than 20). The most likely cause for her hyperprolactinemia is a. Microadenoma b. Macroadenoma c. Antidepressant use d. Exercise induced e. Antihypertensive therapy 399. A 26-year-old woman has been amenorrheic for 2.5 months. Your first choice for diagnostic evaluation is a. hcg b. LH c. Estradiol d. Prolactin e. Progesterone 400. A 40-year-old man has erectile dysfunction. He is noted to have hyperprolactinemia (prolactin of 400 µg/l). On MRI a macroadenoma with supersellar extension is found. The best course of therapy for the patient is a. Medical therapy with bromocriptine b. Transsphenoidal surgery c. Transfrontal surgery d. Medical therapy with somatostatin agonist e. Thyroxine 401. A 35-year-old man has a prolactinoma and a history of severe peptic ulcer disease. There is a family history of pituitary tumors. The findings of what other diagnostic test at this time may be abnormal and potentially useful in diagnosis? a. Fasting blood sugar b. Serum calcium c. Serum calcitonin d. Urinary metanephrine e. Serum ferritin
201 Thyroid and Pituitary Disorders A 45-year-man has decreased libido and decreased sexual function. A large pituitary tumor is found. His prolactin is 20 (less than 15). Testing of his pituitary-gonadal axis most likely will show a. Normal testosterone and low LH b. High testosterone and normal LH c. Low testosterone and low LH d. Normal testosterone and normal LH e. Low testosterone and high LH 403. A 16-year-old boy presents without pubertal development or development of secondary sexual characteristics. He cannot smell (anosmia). The baseline testosterone and the LH response to LHRH most likely are a. Low testosterone and normal LHRH response b. Normal testosterone and normal LHRH response c. High testosterone and normal LHRH response d. Low testosterone and no LHRH response e. Low testosterone and exaggerated LHRH response 404. A 58-year-old woman presents as an outpatient with lethargy, fatigue, and cold intolerance. Thyroid function testing reveals a free T 4 of 0.5 (0.7 to 2.0) and a TSH of 0.1 (0.5 to 5). The best next diagnostic test is a. Thyroid scan and uptake b. MRI of the pituitary c. Prolactin d. Thyroid autoantibodies e. T A 59-year-old man presents with heat intolerance and tremor. Thyroid function testing reveals a free T 4 of 3.0 (0.7 to 2.0) and TSH of 6.0 (0.5 to 5). The next best diagnostic test is a. Thyroid scan and uptake b. MRI of the pituitary c. Prolactin d. Thyroid autoantibodies e. T 3
202 186 Pathophysiology 406. A 25-year-old woman presents with increasing obesity, amenorrhea, hypertension, and abdominal stria. The next best diagnostic test is a. Prolactin b. Free T 4 and TSH c. Overnight dexamethasone suppression test d. Random cortisol e. ACTH 407. A 30-year-old man presents with weight gain, dorsocervical fat pad, and proximal muscle weakness. His urinary free cortisol is significantly elevated and does not suppress with dexamethasone. The plasma ACTH is undetectable. Your next best diagnostic test is a. Serum antidiuretic hormone (ADH) b. Chest CT c. MRI of the pituitary d. ACTH stimulation test e. Abdominal CT 408. A 65-year-old man with a lung mass has increasing skin pigmentation and significant muscle weakness and wasting. Urinary free cortisol is 690 µg/24 h (10 to 80) and is nonsuppressible. Which of the following tests would probably be most diagnostic? a. ACTH stimulation test b. MRI of the pituitary c. CT of the abdomen d. Plasma ACTH e. Parathyroid hormone 409. A 48-year-old woman with a history of pituitary surgery and irradiation is scheduled for elective surgery. She currently requires replacement thyroxine, hydrocortisone, estrogen, and progesterone. In the perioperative period you will treat her with a. Glucose infusion b. Increased hydrocortisone c. ACTH infusion d. Increased estrogen e. Increased thyroxine
203 Thyroid and Pituitary Disorders A 23-year-old woman presents with weakness and amenorrhea. She is clinically hypothyroid. A CT scan of the pituitary shows an expanded sella with a large cystic component with calcifications. The most likely diagnosis is a. Pituitary macroadenoma b. Empty sella syndrome c. Craniopharyngioma d. Optic glioma e. Hypothalamic hamartoma 411. Patients with pituitary macroadenoma present most commonly with a. Bitemporal hemianopsia b. Unilateral optic atrophy c. Left or right homonymous visual field defect d. Unilateral center scotoma e. Left or right superior temporal defect 412. A 45-year-old man has decreased libido and erectile dysfunction. He has noted increasing pigmentation. He has developed liver disease and arthropathy recently. The next best diagnostic test is a. Serum TSH b. Serum calcium c. Serum prolactin d. Serum ferritin e. Serum gastrin
204 188 Thyroid and Pituitary Disorders Answers 367. The answer is b. (McPhee, 2e, pp ) Thyrotoxicosis can have several etiologies. Iodine-induced hyperthyroidism is called the Jod- Basedow phenomenon and can occur in patients with endemic goiter who move to areas where iodine is plentiful The answer is c. (McPhee, 2e, pp ) Diffusely increased radioiodine uptake in the thyroid accompanying thyrotoxicosis usually indicates Graves disease, in which the thyrotropin receptors are stimulated by antibodies. However, in patients with choriocarcinoma high levels of human chorionic gonadotropin can also stimulate the thyrotropin receptor and produce the same finding The answers are 369: a; 370: a. (McPhee, 2e, pp ) Graves disease is associated with related autoimmune phenomena in other tissues such as Graves ophthalmopathy in the orbit and pretibial myxedema in the skin The answer is d. (McPhee, 2e, pp ) Ovarian teratomas can contain thyroid tissue (struma ovarii) and rarely cause thyrotoxicosis with excess thyroid hormone produced by the teratoma rather than the thyroid The answer is c. (McPhee, 2e, pp ; Fauci, 14e, pp ) Hypothyroidism can result from several causes including congenital defects, chronic autoimmune thyroiditis (Hashimoto s thyroiditis), medications (thionamides, lithium, iodine), other iatrogenic causes, iodine deficiency, and hypothalamic or pituitary insufficiency. Chronic autoimmune thyroiditis is the most common cause of hypothyroidism in the U.S The answer is a. (McPhee, 2e, pp ; Fauci, 14e, pp ) World-wide, iodine deficiency (endemic) goiter is very common. It is not common in the United States or other countries where salt is fortified with iodine.
205 Thyroid and Pituitary Disorders Answers The answer is a. (McPhee, 2e, pp ; Fauci, 14e, pp ) Endemic goiter is usually associated with iodine deficiency. Worldwide it is very common The answer is d. (McPhee, 2e, pp ; Fauci, 14e, pp ) Propylthiouracil, propranolol, glucocorticoids, and iodine inhibit conversion of T 4 to T The answer is c. (McPhee, 2e, pp ; Fauci, 14e, pp ) Chronic autoimmune thyroiditis (Hashimoto s thyroiditis) is the most common cause of hypothyroidism in the U.S. and it is associated with high levels of thyroid autoantibodies The answer is d. (McPhee, 2e, pp , ; Fauci, 14e, ) Laboratory measurements of thyroid hormones and thyroidstimulating hormone have proven invaluable in determining the true functional status of the thyroid gland. However, various medications and nonthyroidal illnesses can alter certain values, so usually a combination of values is used to make a diagnosis. TSH values tend to be the most reliable in the absence of hypothalamic or pituitary disease, and mild elevation is seen in hypothyroidism before free T 4 declines The answer is b. (McPhee, 2e, pp , ; Fauci, 14e, ) In severe nonthyroidal illness, T 3 declines first, followed by T 4 if the disease is severe enough, but TSH is usually normal The answer is a. (McPhee, 2e, pp , ; Fauci, 14e, ) Low TSH with high T 4 and T 3 or T 3 alone (T 3 toxicosis) reflects hyperthyroidism The answer is c. (McPhee, 2e, pp , ; Fauci, 14e, ) Estrogens increase thyroxine-binding globulin, elevating total T 4 and T 3, whereas free T 4, free T 3, and TSH remain normal The answer is a. (McPhee, 2e, pp , ; Fauci, 14e, ) Low TSH with high T 4 and T 3 or T 3 alone (T 3 toxicosis) reflects hyperthyroidism.
206 190 Pathophysiology 382. The answer is c. (Fauci, 14e, pp ) Thyroid cancers may arise from the thyroid follicular epithelium, the parafollicular C cells, or lymphoid cells in the thyroid. Papillary carcinomas, including tumors with mixed papillary and follicular elements, are most common and account for 70% of thyroid cancers. Fifteen percent of thyroid cancers have purely follicular histology The answer is d. (Fauci, 14e, pp ) The prognosis of anaplastic cancers, which likely represent dedifferentiation of better differentiated papillary or follicular carcinomas, is very poor with average survival less than 6 months The answer is a. (Fauci, 14e, pp ) Thyroid lymphomas constitute about 5% of thyroid cancers and occur most often in patients with Hashimoto s thyroiditis. Lymphomas and anaplastic carcinomas tend to grow rapidly The answer is c. (Fauci, 14e, pp ) Psammoma bodies are a feature of papillary carcinomas The answer is b. (Fauci, 14e, pp ) Medullary thyroid carcinomas secrete calcitonin, arise in the calcitonin-producing parafollicular cells, and account for about 5% of thyroid cancers The answer is b. (Fauci, 14e, pp 2016, , ) The pattern and amount of radioiodine uptake on 123 I scan is fundamental to the correct diagnosis of thyrotoxicosis. Low-uptake thyrotoxicosis can occur when there is destruction of the thyroid follicles with release of thyroid hormone, such as in subacute thyroiditis, which usually presents as an exquisitely painful gland. Iodine-induced hyperthyroidism, factitious hyperthyroidism, and painless (silent) thyroiditis also cause low-uptake thyrotoxicosis The answer is c. (Fauci, 14e, pp 2016, , ) Patchy radioiodine uptake is common in multinodular goiter and Hashimoto s thyroiditis, but hyperthyroidism with normal or increased uptake typifies toxic multinodular goiter.
207 Thyroid and Pituitary Disorders Answers The answer is a. (Fauci, 14e, pp 2016, , ) In Graves disease, the uptake tends to be increased and more uniform. Uptake may be increased without thyrotoxicosis in conditions characterized by defects in organification of iodine, such as is found in some patients with Hashimoto s thyroiditis, but the uptake tends to be patchy The answer is b. (Fauci, 14/e, p 1982.) The best screening test for suspected acromegaly is an IGF-1. Random growth hormone varies too much to be useful. IGF-1 is more consistent and does not fluctuate episodically throughout the day. TSH and prolactin may be abnormal but are not diagnostic of acromegaly. Fasting blood sugar may be elevated in this patient, but again it is not diagnostic The answer is d. (Fauci, 14e, p 1982.) The most definitive and widely accepted test for the diagnosis of acromegaly is the response of growth hormone during an oral glucose tolerance test. Typically, the growth hormone at baseline in acromegaly will be greater than 5 µg/l. In normal patients, the growth hormone will suppress to less than 2 with an oral glucose tolerance test (OGTT). In patients with acromegaly the GH values may rise, show no change, or suppress partially but not less than 2. A single random growth hormone is not useful, because of the pulsatility in growth hormone. TRH does stimulate growth hormone in many patients with acromegaly, but not all. The insulin tolerance test is a stimulation test of growth hormone and not a suppression test The answer is a. (Fauci, 14/e, p 1982.) Transsphenoidal surgery has the advantages of potential cure with rapid therapeutic response. If the tumor is completely resected, the patient may experience a complete cure. Medical therapy with somatostatin agonist or bromocriptine is helpful, but the patient is dependent on medical therapy indefinitely. Irradiation takes years for full effectiveness and the patient may develop hypopituitarism. Transfrontal surgery is rarely used now The answer is d. (Fauci, 14/e, p 1981.) Patients with untreated acromegaly have shortened life expectancy and develop complications of cardiovascular, cerebrovascular, and respiratory disease. There are recent studies suggesting patients with acromegaly have increased frequency of
208 192 Pathophysiology polyps and subsequent development of colon carcinoma. Bowel surveillance has been suggested. Cervical arthropathy is a frequent complication of acromegaly but does not directly decrease life expectancy The answer is a. (Fauci, 14/e, p 1975.) A common presentation for hyperprolactinemia is amenorrhea. Important in the initial evaluation of amenorrhea is a prolactin determination. Estradiol and progesterone typically are not measured in initial evaluation of amenorrhea. Testosterone and DHEA-S are markers for androgen excess, which may be present in this patient, but do not need to be measured initially The answer is c. (Fauci, 14/e, p 1975.) Galactorrhea in young women is often associated with hyperprolactinemia. Estradiol and progesterone can be useful markers of gonadal function but do not give further diagnostic information. Similarly, testosterone and DHEA-S do not give more diagnostic information The answer is e. (Fauci, 14/e, p 1975.) Men frequently present with marked hyperprolactinemia from a macroadenoma. Presenting manifestations typically are sexual dysfunction and decreased libido. The prolactin causes decrease in LH and concomitant decrease in testosterone. Thus, the patient will have a high prolactin associated with a low LH and low testosterone. The pattern of low testosterone, high LH, and low prolactin is typical of primary hypergonadism The answer is a. (Fauci, 14/e, p 1975.) Medications are important in the differential diagnosis of hyperprolactinemia. Prolactin release is under inhibitory control primarily from dopaminergic neurons in the hypothalamus. Dopamine attaches to D 2 receptors on lactotrophs to reduce prolactin release. Dopamine antagonists reduce the inhibition. A common drug that causes increased prolactin with possible amenorrhea and galactorrhea is haloperidol, a dopamine antagonist. Lisinopril has no effect on prolactin levels. The antidepressants fluoxetine and amitriptyline and anxiolytic bupropion may cause small changes in prolactin levels but rarely enough to cause a clinical syndrome The answer is b. (Fauci, 14/e, p 1975.) The serum level of prolactin correlates roughly with the size of the tumor. Prolactin levels greater than
209 Thyroid and Pituitary Disorders Answers are most likely associated with macroadenoma. Increases in prolactin due to medications are usually less than 100. Microadenomas usually do not exceed levels of 200 to The answer is a. (Fauci, 14/e, p 1975.) The first choice in testing in this patient is a pregnancy test. If her prolactin level was measured without a pregnancy test, an elevation of prolactin could be wrongly considered primary rather than due to pregnancy. The other tests of LH, estradiol, progesterone are not first choices in the evaluation of amenorrhea The answer is a. (Fauci, 14/e, p 1976.) Established therapy of hyperprolactinemia from a pituitary adenoma is treatment with a dopamine agonist such as bromocriptine. Surgical therapy usually does not result in a cure in a macroadenoma and is reserved for those patients who are intolerant to dopamine agonist. Transfrontal surgery is rarely used. Somatostatin agonist and thyroxine have little effects on hyperprolactinemia The answer is b. (Fauci, 14/e, p 1975, 2131.) This patient may have multiple endocrine neoplasia syndrome-1, which presents with pituitary tumors, pancreatic tumors, and hyperparathyroidism. With the history of severe peptic ulcer disease (possible Zollinger-Ellison syndrome) and family history of pituitary tumors, one must suspect MEN-1. A serum calcium will be useful in diagnosing potential hyperparathyroidism. Calcitonin and urinary metanephrines are elevated and characteristic of MEN-2. Serum ferritin and fasting blood sugar would be elevated in hemochromatosis The answer is c. (Fauci, 14/e, p 1984.) The patient has a common presentation for secondary hypogonadism. The large tumor is inhibiting LH secretion with consequently low testosterone secretion. No other pattern fits this clinical presentation The answer is a. (Fauci, 14/e, p 1984.) This patient most typically has Kallmann s syndrome. This is a deficiency in the secretion of LHRH from the hypothalamus. Typically, these patients will respond to LHRH, although they may need LHRH priming. Testosterone will be low from the lack of LHRH stimulation of LH secretion.
210 194 Pathophysiology 404. The answer is b. (Fauci, 14/e, p 1985.) This patient presents with clinical manifestations of hypothyroidism with a low free T 4. Secondary hypothyroidism is suggested by the low TSH. The diagnostic test of choice is a MRI of the pituitary for evaluation of a possible pituitary tumor The answer is b. (Fauci, 14/e, p 1985.) The patient likely has pituitary TSH induced hyperthyroidism. This is a rare diagnosis. However, the pattern of elevated free T 4 and elevated TSH is nearly diagnostic for this disorder. The next diagnostic test is a MRI of the pituitary to evaluate for the presence of microadenoma or macroadenoma The answer is c. (Fauci, 14/e, p 1986.) This patient presents with a high suspicion for Cushing s syndrome. The initial step in the evaluation should be an overnight dexamethasone suppression test. Failure to suppress would indicate high likelihood of Cushing s syndrome. A random cortisol is not sufficient to screen for Cushing s syndrome. An ACTH by itself is not useful The answer is e. (Fauci, 14/e, p 1986.) The suppression of ACTH is characteristic of adrenal adenoma or carcinoma. A CT scan will evaluate for the presence of adrenal tumor. Chest CT is useful in ectopic ACTH secretion. A MRI of the pituitary is useful in pituitary dependent Cushing s disease. The ACTH stimulation test and serum ADH are not diagnostic in this disease The answer is d. (Fauci, 14/e, p 1986.) This patient s presentation suggests ectopic ACTH secretion and ACTH will likely be elevated above 300. A MRI of the pituitary and CT of the abdomen are not useful, because the source of ACTH is from the small cell carcinoma in the lung mass The answer is b. (Fauci, 14/e, p 1994.) This patient has classic history for hypopituitarism. During surgical stress she will require increased replacement dose of steroids. The other treatments will not cover her need for increased glucocorticoids and will not be helpful The answer is c. (Fauci, 14/e, p 1988.) This is the common CT finding and clinical presentation for craniopharyngioma. Empty sella does not usually cause marked enlargement of the sella, and there is no cystic struc-
211 Thyroid and Pituitary Disorders Answers 195 ture with calcification. Pituitary macroadenomas can expand the sella but are not commonly cystic and calcified. Optic glioma and hypothalamic hamartoma are rarely cystic The answer is a. (Fauci, 14/e, p 1990.) Classic presentation is bitemporal hemianopsia with the other visual field disturbances less common The answer is d. (Fauci, 14/e, p 1993, 2150.) The patient has classic manifestations of hemochromatosis that impairs hypothalamic pituitary function. Serum ferritin is potentially diagnostic in this patient. All the other tests are not diagnostic for hemochromatosis.
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213 Reproductive System Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question Which of the following organs is not a major estrogen-dependent tissue in women? a. Brain b. Thyroid c. Hypothalamus d. Pituitary e. Ovaries 414. Which of the following organs does not require androgens for proper growth in males? a. Brain b. Prostate c. Epididymis d. Vas deferens e. Long bones 415. A patient has an excess of 17α-hydroxyprogesterone and 17αhydroxypregnenolone in the urine, and no androgens. Which enzyme is deficient? a. 20,22-Desmolase b. 3β-Hydroxysteroid dehydrogenase c. 17-Hydroxylase d. 17,20-Desmolase (17,20 lyase) e. 17-Ketoreductase 197 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
214 198 Pathophysiology 416. Which of these hormones is also produced in significant amounts outside of the gonads? a. Estrone b. Estradiol c. Androstenedione d. Testosterone e. Dihydrotestosterone 417. A 22-year-old woman marathon runner comes into the office complaining of amenorrhea for 8 months. There has been no weight change, and the serum pregnancy test is negative. She has never been pregnant. Menarche was at 13 years of age, and she had monthly menses until 8 months ago. Physical exam shows a women who is 66 inches tall, 90 pounds, and is otherwise fully normal. Why does she have amenorrhea? a. Hypothyroidism b. Prolactinoma c. Early menopause d. Resistance to LH and FSH e. Excessive exercise 418. A young couple, both in their 20s, have been trying for 2 years to have a baby. The male comes into the office and on workup has oligospermia, high LH, high FSH, and a normal karyotype. How do you treat him? a. Do nothing b. Testosterone injections c. Check the partner for causes of infertility d. Infertility counseling 419. A 28-year-old woman presents to the office with 2 days of abdominal pain and a positive pregnancy test. Her last menstrual period was 9 weeks ago. She reports no dysuria. She reports a history of two episodes of pelvic inflammatory disease. Which of these is the most likely cause of the abdominal pain? a. Endometriosis b. Urinary tract infection c. Ectopic pregnancy d. Placental abruption e. Premenstrual syndrome
215 Reproductive System A 38-year-old woman comes into the office with complaints of amenorrhea for 6 months, with increased cold intolerance, loss of energy, and hair loss. Her menses were normal until this episode started, and she has also gained 22 pounds over these 6 months. Her pregnancy test is negative. Which test would you now order? a. FSH and LH b. Estrogen levels c. Testosterone level d. TSH e. Cortisol level 421. A 29-year-old woman comes into the office after three spontaneous abortions (unplanned). All three occurred at approximately 6 weeks gestational age. Her physical exam is normal. Which of these may be the cause? a. Ovary b. Thyroid gland c. Adrenal gland d. Pituitary gland 422. Which of these medications treats benign prostatic hyperplasia by 5α-reductase inhibition? a. Leuprolide b. Nafarelin c. Flutamide d. Megesterol e. Finasteride 423. How does pregnancy increase the risk of diabetes mellitus? a. Causing weight gain b. Insulin resistance c. Placental production of human chorionic somatomammotropin d. Increase of maternal glucocorticoids
216 200 Pathophysiology 424. Which of these hormones blocks milk production during pregnancy? a. Progesterone b. Prolactin c. Chorionic somatomammotropin d. Thyroxine e. Insulin 425. A 40-year-old female presents with amenorrhea and hirsutism. Which hormone is in excess in this woman with polycystic ovary syndrome? a. Estrogen b. Progesterone c. FSH d. Androgens 426. Which of these is the best therapy for preeclampsia? a. Antihypertensive medication b. Antiseizure medication c. Intravenous fluids d. Delivery of the baby e. Anticoagulation 427. Which of these findings is the best for diagnosis of a congenital absence of the vas deferens? a. Oligospermia b. Azoospermia c. Normal testosterone d. Normal LH e. Normal FSH 428. Which abnormality of adult testicular function (infertility) occurs with normal virilization? a. Hemochromatosis b. Cryptorchidism c. Isolated gonadotropism deficiency d. Klinefelter s syndrome e. XX male
217 Reproductive System A 19-year-old woman comes to the office complaining of galactorrhea. She has never been pregnant. Which hormone is the most likely to be responsible for this situation? a. Prolactin b. Estrogen c. Progesterone d. Thyroxine e. Cortisol 430. A 15-year-old male comes into the office complaining about a lack of pubic hair growth. He also informs you that his voice has not yet deepened, and he has no interest in sexual activity. He is an only child. Blood drawn reveals a very high testosterone level. What is the problem? a. Low FSH and LH b. High FSH and LH c. Androgen insensitivity d. Hyperthyroidism e. XXY karyotype 431. A 52-year-old female presents to the office with a complaint of hot flashes. You suspect menopause. Which of the findings below would confirm your diagnosis? a. Normal androgen level b. Normal or low estrogen level c. Normal prolactin level d. High FSH and LH e. High androgen level 432. Which of the following organs does ovarian estrogen production have a stimulatory effect on? a. Ovary b. Brain c. Hypothalamus d. Pituitary e. Vagina
218 202 Pathophysiology 433. A 19-year-old pregnant female feels tired and out of pep. Her conjunctivae are pale; laboratory tests show she has a mild normocytic, normochromic anemia with a low serum iron and an increased TIBC (transferrin iron-binding capacity). Hemoccult tests are negative. Which is the likely cause of her anemia? a. Gastrointestinal bleeding b. Iron or folate deficiencies c. Autoantibodies d. Vitamin B 12 deficiency e. Menstrual blood loss 434. Which of the following hormones is produced by both the ovary and uterus? a. Inhibin b. Activin c. Follistatin d. Relaxin e. Enkephalin 435. Which of the following hormones is produced both by the theca and the kidney? a. Inhibin b. Relaxin c. Renin d. Epidermal growth factor-like e. Transforming growth factor-β 436. A 31-year-old male presents to the office due to infertility. On history, it is revealed that he has Kartagener s syndrome. Why is he infertile? a. Oligospermia b. Asthenospermia c. Absence of the vas deferens d. Epididymal obstruction e. Undescended testes
219 Reproductive System A 74-year-old male presents to the office with trouble urinating for 1 week. The force of the urinary stream is reduced, but there is no difficulty starting the stream. There is no pain. What is the problem? a. Decreased detrusor contractility b. Detrusor instability c. Detrusor failure d. Acute urinary obstruction e. Chronic urinary obstruction 438. A 65-year-old male presents to the office with benign prostatic hypertrophy and new onset hypertension. Which one medication could you give this patient to handle both diagnoses? a. Nafarelin b. Flutamide c. Finasteride d. Megesterol e. Prazosin 439. A 28-year-old woman presents complaining of infertility. She had a healthy child 3 years ago and has been trying to get pregnant with the child s father for the last 18 months. She does not have dysmenorrhea. Her menses occur regularly, but these show significantly less flow compared with before her pregnancy. She recalls having a curettage performed to remove placental remnants. What is the diagnosis? a. Ovarian failure b. Hypothyroidism c. Asherman s syndrome d. Endometriosis e. Prolactinoma 440. A 28-year-old previously healthy female, with no medical history is now 28 weeks pregnant. She complains of trouble seeing, polyuria, polyphagia, and polydipsia. What is her diagnosis? a. Gestational diabetes mellitus b. Deep venous thrombosis c. Urinary tract infection d. Preeclampsia
220 204 Pathophysiology 441. A 26-year-old female is about to deliver a baby. She asks you why should she breast-feed. Beyond the obvious issue of child to mother bonding, what else must you tell her? a. It s the correct thing to do b. Better nutrition for the baby c. Protect the baby from infections early in life d. Quicker weight loss e. Good contraception 442. Which of the following is not required for successful breast-feeding? a. Prolactin b. Oxytocin c. Good maternal nutrition d. An intact neurologic axis e. High estrogen levels 443. Which of the following hormones in excess causes male infertility? a. FSH b. LH c. Testosterone d. Cortisol e. Prolactin 444. How do varicoceles cause male infertility? a. Decreasing testicular blood flow b. Increasing testicular temperature c. Reduction of testosterone production d. By causing testicular atrophy 445. A 52-year-old female presents to the office with a chief complaint of postmenopausal bleeding for 2 weeks. Her menopause was 7 years ago, and until 2 weeks ago had no vaginal bleeding of any kind. She was not receiving hormonal replacement. Which of the following tests need not be ordered or performed? a. Pap smear b. TSH c. Prothrombin time d. Smear for vaginal infection e. General blood chemistry evaluation
221 Reproductive System In which ovarian compartment is Müllerian-inhibiting substance produced? a. Granulosa b. Theca c. Follicular fluid d. Follicles e. Corpus luteum 447. In which ovarian compartment is plasminogen activator produced? a. Granulosa b. Theca c. Follicular fluid d. Follicles e. Corpus luteum 448. In which ovarian compartment is transforming growth factor-α produced? a. Granulosa b. Theca c. Follicular fluid d. Follicles e. Corpus luteum 449. In which ovarian compartment is basic fibroblast growth factor produced? a. Granulosa b. Theca c. Follicular fluid d. Follicles e. Corpus luteum
222 206 Pathophysiology 450. In which ovarian compartment is angiotensin II produced? a. Granulosa b. Theca c. Follicular fluid d. Follicles e. Corpus luteum 451. During the course of an evaluation for thyroid function, your patient, a 33-year-old man who is infertile, is found to have very low levels of luteinizing hormone. The likely site of his infertility is a. Pretesticular b. Testicular c. Posttesticular d. Idiopathic 452. A 41-year-old man comes to your office with his wife because she has been unable to conceive with him. He is married for the first time. His wife has two children by her previous marriage. The patient is well with no risk factors for heart disease. As a child, he had the usual communicable diseases, including chickenpox and mumps, and as an adult he received the recommended schedule of immunizations. The likely site of his infertility is a. Pretesticular b. Testicular c. Posttesticular d. Idiopathic 453. A 31-year-old man whom you treated for alcoholic intoxication at the emergency room 2 days ago comes to your office because he wants another opinion about his infertility. He has seen other physicians for this condition. Considering his excessive alcoholic intake for the past decade, the likely site of his infertility is a. Pretesticular b. Testicular c. Posttesticular d. Idiopathic
223 Reproductive System A 27-year-old man who suffers seizures controlled with phenytoin comes to your office because his neurologist discovered that the patient has a low FSH level. The patient is infertile. The likely site of his infertility is a. Pretesticular b. Testicular c. Posttesticular d. Idiopathic 455. A urologist refers a 20-year-old man because of hypospadias and infertility. He has been sexually active since his early teens. Recently, he married and, despite many attempts, his wife has been unable to become pregnant. The likely site of his infertility is a. Pretesticular b. Testicular c. Posttesticular d. Idiopathic
224 Reproductive System Answers 413. The answer is b. (McPhee, 2/e, p 519.) The thyroid gland is minimally affected by estrogens, but it may have an impact on estrogen production (still unclear). The brain, hypothalamus, pituitary, ovaries, uterine epithelium, uterine tubes, and vagina are all major estrogen-dependent tissues in women The answer is a. (McPhee, 2/e, p 547.) The brain s growth is not affected by androgens, although there are mental changes associated with androgens. The prostate, epididymis, vas deferens, scrotum, seminal vesicles, penis, and long bones all require androgens for proper growth and physical development The answer is d. (McPhee, 2/e, p 545; Fauci, 14/e, pp 2036, 2100.) 20,22-Desmolase changes cholesterol to pregnenolone. 3β-hydroxysteroid dehydrogenase changes pregnenolone to progesterone and 17α-hydroxypregnenolone into 17α-hydroxyprogesterone. 17-Hydroxylase changes pregnenolone and progesterone into 17α-hydroxypregnenolone and 17α-hydroxyprogesterone, respectively. 17,20-Desmolase changes 17αhydroxypregnenolone into dehydroepiandrosterone (a weak androgen) and 17α-hydroxyprogesterone into androstenedione (a weak androgen). 17- ketoreductase changes dehydroepiandrosterone and androstenedione to androstenediol and testosterone, respectively The answer is c. (McPhee, 2/e, pp 491, 520, 545; Fauci, 14/e, p 2036.) Estrone and estradiol are mainly produced in the ovaries in women. Testosterone and dihydrotestosterone are mainly produced in the testes. Dihydrotestosterone is also produced in the periphery directly from testosterone. Androstenedione is the main end product of the zona reticularis of the adrenal gland, in addition to being produced in the gonads. 208
225 Reproductive System Answers The answer is e. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Hypothyroid patients tend to gain weight. Prolactin-secreting tumors (prolactinomas), being located in the pituitary, would be expected to show abnormal physical examination findings at the eyes, given that the tumor typically sits on the optic chiasma. Early menopause is unlikely in a 22-year-old. Resistance to LH and FSH would have prohibited this patient from ever having menses. This leaves excessive exercise as the only remaining plausible cause in this patient The answer is b. (McPhee, 2/e, p 552; Fauci, 14/e, pp ) This patient presents with classic testosterone deficiency, as evidenced by the low sperm count and elevated gonadotropic hormones The answer is c. (McPhee, 2/e, pp 530, 539; Fauci, 14/e, pp ) Pelvic inflammatory disease is a cause of tubal scarring, setting the stage for an ectopic (tubal) pregnancy. As the pregnancy grows, the tube is stretched, causing pain. Endometriosis causes pain with each menstrual cycle, which is not the case here. Urinary tract infection can cause pain, but she would be expected to have dysuria. Placental abruption occurs only after 20 weeks of pregnancy. She is clearly not premenstrual, because she is pregnant The answer is d. (McPhee, 2/e, pp 481, ; Fauci, 14/e, pp ) Hypothyroidism is the cause of this patient s amenorrhea. Classic findings of hypothyroidism presented here are increased cold intolerance, loss of energy, hair loss, and weight gain. TSH is the best test for this disorder, and it would be increased in the hypothyroid patient The answer is a. (McPhee, 2/e, p 523.) Once the woman is pregnant, she needs to maintain a high level of progesterone in the system to sustain the fetus. The corpus luteum, sitting in the ovary, has that role, under the influence of the β-hcg produced by the placenta. If the corpus luteum cannot produce enough progesterone to get the pregnancy to the tenth week, the pregnancy is lost The answer is e. (McPhee, 2/e, p 555; Fauci, 14/e, pp ) Leuprolide, nafarelin, and megesterol all inhibit LH secretion and thus
226 210 Pathophysiology decrease testosterone and dihydrotestosterone levels. Flutamide and megesterol all are androgen receptor inhibitors. Finasteride blocks 5αreductase, leading to a reduction of dihydrotestosterone and net reduction of prostate size The answer is c. (McPhee, 2/e, p 525; Barron, 2/e, pp ) Human chorionic somatomammotropin is a counterregulatory hormone that works to protect the fetus from hypoglycemia. The net result can be hyperglycemia and thus diabetes mellitus. Weight gain does occur in pregnancy, but insulin resistance and increased production of maternal glucocorticoids have not been proven to occur The answer is a. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) All of these hormones are required for proper preparation of the breast to produce milk in the postpartum period, but high levels of progesterone and estrogen during pregnancy prevent actual milk production. Milk is produced postpartum, once the levels of these two hormones drop The answer is d. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) In polycystic ovary disease, estrogen is usually elevated from nonovarian sources. Progesterone levels are usually unchanged. FSH is usually low. Androgens are usually elevated and are the cause for these symptoms. These androgens are produced in the ovary as the result of elevated LH. Low FSH prevents the formation of ovarian estrogen The answer is d. (McPhee, 2/e, pp ; Barron, 2/e, pp ) Although antihypertensive medication, antiseizure medication, intravenous fluids, and anticoagulation may all take care of parts of preeclampsia, the best therapy is to deliver the baby The answer is b. (McPhee, 2/e, p 552; Fauci, 14/e, pp ) Although all of the above may be present in patients with an absent vas deferens, azoospermia is the best choice. Oligospermia, normal testosterone, normal LH, and normal FSH may also be present in a wide variety of other causes of male infertility, alone or in combination The answer is b. (Fauci, 14/e, p 2092.) Cryptorchidism or failure of the testes to descend from the abdominal cavity to the scrotal sac results in
227 Reproductive System Answers 211 failure of spermatogenesis because it cannot take place in the higher temperature of the abdominal cavity. However, virilization proceeds normally. The other conditions impair fertility and androgenization The answer is a. (McPhee, 2/e, pp , ; Fauci, 14/e, pp ) Prolactin is the major stimulator of breast milk production. Overproduction of prolactin leads to galactorrhea. Estrogen, progesterone, thyroxine, and cortisol are all needed for proper breast development but play no role in actual milk production The answer is c. (McPhee, 2/e, pp ; Fauci, 14/e, pp 2088, ) Androgen insensitivity can present as an inability for a male child to go into puberty. Low FSH and LH are expected to yield low testosterone levels. High FSH and LH are usually markers of end organ damage and lack of feedback of testosterone on the pituitary due to low levels. Puberty can be delayed by hypothyroidism, with FSH and LH usually appropriate to the testosterone level. XXY karyotype (Klinefelter s) often has no effect on testosterone level The answer is d. (McPhee, 2/e, pp ; Fauci, 14/e, p 2012.) In both premenopausal and menopausal women, androgen levels may be normal or high, estrogen levels normal, and prolactin level normal. Androgen production can be in the ovary or the adrenal gland. Estrogen production is mainly in the ovary prior to menopause and in the periphery by conversion of testosterone in menopause. The amount of estrogen during menopause is a function of the patient s amount of adipose tissue. High FSH and LH are the hallmarks of a lack of adequate ovarian production of both estrogen and progesterone, the chemical markers of menopause, due to lack of negative feedback The answer is e. (McPhee, 2/e, pp ) The effect of estrogen on the vagina, uterus, uterine tubes, and breasts is stimulatory. The effect on the ovary is paracrine. There is a negative feedback effect on the brain, hypothalamus, and pituitary The answer is b. (Fauci, 14/e, pp 28, ) Iron and folate deficiencies occur in pregnancy because the fetus uses these substances in large amounts. The pregnant woman needs adequate supplements of iron and
228 212 Pathophysiology folate. Autoantibodies and vitamin B 12 are not unique causes of iron deficiency in pregnancy. The history precludes gastrointestinal bleeding and menses as causes of this patient s blood loss The answer is d. (McPhee, 2/e, p 516.) Relaxin is the only hormone produced both by the ovary and uterus. Inhibin is produced in the granulosa, theca, and corpus luteum. Activin is produced in the granulosa. Follistatin is produced in follicles. Enkephalin is produced by the ovary The answer is c. (McPhee, 2/e, pp 377, 516.) Renin is the only hormone produced by both the theca and kidney. Inhibin is produced in the granulosa, theca, and corpus luteum. Relaxin is produced in the corpus luteum, theca, placenta, and uterus. Epidermal growth factor-like is produced in granulosa and theca. Transforming growth factor-β is produced in theca, ovarian interstitial tissue, and granulosa The answer is b. (McPhee, 2/e, p 551; Fauci, 14/e, pp 1446, 2092.) Kartagener s syndrome is also known as the immotile cilia syndrome. Asthenospermia or poor sperm motility is due to missing dynein arms, the basic defect of Kartagener s syndrome. Kartagener s syndrome has no effect on either sperm count or basic anatomy of the male reproductive tract The answer is a. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Detrusor instability, decreased contractility, and failure are all part of a continuum. Decreased contractility is implied by the decreased force of the stream. Instability alone has only frequency and urgency. Failure implies an inability to urinate due to muscle failure. With acute obstruction, the patient cannot void, and there is significant pain. With chronic urinary obstruction, starting the stream is also a problem The answer is e. (McPhee, 2/e, p 557; Fauci, 14/e, p 598.) α-blockers, such as prazosin, can treat both hypertension and benign prostatic hypertrophy. Nafarelin, flutamide, finasteride, and megesterol have no role in blood pressure management The answer is c. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) One of the least recognized causes of infertility in a female is scarring of the uterus postpartum, called Asherman s syndrome. It classi-
229 Reproductive System Answers 213 cally follows curettage of the uterus, such as occurred here. Women with this syndrome are infertile because an inability to implant. Ovarian failure, hypothyroidism, and prolactinoma are all eliminated because she still has scant regular menses. Endometriosis causes painful menses The answer is a. (McPhee, 2/e, pp 432, 436, 529; Barron, 2/e, pp ) This patient presents with the classic triad of diabetes mellitus polyuria, polyphagia and polydipsia, in combination with visual problems, which can be a marker of diabetic retinopathy. Deep venous thrombosis, urinary tract infection, and preeclampsia are all complications of pregnancy, but none present like this The answer is c. (McPhee, 2/e, pp ) Although all five options sound appealing, only protection of the baby from infection is a proven benefit. This occurs through immunoglobulins (IgA) in the breast milk. Now that various formulas exist, nutrition no longer is a major reason by itself to breast-feed. Quicker weight loss is an old wives tale. The reliability of breast-feeding as a contraceptive technique is low, at best The answer is e. (McPhee, 2/e, pp , ; Fauci, 14/e, pp , ) Prolactin stimulates milk production. Oxytocin stimulates milk ejection. Good maternal nutrition is needed to ensure adequate nutritional content of the milk. An intact neurologic axis is needed to ensure that the sucking by the baby leads to oxytocin and prolactin secretion. High estrogen levels inhibit milk production The answer is e. (McPhee, 2/e, pp , 549; Fauci, 14/e, p 2092.) FSH ensures sperm production. LH ensures androgen production. Testosterone is the end product of the testes, and deficiency causes infertility. Cortisol deficiency stimulates an increase in prolactin secretion. High prolactin levels are a cause of male infertility The answer is b. (McPhee, 2/e, pp 542, ; Fauci, 14/e, p 2093.) Varicoceles (dilation of the peritesticular pampiniform plexus of veins) increase the temperature of the scrotum, and hence the testicles, by an increase in local blood flow. Sperm production is reduced by high temperatures. Testosterone production and testicular atrophy are not caused by varicoceles.
230 214 Pathophysiology 445. The answer is e. (McPhee, 2/e, pp 481, 538; Fauci, 14/e, 2114.) Pap smear may detect a malignancy as the cause of the bleeding; also when uterine cancer is a consideration, as it might be in this case, an endometrial biopsy should be performed. Hypothyroidism is also a cause of postmenopausal bleeding. A bleeding disorder, as documented by an elevated prothrombin time, can explain bleeding. Vaginal infections can also cause vaginal bleeding. A general chemistry evaluation at this time is too nonspecific The answer is a. (McPhee, 2/e, p 516; Fauci, 14/e, pp ) Müllerian-inhibiting substance is produced in the granulosa. Other endocrine and paracrine products of the granulosa include plasminogen activator, activin, inhibin, follicle regulatory protein, insulin-like growth factor-1, epidermal growth factor-like, platelet-derived growth factor, proopiomelanocortin, and gonadotropin surge-inhibiting factor. Some of these are produced also in other ovarian compartments, such as inhibin in the theca and corpus luteum, follicle regulatory protein in the follicular fluid and theca, and epidermal growth factor-like in the theca The answer is a. (McPhee, 2/e, p 516; Fauci, 14/e, pp ) Plasminogen activator is produced in the granulosa. Other endocrine and paracrine products of the granulosa include Müllerian-inhibiting substance, activin, inhibin, follicle regulatory protein, insulin-like growth factor-1, epidermal growth factor-like, platelet-derived growth factor, proopiomelanocortin, and gonadotropin surge-inhibiting factor. Some of these are produced also in other ovarian compartments, such as inhibin in the theca and corpus luteum, follicle regulatory protein in the follicular fluid and theca, and epidermal growth factor-like in the theca The answer is b. (McPhee, 2/e, p 516; Fauci, 14/e, pp ) Transforming growth factor-α and transforming growth factor-β, renin, inhibin, relaxin are produced in the theca. Some of these are produced also in other ovarian compartments, such as transforming growth factor-α and transforming growth factor-β in the interstitial, inhibin in the granulosa and corpus luteum, and relaxin in the corpus luteum The answer is e. (McPhee, 2/e, p 516; Fauci, 14/e, pp ) Basic fibroblast growth factor is produced in the corpus luteum. Other
231 Reproductive System Answers 215 endocrine and paracrine products of the ovarian compartments include the following: from the granulosa: Müllerian-inhibiting substance, activin, inhibin, follicle regulatory protein, insulin-like growth factor-1, epidermal growth factor-like, platelet-derived growth factor, proopiomelanocortin, and gonadotropin surge-inhibiting factor; from the theca: transforming growth factor-α and transforming growth factor-β, renin, inhibin, and relaxin; and from the follicular fluid: luteinizing inhibitor and luteinizing stimulator, oocyte meiosis inhibitor, follicle regulatory protein, and renin The answer is c. (McPhee, 2/e, p 516; Fauci, 14/e, pp ) Angiotensin II is produced in the follicular fluid, as are luteinizing inhibitor and luteinizing stimulator, oocyte meiosis inhibitor, follicle regulatory protein, and renin. Other endocrine and paracrine products of the ovarian compartments include the following: from the granulosa: Müllerianinhibiting substance, activin, inhibin, follicle regulatory protein, insulinlike growth factor-1, epidermal growth factor-like, platelet-derived growth factor, proopiomelanocortin, and gonadotropin surge-inhibiting factor; from the theca: transforming growth factor-α and transforming growth factor-β, renin, inhibin, and relaxin; and from the corpus luteum: basic fibroblast growth factor The answer is a. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Pretesticular causes are those affecting the hormones that stimulate the testicles, such as a low LH or FSH, and include various hypothalamicpituitary disorders including panhypopituitarism and gonadotrophin deficiency. Gonadotrophin deficiency includes isolated LH deficiency and Kallmann s syndrome. Posttesticular causes are those that affect sperm transport, and testicular causes are those with a direct effect on the testicles. Idiopathic causes represent those causes that are likely genetic and not elsewhere classified The answer is b. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Mumps virus infection can directly affect the testicles, producing an orchitis, often very painful, and consequently infertility. Posttesticular causes are those that affect sperm transport, and pretesticular causes are those that affect the hormones that stimulate the testicles.
232 216 Pathophysiology 453. The answer is b. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Testicular causes are those with a direct effect on the testicles. Alcohol directly affects the testicles causing atrophy with inadequate sperm production. It also causes decreased plasma testosterone. Posttesticular causes are those that affect sperm transport, and pretesticular causes are those that affect the hormones that stimulate the testicles. Idiopathic causes represent those causes that are likely genetic and not elsewhere classified The answer is a. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Pretesticular causes are those that affect the hormones that stimulate the testicles, such as a low LH or FSH. Phenytoin acts by reducing FSH. Other causes of a low LH or FSH include various hypothalamic-pituitary disorders, such as panhypopituitarism and gonadotrophin deficiency, including isolated LH deficiency and Kallmann s syndrome. Posttesticular causes are those that affect sperm transport, and testicular causes are those with a direct effect on the testicles. Idiopathic causes represent those causes that are likely genetic and not elsewhere classified The answer is c. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Posttesticular causes of infertility are those that affect sperm transport, such as penile anatomic defects including hypospadias and epispadias. Other posttesticular causes of infertility include genital tract infections, retrograde ejaculation, and antibodies to sperm or seminal plasma. Pretesticular causes are those that affect the hormones that stimulate the testicles, and testicular causes are those with a direct effect on the testicles. Idiopathic causes represent those causes that are likely genetic and not elsewhere classified.
233 Nervous System Questions DIRECTIONS: Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question A 35-year-old man comes to your office with a complaint of recent development of headaches that are generalized in nature. He is accompanied by his wife who recently returned from a trip. She tells you that her husband has been somewhat confused at times and clumsy. He does not confirm this, but he does report that he has been short of breath at times. On examination, he is mildly tachycardia and there is a reddish appearance to his mucous membranes, which is subtle. The only recent new medical problem identified is that the patient was in a motor vehicle accident in which he was struck in the rear end, and it left him with a sore neck. The most likely diagnosis is a. Acquired spinal stenosis (cervical) b. Normal pressure hydrocephalus c. Carbon monoxide poisoning d. Cocaine toxicity e. Muscle tension 457. A 40-year-old man is noted to have miosis of the right eye and ipsilateral ptosis. He reports that he has noted that this side of his face is not sweating when he is working recently. The most cause of this clinical picture may be a. Pancoast tumor b. Brainstem CVA c. Dissection of the carotid artery d. Idiopathic 217 Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
234 218 Pathophysiology 458. A 55-year-old male describes bilateral pain in his lower back and legs with prolonged standing while working on an assembly line. Whenever he sits down and takes a break, he gets some relief, but it recurs when he resumes his job. No other inciting events can be identified. The most likely cause of this problem is a. Degenerative joint disease b. Degenerative disk disease c. Peripheral vascular disease d. Lumbar spinal stenosis 459. An elderly woman is seen at your office with a complaint of loss of vision in her left eye, which had been transient on a couple of occasions but is now persisting. She has been seen recently at urgent care centers for multiple complaints including generalized fatigue, left-sided dull boring headaches with occasional sharp jabbing sensations, and arthritic complaint in the hips. In addition, she reports some recent loss of 7 to 10 pounds. The only remarkable finding on the routine labs obtained from her prior evaluations is an elevated alkaline phosphatase. You determine that the likely cause of her condition is a. Glaucoma b. Brain tumor arising anterior to the optic chiasm c. Optic neuritis d. Temporal arteritis 460. A middle-aged female arrives at your office after not seeing a physician for many years to have a general physical performed. Overall, she appears healthy but a poorly reacting left pupil is noted when a pen light is used. Instillation of a weak solution of pilocarpine leads to constriction of the pupil quickly. Your diagnosis is a. Argyll Robertson pupil b. Adie s tonic pupil c. Trauma-induced pupil dysfunction d. Horner s syndrome
235 Nervous System In the above patient, what other abnormality on physical would be consistent with the diagnosis? a. Ptosis b. Decreased visual acuity on Snellen s chart c. Hyporeflexia in the lower extremities d. Ataxic gait 462. While in the ICU, you are called to your patient s bedside because of the development of seizure activity in a ventilator patient with nosocomial pneumonia. You review the situation including the medication record. The patient is currently receiving dopamine, one-half normal saline, imipenem/ cilastatin, tobramycin, lisinopril, clonidine patch, and famotidine. The laboratory test results from this morning show normal electrolytes, except for a mildly elevated creatinine of 2.4 that is chronic, and CBC shows an improving white blood count of 15,000. After stopping the acute seizure event, you determine the next step in preventing further seizures is a. Stop dopamine b. Stop clonidine c. Intravenous phenytoin d. Change antibiotic coverage e. CT of the head 463. Two days after admission, a 57-year-old man suddenly has a seizure. He was undergoing evaluation for substernal chest pain. The nursing staff noted that he seemed to be a little shaky since shortly after arrival on the floor. He has no history of seizures and a stat CT of the head performed during the postictal state was normal. Laboratory results had shown an MCV of 101 (elevated) and his AST was mildly elevated (one and one-half normal). In this patient, the most likely imbalance that would contribute to this event would be a. Folate deficiency b. Fasting hypoglycemia c. Hypomagnesemia d. Thiamine deficiency e. Vitamin B 12 deficiency
236 220 Pathophysiology 464. A 25-year-old man with a high-frequency fine tremor that may be difficult to see grossly has a. Parkinson s disease b. Essential tremor c. Asterixis d. Hyperthyroidism e. Drug-related tremor 465. A 64-year-old man complains of a resting tremor that lessens with intentional movement and that causes him substantial embarrassment. What is the likely cause? a. Parkinson s disease b. Essential tremor c. Asterixis d. Hyperthyroidism e. Drug-related tremor 466. The tremor associated with hepatic encephalopathy is a. Resting tremor b. Essential tremor c. Asterixis d. Very high frequency e. Drug related 467. The tremor of which condition lessens with consumption of small amounts of alcohol a. Parkinson s disease b. Essential tremor c. Asterixis d. Hyperthyroidism e. Drug-related tremor
237 Nervous System A 65-year-old woman is seen for evaluation of dementia. On examination, you note that her left pupil does not react well to light. When she follows your finger with her eyes, as you approach the bridge of her nose, you note the left pupil to constrict equally as well as the right one. The most important test to order at this point would be a. Titer for Lyme disease b. B 12 level c. RPR d. HIV e. Fasting glucose 469. Which of the following muscle diseases with weakness is an autoimmune disorder? a. Becker muscular dystrophy b. Myotonic dystrophy c. Glycogen storage disorder (acid maltase deficiency) d. Duchenne muscular dystrophy e. Myasthenia gravis 470. A 68-year-old man comes to your office with a complaint of rightsided jaw pain that occurs about half way through his meal. He has seen his dentist already and no abnormality was found. X-rays of the area were taken and they also were unremarkable. The next step in his workup should be a. CT of the region b. CBC c. ESR d. Calcium level e. Carotid duplex 471. Which statement is true regarding the optic neuropathy that occurs with combined use of cigarettes and alcohol? a. It is reversible with B vitamin supplements and abstinence b. Color vision is not impaired c. It is of sudden onset d. Scotomas are present centrally
238 222 Pathophysiology 472. Entrapment of the median nerve causing carpal tunnel syndrome and if severe, muscle wasting in the thenar eminence of the hand, is associated with which of the following diseases? a. Hypothyroidism b. Diabetes c. Amyloidosis d. Rheumatoid arthritis e. All of the above 473. A 75-year-old man is brought to your office by his son with concerns over developing dementia problems. Previously, the patient had been well and was forced to retire from his job a few months ago because of worsening arthritis symptoms limiting his mobility. He has been a widower for 7 months and he lives alone. His family is worried about his safety in view of these changes. The likely cause of this dementia picture is a. HIV related b. B 12 deficiency c. Depression d. Multi-infarct dementia 474. A 35-year-old woman comes to your office complaining of weakness in her limbs and fatigability of her muscles, which, it seems to her, lessens after she rests. Sometimes she does not have any muscle weakness, for months at a time, and then she does; all this has been happening to her for the past few years. She tells you that what bothers her most is the droopiness of her eyelids. Which one procedure provides definitive confirmation of the diagnosis? a. Single-fiber electromyography b. CT scan or MRI of the head c. Antiacetylcholine receptor radioimmunoassay d. Edrophonium chloride test e. Electroencephalogram (EEG)
239 Nervous System A 38-year-old man presents to the emergency room with the sudden onset of a severe headache while chopping wood. This is the worst pain he has ever experienced, and it is accompanied by photophobia and vomiting. Which procedure(s) provide the best chance of making the diagnosis? a. CT scan of the head b. Lumbar puncture c. CT scan of the head and lumbar puncture d. ECG, lumbar puncture, and x-rays of the skull e. Pneumoencephalogram 476. Excitatory neurotransmitters such as acetylcholine and glutamate perform which of the following functions? a. Open cation channels and allow influx of Na + or Ca ++. b. Generate inhibitory postsynaptic potentials c. Activate mitochondria d. Regulate intracellular K + e. Carry impulses between peripheral nerves only 477. A 25-year-old graduate student is injured in a fall during a weekend rock climbing expedition. There is serious damage to the peripheral nerves in his leg. Which of the following can be expected to occur? a. Denervated muscles will hypertrophy b. Individual muscle fibers will not be able to contract spontaneously c. Groups of muscle fibers will not be able to spontaneously discharge d. Normal motor function may never return e. Muscle bulk may increase by one-half within 2 to 3 months 478. Weakness is caused by diseased anterior horn cells in which of the following disorders? a. Myasthenia gravis b. Botulism c. Amyotrophic lateral sclerosis d. Aminoglycoside antibiotic associated weakness e. Lambert-Eaton myasthenic syndrome
240 224 Pathophysiology 479. A 45-year-old man who has consumed excess alcohol for at least 20 years is seen for evaluation of progressive difficulty in walking. He has an ataxic gait and his muscles are generally hypotonic. He has an intention tremor in his arms and legs and he also demonstrates past pointing. His primary brain pathology will be found in the a. Occipital cortex b. Temporal lobe c. Cerebellum d. Brainstem e. Frontal cortex 480. A patient who has been diabetic for 15 years comes to your office complaining of a burning or tingling sensation in both of his feet and the lower aspects of both legs, which bothers him especially at night. His most likely diagnosis is a. Mononeuropathy b. Brown-Séquard s syndrome c. Polyneuropathy d. Mononeuropathy multiplex e. Radiculopathy 481. A moderately obese factory worker who stands for long periods of time begins to experience pain and a severe burning sensation that is localized over the left anterior lateral thigh. This patient has a a. Mononeuropathy b. Brown-Séquard s syndrome c. Polyneuropathy d. Mononeuropathy multiplex e. Radiculopathy 482. A man who was stabbed in the back during a fight is brought to the emergency room. On examination you find impaired pain and temperature sensation in one leg and impaired proprioception and vibration sense in the opposite leg. These findings are descriptive of a a. Mononeuropathy b. Brown-Séquard s syndrome c. Polyneuropathy d. Mononeuropathy multiplex e. Radiculopathy
241 Nervous System A 38-year-old woman with rheumatoid arthritis develops worse joint pain and also pain and paresthesias in scattered locations in both arms and both legs. Her sedimentation rate increases significantly and you diagnose vasculitis causing a. Mononeuropathy b. Brown-Séquard s syndrome c. Polyneuropathy d. Mononeuropathy multiplex e. Radiculopathy 484. A 55-year-old man who has worked for many years as a stevedore develops pain and weakness in the lower back that radiates down the posterolateral thigh and lower aspect of the leg. This is characterized as a. Mononeuropathy b. Brown-Séquard s syndrome c. Polyneuropathy d. Mononeuropathy multiplex e. Radiculopathy 485. An amenorrheic 35-year-old woman with galactorrhea is found to have a large prolactin-secreting pituitary tumor compressing her optic chiasm. Which visual disturbance does she have? a. Left central scotoma b. Bitemporal hemianopsia c. Left nasal hemianopsia d. Left homonymous hemianopsia e. Completely blind left eye 486. A 2-year-old boy is brought to your office by his parents who believe he may not have normal hearing. You determine that he has congenital damage to the left cochlea. This is classified as a kind of a. Conductive deafness b. Sensorineural deafness c. Central deafness d. Tinnitus e. Presbycusis
242 226 Pathophysiology 487. A 77-year-old man complains to you of an annoying buzzing sound in his right ear that bothers him mostly at night. This is classified as a. Conductive deafness b. Sensorineural deafness c. Central deafness d. Tinnitus e. Presbycusis 488. Deafness due to disease of the cochlear nuclei or auditory pathways is classified as a. Conductive deafness b. Sensorineural deafness c. Central deafness d. Tinnitus e. Presbycusis 489. A teenage girl presents for evaluation of hearing loss in her right ear. She has a history of at least 12 episodes of otitis media as a child; at least one time she perforated her ear drum. Her hearing loss is classified as a. Conductive deafness b. Sensorineural deafness c. Central deafness d. Tinnitus e. Presbycusis 490. Which of the following clinical diagnoses is most often accompanied by coma? a. Transient ischemic strokes b. Creutzfeldt-Jakob disease or multi-infarct dementia c. Cerebral hemorrhage, either subarachnoid or intracerebral d. Amyotrophic lateral sclerosis e. Small lacunar infarcts
243 Nervous System Patients commonly complain of dizziness. This symptom is a. A well-defined sensation of one s environment spinning around b. Usually accompanied by the physical finding of nystagmus c. Usually accompanied by hearing loss d. A loosely defined and nonspecific symptom of light-headedness or weakness or spinning e. A specific sign of impending stroke 492. A 70-year-old man is brought to the ER because of sudden onset of right arm weakness and inability to understand speech. This speech problem is called a. Apraxia b. Aphasia c. Abulia d. Anomia e. Alexia 493. A patient whom you have diagnosed with Alzheimer s disease is increasingly unable to retrieve from memory or to appropriately use previously learned words. This disorder is called a. Apraxia b. Aphasia c. Abulia d. Anomia e. Alexia 494. A 50-year-old man who is an alcoholic is severely injured in a barroom brawl. He sustains a major injury to the frontal lobes of his brain. Subsequently, he always seems apathetic and unemotional. This disorder is called a. Apraxia b. Aphasia c. Abulia d. Anomia e. Alexia
244 228 Pathophysiology 495. The inability to read printed words is known as a. Apraxia b. Aphasia c. Abulia d. Anomia e. Alexia 496. A 30-year-old woman undergoes surgery for a very large, but fortunately benign, brain tumor. For 2 days after the surgery she is unable to perform certain previously learned motor functions. This disorder is called a. Apraxia b. Aphasia c. Abulia d. Anomia e. Alexia 497. Abnormalities in the cytosolic copper-zinc superoxide dismutase (SOD1) gene on chromosome 21 have been identified as factors in the pathophysiology of which degenerative disorder? a. Parkinson s disease b. Amyotrophic lateral sclerosis c. Huntington s chorea d. Alzheimer s Disease e. Tuberous sclerosis 498. An 8-year-old girl is noted to be having frequent staring spells during which she seems oblivious to her surroundings. She seems to suddenly return to awareness without realizing that she has been temporarily out. The most likely finding on a full evaluation would be a. Three per second (3-Hz) spike and wave activity on EEG b. Abnormal reflexes in her lower extremities c. An abnormal CT scan showing an occipital mass d. An abnormal MRI showing demyelination e. An abnormal mental status examination showing disorientation to time
245 Nervous System Which clinical scenario best describes a patient with midstage dementia of the Alzheimer s type? a. A patient has gradually developed memory deficits over the past four or five years; the deficits worsen each time he has a spell, described by the family as little strokes that get better in a few days b. A patient has had Parkinson s disease for years, and after becoming nearly immobile, he is also noted to have memory and language deficits c. A patient has become progressively more withdrawn and shows deficits in short- and long-term memory; these deficits have been noticed by the family since the patient s wife and his last sibling died about 5 months ago d. A patient became socially withdrawn a couple of years ago because he could not keep up with his friends activities such as golf and bridge; now he is getting lost whenever he leaves his house e. A long-term, often homeless, alcoholic becomes progressively disoriented and confused, and the condition cannot be reversed by a move to a nursing home where he receives adequate nutrition and medical care 500. Which cerebral artery is blocked in an ischemic stroke that presents with the following symptoms: aphasia, right hemiparesis, and right arm numbness? a. Right anterior cerebral b. Right middle cerebral c. Right proximal posterior cerebral d. Left anterior cerebral e. Left middle cerebral
246 230 Nervous System Answers 456. The answer is c. (Fauci, 14/e, p 2533.) This is the classic presentation of carbon monoxide poisoning, which includes confusion, shortness of breath, tachycardia, and reddish appearance of the mucous membranes. There would be a discrepancy between the po 2 and O 2 saturation on the ABG. Pulse oximetry would be correct in the O 2 saturation estimation The answer is d. (Fauci, 14/e, pp 559, 160; Adams, p 470.) Although all of these processes may cause Horner s syndrome, the most common cause remains idiopathic. The Pancoast tumor and dissection of the carotid impinge on the sympathetic nerves, thus exerting their effect. Brainstem strokes would work at the central level to interrupt the sympathetic nerves The answer is d. (Fauci, 14/e, p 77.) This syndrome is called pseudoclaudication. It may also occur at times with exertion, thus causing confusion with peripheral vascular disease. Nerve impingement by osteoarthritis and by degenerative disk disease tends to give a radicular pattern to the discomfort The answer is d. (Fauci, 14/e, pp 71, ) There is a high correlation between temporal arteritis and the occurrence of polymyalgia rheumatica, and this would explain the proximal muscle girdle pain that is a frequent finding in temporal arteritis. This disease is an inflammation of the small arteries although there may be some involvement of the middlesized arteries. The only laboratory test to attempt to confirm your diagnosis is to obtain an ESR, which should be elevated above 100. Definitive diagnosis is by temporal artery biopsy. Treatment with steroids prevents the occurrence of blindness as a complication. The elevated level of alkaline phosphatase is an incidental finding, perhaps because of alcohol consumption The answer is b. (Fauci, 14/e, p 160.) This disorder is benign and generally noted in younger females where it is felt to represent a mild
247 Nervous System Answers 231 dysautonomia. Tonic pupils may be seen also in diabetes, segmental hypohidrosis, Shy-Drager hyperhidrosis syndrome and amyloidosis The answer is c. (Fauci, 14/e, p 160.) Hyporeflexia in the lower extremities may be seen with this benign condition The answer is d. (Fauci, 14/e, p 865.) β-lactam antibiotics, in particular high-dose penicillin G and imipenin, are known to induce seizures especially in the face of renal dysfunction. Acute treatment of the seizure would be the same as for any other source of seizure. Other medications could contribute to lowering seizure threshold via lowering the magnesium level (such as diuretics). The use of phenytoin should not be necessary unless recurrent events occur. The CT of the head is reasonable; however, the discontinuation of the β-lactam would be the first step The answer is c. (Fauci, 14/e, pp 2265, ) Alcohol withdrawal seizures are suspected because the man became shaky 2 days after admission in the hospital where he would not have access to alcoholic beverages, he has a macrocytosis consistent with folate deficiency due to alcoholism, and the diagnostic tests showed no underlying neurologic disease. The consumption of alcohol leads to excessive loss of magnesium in the urine and thus lowers seizure threshold. The AST level in general will increase more in the face of alcohol usage than will the ALT. The bulk of alcohol withdrawal seizures will occur within 5 days of the cessation of alcohol consumption The answer is d. (Fauci, 14/e, pp , 424t, 1716.) The tremor of hyperthyroidism is very high frequency and fine, unlike the tremors of Parkinsonism, asterixis, essential, and drug related. It does not depend on rest or movement. The tremor of Parkinson s disease is a coarse resting tremor that decreases with intentional movement. Cogwheel rigidity is also seen. In hepatic encephalopathy, the flapping tremor of asterixis is seen. Drug-related tremors are usually seen with β-2 agonists and methylxanthines. These are frequently of abrupt onset and time related to the usage or dosage adjustment with these medications The answer is a. (Fauci, 14/e, pp , 424t, 1716.) The tremor of Parkinson s disease is a coarse resting tremor that decreases with inten-
248 232 Pathophysiology tional movement. Cogwheel rigidity occurs in Parkinsonism. By contrast, the tremor of hyperthyroidism is very high frequency and fine, and it does not depend on rest or movement. In hepatic encephalopathy, the flapping tremor of asterixis is seen. Drug-related tremors are usually seen with β-2 agonists and methylxanthines. These are frequently of abrupt onset and time related to the usage or dosage adjustment with these medications The answer is c. (Fauci, 14/e, pp , 424t, 1716.) In hepatic encephalopathy, the flapping tremor of asterixis is seen. It can be elicited by gently extending the hand and holding it in that position. The other tremors are not elicited by these manipulations The answer is b. (Fauci, 14/e, pp , 424t, 1716.) An essential tremor lessens with small amounts alcohol consumption. The tremors of hyperthyroidism, Parkinson s disease, hepatic encephalopathy, and those related to drug ingestion do not do so The answer is c. (Fauci, 14/e, p 160.) This is the typical Argyll Robertson pupil found in syphilis. The RPR (rapid plasma reagin), a nontreponemal antibody test for syphilis, will be positive The answer is e. (Fauci, 14/e, pp ) Myasthenia gravis is an autoimmune disorder in which specific antibodies to acetylcholine receptors (AchRs) reduce the number of AChRs available at neuromuscular junctions. Becker muscular dystrophy and Duchenne muscular dystrophy (called pseudohypertrophic muscular dystrophy) are X-linked hereditary myopathies, and myotonic dystrophy is an autosomal dominant hereditary myopathy, all muscular dystrophies. Glycogen storage disorder is an autosomal recessive disorder with muscle weakness because of the acid maltase deficiency and glycogen accumulation; the adult form begins in the thirties or forties The answer is c. (Fauci, 14/e, pp ) Jaw claudication is a classic presentation of temporal arteritis. The ESR in this disease should be greater than 100 in general. The definitive diagnosis is by temporal artery biopsy only.
249 Nervous System Answers The answer is d. (Fauci, 14/e, p 2457.) The typical deficiency amblyopia that occurs with these substances is a gradual process with no reversibility; only stability of the current status can be achieved. Color vision may be affected and scotomas in the central or paracentral location are common The answer is e. (Fauci, 14/e, pp 2466, ) Carpal tunnel syndrome is typically associated with repetitive use of the hand/forearm, and multiple diseases may contribute also including these. Pregnancy may also cause this condition to surface; however, in this situation, it generally improves postpartum The answer is c. (McPhee, 2/e, p 156; Fauci, 14/e, p 147.) As many as 10 to 15% of patients evaluated for dementia are found to have depression. Care must be taken not to overlook this diagnosis as the underlying cause of dementia or an aggravating factor. Severe depression affecting multiple areas of life are seen commonly with 6 to 9 months after the loss of a spouse The answer is c. (Fauci, 14/e, pp ) This woman likely has myasthenia gravis; the incidence in women peaks in their twenties and thirties and women are more often affected, about 3:2, than men. Measurement of the antibody antiacetylcholine receptor provides a definitive diagnosis in 90% of cases of generalized disease, which this patient manifests, and 50% in ocular disease alone. Single-fiber electromyography is not specific for myasthenia gravis. Edrophonium chloride test, if unequivocally positive, makes the diagnosis highly probable. CT scan, MRI scan, and the EEG do not play a role in the diagnosis of myasthenia gravis The answer is c. (Fauci, 14/e, p 2345.) This patient has symptoms and signs consistent with a subarachnoid hemorrhage (SAH), which is associated with berry aneurysm, AV malformations, cocaine use, and extension of primary intracerebral hemorrhage and is reported to occur in conjunction with exertion. Typically, episodes of SAH begin suddenly and are severe in nature. The patient usually comments that its the worst headache I ve ever had. The lack of objective neurologic findings is common. The severity of the episode and the presence of vomiting along with
250 234 Pathophysiology loss of consciousness 50% of the time suggests this diagnosis. The CT will miss 20% of these hemorrhages and a lumbar puncture (LP) is required to completely exclude this diagnosis. A lumbar puncture can show the presence of subarachnoid blood. The ECG may have a prolongation of the QRS complex, prolongation of the QT interval or T wave changes consisting of inversions or tall peaked waves. However, skull x-rays or pneumoencephalogram do not aid in the diagnosis The answer is a. (McPhee, 2/e, p 126.) Excitatory neurotransmitters generate excitatory postsynaptic potentials by opening channels that allow Na + and Ca ++ to enter neurons. Different neurotransmitters, such as GABA and glycine, cause inhibition of signals The answer is d. (McPhee, 2/e, p 131.) Fasciculation, fibrillation, and substantial atrophy can be expected. Normal muscle function will not likely return without aggressive medical intervention and may not return at all The answer is c. (McPhee, 2/e, pp 130, 149; Fauci, 14/e, pp 2368, ) The weakness of ALS ( Lou Gehrig s disease ) is due to diseased motor neurons in the anterior horn cells. The weakness in the other disorders is caused by impaired neuromuscular transmission by impaired calcium channel function in aminoglycoside-associated weakness, by autobodies to the calcium channels in Lambert-Eaton syndrome, by toxins that prevent neurotransmitter release in botulism, and by autobodies to neurotransmitter receptors in myasthenia gravis The answer is c. (McPhee, 2/e, p 134; Fauci, 14/e, p 116.) The cerebellum functions as a coordinating center for the maintenance of muscle tone and the regulation of motor tasks. It does not supply nerve impulses to directly cause muscles to contract The answers are 480: c; 481: a; 482: b; 483: d; 484: e. (McPhee, 2/e, p. 140; Fauci, 14/e, pp ) Numerous localized disorders and many systemic diseases can damage the spinal cord or the peripheral nerves. The pattern of pain, sensory loss, and sometimes weakness can help classify the disorder. A mononeuropathy involves pain/temperature and vibratory/joint position abnormalities, along the
251 Nervous System Answers 235 precise path of an individual nerve with associated weakness and pain. Mononeuropathy multiplex involves multiple noncontiguous peripheral nerves in a sequential fashion taking place over days to years. A radiculopathy involves a nerve root with dermatome distribution of both pain/temperature and vibratory/joint position abnormalities and weakness of the innervated muscles. Brown-Séquard s syndrome also involves pain/temperature and vibratory/joint position abnormalities; however, the distribution is ipsilateral pain/temperature and contralateral vibratory/joint position abnormalities with an ipsilateral motor deficit. A polyneuropathy similarly involves pain/temperature and vibratory/joint position abnormalities with a stocking-glove distribution and painful paraesthesias The answer is b. (McPhee, 2/e, p 142; Fauci, 14/e, pp , ) The optic chiasm is the area where fibers receiving input from both temporal visual fields cross. Compression at the chiasm causes dysfunction in both sets of fibers and thus loss of vision in both temporal visual fields The answers are 486: b; 487: d; 488: c; 489: a. (McPhee, 2/e, p 145; Fauci, 14/e, pp ) Sounds must be conducted through the middle ear and sensed by the cochlea and CN VIII; then they are processed by the cochlear nuclei and CNS pathways. Conductive deafness is hearing loss due to external auditory canal or middle ear disease. Sensineural deafness is a perceptive loss of hearing due to disease of the inner ear or eighth nerve. In conductive deafness, bone conduction is better than air conduction, and the reverse is the case for sensineural deafness. Central deafness is caused by disease affecting the central auditory pathways. Tinnitus an annoying noise in the ear that is usually benign, often is caused by cochlear or eighth nerve disorders. Hearing may be diminished, but the patient is not rendered fully deaf. Presbyacusis is hearing loss due to advanced age The answer is c. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) Many toxins and metabolic disturbances cause coma, as do structural lesions such as hemorrhages and large infarcts. Dementing illnesses do not ordinarily cause coma, although in their terminal stages, patients may be bedridden and virtually unresponsive.
252 236 Pathophysiology 491. The answer is d. (McPhee, 2/e, p 146; Fauci, 14/e, pp ) Dizziness is a nonspecific term and an ill-defined symptom sometimes describing faintness or weakness and sometimes meaning true vertigo. Vertigo should be used only when there is actually a sensation of movement; usually, the patient feels that he or she is spinning or the room is spinning around them The answers are 492: b; 493: d; 494: c; 495: e; 496: a. (McPhee, 2/e, p 148; Fauci, 14/e, pp ) Although various areas of the cerebral cortex are specialized to perform certain functions, the cognitive and behavioral domains (language, memory, calculation ability, and so forth) are interconnected to both cortical and subcortical neural networks. Specific deficits identified in a careful neurologic exam will help define which area or network has been damaged. Aphasia is an abnormality of language. Anomia, the inability to name, is a form of aphasia. Apraxia is a complex motor deficit not attributable to pyramidal, extrapyramidal, cerebellar, or sensory abnormalities The answer is b. (McPhee, 2/e, pp ) Abnormalities in the SOD1 gene have been linked to amyotrophic lateral sclerosis (ALS; Lou Gehrig s disease). The intact SOD1 gene catalyzes the formation of hydrogen peroxide from superoxide anion; the hydrogen peroxide is detoxified by catalase to form water. The mutant gene in some forms of ALS catalyzes the reduction of hydrogen peroxide to hydroxyl radicals which may contribute to the pathogenesis of ALS The answer is a. (McPhee, 2/e, pp Fauci, 14/e, pp ) The EEG abnormality described is typical of absence seizures. This disorder typically presents with the clinical scenario described in this question The answer is d. (McPhee, 2/e, pp ; Fauci, 14/e, pp ) A describes a patient with probable multi-infarct dementia; B is a patient with Parkinson s dementia complex or perhaps Lewy body disease; C is consistent with the pseudodementia of depression. D is the description most closely associated with Alzheimer s disease although the student should realize that the clinical syndromes may overlap consider-
253 Nervous System Answers 237 ably. Case E describes a long-term alcoholic whose dementia may be multifactorial, with possible direct toxic damage to the brain, possible nutritional deficits, and a social history that might well include episodes of head trauma The answer is e. (McPhee, 2/e, p 160; Fauci, 14/e, pp ) An infarction of the left hemisphere causes weakness or paralysis and sensory loss on the right. Most right-handed patients have their dominant speech center on the left, and it is supplied by the middle cerebral artery, as is the somatic motor area.
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255 Bibliography Barron WM, Lindheimer MD: Medical Disorders During Pregnancy, 2/e. St. Louis, Mosby, Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL (eds): Harrison s Principles of Internal Medicine, 14/e. New York, McGraw-Hill, Lilly LS (ed): Pathophysiology of Heart Disease. Philadelphia, Lea & Febiger, McPhee SJ, Lingappa VR, Ganong WF, Lange JD (eds): Pathophysiology of Disease, 2/e. Stamford, Connecticut, Appleton & Lange, Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA: Medical Microbiology, 5/e. St. Louis, Mosby, Roitt R, Brolstoff J, Male D: Immunology, 5/e. London, Mosby International, Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
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257 Index A A-a gradient, 112, 116, 117 Absence seizures, 228, 236 Abulia, 227, 236 Acetaminophen-induced liver damage, 162, Achalasia, , 153 Achlorhydria, 3 Acromegaly, 182, 191 ectopic, 43, 55 untreated, 183, ACTH (adrenocorticotropic hormone), suppression of, 186, 194 Acute lung injury (ALI), 111, 116 Acute respiratory distress syndrome (ARDS), 111, 116 Addison s disease, 6 Adenoma, 2 adrenal, 186, 194 hepatocellular, 168, 176 (See also Macroadenoma, pituitary) Adie s tonic pupil, 218, Adrenal adenoma/carcinoma, 186, 194 α-fetoprotein, 167, 175 AIDS (acquired immunodeficiency disease), 7 CD4 T lymphocyte and, 68, 78 pneumonia and, 66, 76 [See also HIV (human immunodeficiency virus)] Alcoholics infertility in, 206, 216 Alcoholics (Cont.) pneumonia and, 66, 77 seizures in, 219, 231 Alexia, 228 Alkaline phosphatase, 159, 169 Allele dominant, 31, 40 mutant, 28, 37 premutation, 30, 39 Alzheimer s disease, 229, 236 (See also Dementia) Amenorrhea, , exercised-induced, 198, 209 Aminotransferase ALT, 159, 169 Amylase, Amyotrophic lateral sclerosis (ALS), 223, 228, 234, 236 Anaphylatoxins, 21 Anaphylaxis, 16, 24 Androgens, , Androstenedione, 198, 208 Anemia microcytic, 48, 57 pernicious, 3, 50, 59, 145, 155 in pregnancy, 202, sickle cell, 34 35, Angina, 5 Angiotensin II, 206, 215 Anion gap, 122, 132 urine, 125, Anomia, 227, 236 Anterior horn cells, diseased, 223, 234 Antiacetylcholine receptor radioimmunoassay, Copyright 2002 The McGraw-Hill Companies. Click Here for Terms of Use.
258 242 Index Antibiotics nonuse of, 64, 74 seizures and, 219, 231 Anticipation, 34, 87 Anti-GBM (glomerular basement membrane) disease, , 131 Antigenic determinants (see Epitopes) Antigen-presenting cell (APC), 10, 19 Antineutrophil cytoplasmic antibody (ANCA), 121, 131 Aortic regurgitation, 93, 106 Aphasia, 227, 236 Apraxia, 228, 236 Argyll Robertson pupil, 221, 232 Asbestos, exposure to, 112, 117 Ascites, formation of, 164, 173 Asherman s syndrome, 203, Asthenospermia, 202, 212 Asthma, 4 acute episodes of, 110, 115 Atherosclerosis, 29, 38 Atrial contraction, 90 Atrial enlargement, 86, 99 Autoimmune disorders, 221, 232 Autosomal dominant polycystic kidney disease, 124, Autosomal recessive disease, 35, 43 AV block, 92, AV valves, 90 Azoospermia, 200, 210 B Bacteria gram-positive/gram negative, 64, 75 intracellular, 14, 22 phagocytosis of, 11, 20 Barrett s esophagus, 5 Barrter s syndrome, 124, 133 B cell neoplasm, 14, 22 Benign prostatic hyperplasia, 199, Benign prostatic hypertrophy (BPH), 125, 135, 203, 212 β 2 -agonists, 110, 115 Biliary tract infections, 69, 79 Bilirubin metabolism, disorders of, 165, 174 Biopsy, 45 46, 55 Bitemporal hemianopsia, 187, 195, 225, 235 Bites, human, 64, Bleeding, postmenopausal, 204, 214 B lymphocytes, deficiency in, 10, Bone marrow, transplantation of, 17, 25 Bowel contents, osmolality of, 145, 154 Brain, growth of, 197, 208 Breast-feeding, 204, 213 Bronchiectasis, 111, 115 Brown-Séquard s syndrome, 224, 235 Bundle branch block, 87, 100 Burkitt s lymphoma, 14, 22
259 Index 243 C Calcitonin, elevated, 181, 190 Carbon monoxide poisoning, 217, 230 Carcinogenesis, multistep theory of, 48, 57 Carcinoid syndromes, 3 Carcinoma adrenal, 186, 194 colon, 2, 48, 57, 183, 192 hepatocellular, 167, 175 phenotypic transition of, 2 (See also Malignancies; specific type) Cardiac output, 83, 93, 96 97, 97f, 107 increased, 90 Cardiomyopathy, 123, 133 diuretics and, 126, 136 Carpal tunnel syndrome, 222, 233 Cat-scratch disease, 72, 82 CD4 T lymphocyte, 68, 78 Centimorgan, 33, 42 Central deafness, 226, 235 Cerebellum, functions of, 224, 234 Cerebral hemorrhage, 226, 235 Cervical nodes, biopsy of, 46, 55 Chlamydia psittaci, 67, 77 Choriocarcinoma, 177, 188 Chromosomes, identical, 33, 42 Chronic lymphocytic leukemia (CLL), 46, 52, 55, 60 Chronic myelocytic leukemia, 51, Chronic obstructive pulmonary disease (COPD), , Chronic obstructive pulmonary disease (COPD) (Cont.) vomiting and, 126, 135 Chronic pulmonary disease, 67, 77 Cirrhosis, 109, 114, 125, 135, 149, 157, , 167, 173, 175 primary biliary (PBC), 149, 157, 160, , 176 Classical pathway, activation of, 12, 21 Clostridium difficile, 148, 157 Clostridium spp., 65, 75 Coagulation factors, 53 54, Colitis, ulcerative, 7, 146, 156 Conductive deafness, 226, 235 Congestive heart failure, 123, 132 Conn s syndrome, 6 Coombs test, 14, 23 Corpus luteum, 199, 205, 209, 214 Coxiella burnetii, 70, 80 CpG islands, 30, Craniopharyngioma, 187, 194 Crohn s disease, 125, 134, 147, 156 common manifestations of, 5 Cryptorchidism, 200, Cryptosporidium, 69, 79 Cushing s syndrome, 6, 186, 194 Cystic fibrosis, genetics of, 28, 37 Cytokines, functions of, 17 18, 25 Cytolysis, 11, 20 Cytomegalovirus, 70, 79 Cytomegalovirus infection, acute (CMV), 72, 81
260 244 Index D Deafness, , 235 Decadron (dexamethasone), 47, 56 Delayed type hypersensitivity (DTH), 14, 22 Dementia, , 229, 233, 236 Dendritic-Langerhans cells, 10, 19 Detrusor contractility, decreased, 203, 212 Diabetes insipidus, nephrogenic, 124, 133 Diabetes mellitus, 5 6 gestational, 199, 203, 210, 213 Diabetic ketoacidosis, 126, 136 Diabetic nephropathy, 125, 134 Diarrhea, 67, Diastole, 96 Diastolic murmur, 93, 106 Disseminated intravascular coagulation (DIC), 52, 61 Diuretics, , 132 cardiomyopathy and, 126, 136 Dizziness, 227, 236 Dominant allele, 31, 40 Down s syndrome, 31 32, 40 Duchenne s muscular dystrophy, 29, 38 Duodenal ulcer, 140, 144, 151, 154 Duodenum, flow rate in, 145, 154 Dysphagia, 148, 157 E E. coli, 67, 77 E. histolytica, clinical infection with, 71, 81 ECG, components of, 83, 95, 95f inferior cardiac wall and, 92, 105 ECG (Cont.) isoelectric ST segment on, 91, 104 loss of P waves on, 93, QRS complex on, 91, 103, 107 tracing diagram, 86, 86f, 87 T wave on, 91, 104 Eclampsia, 6 Ectopic acromegaly, 45, 55 Ectopic pregnancy, 198, 209 Electrolyte abnormalities, 101 flux, 87, 87f, 88, , 102f Embolism, pulmonary, 4, , Emphysema, 113, 118 Endocarditis, infective, 64, 74 in drug abusers, 72, 81 left-sided, 65, 75 Endoscopic retrograde cholangiopancreatography (ERCP), 142, 153 Enzyme-linked immunosorbent assay (ELISA), 14, 23 Eosinophils, 11, 20 Epitopes, 11, 20 Erythrocytes, 50, 60 Erythropoietin, , 130 Esophageal reflux, chronic, 5 Esophageal spasm, 143, 153 Esophageal ulcers, 140, 151 Esophagitis, 69, 79 Essential hypertension, 126, 135 Essential tremor, 220, 232 Estrogen production, ovarian, 201, 211 Estrogen therapy, thyroid and, 180, 189
261 Index 245 Excitatory neurotransmitters, 223, 234 F Factor XIII, 48, 57 Falciparum malaria, 72, 81 Fanconi s syndrome, Fatal fulminant disease, 162, 172 Fibrin-stabilizing factor (see Factor XIII) Fibroblast growth factor, 205, 214 Finasteride, 199, 210 First heart sound, splitting of, 89, 103 Fitness, genetic, 28, 37 5α-reductase inhibition, 199, 210 Flow cytometry (FACS), 15, 23 FMR1 family mental retardation, 30, 39 Focal sclerosis, 125, 134 Follicular fluid, 206, 215 Fragile X-associated mental retardation, 30 31, Frank-Starling curves, 4 5, 84, 84f, 97 Frontal plane QRS axis, 87, 101 Fulminant hepatitis, 161, 171 G Galactorrhea, 183, 192, 201, 211 Gallstones, 147, 156 Gastric ulcers, 139, 144, 151, 154 bleeding from, 146, 155 Gastroesophageal reflux disease (GERD), 143, 145, 153, 155 Gastrointestinal tract (GI), bleeding from, 139, 151, 165, 173 Genetic mosaicism, 30, 39 Geriatric patients, communityacquired pneumonia and, 110, 114 Gestational diabetes mellitus (see Diabetes mellitus, gestational) Glomerulonephritis acute, 119, 129 membranoproliferative, 127, 137 postinfectious, 121, 131 poststreptococcal, 16, 24 (See also Nephritis) Glycogen storage disorder, 221, 232 Glycosuria, 124 Goiter endemic, 178, toxic multinodular, 181, 190 Gonadotropin deficiency, 215 Goodpasture s syndrome, 15, Graft versus host disease (GVH), 1, 17, 25 Granulosa, 205, 214 Graves disease, , 182, 188, 191 Growth retardation, 124 H H2 blocker therapy, 144, 154 Haloperidol, 183, 192 Hashimoto s thyroiditis, , Hearing loss, pathophysiology of, 3t Heart block (see AV block) Heart failure, congestive, 123, 132
262 246 Index Heart sound, first, 89, 103 Helicobacter pylori, 5, 144, 154 Hemochromatosis, 148, 157, 162, 171, 187, 195 Hemodialysis, 123, 133 Hemolysis, intravascular and extravascular, 165, 174 Hemolytic disease, in neonates, 16, 24 Hemolytic uremic syndrome, 122, 132 Hemoptysis, 113, 118 Hepatic encephalopathy, , , 220, 232 Hepatitis, 165, 174 acute viral, 149, 158 alcoholic, 150, 158, 161, 171 chronic, 163, 172 fulminant, 161, 171 liver damage from, 163, 172 vaccine for, 149, 158 [See also under Hepatitis B (HBV)] Hepatitis A (HAV), 148, 157, 164, 167, transmission of, 160, 168, 170, 175 Hepatitis B (HBV), 160, , chronic, 141, 152, 157, 161, 167, 170, 175 vaccine for, 149, 158 Hepatitis C (HCV), 141, 149, 152, 157, 163, 172 in HIV-infected persons, 168, 175 Hepatocellular adenoma, 168, 176 Hepatocellular carcinoma, 167, 175 Hepatoma, 149, 157 Hepatorenal syndrome, 166, 174 Herpesvirus varicellae, 69, 79 Heterogeneity, genetic, 28, 36 Heterozygote advantage, 28, 37 Histocompatibility antigens, 1 HIV (human immunodeficiency virus), 7 biliary tract infections and, 69, 79 CD4 T lymphocyte and, 68, 78 cytomegalovirus and, 70, 79 esophagitis and, 69, 79 focal sclerosis and, 125, 134 hepatitis C (HCV) and, 168, 175 Herpesvirus varicellae and, 69, 79 Kaposi s sarcoma and, 70, 79 Mycobacterium avium and, 70, 80 opportunistic infections and, 68, 79 pneumonia and, 66, 76 progression of, 68, 78 toxoplasmosis and, 69, 79 [See also AIDS (acquired immunodeficiency disease)] Hodgkin s disease, 52, 61 Horner s syndrome, 230 Human chorionic somatomammotropin, 199, 210 Human genome, size of, 31, 40 Huntington s chorea, 31, 39 Hypercalcemia, 46, Hypercalciuria, idiopathic, 127, 136 Hypercoagulability, 111, 115 Hyperkalemia, 87, 101, 127, 136 Hyperlipidemia, 119, 129
263 Index 247 Hypermagnesemia, 119, 129 Hyperparathyroidism, 120, 130 Hyperprolactinemia, , Hypertension, 203, 212 essential, 126, 135 portal, 164, 173 primary pulmonary, 109, 114 Hypertensive LES, 143, 153 Hyperthyroidism, 6, 177, , , 220, 231 pituitary TSH-induced, 185, 194 Hypervolemia, 120, 130 Hypervolemic hyponatremia, 125, 135 Hypocalcemia, 45 Hypogonadism, secondary, 185, 193 Hypokalemia, 86, 99 Hypomagnesemia, 219, 231 Hyponatremia, 123, 132 hypervolemic, 125, 135 Hypophosphatemia, 124 Hypopituitarism, 186, 194 Hyporeflexia, 219, 231 Hypospadias, 207, 216 Hypothyroidism, 6, 179, 189, 199, 209 I Immune response, 11, 20 cellular, 17, innate, extracellular bacteria and, 10, 19 primary, immunoglobulin in, 9, 19 Immune thrombocytopenic purpura (ITP), 52, 61 Immunization, 13, 21 Immunoglobulin, classes of, 9, 19 Impetigo, 73, 82 Infarction, left hemisphere, 229, 237 Infection in injection drug users, 64, 74 Neisseria, 12, 21 nosocomial, 64, 75 pyogenic, 12, 21 (See also specific type) Infertility, male, 204, , 213, Influenza virus, 111, 115 Inheritance semidominant, 28, 37 X-linked, 35, 44 X-linked recessive, 29, 38 INH prophylaxis, 72, 81 Insulin-like growth factor type 1 (IGF-1), 182, 191 Interleukin 17, 25 Ipsilateral ptosis, 217, 230 Iron deficiency, 49, 58 in pregnancy, 202, Ischemic stroke, 229, 237 Isoelectric ST segment, 91, 104 J Jaundice, obstructive, 142, 147, 153, 156 Jod-Basedow phenomenon, 177, 188 K Kallman s syndrome, 185, 193 Kaposi s sarcoma, 70, 79 Kartagener s syndrome, 202, 212 Ketoacidosis, diabetic, 126, 136
264 248 Index Kidney disease, autosomal dominant polycystic, 124, Klebsiella pneumoniae, 66, 77 Klinefelter s syndrome, 31, 40 L Lactate dehydrogenase (LDH), 45, 55 Lactulose, 166, 174 Latex agglutination, 15, 23 Left ventricular end-diastolic pressure, 4 volume loop, 85, 85f, 86, 98, 98f LES, hypertensive, 143, 153 Leukemia chronic lymphocytic (CLL), 46, 52, 55, 60 chronic myelocytic, 51, Leukocytosis, 49, 58 Light chain deposition disease, 123, 133 Lipase, 145, 154 Lipopolysaccharide (LPS), 65, 75 Lithium, long-term, 124, 133 Liver, 159, 169 acetaminophen-induced damage of, 162, 172 Lou Gehrig s disease [see Amyotrophic lateral sclerosis (ALS)] Lung disease, obstructive vs. restrictive, 4t Lung transplantation, single, 111, 116 Luteinizing hormone (LH) deficiency, 206, 215 Lymphomas, thyroid, 180, 190 M Macroadenoma, pituitary, , 187, , 195 Macrocytic anemia, 3 Malabsorption syndrome, 146, 155 Malaria, falciparum, 72, 81 Malignancies hypercalcemia and, 3 indirect system effects of, 2 3 lung, 2 3 (See also Carcinoma; specific type) Mallory bodies, 150, 158, 161, 171 Mammogram, biopsy and, 45, 55 Mast cells degranulation of, 21 immunoglobulin in, 9, 19 M cells, 14, 23 Membrane attack complex (MAC), 11 12, Meningitis bacterial vs. viral, 1t 2t neonatal, 65, 75 subarachnoid space inflammation of, 65, 75 Menopause, 201, 211 Mental retardation, 30, (See also specific type) Metabolic alkalosis, 124, 133 Metastasis, 2 Metastatic disease, vs. vascular disease, 147, 156 Microcytic anemia, 48, 57 Minimal change disease, 7, 126, 135 Miscarriage, 199, 209
265 Index 249 Mitral stenosis, 91 Mitral valve prolapse, 91 Mixed lymphocyte reaction assay, 15, 23 Mononeuropathy, 224, Mononeuropathy multiplex, 225, 235 Moraxella catarrhalis, 67, 77 Mucosal secretions, immunoglobulin in, 9, 19 Müllerian-inhibiting substance, 205, 214 Multiple arteriovenous malformations (AVMs), 140, 151 Multiple endocrine neoplasia syndrome-1, 184, 193 Multiple myeloma, 127, 136 Mumps, 206, 215 Mutant allele, 28, 37 Mutations hypermorphic, 28, 37 missense, 33, 42 Myasthenia gravis, 3, 222, 233 Mycobacterium avium, 70, 80 Mycobacterium tuberculosis, 66, 76, 113, 118 Mycoplasma pneumoniae, 66, 71, 76, 80 Myocardial depolarization, 92, 105, 105f N Neisseria, 12, 21 Neonates group B streptococcus infections in, 10, 20 hemolytic disease in, 16, 24 infections in, 11 Nephritis tubulointerstitial, 123, 132 (See also Glomerulonephritis) Nephron segment, function of, 120, Nephropathy, 125, Nephrotic syndrome, 119, 129 in children, 7 Neurofibromatosis, 29, 37 Neurogenic tumors, 113, 118 Neutralizing antiviral antibody, 13, 22 Neutropenia, 60 Neutrophil polymorphonuclear leukocyte (PMN), 51, 60 Neutrophils, 10, 12, 19, 21 Nitric oxide, 68, 78 Nondysjunction events, 32, Nonsteroidal anti-inflammatory drugs, ulcers and, 144, 154 Nonthyroidal illness, 179, 189 O Obstructive airway defect, 110, 115 Obstructive nephropathy, 125, 135 Obstructive sleep apnea (OSA), 113, 118 Opsonization, 11, 20 Optic neuropathy, 221, 233 Oral glucose tolerance test (OGTT), 182, 191 Osmolar gap, 122, 132 Osteogenesis imperfecta, 29, 38 Osteomyelitis, 63, 74 Ovarian compartments, 205, 214
266 250 Index Ovarian estrogen production, 201, 211 Overnight dexamethasone suppression test, 186, 194 P Pancreatitis acute, , 152 chronic, 142, 146, 152, 155 Paraneoplastic syndrome, 45 47, Parasites, 11, 20 Parkinson s disease, 220, Penetrance, reduced, 27, 36 Peptic ulcer, 5 bleeding from, 139, 151 Peptidoglycans, bacteria and, 64, 75 Peripheral nerves, damage to, 223, 234 Peritoneal dialysis, 123, 133 Pernicious anemia, 3, 50, 59, 145, 155 Peutz-Jeghers syndrome, 46, 56 Peyer s patches, M cells along, 14, 23 Phenotype, 27, 36 Phenylketonuria, 32 33, Phenytoin, 207, 216 Pituitary macroadenoma, , 187, , 195 Pituitary TSH-induced hyperthyroidism, 185, 194 Pituitary tumor, 185, Placenta, immunoglobulin crossing of, 10, 19 Plasminogen activator, 205, 214 Platelet production, 48, 57 Pleural effusion, 109, 114 Pneumococcal polysaccharide vaccine, 71, 80 Pneumonia acute eosinophilic, 112, 117 alcoholics and, 66, 77 Chlamydia psittaci, 67, 77 community acquired, 65, 76, 110, 114 Klebsiella pneumoniae, 66, 77 Moraxella catarrhalis, 67, 77 Mycoplasma pneumoniae, 66, 71, 76, 80 Pneumocystis carinii (PCP), 7, 66, 68, 76, 79 Streptococcus pneumoniae, 65, 76 Poison ivy, 16, 24 Poliovirus vaccine, 71, 81 Polycystic kidney disease, autosomal dominant, 124, Polycystic ovary syndrome, 200, 210 Polycythemia vera (see Primary polycythemia) Polymerase chain reaction, 34, 43 Polymyalgia rheumatica, 218, 230 Polyneuropathy, 224, 235 Posterior mediastinum, tumors in, 113, 118 Postmenopausal bleeding, 204, 214 Postsplenectomy, 49, 59 Potassium loss, renal failure and, 121, 130 Prazosin, 203, 212 Preeclampsia, 6, 200, 210
267 Index 251 Pregnancy, 193 anemia in, 202, cardiovascular changes in, 83, 96 diabetes mellitus and, 199, 203, 210, 213 ectopic, 198, 209 milk production during, 200, 210 progesterone and, 200, 210 spontaneous abortion of, 199, 209 test for, 184 Preload (see Left ventricular enddiastolic pressure) Premutation allele, 30, 39 Prerenal azotemia, 122, 131 Pretibial myxedema, 177, 188 Primary biliary cirrhosis (PBC), 149, 157, 160, , 176 Primary polycythemia, 49, 58 Primary pulmonary hypertension, 109, 114 Progesterone, in pregnancy, 200, 210 Prolactin, 201, 211 male infertility and, 204, 213 Prolactinoma, 184 Propylthiouracil, 179, 189 Psammoma bodies, 181, 190 Pseudoclaudication, 218, 230 Psoriasis, 4 Pulmonary congestion, 119, 129 Pulmonary disease chronic, 67, 77 chronic obstructive (COPD), , , 126, 135 Pulmonary embolism, 4, , Pulmonary function tests, 4t Pulse waveforms, arterial/arteriole, 89, 102 P waves, 93, Q Q fever, 70, 80 QRS complex, 91, 103, 107 QT interval, 83, Q wave, 93, 93f, 107 R Radiculopathy, 225, 235 Rapid plasma reagin (RPR), 221, 232 Recessive gene, mutant, 27, 36 Red cells (see Erythrocytes) Relaxin, 202, 212 Renal failure, 122, 132 acute, 120, 130 chronic (CRF), , 123, , 133 diuretics and, 123, 132 hematologic disorders in, 120, 130 retardation of, 121 Renal insufficiency, methicillininduced, 122, 132 Renin, 202, 212 Right ventricular hypertrophy, 94, 107 S Salmonella typhi, 67, 78 Sarcoidosis, 111, 116 Scotomas, 221, 233 Seizures, 219, 231 absence, 228, 236
268 252 Index Selective proteinuria, 126, 135 Semilunar valves, 90 Sensorineural deafness, 225, 235 Septic shock, mediator of, 68, 78 Serum, normal adult human, immunoglobulin in, 9, 19 Serum-ascites albumin gradient, 165, 173 Serum ferritin, 187, 195 Serum sickness, 15, 24 17,20 Desmolase (17,20 lyase), 197, 208 Sick euthyroidism, 179 Sickle cell anemia, 34 35, Silicosis, 110, Sjögren s syndrome, 123, 132 Southern blot, 34, Spinal cord compression, 47, 56 Spinal stenosis, lumbar, 218, 230 Spinobulbar muscular atrophy, 31, 39 Spinocerebellar ataxia 31, 39 Spontaneous bacterial peritonitis (SBP), 166, 174 Staphylococcus aureus, 63, 74 Staphylococcus pyogenes, 63, 74 Steatorrhea, 146, 155 Streptococcus, group B, in neonates, 10, 20 Streptococcus pneumoniae, 65, 76 Stroke, ischemic, 229, 237 Stroke volume, 4 5 Struma ovarii, 178, 188 Subarachnoid hemorrhage (SAH), 223, Superantigen, 13, 22 Superior vena cava syndrome, 47, 56 Surface glycoproteins, 13, 22 Syphilis, 221, 232 Systemic vascular resistance, 83, 96 Systole, 83, 96 T T cells CD8 positive, 13, 22 interleukin 2 and, 17, 25 Temporal arteritis, 218, 221, 230, 232 Testosterone deficiency, 198, 209 Tetracycline, 166, 174 Thalassemia, 48, Theca, 205, 214 Thrombic microangiopathy, 122, 132 Thrombocytopenia, 50, 52 53, 59, 61 Thrombocytosis, 49, 59 Thrombopoiesis (see Platelet production) Thrombotic thrombocytopenic purpura (TTP), 53 Thyroid cancer of, , 190 estrogen and, 197, 208 estrogen therapy and, 180, 189 Thyroidal peroxidase, 179, 189 Thyroiditis, subacute, 181, 190 Thyroid-stimulating hormone (TSH), 179, 199, 209 values of, 189
269 Index 253 Thyrotoxicosis, , , 188, Tinnitus, 226, 235 Toxic shock syndrome (TSS), 13, 22 Toxoplasmosis, 69, 79 Transferrin, 49, 58 Transforming growth factor-α, 205, 214 Transsphenoidal surgery, 182, 191 Tremor, 220, Tricuspid valve prolapse, 91 Trimethoprim, 127, 136 Tuberculin reaction, 16, 24 Tuberculosis, 110, 115 Mycobacterium tuberculosis, 66, 76, 113, 118 Tubular necrosis, 122, 131 acute, 120, 129 Tubulointerstitial nephritis, 123, 132 T wave, 91, 104 Tyrosinase, 33, 41 T 3 /T 4 conversion, 179, 189 U Ulcerative colitis, 5, 146, 156 Ulcers esophageal, 140, 151 gastric, 139, 144, 146, 151, malignancy in, 144, 154 nonsteroidal anti-inflammatory drugs and, 144, 154 Urinary tract infection, 64, 75 V Vaccine hepatitis, 149, 158 pneumococcal polysaccharide, 71, 80 poliovirus, 71, 81 (See also specific type) Variable expressivity, 27, 36 Varicoceles, Vasculitis, 128, 137 Vas deferens, congenital absence of, 200, 210 Ventricles, repolarization of, 86, 100 Ventricular action potential, 104f Ventricular function curves, 4 5 Vertigo, 227, 236 Viruses, diarrhea and, 67, Vitamin B 12 deficiency, 52, 61 Von Willebrand factor (vwf), 48, 57 Von Willebrand s syndrome, 53, 61 W Wegener s granulomatosis, 121, 131 Wenckebach heart block, 105 Wilson s disease, 162, 171 Wormian bones, 29, 38 X X inactivation, 35, 44 Z Zollinger-Ellison syndrome, 5, 146, 155
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271 1 كد: ٠٠٧ مركز خدمات فرهنگي سالكان اراي هكننده كتاب و نرمافزارهاي تخصصي پزشكان همگام با توسعه علمي و فرهنگي جهان معاصر و استفاده روزافزون كامپيوتر در بين جوامع بشري خصوص ا رشتههاي مختلف علوم و استفاده بهينه از ا خرين يافتههاي پزشكي دنيا و اراي ه اين يافتهها در قالب نرمافزارهاي پزشكي ebook) VHS DVD VCD و...) ما را بر ا ن داشت كه با گردا وري و اراي ة اين يافتهها گامي كوچك در راه ارتقاء سطح علمي متخصصين كليه رشتههاي پزشكي كشور به صورت سمعي و بصري برداريم. اميد است مشوق ما در اين راه باشيد. لذا علاقمندان ميتوانند براي دريافت هر يك از محصولات اراي هشده به ازاء هر CD مبلغ ٥٠٠٠ تومان به حساب جاري ١٣٢٤٣٦ بانك رفاه كارگران شعبه ميدان انقلاب كد شعبه ١١٢ به نام مركز خدمات فرهنگي سالكان واريز و پس از فاكس فيش فوق به همراه نشاني دقيق نسبت به خريد اقلام و دريافت كالاي مورد نظر خود اقدام نمايند. خواهشمند است از واريز وجه به هر گونه حساب ديگري اكيدا خودداري فرماي يد. لازم به ذكر است در صورت نياز به هرگونه اطلاعات تكميلي ميتوانيد به نشاني مركز مراجعه و يا با تلفن ٦٦٩٣٦٦٩٦ تماس حاصل نماييد. لازم به ذكر است فقط به سفارشاتي كه وجه مورد سفارش به حساب فوق ذكر واريز شده ترتيب اثر داده خواهد شد لذا ١- راديولوژي عنوان CD 3D Conformal Radiation Therapy A multimedia introduction to methods and techniques (Springer) Abdominal and pelvic Ultrasound with CT and MR correlation (R. Brooke Jeffrey, Jr., M.D.) اين يك نرمافزار ا موزشي قوي بمنظور Self teaching و Self evaluation تشخيصهاي سونوگرافي شكم و لگن ميباشد كه در كنار تصاوير سونوگرافيك مربوط به هر بيماري از تصاوير همزمان CT Scan و MRI براي فهم و درك بهتر مطالب استفاده شده است. در اين CD مباحث مختلف به صورت Case مطرح گرديده و ضمن بيان شرح حال بيمار تصاوير سونوگرافي (و در صورت لزوم MRI و (CT Scan به نمايش گذاشته شده و با Click ا راية Text مطالب تي وري مربوط به هر Case با بياني ساده و در عين حال كامل در اختيار كاربر قرار ميگيرد. سال انتشار تعداد Caseهاي موجود در اين CD بر حسب موضوع به قرار جدول ذيل ميباشد: موضوع تعداد Case موضوع تعداد Case موضوع تعداد Case موضوع تعداد Case موضوع تعداد Case موضوع تعداد Case كبد ٦٧ كيسة صفرا ومجاري صفراوي ٤٠ طحال ١٢ پانكراس ٣٧ كليه و غده ا درنال ٣٥ سيستم گوارشي ٧٨ حاملگي ١٠ لگن ٤٦ رتروپريتوي ن ٧ 3.1 ACR - Chest (Learning file) (American college of Radiology) اين CD شامل عناوين زير ميباشد: chest Trauma 2- Cardiac Disease 3- Vascular Disease 4- Airway Disease 5- Mediastinal Masses 6- Pleural Disease 7- Chest Wall and Diaphragm 8-Pediatric Chest 9- Normal Disease 10- Neoplasma and Tumors 11- Pulmonary Infection 12- Immunocompromised Host 13- Diffuse Disease مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
272 ACR - Gastrointestinal (Learning file) (American college of Radiology) (Igor Laufer, M.D., James M. Messmer, M.D.) ACR - Genitourinary (Learning file) (American college of Radiology) اين CD شامل فصول متعددي در خصوص اوروراديولوژي ميباشد و در هرفصل تعدادي Case مطرح گرديدهاند. هر Case داراي تاريخچه باليني تصاوير راديوگرافيك (عكسهاي ساده مطالعات با مواد حاجب CT Scan سونوگرافي و...) بوده و درصورت نياز فرد ميتواند از يافتههاي Imaging با Click نمودن برروي ا يكون Finding مطلع گردد. درنهايت با استفاده از ا رايههاي مربوطه ميتوان از تشخيصهاي افتراقي تشخيص نهايي و همچنين توضيحات علمي اضافه مرتبط با تشخيص با اطلاع شد. تعداد Case هاي مطرح شده بر حسب هر فصل به قرار زير ميباشد: تعداد موضوع Case تعداد موضوع Case تعداد موضوع Case تعداد موضوع Case تعداد موضوع Case 2 تعداد موضوع Case تعداد موضوع Case تعداد موضوع Case تعداد موضوع Case تعداد موضوع بيماريهاي كليه بالغين ١١٨ بيماريهاي كليه اطفال ٢٦ بيماريهاي حالب ١٧ بيماريهاي ژنيكولوژيك ACR - Head & Neck (Learning file) (American college of Radiology) ١٥ غدد ا درنال ACR - Neuroradiology (Learning file) (American college of Radiology) ١١ سيستم ادراري تحتاني اطفال ١٠ رتروپريتوي ن ١٨ ACR - Nuclear medicine (Learning file) (American college of Radiology) (Paul Shreve, M.D. and James Corbett, M.D.) ACR - Pediatric (Learning file) (American college of Radiology) (Beverly P. Wood, M.D., David C. Kushner, M.D.) CD فوق يك Teaching File مرتبط با راديولوژي اطفال بوده و داراي مباحث زير ميباشد: بيماريهاي مثانه ١٧ بيماريهاي پروستات ١٠ دستگاه تناسلي خارجي مذكر عنوان تعداد Case عنوان تعداد Case عنوان تعداد Case عنوان تعداد Case عنوان تعداد Case Chest ٢٠٢ قلب ٧٨ گوارش ١٦٣ كبد طحال پانكراس ٧١ Genitourimary ١٠٩ سر و گردن ٣١ نوروراديولوژي ٩٠ Skeletal ٩٧ ACR - Skeletal (B.J Manaster, M.D., Ph.D.) (Learning file) 1. Tumolrs 2. Arthritis 3. Trauma 4. Metabolic Congeaital ACR - Ultrasound (Learning file) (American college of Radiology) Anatomy and MRI of the JOINTS (A Multiplanar Atlas) (William D. Middleton, Thomas L. Lawson) (Department of Radiology Medical College of Wisconsin Milwaukee, Wisconsin) The Tmporomandibular The Shoulder The Wrist The Finger The Vertebral Column The Hip The Knee The Ankle Brainiac! TM Medical Multimedia Systems Presents (Version 1.52) (An interactive digital atlas designed to assist in learning human neuroanatomy) (Serial # ) Breast Implant Imaging (SALEKAN E-BOOK) (MICHAEL S. MIDDLETON, PH,D., M.D, MICHAEL P.MCNAMARA JR., M.D.) اين كتاب كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده است شامل عناوين زير ميباشد: A History and Overview of Breast Augmentation and Implant Imaging Clinical Presentation Methods of Imaging Basic Principles of Breast Implant Imaging Principles of Imaging Breast Implant Rupture and Soft-Tissue Silicone Artifacts of MR and Ultrasound Imaging of Breast Implants and Soft-Tissue Silicone Classification of Breast Implants Practical Consideration in the Evaluaion of Implant Integrity Evaluation of Soft-Tissue Silicone from Ruptured Implants Evaluation of Silicone Fluid Injecitons Breast Cancer Imaging Surgical and Other Considerations 14.1 Carotid Duplex Ultrasonography Extracranial and Intracranial (Michael Jaff DO, Serge Kownator MD, Alain Voorons Audlovlsuel) در اين CD كليات انجام سونوگرافي داپلر شريانهاي كاروتيد ساب كلاوين ورتبرال حلقة ويليس تنه براكيوسفاليك و قوس ا ي ورت مورد بحث و بررسي قرار گرفته است و از تصاوير ثابت و متحرك گويا (به زبان انگليسي) جهت نمايش تكنيكهاي سونوگرافيهاي فوق و همچنين چگونگي تفسير نتايج حاصل از سونوگرافي داپلر شريانهاي فوق و همچنين چگونگي تفسير نتايج حاصل از سونوگرافي داپلر شريانهاي فوقالذكر استفاده شده است. ري وس مطالب مورد بحث در اين نرمافزار بدين قرار است: شريانهاي كاروتيد اكستراكرانيال قوس ا ي ورت و تنة براكيو سفاليك چگونگي اسكنكردن عروق فوقالذكر و نحوة Setting دستگاه شريانهاي ورتبرال ا شنايي با دستگاه سونوگرافي داپلر شريانهاي ساب كلاوين شريانهاي اينتراكرانيال سوبرال و حلقة ويليس سونوگرافي داپلر پس از Revaseularization ضايعات مجاور Case ضمن ا اين CD جهت ارزيابي فرد از خود داراي Pre-Test و Post-Test ميباشد. ١٦ مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
273 CASE REVIEW Obstetric and Gynecologic Ultrasound WITH CROSS-REFERENCES TO THE REQUISITES SERIES (Pamela T. Johnson, Alfred B. Kurtz) اين CD محتوي Case ١٢٧ سونوگرافي زنان و زايمان (بصورت پرسش و پاسخ) ميباشد كه به همراه توضيحات و تصاوير مربوطه بوده و در فهم تشخيصهاي سونوگرافيك Gynecology و Obstetric بسيار مفيد خواهد بود. CD Roentgen (Michael McDermott, M.D., Thorsten Krebs, M.D.) (Williams & Wilkins) Cerebral and Spinal Computerized Tomography Cerebral MR Perfusion Imaging CD-ROM to complement the book (A. Gregory Sorensen, Peter Reimer) (Thieme) اين CD در زمينة تصويربرداري پرفوزيون مغزي بوسيلة MRI به شرح تكنيكهاي مربوطه و همچنين كاربردهاي باليني ا نها پرداخته و با استفاده از تصاوير ثابت و متحرت به شرح مفاهيم مرتبط با اين روش تشخيصي ميپردازد. CD حاضر يكي از بهترين برنامهها (چه كتاب و چه (CD در مورد چگونگي تفسير CXR ميباشد. اين CD شامل تشخيص افتراقي وجود دارد و براي فهم مطلب فيلمهاي ٣ بعدي animatory نشان داده شده است. در بخش اول: Library يا كتابخانه : الف) بيماريها به ترتيب حروف الفبا ا ورده شده و سپس CXR و متن مربوط به ا ن بيماري و تفسير راديولوژي ا ورده شده است. ب: ابتدا يك عكس ريه نشان داده شده است و سپس تشخيص افتراقي ا ن شرح داده شده است ج: : Sings, clue علاي م راديولوژيك تعريف و در CXR نشان داده شده مانند: Sign) (,westermark Sing, د: : Anatomy World ا ناتومي قفسه سينه با مقاطع طولي و عرضي و هوريزنتال به صورت 3D نشان داده شده است. ه: ديكشنري: تعاريف علاي م و نشانههاي نمايش داده شده است. و: :CME Quiz عكس راديوگرافي و شرح حال بيمار نشان داده شد. سپس كاربر بايد يافتههاي راديولوژي را مشخص نمايد. CHEST X-RAY INTERPRETATION ٣ بخش ١- Library ٢- seminar ٣- Clinic ميباشد. در هر بخش عكس سالم ريه همراه با توضيحات و بخش دوم يا :Seminar به ٥ بخش: ١- tissue ٢- Soft استخوانها ٣- پلوروديافراگم ٤- ريه و ٥- مديشان تقسيم شده. در هر قسمت ابتدا عكسي از ريه نشان داده شده و شخص بايد محل ضايعه و تشخيص بيماري را مشخص سازد. در مورد قسمت ريه خود به ٤ بخش Search و Localize و describe و تشخيص افتراقي تقسيم شده است. : Search عكس ريه نشان داده شده و كاربر بايد محل ضايعه را نشان دهد ) با استفاده از موس) :Localize ابتدا علامت يا نشانه بيماري در CXR شرح داده ميشود و كاربر بايد محل ا نرا نشان دهد. :Describe ابتدا CXR نشان داده شده و كاربر بايد از بين ٢ گزينه يكي را انتخاب نمايد مث لا تودهاي در CXR نشان داده ميشود كاربر بايد بتواند تعيين كند خوش خيم است يا بد خيم. CXR :Differential diagnosis نشان داده ميشود وسپس بيماريها patternهاي بيماري به صورت تست چند جوابي ا ورد شده است. بخش سوم :Clinic اين بخش را براي كمك به تقسيم قدم به قدم و يا نوشتن يك تفسير راديولوژي است. بيمار به همراه شرح حال معاينه فيزيكي و CXR و در صورت لزوم CT/MRI برونكوسكويي و بيوپسي و نوكي ارداسكن اراي ه شده است. كاربر بايد بر اساس فوريت تعيين شده ابتدا Softtissue استخوان پلوروديافراگم ريه مديستان ناف ريه عكس را مطالعه نمايد براي كمك به تفسير خود برنامه با تعيين خصوصيات منطقه به كاربر در تفسير كمك ميكند براي مثال: در مورد... Softtissue بافت نرم جدار قفسه سينه افزايش كاهش نرمال و كليسفيكاسيون و ابنرمال air و... ميباشد Comprehensive Reviw of Radiography (Mosby) اين CD بمنظور خودا زمايي evaluation) (Self افراد مرتبط با حرفة راديولوژي تشخيصي در زمينههاي زير اراي ه گرديده است: تهيه و ارزيابي گرافيهاي راديولوژي كاركرد و نگهداري از دستگاههاي راديولوژي حفاظت از اشعه نگهداري و مديريت برخورد با بيماران روشهاي راديوگرافيك پس از نصب CD فوق در شروع شخص بايستي يكي از مباحث پنجگانه فوق را جهت خودا زمايي انتخاب نمايد و به دنبال ا ن سو الات هر مبحث بصورت چندگزينهاي مورد ا زمون قرار خواهند گرفت و به دنبال هر پاسخ توضيحات علمي مربوط جهت ارتقاء علمي فرد به وي اراي ه خواهد گرديد. مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
274 Computed Body Tomography with MRI Correlation (Joseph K. T. Lee, Stuart S. Sagel, Robert J. Stanley, Jay P. Heiken) (3rd Edition) (LIPPINCOTT WILLIAMS & WILKINS) CT Teaching Manual (Matthias Hofer) (Thieme) (Salekan E-Book) Diagnostic Imaging Expert (A CD-ROM Reference & Review) (Ralph Weissleder, Jack Witterberg, Mark J. Rieumont, Genevieve Bennett) اين يك نرمافزار ا موزشي از مطالب مختلف راديولوژي و تصويربرداري محسوب ميشود و در زمينههاي مختلف به بحث در مورد بيماريها و روشهاي راديولوژي و Imaging مربوط به ا نها ميپردازد. اين CD داراي ا رايههاي ذيل ميباشد: 14- Vascular 13- Head and Neck 11- Neurologic 9- Musculoskeletal 7- Genitourinary 5- Gastrointestinal 3- Cardiac 1- Chest 12- Imaging Physics 10- Contrast agent 8- Nuclear Imaging 6- Pediatric 4- Obstetric 2- Breast DIAGNOSTIC ULTRASOUND A LOGICAL APPROACH (JOHN P. McGAHAN, BARRY B. GOLDBERG) اين كتاب الكترونيكي ٣ قسمت است: ١- كتاب Diagnostic Ultrasound علاوه بر اين كتاب دو جزء منحصر به فرد ديگر شامل دو فيلم سونوگرافي و داپلر هر بخش به صورت زنده با كيفيت بالا نشان داده شده است. ٢- Selp-assessment به صورت CMP و تستهاي چندگزينهاي ميباشد. كتاب الكترونيكي حاضر شامل ٤١ فصل ميباشد كه شامل: ١- فيزيك ٢- bioeffects ا رتفكت ٣ و ٤- روشهاي تهاجمي با سونوگرافي در (بيوپسي ا سپيراسيون و درناژ) و در بيماريهاي زنان و زايمان ٥- روشهاي اولتراسونوگرافي حين عمل جراحي ١٨-٦: سونوگرافي تريمستر اول حاملگي پلاسنتا و Cervix و بند ناف و پرده ا منيوتيك سر و صورت و گردن و قفسه سينه شكم و لگن و ضربان قلب و اندازههاي جنين و حاملگي دوقلوي ي و Small-for-date, large-for-data و... در بخشهاي ديگر هر سيستم بدن از لحاض ا ناتومي نرمال تشخيصهاي افتراقي در سونوگرافي تقسيمبندي يافتهها به نرمال و غيرنرمال در سونوگرافي تشخيص يافته و رسيدن به يك تشخيص باليني در سونوگرافي ١٩- دستگاه گوارش (حفره پريتوان) ٢٠- ارزيابي سونوگرافي اعضاء پيوند زده شده (كبد كليه- پانكراس) ٢١- كبد ٢٢- كيسه صفرا و مجاري صفراوي ٢٣- رتروپرتيوان و پانكراس طحال لمف نود ٢٤- دستگاه ادراري ٢٥- پروستات ٢٦- Penis ٢٧- اسكروتوم و testes Pediactric Head -٣٧ Softtissue و Skeletal تيروي يد پاراتيروي يد و غدد ديگر -٣٦ سيستم -٣٥ Chest -٣٤ Brest -٣٣ trans cranial سيستم عروق محيطي -٣١ كاروتيد -٣٢-٣٠ Post meno Pausal Pelvis -٢٩ Female Pelvis -٢٨-٣٨ agent -٣٩ Ultrasoud Contrast ultrasound -٤٠ Three dimensional Ablation -٤١ ultrasound-guided Percutaneous tissue اولتراسونداندوسكوپيك لازم به ذكر است كه در هنگام نصب اين CD بايستي از كد عبور RUSR 2335 استفاده شود. Diagnostic Ultrasound of Fetal Anomalies: Principles and Techniques (CD I,II) اين نرمافزار ا موزشي داراي ٢ عدد CD ميباشد. در CD شماره ١ با بهرهگيري از تصاوير ثابت و متحرك سونوگرافي جنين كه داراي كيفيت فوقالعاده عالي ميباشند ا نوماليهاي مختلف مادرزادي بصورت تيپيك به نمايش درا مده و در مورد هر يك توضيحات كافي داده شده است. در CD شماره ٢ امكان خودا زمايي شخص به صورت Caseهاي مختلف و به طريقة Multiple Choice question فراهم گرديده و در مورد هر Case توضيحات لازم داده شدهاند. مباحث و تعداد Case هاي مطرحشده در اين ٢ عدد CD به شرح ذيل ميباشند: تعداد Case مبحث تعداد Case مبحث تعداد Case مبحث تعداد Case مبحث تعداد Case مبحث Head جنين ٣٦ Neural tube ١٩ Amniotic Fluid ٢ جنسيت ٤ سيستم اسكتال جنين ١٦ Body wall ٢٠ Umblical Cord ٣ موارد متفرقه ٢ دستگاه ادراري جنين ١٢ قلب جنين ١٤ صورت جنين ٦ Chest جنين ١٢ سيستم گوارشي جنين ٤ Digital Human Anatomy and Endoscopic Ultrasonography (MANOOP S. BHUTANI, MD, JOHN C. DEUTSCH, MD) (Salekan E-Book) EBUS (Endo Bronchial Ultrasound) Endoscopy and Gastrointestinal Radiology (Gregory G. Ginsberg, Michael L. Kochman) Upper endoscopy Colonoscopy Endoscopiy Contrast Radiology Clinical Application of Magnetic Resonance Imaging in the Abdomen Percutaneous Management of Biliary Obstruction Endoscopic Retrograte Cholagiopancreatography Computed Tomography and Ultrasound of the Abdomen and Gastrointestinal Tract Endoscopic Ultrasound Essentials of Radiology در CD فوق ضروريات راديولوژي تشخيصي بصورت Case مطرح گرديدهاند و از تصاوير راديوگرافيك تيپيك همراه با توضيحات كافي و توصيف دقيق نماهاي راديولوژيك استفاده شده است. تعداد Caseهاي مطرحشده در اين CD بر حسب موضوع به قرار زير ميباشد: تعداد Case موضوع تعداد Case موضوع تعداد Case موضوع تعداد Case موضوع مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
275 پنوموني ٣٠ انسداد و پرفوراسيون ٨ TB ١٥ مراقبت بحراني ٢٠ كانسر ريه ١٢ ناحيه RUQ شكم ١٢ ناحيه RLQ شكم ٧ كولون و ناحيه LLQ شكم ١٦ مري ٦ معده ٦ روة باريك ٧ مطالعات فلوروسكوپيك شكم ١ پنوموكونيوز ٩ AIDS ١٢ قلب ٧ سيستم ادراري تناسلي ١٣ اطفال ١٨ تروما ١٧ ژنيكولوژي ٥ سيستم اسكلتال ٢٨ obstetrics ١٦ بيماريهاي Breast ١٨ نوروراديولوژي ستون فقرات ٣ نوروراديولوژي مغز ١٢ پزشكي هستهاي ١٣ Exam Preparation for Diagnostic Ultrasound Abdomen and OB/GYN (RogerC. Sanders, Jann D. Dolk, Nancy Smith Miner) Fundamentals of Body CT (Second Edition) (W. Richard Webb, M.D., William E. Brant, M.D., Clyde A. Helms, M.D.) (Salekan E-Book) Image Data Bank RADIOGRAPHIC ANATOMY & POSITIONING (APPLETON & LANGE) Imaging Atlas of Human Anatomy (version 2.0) (Mosby) با كمك اين نرمافزار قادر خواهيد بود كه در مدت بسيار كوتاهي با ا ناتومي بدن در تصاوير مختلف راديولوژي (فيلمهاي ساده تصاوير با كنتراست راديوگرافيك MRI CT Scan و سونوگرافي) ا شنا شويد. روش يادگيري ا ناتنومي راديولوژيك با استفاده از اين CD بسيار ا سان بوده و امكانات مختلفي از قبيل بزرگنمايي تصوير negative كردن تصوير خودا زمايي و... جهت ايجاد علاقمندان بيشتر در امر يادگيري در نظر گرفته شده است. ضمن ا با استفاده از ا راية note ميتوان به اطلاعات علمي اضافي مرتبط با تصوير مورد مطالعه دستيابي پيدا نمود. Imaging of Diffuse Lung Disease (David A. Lynch, MB, John D. Newell Jr, MD, FCCP, Jin Seong Lee, MD) CD حاضر شامل ١١ فصل از بيماريهاي منتشر ريه (DLN) ميباشد. كه به گفته مو لفين شامل تلفيقي از معاينه شرح حال پاتوفيزيولوژي و تفسير عكسبرداري MRI,CT-Xray) و...) در اطفال و بالغين در مورد بيماريهاي منتشر ريه ميباشد. اين كتاب در برنامه Acrobat Reader بوده و به گفته مو لفين نگاهي جديد به متخصصين و رزيدنتهاي داخلي ريه قلب و راديولوژي ميدهد. بعضي فصول كتاب شامل : تصويربرداري DLD كودكان تصوير برداري عروق ريوي پيوند ريه بيماريهاي شغلي و محيطي وDLD ارزيابي پاتولوژي بيمارهاي ريه تصويربرداري بيماريهاي انفيلتراتيو ريه تصويربرداري ا مفيزم تصويربرداري راههاي هواي ي تشخيص افتراقي راديولوژي DLD و مقايسه X-Ray,CT ا نها به طور مجزا ميباشد Imaging of Spinal Trauma in Children (Lawrence R. Kuhns, M.D.) (University of Michigan Medical Center) Principles AND TECHNIQUES ATLAS OF SPINAL INJURIES IN CHILDREN Epidemiology Normal Spine Variants and Anatomy Special Views and Techniques Cervcal Spine Lumbar Spine Measurements Mechanisms and Patterns of Injury Experimental and Necropsy Data Thoracic Spine Sacrococcygeal Spine Occipitocervical Injuries Thoracic Spine Injuries Sacral Injuries Lumbar MAGNETIC RESONANCE IMAGING (Third Edition) (Dauld Stark, William Bradley) 1. Generation and Manipulation of Magnetic Resonance Images 2. Magnetic Resonance: Bioeffects and Safety 3. Three-Dimensional Magnetic Resonance Rendering Technique 4. Principles of Echo Planar Imaging: Implications for Musculoskeletal System 5. MR Imaging of Articular Cartilage and of Cartilage Degneration 6. The Hip 7. The Knee 8. The Ankle and Foot 9. The Shoulder 10. The Elbow 11. The Wrist and hand 12. The Temporomandibular Joint 13. Kinematic Magnetic Resonance Imaging 14. The Spine 15. Marrow Imaging 16. Bone and Soft-Tissue Tumors 17. Magnetic Resonance Imaging of Muscle Injuries سه جلد كتاب David Stark در اين CD موجود ميباشد. Magnetic Resonance Imaging computed Tomography of the Head and Spine (C. Barrie Grossman) Magnetic Resonance Imaging in Orthopedics and Sport Medicine (David W. Stoller) اين نرمافزار در ارتباط با كاربرد MRI در ارتوپدي و طب ورزش ميباشد و شامل مباحث زير است: ١- تهية تصاوير MRI ٦- اثرات بيولوژيك و ايمني در MRI ١١- تكنيك بازسازي جهت MRI سهبعدي ١٦- تومورهاي استخوان و بافت نرم ٢- اصول تصويرسازي Echo-Planar جهت سيستم موسكولواسكلتال ٧- MRI عضروف مفصلي و دژنراسيون عضروفي ١٢- مفصل ران (Hip) ١٧- MRI ا سيبهاي عضلاني مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
276 در اين CD مطالبي در رابطه با ماموگرافي با عناوين ذيل مطرح شده است: - ا ناتومي نرمال پستان - تغييرات زمان و ا رتفكتها - روشهاي انجام ماموگرافي (به صورت لوكاليزه با Needle و يا سونوگرافي) 6 ٣- زانو ٨- مچ پا و پا ١٣- شانه ٤- ا رنج ٩- مچ دست و دست ١٤- مفصل كمپورومانديبولار (TMJ) Kinematic MRI -٥ ١٠- ستون فقرات ١٥- تصويربرداري MRI از مغز استخوان - تغييرات فيبروكيستيك و تودههايي با حدود مشخص و خوشخيم - بررسي بيماريهاي پيشرفته و متاستاز و همچنين در مورد راديوتراپي Mammography Diagnosis and Intervention (Ralphl. Smathers, M.D.) - تودههايي با حدود نامشخص و تومورهاي بدخيم و Aggressive MR Angiography Thoracic Vessels (O. Ratib & D. Didier) Methods & Techniques Aortic Aneurysms Aortic Arch Anomalies Aortic Arch Anomalies Aortic Coarcation Aortitis Pulmonary astesies diseases Aequised venous diseases Congenital venous anomalies Miscellaneous MR Imagin Expert (Geir Torhim, Peter A. Rinck) 4th Edition This version is a special adaptation for "Magnetic Resonance in Medicine The Basic Textbook of the European Magnetic Redonance Forum" MRI der Extremitaten MRI of the BRAIN & SPINE (SCOT W. ATLAS) (LIPPINCOTT-ROVEN) اين CD يك نرمافزار ا موزشي چندمنظوره به حساب ميا يد زيرا در ا ن علاوه بر توضيحات لازم و در عين حال مختصر در مورد فيزيك و اصول MRI و همچنين تكنيكهاي مربوطه در مورد هر مبحث باليني نيز در طي ٣٢ فصل به بحث و بررسي يافتههاي Imaging پرداخته شده و بيش از ٤٠٠٠ تصوير MRI با كيفيت بالا برحسب مورد به نمايش درا مده است. ضمن ا براي فهم بهتر مطالب در ارتباط با هر موضوع باليني و يا تصويربرداري از جداول مفيد استفاده شده است. در قسمت ا ناتومي نيز نوروا ناتومي به صورت Sectional و با استفاده از سه روش (تصاوير شماتيك + تصاوير طبيعي+ تصاوير (MRI ا موزش داده شده است. نكتة بسيار جالب در اين نرمافزار خودا زمايي مطالب مطالعه شده بوسيله Case هاي متعدد است كه برحسب موضوع تعداد Case هاي مطرح شده به قرار زير ميباشد: تعداد Case هاي مطرح شده موضوع تعداد Case هاي مطرح شده موضوع اختلالات تكاملي مغز ٧ خونريزي اينتراكرينال ٥ تومورهاي اينتراا گزيال مغز ٦ تومورهاي اكستراا گزيال مغز ٦ مالفورماسيونهاي عروقي و ا نوريسمهاي اينتراكراينال ٦ ايسكمي و ا نفاركتوس مغزي ٦ تروماي سر ٥ بيماريهاي مادة سفيد ٦ عفونتهاي اينتراكراينال ٥ تظاهرات سيستم اعصاب مركزي در ارتباط با فاكوماتورها ٦ Aging مغز و بيماريهاي نورودژنرايتو ٤ سلاتورسيكا و ناحيه پاراسلار ٥ قاعدة جمجمه ٥ ا ناتومي و بيماريهاي استخوان كمپورال ٣ اوربيت و سيستم بينايي ٦ بيماريهاي اژنرايتو ستون فقرات ٥ تروماي ستون فقرات ٣ بيماريهاي عفوني و التهابي ستون فقرات ٤ ا ناماليهاي مادرزادي ستون فقرات و نخاع ٣ بيماريهاي ني وپلاستيك ستون فقرات و نخاع ٥ اختلالات عروق نخاعي ٢ Normal Findings in CT and MRI (Torsten B Moeller, Emil Reif) (Thieme) Obstetric Ultrasound Principles and Techniques در اين CD مطالب جامع و ارزندهاي در رابطه با مهارتهاي لازمه در سونوگرافي ماماي ي اراي ه ميشود كه عناوين ا ن به شرح زير ميباشد: - بررسي ا ناتومي جنين و ا نوماليهاي CNS و Body - تعيين سن حاملگي بر اساس معيارهاي FL. BPD و AC و HC و جداول ا نها - ا ناتومي رحم و ا دنكسها و امبريو و كيسه زرده در تريمستر اول - تعيين سن بارداري در تريمستر اول بر اساس Gs و CRL و نحوة اندازهگيري ا نها - تعيين سن بارداري در تريمستر دوم و سوم بر اساس FL و AC و نحوه اندازهگيري ا نها - تعيين سن بارداري در تريمستر دوم و سوم بر اساس دور سر و نحوه اندازهگيري ا ن - تعيين محل جفت و حجم مايع ا منيوتيك - مطالب جالبي در رابطه با ا ناتومي جنين در تريمستر دوم و سوم (معده- كليه...) - انفاركتوس و وارياسيون محل خروج بند ناف Insertion) (Cord - تعيين محل لانهگزيني جفت و بررسي ركولمان و پلانتاپرويا - بررسي لكينيكال و سونوگرافي Case Study و مطرحكردن سو الات در رابطه با ا نها و پاسخ مربوطه - توضيحاتي در رابطه با BPP (بيوفيزيكال پروفايل) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
277 45.1 PEDIATRIC GASTROINTESTINAL IMAGING AND INTERVENTION (Second Edition) (DAVID A. STRINGER, PAUL S. BABYN, MDCM) Peripheral Musculoskeletal Ultrasound Interactive Atlas A CD-ROM (J. E. Cabay, B. Daenen) (R. F. Dondelinger) ا موزش سونوگرافي MusculoSkeletal محسوب نمود چرا كه با كمك تصاوير ثابت و متحرك متعدد و تيپيك شما را به خوبي با تكنيكهاي لازم جهت سونوگرافي نسوج نرم سطحي و تصاوير نرمال و پاتولوژيهاي اين سيستم ا شنا ميسازد و ضمن ا امكان خودا زمايي (Quiz) در اين نرمافزار فراهم است. در منوي اين CD شما براي بررسي تصاوير سونوگرافيك نرمال و يا پاتولوژيك در سيستم موسكولو اسكلتال از دو شيوة مختلف ميتوانيد بهرهمند شويد: الف- با استفاده از منوي :General كه در اين صورت شما يكي از itemهاي زير را ميتوانيد انتخاب نماي يد: ١٠- پوست ٩- عصب ٨- عروق ٧- غضروف فيبرو ٦- غضروف هيالين ٥- كپسول مفصلي و بورس ٤- استخوان و پريوست ٣- ليگامان ٢- تاندون ١- عضله ب- با استفاده از منوي :Region كه در اين صورت شما ميتوانيد يكي از itemهاي زير را انتخاب نماي يد: Wrist 7- Shoulder 6- Knee 5- Hip 4- Hand 3- Foot 2- Elbow 1- Ankle Principles of MRI Quality Management in the Imaging sciences (Jeery Papp) (Mosby) RADIOLOGIC ANATOMY Interactive Tutorial on Normal Radiology (UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE DEPARTMENT OF RADIOLOGY) براي استفاده از اين CD ابتدا بايد بر روي قسمت مورد نظر بر روي شكل انسان (در كادر سمت راست) Click شود (مث لا اگر ميخواهيم در مورد (Lower Extremity اطلاعات ا ناتوميك راديولوژي بدست ا وريم بر روي اندام تحتاني شكل مذكور Click ميكنيم) سپس در كادر سمت چپ ليست قسمتهاي كلي مربوط به ناحيه ا ناتوميك مورد مطالعه ظاهر ميشود و ما ميتوانيم با انتخاب هر كدام از اين قسمتهاي كلي وارد جزي يات بيشتر ا ن شويم. ضمن ا در قسمت پايين كادرهاي فوق سه عدد Icon كاربردي در قسمت وسط وجود دارد كه با كمك ا نها ميتوان بترتيب از تكنيك تصويربرداري مربوط به قسمت مورد نظر ا ناتومي طبيعي قسمت مذكور و همچنين مساي ل كلينيكي و پاتولوژيك عضو مورد مطالعه ا گاهي كامل يافت. ضمن ا امكان خودا زمايي evaluation) (Self بر اساس مباحث مورد نظر وجود دارد. نكتة قابل توجه در اين CD استفاده از كلية روشهاي Imaging (از قبيل Plain Film مطالعات با مواد حاجب راديوگرافيك MRI CTScan و...) براي نشاندادن تكنيكهاي مختلف مربوط به Imaging هر عضو استفاده شده است. طريقة نصب : hcd بعد از قراردادن CD در CD-ROM دستگاهتان صفحة Autoplay menu را ببنديد سپس به my computer رفته و روي درايو CD-ROM دستگاه خود راستكليك كنيد و گزينة Open را انخاب كنيد سپس روي Setup* دابل كليك كنيد صفحهاي با نام radiologic Anatomy installation ظاهر ميشود مسير نصب را وارد كرده و يا پيشفرض را با كليك بر روي OK انتخاب كنيد. بعد از نصب پيغامي مبني بر نصب كامل CD ميا يد كه ا ن را OK كنيد سپس از منوي Start به Program رفته و در radilogic Anatomy عنوان مربوطه را انتخاب كنيد. * iconهاي ديگري با عناوين Setup.) (ssetup.apm setup.cfg ssetup وجود دارد كه مربوط به اين برنامه نيست لطف ا فقط setup.exe را انتخاب كنيد Radiology Image Bank: Orthopedic Radiology (International Medical Multimedia) Radiology on CD-ROM Diagnosis, Imaging, Intervention (Juan M. Taveras, MD, Joseph T. Ferrucci, MD) اين CD مجموعه كاملي از كتاب راديولوژي Tavers (كه يكي از معتبرترين و كاملترين مراجع راديولوژي در جهان ميباشد) همراه با ا خرين تغييرات دادهشده تا سال 2001 ميلادي بوده و شامل مباحث عمدة زير ميباشد: ١ راديولوژي Pulmonary ٢- سياست بهداشتي و مديريت در راديولوژي -٣ راديولوژي Vascular -٤ راديولوژي Gastrointestinal -٥ راديولوژي Genitourinary ٦- فيزيك راديولوژي Breast Imaging -٧-٨ راديولوژي Cardiac ٩- نوروراديولوژي و راديولوژي سر و گردن ١٠- راديولوژي Adbomen -١١ راديولوژي Skeletal REVIEW FOR THE Radiography Examination (A & LERT) (McGrow-Hill's) Teaching Atlas of Mammography (Laszlo Tabar, Peter B. Dean) (Thieme) The Basics of MRI of NMR (Joseph P. Hornak, Ph.D.) 55.1 The Encyclopaedia of Medical Imaging from NICER 56.1 THE MRI TEACHING FILE (Robert B. Lufkin, William G. Bradley, Jr., Michael Brant-Zawadzki) CD فوق داراي Caseهاي متعدد مربوط به مباحث مختلف در زمينة MRI ميباشد و هر Case با توجه به شرح حال و يافتههاي راديوگرافيك داراي تشخيصهاي افتراقي و تشخيص نهايي بوده و در مورد هر تشخيص نكات مهم شرح داده شده است. تعداد Caseهاي مطرحشده بر حسب هر موضوع در اين CD بصورت جدول ذيل ميباشد: موضوع تعداد Case موضوع تعداد Case موضوع تعداد Case موضوع تعداد Case بيماريهاي غيرني وپلاستيك مغز ٢٠١ ني وپلاسمهاي مغزي ١٠٢ MRA مغز ١٠ سر و گردن ١٠٠ ستون فقرات ١٠٠ سيستم عضلاني اسكلتي ١٠٠ تنه ١٠٢ سيستم قلبيعروقي ١٠٤ اطفال ١٠٠ اصول و ا رتيفكتها ١٠٠ مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
278 THE RADIOLOGIC CLINICS OF NORTH AMERICA High-Resolution CT of the Lung II (DAVID A. LYNCH, MD) (NUMBER 1 VOLUME 40) اين CD برگردان شماره اول جلد چهلم از مجموعة كتابهاي The Radiologic clinics of North America ميباشد و داراي مباحث عمدة ذيل درخصوص HRCT ريه است: CT Scan - مربوط به بيماريهاي Air Way و برونشكتازي - HRCT مربوط به بيماريهاي Peripheral Airways - Scan CT مربوط به ا مفيزم - نقش HRCT در ارزيابي بيماريهاي ريوي اطفال - نقش HRCT در ارزيابي بيماريهاي شغلي و محيطي ريه HRCT - مربوط به بيماريهاي ريوي Drug-Induced - Scan CT مربوط به عفونتهاي مايكوباكتريايي TB و Non-TB - Scan CT مربوط به بيماريهاي ترومبوا مبوليك ريوي - CT كميتي (quantitative) ريه - ندول منفرد ريوي THE RADIOLOGIC CLINICS OF NORTH AMERICA Imaging of Musculoskeletal and Spinal Infections PRINCIPLES AND TECHNIQUES 1. Epidemiology 3. Normal Spine Variants and Anatomy 5. Measurements 7. Sacral Injuries 9- Mechanisms and Patterns of Injury 2. Thoracic Spine Injuries 4. Experimental and Necropsy Data 6. Special Views and Techniwques 8. Occipitocervical Injuries ATLAS OF SPINE INJURIES IN CHILDREN 1. Cervcal Spine 2. Thoracic Spine 3. Lumbar Spine 4. Sacrococcygeal Spine THE RADIOLOGIC CLINICS OF NORTH AMERICA Pediatric Musuloskeletal Pediatric Radiology (SALEKAN E-BOOK) (James S. Meyer, MD) اين CD كه در مركز خدمات فرهنگي سالكان تبديل به كتتاب الكترونيكي گرديده است شامل اين مباحث ميباشد: Ultrasound in Padiatric Musculoskeletal Disease: Teachinques and Applications Nuclear Medicnine Topics in Pediatric Musculoskeletal Disease: Teachinques and Applications Imaging of Musculoskeletal Infections Malignant and Benign Bone Tumors Magnetic Rsonance Imaging of Musculoskeletal Soft Tissue Mass Imaging of Pediatric Hip Disorder Imaging of Pediatric Foot Disorder in Children Imaging of Sports Injuries in Children and Adolescents A Pragmatic Approach to the Radiologic Diagnosis of Pediatric Syndromes and Skeletal Dysplasias The Orthopedists Perspective: Bone Tumors, Scoliosis, and Trauma Imaging of Crowth Distubance in Children Imaging of Child Abuse THE RADIOLOGIC CLINICS OF NORTH AMERICA Update on Nuclear Medicine THE RADIOLOGIC CLINICS OF NORTH AMERICA Update on Ultrasonography (FAYE C. LAING, MD) (W.B. SAUNDERS COMPABY) اين CD برگردان شماره سوم جلد ٣٩ از مجموعه كتابهاي The Radiologic Clinics Of North America ميباشد و داراي مباحث عمدة ذيل در خصوص سونوگرافي است: ١- تكنولوژي روز ٢- مواد حاجب اولتراسوند ٣- اقدامات مداخلهاي (intervention) تحت راهنمايي سونوگرافي ٤- سونوگرافي در حين عمل جراحي ٥- وضعيت فعلي تشخيصي و درماني سونوگرافي اندوسكوپيك ٦- سونوگرافي موسكولواسكلتال ٧- سونوگرافي Breast ٨- سونوگرافي سهبعدي در Obstetric و Gynecology -٩ سونوگرافي Gynecologic ١٠- ارزيابي سونوگرافيك اتساع بطنهاي داخل مغزي به دنبال خونريزي ١١- سونوگرافي شريانهاي محيطي ١٢- سونوگرافي كاروتيد 62.1 Ultrasound Atlas of Vascular Diseases (Carol A. Krebs, RT, RDMS, Vishan L. Giyanani,, Ronald L. Eisenberg) (APPLETON & LANGE Stamford, Connecticut) (SALEKAN E-Book) 63.1 Ultrasound Teaching Manual The basics of Performing and Interpreting Ultrasound Scans (Matthias Hofer) (With the collaboration of Tatjana Reihs) (Thieme) 64.1 Uterosalpingography in Gynecology Hysterospingography (Salekan E-Book) 65.1 VOXEL-MAN 3D-Navigator Brain and Skull (Regional, Functional, and Radiological Anatomy) (IMDM university Hospital Eppendorf, Humburg) (Springer) اين نرمافزار در قالب يك اطلس سهبعدي Interactive از اندامهاي داخلي تنه در سه عدد CD جهت تشخيصهاي راديولوژيكي طراحي شيوة عمل جراحي و ا موزش دروس ا ناتومي و راديولوژي طراحي شده است. فصول مختلف اين CD به شرح ذيل است: ١-١: تشريح سهبعدي اندامهاي داخل تنه: در اين قسمت ا ناتومي سهبعدي قفسه سينه با قابليت چرخش Ventricol و چرخش horizontal و ا ناتومي شكم با قابليت چرخش افقي و عمودي اراي ه شده است. در اين بخش قابليت حذف و اضافهنمودن هر بخش اول) ا ناتومي: ١-٣ : (اسكلت استخواني سيستم قلبي عروقي سيستم عصبي كبد و اندامهاي جانبي شبيهسازي گاستروسكوپي با قابليت حركت در فضاي مري و معده) ١-٢ : تشريح دستگاهها كه در ٩ بخش اراي ه شده است يك از بخشهاي تصاوير و چرخش ١٨٠ o ا نها وجود دارد. ا ناتومي مقاطع عرضي: شامل ٢ قسمت ا ناتومي مقاطع عرضي سطوح Coronal و Sagittal ميباشد. - توموگرافي بخش دوم) راديولوژي: ١-٢- مقاطع عرضي ا ناتوميكي (با قابليت حركتدادن سطح مقطع و مشاهده تصوير هر قسمت) ١-١- مقاطع عرضي CT ١-٤- شبيهسازي قسمت اولتراسونيك كبد ١-٣- مقايسه بين تصاوير CT با تصاوير سهبعدي و مقاطع عرضي ا ناتوميكي ٢-٤- تصاوير X-ray از كلية اندامها ٢-٣- تصاوير X-ray از اندامهاي منفرد ٢-٢- تصاوير X-ray از شكم ٢-١- تصاوير X-ray از قفسة سينه - تصاوير X-ray ماركدارنمودن هر بخش از تصاوير و مقاطع تشريحي قدرت افزايش Zoom تصاوير اراي ه تصاوير بازسازيشده كام لا واقعي كه كاربرد نامگذاري بخشهاي مختلف تصاي ير بصورت Intractive اراي ه فهرست كامل مندرجات تصاوير به سه زبان انگليسي ا لماني و لاتين ا موزشي جذابي را به همراه دارد. تذكر: جهت استفاد ة بهينه از اين CD به ميزان وضوح نمايشگر * ٧٦٨ ١٠٢٤ پيكسل و حافظة ١٠٠MB نياز است. مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
279 VOXEL-MAN 3D-Navigator Inner Organs (Regional, Systemic and Radiological Anatomy) (IMDM university Hospital Eppendorf, Hamburg) Whole Body Computed Tomography (Second Edition) (Otto H. Wegener) (Blackwell Science) در اين CD در طي ٢٨ فصل به شرح ا ناتومي تكنيك و فيزيك مربوط به CT Scan همراه با بررسي جزء به جزء مساي ل پاتولوژيك نواحي مختلف بدن با استفاده از تصاوير گوياي CT Scan پرداخته شده است. كليه ارگانهاي تناسلي زن تومورهاي استخواني مواد حاجب تحليل تصوير در CT Scan ا ناتومي در CT Scan تكنيكهاي CT Scan غدد فوق كليوي حفرة رتروپريتوي ن ستون فقرات ريهها قلب مدياستن روش و استراتژي ارزيابي بيمار جنب (پلور ( مثانه عضلات لگن استخواني سيستم صفراوي كبد ديوارة قفسه سينه پروستات و سمينال وزيكولها تومورهاي نسج نرم ترمينولوژي CT طحال حفرة پريتوي ن دستگاه گوارش پانكراس فهرست كلي فصول به قرار زير ميباشد: عنوان CD A Case Approach to Open Structure Rhinoplasty (Calevln, Johnson) Advanced Rhinoplasty Techniques Cosmetic Rhinoplasty (Rollin K. Daniel, M.D.) ٢- گوش حلق و بيني سال انتشار Analysis, Marking & Anesthesia, Closed/Open Approach, Septum Exposure, Exposure & Dorsal Reduction, Caudal Septum Resection, Ideal Profile Line, Open Approach, Tip Analysis, Septoplasty & Septal Harvest, Grafts, Spreaser Grafts, Grural Strut, Tip Suture Technique, Closure, Nostril Sill Alar Wedge, Composite Graft, Lateral Osteotomy, Final Steps, Acknowledgments Advanced Therapy of OTITIS MEDIA Aesthetic Facial Plastic Surgery A Multidisciplinary Approach( Romo & Millman) Aesthetic Rhinoplasty (second Edition) (Jacizh-SHEEN, Anitra SHEEN) (Volume 1, 2) An Atlas of Head & Neck Surgery (John M. Lore, Jr., M.D, Jesus E. Medina) (CD I, II) Aphasia & Related Neurogenic Language Disorders (Third Edition) (Leonard L. LaPointe, Ph.D.) Atlas D'ORL Realise avec la collaboration des (Dr Michel Boucherat, Dr Jean-Robert Blondeau) -Anatomie de l oreille normale - Images pathologiques - Cas cliniques -Anatomie naso-sinusienne normale -Images pathologiques - Cas cliniques - Rappels des principes de la TDM et de l IRM Atlas of Head & Neck Surgery Otolaryngology (TEXTBOOK) (Byron J. Bailey, Karen H. Calhoun, Amy R. Coffey, J. Gail Neely) 1- Atlas : - Head & Neck Surgery : در اين قسمت ٢٥ روش جراحي انتخابي اراي ه شده است. اين قسمت داراي ٢٥ فصل در چهار بخش اصلي است: شامل ٦ عنوان اصلي است كه در هر قسمت اطلاعات اساسي راجع به انديكاسيون تمهيدات قبل از عمل جراحي وسايل و روشهاي بيهوشي و... اراي ه شده است. ٦ عنوان اصلي شامل موارد زير است: Salivary Gland Nose & maxilla Oral Clarity Ear Neck & Larynx Thyroid & Parathyroid - Otologic procedures : Middle Ear and Ossicular Chain Tran temporal Skull Base Congenital Aural Base - Plastic & Reconstructive Surgery : Larygoplasty, Rhytidectomy, Rhinoplasty Mandibular Surgery, Local & Regional Flaps, Excision of skin Lesions - Pediatric and General Otolaryngology : Frontal Sinus Nasal Polypectomy Ton Sillectomy در اين قسمت بر اساس موضوع كلمات و واژهاي تخصصي نام نويسنده شمارة مجله ميتوانيد مباحث مورد نظرتان را جستجو و مطالعه نماي يد.: Medline -2 Bilbo Med 3- Head & Neck Surgery: - Textbook - Drug Reference مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
280 10 - Textbook : اين بخش بصورت يك كتاب الكترونيكي نوشتة دكتر Bailey همراه با تصاوير رنگي متعدد گويا و نمودارهاي ا موزشي است كه شامل ١٨٠ فصل ميباشد. ٤ بخش اصلي اين كتاب به اين شرح است: -1 Basic Science / General Medicine (شامل مباحث گوناگون و تخصصي راجع به ا ناتومي و فيزيولوژي گوش سر گردن ( : Neck -2 Head & Otology 4- Facial Plastic Reconstructive Surgery داروهاي اصلي و ژنوتيك به شكل الفبايي ا ورده شده است و اطلاعات كامل ) انديكاسيون ردة دارويي اسامي شيميايي و تجارتي مقدار مصرف اثرات جانبي فارماكوكسيك دارو و...) : Reference - Drug Atlas of Rhinoplasty Open and Endonasal Approaches (Gilbert Aiach, M.D) 11.2 AUDIOLOGY The Fundamentals (Third Edition) (Fred H. Bess, Larry E. Humes) 12.2 Causes of FAILURE in STAPES SURGERY (VCD I) (Howard P. House, TED N. Steffen) PITFALLS in STAPES SURGERY (VCD II) STAPEDECTOMY (Prefabricated Wire-Loop and Gelfoam Technique) (VCD III) 13.2 Chirurgia Endoscopica Dei Seni Paranasali (A Cura di E. Pasquini G. Farneti) Principi di anatomia endoscopica 2. Tecnica chirurgica 3. Aspetti radiologici Clinical Otoscopy An Introduction To Ear Diseases (Michael Hawke, Malcolm Keene, Peter w. Alberti) Cobblation Assisted Tonsillectomy (CAT) Cobblation Assisted Procedures (VCD) (CD I, II) شمارة ١ نحوة انجام اعمال جراحي روي تونسيلها با كمك دستگاه Coblation به شما نشان داده ميشود. اين VCD شامل موارد ا موزشي زير ميباشد: در 1- Subtotal Cololation Assisted tonsillectomy 2- Lop off "CAT" technique 3- Coblation Assisted tonsilectomg CD در CD شمارة ٢ شما با دستگاه Coblation كه تحولي عظيم در حيطه اعمال جراحي ENT ايجاد كرده است ا شنا ميشويد. نحوة عملكرد دستگاه بر اساس امواج راديوفركوي نسي با واسطه پلاسما مايع ميباشد و مزاياي فراواني بر دستگاههاي ليزر و راديوفركوي نسي قديمي دارد. عدم نياز به بيهوشي عمومي و امكان انجام اعمال جراحي به صورت سرپايي دوران recovery كوتاه تحمل بالاي بيماران وجود درد بسيار مختصر يا حتي عدم وجود درد پس از اعمال جراحي ظرافت و تميزي اعمال هموستاز عالي حصول سريع نتايج سرعت بالاي انجام عمل و راحتي فوقالعاده جراح برخي از مزاياي استفاده از اين دستگاه ميباشد. از اين دستگاه در حيطة ENT در موارد زير استفاده ميشود: 1- Coblation channeling of the inferior turbinate با استفاده از اين دستگاه و تحت بيحسي لوكال انسداد بيني ناشي از هيپرتروفي توربينه تحتاني به كمك Channeling توربينه درمان ميشود. نتيجه عمل به صورت ريداكشن سريع توربينه بلافاصله قابل مشاهده است: اين عمل تقريب ا بيدرد خواهد بود. در اين عمل با Channeling كام نرم از حجم ا ن كاسته شده و باعث رفع خرخر در بيماران ميشود. اين عمل سرپايي و تحت بيحسي لوكان و تقريب ا فاقد درد است. با اين روش هيپرتروني تونسيلر برطرف شده و از bulk تونسيل كاسته ميشود. بسته به شرايط اين عمل ميتواند سرپايي يا تحت بيهوشي عمومي باشد. نتيجة عمل نيز به سرعت حادث ميشود. نتيجه به سرعت حادث شده و عمل تقريب ا فاقد درد است. در صورت وجود تونسيلهاي بزرگ يا تونسيليت فرض از اين روش جهت انجام تونسيلكتومي استفاده ميشود. درد پس از عمل معمو لا بسيار مختصر است. و دوران بهبودي سريع ميباشد Coblation channeling of the Soft palate 3- Coblation channeling of the tonsil 4- Coblation Assisted Tonsillectomy(CAT) Color Atlas of Diagnostic Endoscopy in Otorhinolaryngolgy (EIJI YANAGISAWA, MD) Color Atlas of Ear Disease (Salekan E-book) (Richard A. Chole, MD, PhL, James W. Forsen) Color Atlas of Otoscopy From Diagnosis to Surgery (Mario Snna) Cosmetic Blepharolasty & Facial Rejuvenation (Stephen L. Bosniak, M.D.,) Cosmetic Surgery of the Asian Face (John A. McCurdy, Samuel M. Lan) (CD 1-6) Cumming's Otolaryngology Head & Neck Surgery (Fourth Edition) (E-Book & Image Colleciton) (Volume 1-4) Current Diagnosis & Treatment in OTOLARYNGOLOGY HEAD & NECK SURGERY (Anil K. Lalwani, MD) Current Topics in Otolaryngology -Head & Neck Surgery Lasers in Otorhinolaryngology (Kari-Bernd Huettenbrink) (Second Edition) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
281 DALLAS RHINOPLASTY Nasal Surgery by the Masters (Reducing Tip Projection and Nostrill Show Via the Open Approach) (CD I, II) VCD: 1 1) Cadaveric Rhinoplasty Dissection Technique 2) Role of Component Dorsal Reduction: Spreader Grafts in the Deviated Nose Gunter به 1) Exposure/Nasal incisions A. Closed endonasal approach - Intracartilaginous (IC) incision B. Cartilage delivery technique - Infracartilaginous incision - Intercartilaginous incision C. Open Rhinoplasty approach - Transcolumellar incision 11 VCD: 2 Reducing Tip Projection and Nostril Show Via the Open Approach در VCD شمارة ١ كه در سپوزيوم رينوپلاستي دالاس تهيه شده است به شما تكنيكهاي جراحي رينوپلاستي بر روي كارا ور از ابتدا و در غالب عناوين زير به ترتيب ا موزشي داده ميشود: 2) Tip Alteration A. Columellar Stat placement - Intercarural suture stabilization B. Controlling dome angalation and tip defining points - Interdomal sutures - Transdomal Satares C. Correction of alar pinching/notching - lateral crural strut grafts - Alar contour grafts D. Tip grafts - Infratip graft - Onlay tip graft 3) Sptal reconstraction A. Septal reconstraction - Inferior tarbinate resection (Submacosal) - Septal reconstruction B. Modification of the dorsum - Component dorsum reduction - Spreader graft placement 4) Osteotmies A. Medial Osteotomy B. Lateral Osteotomy C. External Osteotomy 5) Adjuctive techniques/closure A. Alare base resection - Correction of alalr flaring - Diminishing nostril shape B. Closare C. Splints در VCD شمارة ٢ خانم جواني با شكل nostril show, Projected tip زياد توسط ا قاي دكتر Gunter تحت عمل جراحي رينوپلاستي با اپروچ Open قرار ميگيرد. ا موزش در اين VCD از مصاحبه با بيمار ا غاز شده و سپس دكتر ا ناليز نازوناشيال وي ميپردازد. سپس عمل جراحي با ظرافت عالي در غالب مراحل زير انجام ميشود. 4) Transaction of lat Crura 3) Underminig tip Skin 2) Infracartilaginous and trans columellar incisions 1)Complete transfixion incision 8) Reduction of dorsal septum (DS) and upper lateral cartilage (ULC) 7) reduction of bony darsum (BD) 6) Preparing submucosal tunnels 5) Resection of feet of medial crura 12) Cephalic resection of lateral Crura (LC) 11) Spreader grafts 10) Medial asteomius 9) Harvesting Septal cartilages for grafting 16) Final adjustment of dorsal height 15) Lateral asteotomy Cinternal 14) Aligning the dorsum 13) Preparation for lateral crural grafts (LCSG) 19) Closure 18) Placement of lateral crural strut grafts 17) Columellar strt placemend در نهايت شما نتايج بعد از عمل بيمار در فواصل مختلف مشاهده ميكنيد. در اين VCD توجه شما را به استفاده از وسيله ريداكشن دور سوم استخواني نيز جلب ميكنيم!! Dallas Rhinoplasty (Nasal Surgery by the Masters) (Salekan E-Book) (Volume 1, 2) Diseases of the Sinuses Diagnosis and Management (Darid W. Kennedy, MD, FRCSI, William E. Bolger, MD, FACS, S. James Zinreich, MD) در اين text book CD تشخيص و درمان بيماريهاي سينوس به تاليف ا قاي دكتر ديويدكندي محصول سال 2001 گنجانده شده است. اين كتاب تقريب ا معتبرترين رفرانس سينونازولوژي در دنيا ميباشد. EENT Welch Allyn Institute of Interactive Learning ENDONASAL SINUSECTOMY WITH CORRECTION OF THE NASAL CAVITY (Rikio Ashikawe, Takashi Ohmae, Toshio Ohnisshi, Yutaka Uchida) The Endonasal sinusectomy with correction of the nasal cavity (Takahash's methodn) is carried out in seven steps. Endoscopic Assisted Procedures used in Astatic Facial Plastic Surgery (VCD) (CD I, II) در اين VCD اول شما در ابتدا شركت كارل اشتورتز پيشرو در اراي ه تجهيزات اندوسكوپي و محصولات ا ن ا شنا ميشويد. سپس به شما تكنيك جراحي اندوسكوپيك مالاروفرونتال كه توسط دكتر هنري دلمار اراي ه ميشود ا موزش داده ميشود. ا موزشي به صورت قدم به قدم از نشانهگذاري روي پرت و تزريق و برشها شروع شده و تا پايان عمل (closure) ادامه مييابد. در مرحلة بعد دكتر Grlecory.S Keller تكنيك جراحي Endoscopic forehead rhytidectomy and brow elevation را به نمايش ميگذارد. Extended Composite face Lift Endoscopic midface Lift در VCD دوم تحت عنوان Endoscopic assisted forehead and face lifting شما با اين موارد: Endoscopic forehead Lift انديكاسيونها و فوايد هر روش ا شنا ميشويد. در هر مورد براي شما يك بيمار مورد عمل جراحي توسط ا ن تكنيك قرار گرفته و نتايج بعد از عمل جراحي هم به شما معرفي ميشود. (٢ ماه بعد) هم به شما نشان داده ميشود. در پايان نحوة ثبت سهبعدي تغييرات ابزارا لات لازم در عمل Endoscopic Management of Cholesteatoma (Muaaz Tarabichi) (CD I, II) 2005 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
282 Endoscopic Sinus Surgery (SALEKAN-eBook) در اين CD كه به صورت طبقهبندي اراي ه ميشود شما با فيلد تشخيص و درمان ا ندوسكوپيك بيماريهاي سينوسي ا شنا ميشويد. ا شنايي شما شامل ابتداييترين مساي ل منجمله ابزارا لات بكار رفته در جراحيهاي ا ندوسكوپيك سينوس و حتي نحوة ايستادن يا نشستن هنگام عمل و گرفتن ابزار در دست هم ميشود. مباني ا ناتوميك و دايسكشن براي شما تشريح ميشود. مراحل مختلف جراحي ا ندوسكوپيك سينوسهاي پارانازال و بيماريهاي مرتبط با انها به صورت متن و گراف textbook) (Atlas and به شما نشان داده ميشود. فصول اين CD شامل مباحث زير است: 1- Consistent and Relible Anatomical Landmarks in Endoscopic Sinus Surgery 2- Surgical Instrumentation 3- Setup and patient positioning 4- Basic Dissection 5- Advanced Dissection Endoscopic Sinus Surgery Anatomy Three-Dimensional Reconstruction, & Surgical Technique (Peter-John Wormald) Endoscopic Sinus Surgery NEW HORIZONS (Nikhil J. Bhatt, M.D.) Essentials of Septorhinoplasty philosophy-approaches-techniques EVIDENCE-BASED OTITIS MEDIA (Richard M. Rosenfeld, MD, MPH, Charles D. Bluestone, MD) در اين CD شما با بيماريهاي اوتيت مديا به صورتي اصولي ا شنا ميشويد. ا شنايي از مساي ل اپيدميولوژيك و تحقيقات انجام شده ا غاز شده و در ادامه به موشكافي در مورد انواع اتيولوژي علاي م و مسير باليني تشخيص درمانهاي دارويي و جراحي ا ن ميپردازد. در انتها نتايج درمان بررسي ميشود. در ضمن اثرات اين بيماري روي تكامل كودك و كيفيت زندگي او نيز تشريح ميگردد. فصول اين CD شامل مباحث زير است: 1- Methodology 2- Clinical Management 3- Consequences and Sequelae Facial Nerve Surgery (Jack L. Pulec, M.D.) Otologic Medical Group, Inc. Los Angeies Facial Plastic & Reconstructive Surgery (Terence M. Davidson, MD) (VCD I, II) Functional & Selective Neck Dissection (Javier Gavihin, Jesus Herranz, Lawrence W. Desanto) Functional Reconstructive Nasal Surgery (egbert H. Huizing) Handbook of Clinical Audiology (Fifth Edition) (Jack Katz, Ph.D.) Head and Neck Surgery (Jatin P Shah, MD, MS (Surg), FACS) (Mosby) HEAD, FACE, AND NECK TRAUMA COMPREHENSIVE MANAGEMENT (Michael G. Stewart, M.D., M.P.H.) Hearing ITS Physiology & Pthophysiology (Aage R. Moller, ph.d) 44.2 Imaging of the Temporal Bone (Third Edition) (Joel D. Swartz, H. Ric Harnsberger) 45.2 Introduction to Ear Acupuncture (Martin Franke) در اين CD ا موزشي كه توسط مارتين فرانك تهيه و توسط انتشارات معتبر Thieme اراي ه شده است شما با اصول كلي طب سوزني گوش ا شنا ميشويد. ا موزش از ا ناتومي و نواحي مختلف موردنظر در طب سوزني گوش ا غاز شده و سپس با نحوة انجام طب سوزني در بيماريهاي مختلف همچون ميگرن بيماريهاي خواب سرگيجه اعتياد به سيگار و... ادامه مييابد سپس شما ميتوانيد نگاهي به نتايج اين اعمال هم داشته باشيد و ا نها را ارزيابي نماي يد Localization Assignment 2- Localization Determination 3- Treatment 4- Evaluation La Rhinoplastica Ragionata (Valerio Micheli-Pellegrini, Roberto Polselli) Local Flaps in Head and Neck Reconstruction (Lan T. Jackson, M,D.) (SALEKAN E-BOOK) Medical Speech-Lanaguage Pathology A Practitioner's Guide (Alex F. Johnson, Barbara H. Jacobson) Nasal Aesthetics and Anatomy: A Cadaver Study (Rollin K. Daniel, M.D.) Oculoplastic Surgery (William P. Chen) Office-Based Surgery in Otolaryngology (Andrew Blizer, Harold C. Pillsbury, Anthony F. Jahn) OPEN RHINOPLASTY Cadaver Dissection Program (Dean M. Toriumi, MD.) (Vol I, II) (College of Medicine at Chicago) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
283 Access to nasal Septum - Hemitrans Fixatu incision - Havvestiong Septal Cartilage 2- Havvestiog of Conchal Cartilage - Anterior approach for harvestiog Cartilage - Flap elevention - Cartilage excision - Closure and dressing 3- Open Rhinoplasty approach - Incisions - Flap Elevation 4- Stractural grafts used in Secondary - loteral Crural grafts - Alar Batten grafts Open Structure Rhinoplasty (A Case Oriented Approach) (CD I, II) Management of Middle Nasal Vault - Division of apper Lateral Cartilages from septum - Application of Spreader grafts 6- Major septal reconstruction - Reconstraction of L-Shaped Septal Strat 7- Management of Lower third of the nose - Cephalic trimming of lateral Crura - Satured in place Collamellar Strut - Transdomal Sutur - Sutured in place tip 8- Chin augmentation - Preparation of the implant - Incision and dissection - placement of Implant Open Tip Graft in Twin Patient (Rollin K. Daniel, M.D.) Analysis, Operative Planning, Twins Pre and Post, Anesthesia, Transfixion Incision, Septal Harvest, Open Approach, Exposure, Tip Anatomy, Tim Strips, Graft Preparation, Radix Graft, Crural Strut, Domal Excision, Graft, Shaping, Graft, Insertion, Closure, Post Op Result, Credits Ophthalmic & Facial Plastic Surgery (Frank A. Nasi., Geoffrey J. Gladstone, Brian G. Brazzo) Otorhinolaryngology Head and Neck Surgery (SIXTEENTH EDITION) (James B, Snow Jr, MD, John Jacob Ballenger, MD,) Otology and Neurotology Facial Plastic and Reconstructive Surgery Pediatric Otolaryngology Rhinology Bronchoesphagology Laryngology Head and Neck Surgery Plastic Surgery (Fifth Edition) (Grabb and Smith's) (Salekan E-Book) اين كتاب الكترونيكي مشتمل بر ٩٢ فصل در ٧ قسمت كتابي كامل و كاربردي در تمام مباحث جراحي پلاستيك ميباشد. اين كتاب به منظور علاقمندي به جراحي پلاستيك در تمام سطوح ا موزش و درمان پزشكي ميباشد و مورد استفاده دستياران و متخصصين جراحي پلاستيك ميباشد. به گفتة مو لفين اين كتاب همچنين براي امتحانات و ا موزش مداوم بورد جراحي پلاستيك ا مريكا سودمند است. بخش اول: General Reconstruction بوده و در مورد ترميم زخم تكنيكهاي اولية جراحي پلاستيك ا نشري implants تكنيكهاي استفاده از flap و graft و... ميباشد. بخش دوم: به جراحي پلاستيك در پوست ميپردازد كه شامل چگونگي جراحيهاي تومورهاي پوست خالهاي مادرزادي جراحي با Moths و استفاده از ليزر در پوست ميباشد. بخش سوم: به درمان ضايعات سر و گردن ميپردازد مانند (اصلاح دفريتميهاي سر و صورت اتوپلاسمي Reconstruction بيني گوش و گونه و لب و...) ميباشد. بخش چهارم: جراحيهاي زيبايي ميباشد شامل: peeling) dermabrasion, تزريق كلاژن بلفاروپلاستي ليپوساكشن (...endoscopic plastic surgery ميباشد. بخش پنجم: جراحيهاي زيبايي و ترميمي breast شرح داده شده كه شامل: ماموپلاستي كمپليكاسيون تصيحيحي ژينكوماستي و... پرداخته است. بخش ششم: اين قسمت به جراحي ترميمي دست اختصاص دارد. بخش هفتم: مربوط به ناحية اندام تحتانني و تنه ميباشد شامل: درمان زخم بستر Reconstruction ديوارة شكم و... بخش هشتم: بحث ناحية ژنيتاليا ميباشد شامل: درمان هيپوسپادياس و Reconstruction of peni و... مو لفين كتاب از برجسته ترين پيشگامان استفاده از ليزر در درمان ضايعات پوستي ميباشند Fitzpatrick و Goldman همراه با Alster سه تن از مطرحترين اشخاص در مباحث ليزري ميباشند. به گفتة مو لفين: ما سعي كرده ايم يكبار ديگر اكثر تحقيقات و دانش كاربرد ليزر در پوست را د اخل يك كتاب گردا وري كنيم. مباحث اين كتاب به طور تخصصي مورد استفادة درماتولوژيست ها و جراحاني كه در زمينة rejuvenation پوست صورت فعاليت دارند مورد استفاده است. Primary Rhinoplasty (Bahman Guyuron, MD, FACS, Cleveland, Ohio) (VCD) در اين VCD ا موزشي كه توسط يكي از بزرگترين جراحان صاحب نام دنيا از كشور عزيزمان ايران به نام ا قاي دكتر بهمن غيوران از دانشگاه Ohio تهيه شده است مراحل مختلف يك عمل رينوپلاستي اوليه با اپروج Open ا موزش داده ميشود. مورد عمل دختر جواني ميباشد كه Case فوقالعاده مشكلي در زمينه رينوپلاستي محسوب شده و ا قاي دكتر غيوران پس از ا ناليز كامل نازوفاشيال جراحي را با ظرافت هر چه تمامتر از ابتداي امر (تزريق و بيحسي توپيكال) تا انتها (پانسمان) اجرا ميكنند. ديدن اين VCD را اكيد ا به كليه متخصصين توصيه ميكنيم RHINOPLASTY GOLDMAN TECHNIQUE (ROBERT L. SIMONS, MD., NORTH MIAMI BEACH, FLORIDA) (VCD) (CD I, II) در اين VCD ا موزشي مراحل مختلف عمل رينوپلاستي توسط دكتر سيمون از دانشگاه ميامي تشريح ميشود. عمده هدف اين برنامه تصحيح tip بيمار plasty) (tip با كمك تكنيك گلدمن ميباشد. در نرمافزار فوق براي تشريح تكنيك يك Case كه خانم ٢٧ سالهاي ميباشد تحت عمل با بيهوشي Stand by انجام ميشود. بيني بيمار از نوع projected tip ميباشد. در ابتدا يك ا ناليز كامل استاتيك نازوفاشيال از بيمار به عمل ميا يد RHINOPLASTY A Practical Guide to functional and asthetic surgery of the nose (G. J. Nolst) اين برنامه ا موزشي كه توسط دكتر نولست اراي ه ميشود. راهنمايي عملي جهت جراحي فانكشنال و استاتيك بيني ميباشد. در اين فيلم اصول پايه زيباييشناسي و تكنيكهاي جراحي از مراحل پايه (از تكنيك تا اعمال جراحي) (تحت بيهوشي عمومي) ا موزش داده ميشود مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
284 14 در اين فيلم توجه شما را به نحوة انجام استي وتومي از راه پوست و نيز حفظ ساپورت tip جلب ميكنيم. در انتها از غضروف كونكاي گوش بيمار گرافت (شيلد يا استرات كلوملا) تهيه ميشود و براي قراردادن ا ن از اپروچ open كمك گرفته ميشود. در هر فصل ابتدا به صورت text توضيحاتي داده شده و سپس تصاوير رنگي و فيلم مربوط به جراحيهاي ا ن بخش نشان داده شده است. فصول اين CD شامل: - Knowledge : Basic شامل ا ناتومي زيباي يشناختي Pre-op و Post-op و كمپليكاسيونها و نحوة بيحسي به صورت فيلم پرداخته است. external rhinoplasty Open رينوپلاستي osseocartileginous جراحي Spreadergrafs modified zplasty-nasalvalve surgery گرافتها turbinate surgery به شيوههاي عمل سپتوپلاستي و : Operative techniques - Wedgeresection in alar base surgery پرداخته است. - selecta : Capita فصل ا خر به درمان بيماريهاي ساختماني پرداخته است مانند تصحيح شكاف لب و بيني استفاده از اين CD ا سان بوده و داراي Video gallery شامل: rhinosurgery augmentation rhinoplasty در كودكان Revision surgery تصحيح Pverprojected nasel tip. Saddle nose پرداخته است. نشان دادن تكنيكهاي رينوپلاستي كودكان و اپروچهاي مختلف براي رينوپلاستي (اكسترنال و... ( ميكرواستي وتومي و Conchal Cartilage harvesting ميباشد. Rhinoplasty The American Academy of Facial Plastic and Reconstructive Surgery (CD I, II) (E. Gaylon McCollough, M.D.) (the St. Louis Aging Face Symposium) در اين برنامة ا موزشي كه توسط دكتر M.D.).E) Gaglon McCollough در سمپوزيوم Aging Face اراي ه ميشود مراحل مختلف يك عمل رينوپلاستي بر روي بيمار ميانسال تحت بيهوشي Stand by به تفكيك بيان و اجرا ميشود. اپروچ Closed استفاده ميشود و بيشترين توجه روي tip plasty ميباشد. بر روي tip بيني اين بيمار افزايش rotation داده ميشود. از روش delivery جهت ترميمكردن قسمت سفاليك غضروفهاي LLC استفاده ميشود. در نهايت براي بيمار Alar base resection انجام شده و پانسمان مخصوص و جالب مولف بر روي صورت بيمار قرار داده ميشود. در اين عمل از 61.2 RHINOPLASTY DOUBLE DOME UNIT (CD I, II) (E. Gaylon McCollough MD, Birmingham, Albama) در اين برنامة ا موزشي كه توسط دكتر.E Gaglon MC Collouch از دانشگاه بيرمنگام اراي ه ميشود. به Double Dome Unit و نحوة management ا ن است. مراحل مختلف عمل رينوپلاستي بر روي خانمي انجام ميشود كه مشكل ا ن عمدت ا در ناحيه tip بوده و هدف عمده جمع كردن ا ن است. اين برنامه نگرشي Rhinoplasty The Overly Projected Nasal Tip (Trent W. Smith, M.D.F.A.C.S.) در اين برنامة ا موزشي مترولوژي و نتايج كلينيكي رينوپلاستي در بينيهاي با tip برجسته مورد بررسي قرار گرفته و مراحل مختلف عمل بر روي يك بيمار انجام ميشود. با توجه به بلندبودن طول مويال كروراها به عنوان علت برچسته بودن tip بيني تلاش در جهت كوتاه بودن طول ا نها در جهت اصلاح اين برجستگي انجام ميشود. اين برنامه توسط ا قاي دكتر اسميت استاد و مدير گروه بخش گوش و حلق و بيني و جراحي پلاستيك دانشگاه اوهايو اراي ه شود. San Diego Classics in Soft Tissue & Cosmetic Surgery Rhinoplasty (Part 1-6) (Richard C. Webster, MD, Terence M. Davidson, Alan M. Nahum) Secondary Rhinoplasty & Nasal Reconstruction (Rod J. Rohrich, Jack H. SHEEN, Gary C. Burget, Dean E. Burget) Smile Train Virtual Surgery Videos (Unilateral Cleft Bilateral Cleft Cleft Palate) (Court B.Cutting, Donato LaRossa) (Vol I, II, III) SURGERY of the EAR (Fifth Edition) (Glasscock-Shambaugh) (Michael E. Glasscock III, MD, FACS, Aina Julianna Gulya, MD) در اين textbook. CD جراحي گوش شامپو گلاسكو اويشن پنجم (2003) به شما اراي ه ميشود. كتاب شامپو يكي از معتبرترين رفرانسهاي جراحي گوش در دنيا ميباشد. عناوين اين CD عبارتند از: 1- Scientific Foundations 3- Clinical Evaluation 5- Fundametals of Otologic/Neurotologic Surgery 7- Surgery of the External Ear 2- Surgery of the Tympanomastoid Compartment 4- Surgery of the Inner Ear 6- Surgery of the IAC/CPA/Petrous Apex 8- Surgery of the Skull Base Surgical Approaches in Otorhinolaryngology (W.F. Thumfort, W. Platzer) Teaching Atlas of Head & Neck Imaging (Rtbert Lufkin, Alexandra Borges) The Audiogram Workbook (Sharon T. Hepfner) (Thieme) The MACS Lift Short-Scar Rhytidectomy (Textbook) (Patrick L. Tonnard, Alexis M. Verpaele) (CD I, II) The MEDPOR Lower Eyelid Spacer (James Patrinely, M.D.F.A.C.S., and Charles N.S. Soparkar, M.D., Ph.D.) (VCD) در اين VCD ا موزشي كه توسط دكتر پاترينلي و دكتر سوپاركار اراي ه ميشود شما با پروتزهاي مدپور پلك تحتاني ا شنا ميشويد. اين ا شنايي در غالب موارد زير اراي ه ميشود. 3) Medpore biomaterial 2) Addressing and management potential Complications - managing winging are edge flare - managing ridging - managing under correction - managing overcorrection 1) Introduction and Surgical technique - Cartilage grafts - Non-rigid spacer grafts (hard Patale/Sclera,dermis) - Medpore Lower Lid Advantages مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
285 managing implant exposure - managing entropion - managing entropion - Implant exchange The MEDPOR Nasal Shell Implant (Paul O'Keefe, M.B, B.S., (SYD), F.R.C.S., F.R.A.C.S.) (VCD) THE VIDEO ATLAS OF COSMETIC BLEPHAROPLASTY (8 CDs) (S.LBosniak) مجموعة VCD ٨ فوق يك دورة كامل ا موزش جراحي پلك ميباشد كه توسط استاد برجسته S.LBosniak ا موزش داده ميشود و شامل تمامي مباحث از ا ناتومي پلك و روشهاي مختلف بيحسي تا جديدترين تكنيكهاي جراحي در اصلاح و ترميم كلية مساي ل و مشكلات پلكي منجمله ا نتروپيون اكتروپيون پتوز درماتوشالازيس و... ميباشد. استفاده از اين مجموعه را بايد به منزلة گذراندن يك دوره كارگاه ا موزشي بلفاروپلاستي دانست. VCD Journal of ENT APPROACH VESTIBULAR NEURECTOMY-TRANSTEMPORAL SUPRALABYRINTHINE APPROACH MICROSURGERY OF THE SKULL BASE TRANSOTIC APPROACH ACOUSTIC NEUROMA (Prof. U. Fisch Zurich) (VCD#2) VCD Journal of ENT INFRATEMPORAL FOSSA APPROACH TYPE C (Prof. U. Fisch Zurich) (VCD#4) VCD Journal of ENT INFRATFMPORAL FOSSA APPROACH GLOMUS TEMPORALE TUMOR (Prof. U. Fisch Zurich) (VCD#1) VCD Journal of ENT MICROSURGERY OF THE SKULL BASE TRANSOTIC APPROACH ACOUSTIC NEUROMA-INFRATEMPORAL FOSSA APRROACH TYPE C (Prof. U. Fisch Zurich) (VCD#3) VJGS Invited Presentation: Thyroidectomy (Jon A. van Heerden, ND) 15 ٣- زنان و ماماي ي عنوان CD Abdominal Colposacropexy and Vaginal Sacropinus Suspension (Harold P. Drutz MD FRCS (C) (VCD) Active Management of Labour (Kieran O'Driscoll, Declan Meagher) (SALEKAN E-BOOK) Adapted form Physical Examination and Health Assessment, 2/e (Carolyn Jarvis, RN, C, MSN, FNP) (W.B. Saunders Company) (VCD) Advanced Colposcopy: Understanding Vessel Patterns (Dorothy M. Babo, MD) (VCD) سال انتشار اين ويدي و CD از سري VJOG در مورد: تغيير كولپوسكوپي به دو فاكتور مهم نياز دارد: ١- نگرش دقيق ٢- دانش الگوهاي نرمال يا ابنرمال سرويكس. ابتدا در مورد فيزيك دستگاه و سپس عواملي كه در مشاهده ضايعات موثر است روش كاركردن صحيح با كولپوسكوپ نشان داده شده است. (مانند بازتاب نور توسط موكوس كراتين و...) و افتراق ا نها از يكديگر و پاتولوژي ضايعات همراه با عكسهاي رنگي و اسلايد نشان داده شده است در قسمت ا خر Advanced Therapy of BRAST DISEASE (S. Eva Singletry, MD, Geoffrey L. Robb, MD) American Cancer Society Atlas of Clinical Oncology (Cancer of the Female Lowe Genital Tract) (Patricia J. Eifel, M.D. Charles Levenback, M.D.) (SALEKAN E-BOOK) اين كتاب الكترونيكي به گفتة مو لفين به منظور فراهمكردن مرور و ا ناليز بيولوژي تشخيص ارزيابي و درمان كانسرها دستگاه تناسلي تحتاني زنان ميباشد. ا خرين تغييرات در درمانهاي پذيرفتهشده براي كانسر مهاجم Cervix و يك بازنگري كلي در همه مباحث ا ورده شده شده است. Chemotherapy in Curative Management Post-treatment Surveillance Palliative Care Surgery for Vulvar Cancer Radiation Therapy for Vulvar Cancer Acute Effects of Radiation Therapy Late Complications of Pelvic Radiation Therapy Surgical Treatment of Invasive Cervical Cancer Radiation Therapy for Invasive Cervical Cancer Radical Management of Recurrent Cervical Cancer Management of Vaginal Cancer Diagnostic Imaging Screening for Neoplasms Treatment of Squamous Intraepithelial Lesions Invasive Carcinoma of the Cervix Epidemiology Pathology Molecular Biology Anatomy and Natural History مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
286 An Atlas of Erectile Dysfunction (Second Edition) (Roger S. Kirby, MD, FRCS) (The Encyclopedia of Visual Medicine Series) Atlas of Clinical oncology Breast Cancer (American Cancer Society ) (David J Winchester, MD, David P Winchester, MD) عناوين اين CD شامل مباحث زير ميباشد: Genetics, Natural History, and DNA-Based Genetic Counseling in Hereditary Brast Cancer Breast Cancer Risk and Management: Chemoprevention, Surgery, and Surveillance Screening and Diagnostic Imaging Imaging-Directed Breast Biopsy Histophathology of Malignant Breast Disease Unusual Breast Pathology Prognostic and Predictive Markers in Breast Cancer Surgical Management of Ductal Carcinoma In Situ Evaluation and Surgical Management of Stage I and II Breast Cancer Locally Advanced Breast Cancer Breast Reconstruction ATLAS OF ENDOSCOPIC TECHNIQUES IN GYNECOLOGY (First Edition) (Jeffrey M. Goldberg, MD, Tommaso Falcone, MD) ( W.B. Saunders, Philadelphia) Instrumentation and Pelvic Anatomy Patient Preparation Tubal Surgery Ovarian Surgery Complications Surgery for Pelvic Support Surgery for Endometriosis and Pelvic Pain New Procedures Uterine Surgery Hysteroscopic Surgery 16 اين كتاب الكترونيكي شامل عناوين ذيل ميباشد: 10.3 Atlas of Gynecologic Surgery (3 rd edition) (H.A. Hirsch, M.D., O. Käser, M.D., F.A. Iklé, M.D.) (Thieme) (SALEKAN E-BOOK) 11.3 Atlas of Transvaginal Surgery (Second Edition) ( W.B. Saunders, Philadelphia) (VCD) - Prolene sling in the treatment of stress incontinence - Fibro-fatty labial flap (Martius Flat) for vaginal reconstruction - Transvaginal hysterectomy for severe prolapse - Transvaginal repair of enterocele and vault prolapse - Transvaginal repair of vesico-vaginal fistula using a peritoneal flap - Transvaginal repair of grade IV cystocele - Excision of urethral diverticula - Transvaginal repair of posterior vaginal wall prolapse Before We Are Born Essentials of Embryology & Birth Defects (Moore, Oersaud) (6 th Edition) COLPOSCOPY an Interactive CD-ROM (Thomas V. Sedlacek, MD, Charles J. Dunton, MD) Core Curriculum in Primary Care Patient Evaluation for Non-Cardiac Surgery and Gynecology and Urology (Michael K. Rees, MD, MPH) CCC مجموعهاي از CDهايي ميباشد كه براي ا موزش مداوم دستيارانگ و متخصصين هر رشته توسط اعضاء هيي ت علمي دانشگاه پزشكي Harvard بنا نهاده شده است. CD حاضر در مورد جراحي زنان و اوروژي را گردا وري كرده است. هر كدام از اين سخنرانيها علاوه بر اسلايدهاي ا موزشي متن سخنراني نيز در دسترس كاربر ميباشد. در ا خر هر سخنراني و مبحثي سو الات مربوطه به صورت چهارگزينهاي براي ارزيابي كاربر ا ورده شده است. سپس خلاصه هر سخنراني به صورت يك مقاله چاپي در مجلات علمي و روزنامهها ا ورده شده است. شامل مباحث زير ميباشد: -٣ عقيمي مردان Male impotence ١- چگونه يك بيمار را براي اعمال جراحي (بجز جراحي قلب) ارزيابي و ا ماده كنيم ٢- ارزيابي خونريزيهاي ابنرمال رحم.(AUB) Core Curriculum in Primary Care Gynecology (Michael, Isaac Schiff, Keith, Thomas, Annekathryn) 16.3 Danforth's Obstetrics and Gynecology (James R. Scott) (9 Edition) (SALEKAN E-BOOK) 17.3 Diagnosis of Benign Breast Disease (Dorothy M. Barbo, MD) (VCD) Submitted Subject The Limits of Laparoscopy: Diapharbmatic Endometriosis (David B. Redwine, MD) اين ويدي و CD از سري (Video Journal ob/gyn) VJOG ميباشد. ١. اين ويدي و CD ابتدا ا ناتومي و سپس طرز معاينه و افتراق ضايعات خوشخيم از بدخيم از طريق شرح حال باليني و ماموگرافي ا ورده شده است و سپس شكايات شايع بيماران بيان شده و سپس بصورت الگوريتم طرز برخورد و انجام ا زمايشات مربوطه در مورد nipple discharge Mastodynia و Cyst و يك توده Solid ا ورده شده است. ٢. در اين ويدي و CD در مورد محدوديتهاي لاپاراسكوپي بحث شده است. و در مورد تشخيص و درمان ٢ بيمار با اندومتريوز ناحيه ديافراگم بحث گرديده است Endoscopic Surgery for Gynecologists (Suttond & diamond) (second Edition) Handbook of disease of the breast (Second Edition) (Michael Dixon, Richarc Sainsbury) (Salekan E-book) Haines & Taylor OBSTETRICAL & GYNAECOLOGICAL PATHOLOGY (Fifth Edition) (Harold Fox-Michael Wells) (CD I, II) INTERACTIVE COLOR GUIDES Obstetrics Gynecology Neonatology (David James, Mary Pillai, Janice Rymer, Andrew N. J. Fish, Warren Hye) 1. Normal Infant 3. Birth Trauma 5. Deformations 7. Iatrogenic Lesions 9. Skin Disorders 2. Congennital Abnormalities 4. Syndromes 6. Infection 8. Surgical Problems 10. Low-Birth-Weight Infants LAVM: Our First one Hundred Cases; What have We Learned? (Dr G. F. Stohs, MD & Dr. L. P. Johonson, MD) امروزه هيستركتومي به طريقه لاپاراسكوپي فراگير شده است. در اين ويدي و CD موربيديتي و مورتاليتي و عوارض ايجاد شده با اين روش حين عمل در ١٠٠ بيمار نشان داده شده است. Male Infertility A Guide for the Glinician) (Anne M. Jequier) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
287 Male Reproductive Dysfunction (Mrs Baruna Basu, Dr. Suresh Chandra Basu) Menopause Biology & Pathobiology (Rogerio, Jennifer Kelsey, Robert Marcus) Nine Month Miracle (A.D.A.M. Software, Inc.) 1. Anatomy 2. The Family Album 3. A Child's View of Pregnancy Novak's Gynecology (Thirteenth Edition) (Jonathan S. Berek, MD) Obstetric Ultrasound Principles and Techniques 17 - تعيين سن حاملگي بر اساس معيارهاي FL. BPD و AC و HC و جداول ا نها - تعيين سن بارداري در تريمستر اول بر اساس Gs و CRL و نحوة اندازهگيري ا نها - تعيين سن بارداري در تريمستر دوم و سوم بر اساس دور سر و نحوه اندازهگيري ا ن - مطالب جالبي در رابطه با ا ناتومي جنين در تريمستر دوم و سوم (معده- كليه...) - تعيين محل لانهگزيني جفت و بررسي ركولمان و پلانتاپرويا - توضيحاتي در رابطه با BPP (بيوفيزيكال پروفايل) - بررسي ا ناتومي جنين و ا نوماليهاي CNS و Body - ا ناتومي رحم و ا دنكسها و امبريو و كيسه زرده در تريمستر اول - تعيين سن بارداري در تريمستر دوم و سوم بر اساس FL و AC و نحوه اندازهگيري ا نها - تعيين محل جفت و حجم مايع ا منيوتيك - انفاركتوس و وارياسيون محل خروج بند ناف Insertion) (Cord - بررسي لكينيكال و سونوگرافي Case Study و مطرحكردن سو الات در رابطه با ا نها و پاسخ مربوطه Operative Obstetrics (Larry C. Gilstrap III) (2 nd Edition) (SALEKAN E-BOOK) Safety principles for surgical techniques in minimally invasive gynecologic surgery (Dr. Samir Sawalhe) (CD I, II) (Equipment, preparation, positioning, approach alternatives, safe entry, nots on application) در اين ويدي و CD روش لاپاراسكوپي به صورت Single puncture توصيف گرديده و شرايط اطاق عمل طريقه و وساي ل عمل توضيح داده ميشود. 1. Instruments/equipment 2. Positioning 3. Disinfection/preparation 4. Approach alternatives 5. Electrical morcellation Single Puncture Laparoscopic Technique (Marco Pelosi, MD) (VCD) و سپس مزايا اين روش به نوع multiple puncture بيان ميگردد. Submitted Subject: Transvaginal Sonographic Assessment of Pelvic Pathology: Preoperative Evaluation (Frances R. Batzer, MD) اين ويدي و CD از ٣ بخش زير تشكيل شده است: (فيلم اول): در اين قسمت ابتدا در مورد كاربردهاي سونوگرافي ترانس واژينال بحث شده و سپس شرح حال ٦ بيمار بيان شده و با سونوگرافي ترانس واژينال تشخيص و محل دقيق ضايعات لگن داده ميشود و سپس با هيسترسكوپي و لاپاراسكوپي ضايعات جراحي ميگردد. Case هاي سطر به شرح زير است: خانم ٤٢ سالهاي به منومتروراژي به مدت ٢ سال تشخيص ترانس واژينال سونوگرافي ساب موكوس فيبرون درمان خانم ٢٤ سالهاي با تاريخچه ختم حاملگي مكرر در تريمستر دوم تشخيص ترانس واژينال سونوگرافي uterus Septate ١- خانم ٣٦ ساله با تاريخچه اندومتريوز و درد ناگهاني و ش ٢- ديد ناحيه لگن تشخيص ترانس واژينال سونوگرافي اندومتريوما درمان: برداشتن كيست با لاپاراسكوپ با ليزري YA ٣- خانم ٤١ ساله با درد ناحيه لگن تشخيص ترانس واژينال سونوگرافي درموي يد Cyst ٤- خانم ٤٣ ساله بطور اتفاقي متوجه بزرگي تخمدان يكطرف ميشود تشخيص ترانس واژينال سونوگرافي فوليكول در ٥- تشخيص ترانس واژينال سونوگرافي ectopicpregnancy ٦- خانم ٢١ سالهاي با خونريزي مداوم و ٣ LMP هفته قبل تشخيص (فيلم دوم): هيستروسكوپيك resection درمان: برداشتن درموي يد كيست با لاپاراسكوپي درمان: Hysteroscopic Resection Cyst درمان: برداشتن ضايعه با لاپاراسكوپ درمان: Left Salpingectomy Limiting Physician Exposure to Hepatitis B and HIV : Ob / Gyns (R.Viscarello.MD) در اين ويدي و CD راههاي پيشگيري و درمان فردي كه با HBV يا HIV در تماس ميباشد گفته شده است و راههاي صحيح استفاده از سونوگرافي و لاپاراسكوپي و روشهاي پيشگيري در مطب متخصصين زنان و زايمان بيان شده است. (فيلم سوم): در اين ويدي و CD طريقه اصلاح Stress incontinence بطريقه لاپاراسكوپي بيان شده است. Laparoscopic Retropubic Colposuspension For Stress urinary incontinence (Gordon. D. Davis, MD. & R.W.Lobel,MD 2005 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
288 (فيلم چهارم): Bi-polar Desiccation of Vascular Tissue: Laparoscopic Hysterectomy (Paul, D. Indman,MD) در اين فيلم طريقه برداشتن پايههاي عروقي كوچك و متوسط در اعمال جراحي توسط bi-polar desiccation نشان داده شده است. TEXT AND ATLAS OF Female in Fertility Surgery (ROBERT B. HUNT) (Third Edition) (Mosby) (SALEKAN E-BOOK) BASIC SCIENCE ENERGY SOURCES RADIOLOGIC PROCEDURES HYSTEROSCOPY LAPAROSCOPY LAPAROTOMY ENDOMETRIOSIS ADDITIONAL CONSIDERATIONS Textbook of Assisted Reproductive Techniques Laboratory and Clinical Perspectives (David K Gardner, Ariel Weissman, Colin M Howles, Zeev Shoham) The Boston IVF Handbook of Infertility A Practical guide for practitioners who care for infertile couples (Steven R. Bayer, Michael M. Alper, Alan S. Penzias) The Infertility Manual (2nd Edition) (Kamini A Rao, Peter R Brinsden, A Henry Sathananthan) Triplet Pregnancies and their Consequences (Louis G. Keith, MD, Isaac Blickstein, MD) (SALEKAN E-BOOK) Epidemiology and biology Antepartum considerations Delivery/birth considerations The Matria database Short-term outcomes Sources of information on multiple births Prenatal diagnosis Long-term outcomes Preventive measures Miscellaneous Future dicections TVT Tension-free Vaginal Tape Stress Incontinence Anatomy&Terminology Tension-free Vaginal Tape Indication&Patient Selection TVT Procedure Clinical Information Sales Support Urogynecology: Evaluation and Treatment of Urinary Incontinence (Bruce Rosenzweig, MD, Jeffrey S. Levy, MD, Donald R. Ostergard, MD) اين CD كه به صورت تصاوير كام لا رنگي بوده و توضيحات به صورت نوشتاري و فايل صوتي كه بر روي هر قسمت از اين CD وجود دارد. Consideration for the OB/GYN Generalist Types of incontinernce Cystoscopy uroflowmetry - - اين قسمت خود شامل مباحث: won surgical & surgical Management incontinence awareness Postvoid residual Cystometrogram Patient misconceptions Pad test Evaluation - ٤ Urogynechology قسمت مجزا دارد شامل: Introduction Definigg Incontinence - :Introduction & Defining Incontince (١ affected women تشخيص incontince ٢) ارزيابي بيماران با :incontinency معاينات باليني Pessary test u/s Voiding diary un, تاريخچه Multi-Channel urodynamics ٣) تدابير درماني جراحي و غير جراحي در : Stress urinary incontinence اين قسمت شامل الگوريتم تصميمگيري در مورد روش درماني ميباشد و سپس روش درماني غيرجراحي modification)) biofeedback, Beharioral و درمانهاي داروي ي funetional electrieal Stimalation و...) بحث شده است. روشهاي جراحي: ابتدا در مورد روشهاي انجام جراحي بحث شده و سپس Procedure اعمال جراحي شرح داده شده است. در قسمتهاي بعدي مقايسه درصد موفقيت روشها ذكر شده و در ا خر Complication اين روشها توضيح داده شده است. incontinrence management to private patients equipment cost Non surgical therapy Set-up requirement Urodynamics : Consideration for the OB/Gyn Generalist (٤ urogynechology as a subdiscipline professional consideration در اين فصل: Staff Allied مورد بحث قرار گرفته است. Ultrasound in Obstetrics & Gynecology (Eberhard Merz.M.D) UTEROSALPINGOGRAPHY IN GYNECOLOGY (Hysterosalpingography) It's Application in Physiological And Pathological Conditions (SALEKAN E-BOOK) eystometry اين CD حاوي مطالب ذيل در ارتباط با Utero Salpingography ميباشد: - اصول كلي در Uterosalpingography - سقط مكرر و قاعدگي دردناك (ديس منوره) در CD فوقالذكر تصاوير راديوگرافيك متعدد واضحي در ارتباط با USG گنجانده شده است. - عملكرد رحم و لولههاي فالوپ - سل تناسلي و فيستول ژنيتال - ا نوماليهاي مادرزادي رحم و لولههاي فالوپ - پاتولوژي لولههاي فالوپ پريتوي ن و تخمدانها - تغييرات پاتولوژيك رحم مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
289 Video Journal of Gynecology (Vaginal Hysterectomy Wedge morcellization Technique for the Large Uterus) (The Infertile Couple) (David Olive, MD, George W. Morley MD,) William's OBSTETRICS (Twenty-second edition) (F. Gary Cunningham, Kenneth J. Leveno) (CD I, II) WOMEN'S HEALTH (MOSBY'S PRIMARY CARE) اين CD شامل Procedure هاي سرپاي ي مربوط به بيماريهاي زنان و دستگاه ژنيتالهاي زنان Genitalia) (Female و معاينات باليني Female Genitiourinary Tract ميباشد. در هر فصل علاوه بر روش L ا ناتومي انديكاسيون و كنتراانديكاسيون L و چگونگي انجام عمل و عوارض و تستهاي تشخيصي و غيره بحث شده است. خصوصيت منحصر به فرد اين CD شامل : نشان دادن تمام روشها به صورت فيلمهاي ويدي وي ي در CD و ديگر CNG يا تستهاي چند گزينهاي است كه در ا خر هر بخش ا ورده شده است: عناوين اين CD شامل : ١- examination Breast شامل: ا ناتومي پاتوفيزيولوژي انديكاسيون و كنتراانديكاسيون تجهيزات ا موزش به بيمار فرم رضايت نامه Pojition بيمار تكنيك و ثبت يافتهها و پرونده و اشكالات تكنيكي تشخيص افتراقي و quiz انتهاي بخش ميباشد تمام مراحل بايد به صورت تماسهاي رنگي و فايلهاي ويديوي ي به نمايش درا مده است ٢- Colposcopy : ابتدا ا ناتومي cervix با شكلهاي تمام رنگي نمايش داده شده است و توضيحات لازم در متن ا ورده شده است. سپس در مورد پاتولوژي و فيزيولوژي ناحيه سروكيل شرح داده شده است. انديكاسيون و كنتراانديكاسيون با ا موزش به بيمار تجهيزات لازم Positioning ا ماده كردن محل ا نستزي تكنيك انجام Procedne و كمپيكاسيون تشخيصهاي افتراقي و تغيير نتايج شرح داده شده در ا خر فصل Quiz وجود دارد. ٧ فيلم در مورد چگونگي انجام روش كوپيوسكوپي در اين فصل وجود دارد. ٣- اندومتريال بيوپسي: ابتدا و مقدمه تاريخچهاي از D&C و بيوپسي ا ندومتريال همراه با تصاوير قديمي ا ورده شده است سپس ا ناتومي پاتوفيزيولوژي ا ن به تصاوير رنگي شرح داده شده است.سپس مانند ديگر Procedure ها انديكاسيون و كنتراانديكاسيون و تكنيك ا مادگي بيمار Position بيمار ا نستزي و... ا ورده شده است. در ا خر فصل فيلمهاي مربوط به تجهيزات و روشهاي انجام بيوپسي ا ورده شده است. ا خر فصل Quiz قرار دارد. ٤- Examination : Pelvic بعد از مقدمه در مورد ا ناتومي ناحيه ژنتيكي valve) (utenes, carivx, vagina, با تصاوير رنگي ا ورده شده و چگونگي انجام معاينه Position بيمار انديكاسيون كنترايكاسيون و تغيير يافتهها ا ورده شده است. و سپس ٦ فيلم معاينه لگني كامل معاينه exetrnalgenifalicn با پاپ ا سمير معاينهbimanual rectovaginal, و چگونگي گذاشتن اسپكولوم و تجهيزات نشان داده شده است. در ا خر Quiz ا ورده شده است. ٥- Smear : Pap ابتدا بعد از مقدمهاي كوتاه در مورد ا ناتومي منقطع و پاتوفيزيولوژي بيماريهاي كه ميشود با پاپ ا سمير بررسي كرد. انديكاسيون كنتراانديكاسيون Position روش انجام اشكالات تكنيكي تجهيزات و... شرح داده شده است. ٥ فيلم از چگونگي معاينه گذاشتن اسيكولوم و انجام پاپ اسمير و تجهيزات ا ن ا ورده شده است. ٦- Secretion Vaginal (ترشح واژينال): در اين مبحث ابتدا علل ترشح واژينال و تشخيصهاي افتراقي ا ن پرداخته شده است و سپس تجهيزات مورد نياز چگونگي گرفتن كشت انجام تست KOH قرار دادن ترشحات بر روي slide و مشاهده ا ن با ميكروسكوپ با فيلم و تصاوير رنگي نشان داده شده است و Quiz نيز در ا خر فصل وجود دارد. Your Pregnancy, Your Newborn The Complete Guide for Expectant and New Mothers ٤- علوم ا زمايشگاهي عنوان CD A Laboratory Guide to the Mammalian Embryo A Manual of Laboratory & Diagnostic Tests (Frances Fischbach) (Sixth Edition) (SALEKAN E-BOOK) سال انتشار اين CD كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي شده است مشتمل بر ١٦ فصل است و شامل موارد زير ميباشد: Diagnostic Testing Blood Studies Urine Studies Stool Studies Cbemistry Studies Microbiologic Studies Immunodiagnostic Studies Nuclear Medicine Studies Cytology, Histology, and Genetic Studies Endoscopic Studies Ultrasound Studies Pulmonary Functio and Blood Gas Studies Prenatal Diagnosis and Tests of Fetal Well-Being Cerebrespinal Fluid Studies X-ray Studies Special Systems, Organ Functions, and Post Mortem Studies A Slide Atlas of ATHEROSCLEROSIS (Progression and Regression) (Herbert C. Stary) اين نرم افزار با ۹۴ اسلايد تخصصي مراحل مختلف پيشرفت و پسرفت بيماري ا ترواسكلروزيس در سنين مختلف و قلب و عروق مختلف بدن را با تصاوير ميكروسكوپي و الكتروني به زيبايي به تصوير كشيده است. مطالعه اين نرم افزار به متخصصين پاتولوژي و قلب و عروق توصيه ميشود. American Sodiety of Hematology (CD 1-5) (44 th Annual Meeting) CD-1: ALL -AML -ASH/ASCO Joint Symposium -Atypical Cellular Disorders CD-2: CLL -CML -CNS Lymphoma -Cutaneous Lymphoma -E. Donnall Thomas Lecture مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
290 5.4 CD-3: Enhancing Physician/Patient Communication Regarding Hematologic Disorders -Ham-Wasserman Lecture -Hematology Grants Workshop -Hypercoagulability: Too Many Tests, Too Much Conflicting Data -Malaria and the Red Cell -Marrow Failure CD-4: Multi[ple Myeloma -Myelodysplastic Syndromes Non-Myeloablative Transplantation -Platelets: Thrombotic Thrombocytopenic -Purpura Plenary Policy Frum CD-5: Presidential Symposium -Red Cell Antigens as Functional Molecules and Obstacles to Transfusion -Sickle Cell Disease -Stem Cell Transplantation: Supportive Care and Long-Term Complications -Stem Cells: Hype and Reality Update on Epidemiology and Therapeutics for Non-Hodgkin s Lymphoma An Electronic Companion to Microbiology for Majors TM 20 (Mark L. Wheelis) Reviw, Test yourself اين CD شامل عناوين زير ميباشد: What Are Microorganisms? Methods of Microbiology Eukaryotic Cell Struture Metabolism & Energy Gene Regulation Microbial Ecology Disease Classification Prokaryotic Cell Struture Growth & Reproduction Microbial Genetics Viruses Defenses Againses Infection Animal Cell Culture (Third Edition) (A Practical Approach) (John R. W. Masters) Antibody Engineering (R. Kontermann S. Dubel) Antibody Phage Display Methods and Protocols (Philippa M. O'Brien, Robert Aitken) APPLIED ANIMAL REPRODUCTION (h. joebearden, John W. Fuquay) Applied Molecular Genetics (Roger L. Miesfeld) Atlas of HEMATOLOGY اين CD حاوي موارد زير ميباشد: Examination of Blood Cells 2. Normal Hematopoiesis and Blood Cells 3.Dynamic Cell Morphology 4. Hematolopathology 5. Cluster of differentiation Archive 6. Self-Assessment Atlas of Diagnostic Cytopathology (Barbara F. Atkinson, MD) Atlas of Medical Parasitology (Dr. K. Ghazvini) نرمافزار فوق حاوی حدود 2000 تصویر رنگی از انواع انگلهای بیماریزای انسانی شامل تصویر انگل ضایعات ایجادشده ناقل انگل و سیکل زندگی و تکثیر انگل است که جهت استفاده گروههای مختلف رشتههای پزشکی خصوصا رشته علوم آزمایشگاهی مفید است. تصاویر مجموعه مزبور از منابع مختلف جمعآوری گردیده است که توسط دکتر قزوینی بازنگری و ویرایش گردیده است. بسیاری از تصاویر موجود در این مجموعه منحصر به فرد میباشد. مباحث مطرحشده در این نرمافزار عبارتند از: * Heart and Muscles Parasites * Eye Parasites * Case reports and updates in parasitology * Central Nervous System (CNS) Parasites * Gnito-Urinary Parasites * Lung Parasites * Skin Parasites * Blood, Bone Marrow, Spleen Parasites * Liver and Biliary Tree Parasites * Intestinal Parasites (Helminths) * Intestinal Parasites (Protozoa) Atlas of Surgical Pathology (Johns Hopkins) (Jonathan I. Epstein, Neera P. Agarwal-Antal, David B. Danner, Kim M. Ruska) Basic Cell Culture A Practical Approach (I. M. Davis) Basic histology: TEXT & ATLAS IMAGE LIBRARY (Tenth Edition) (Luiz Carlos, Juhqueira, Jose CARNEIRO) (A Division of The McGraw-Hill Companies) 1- Luiz Carlos JUNQUEIRA 2 - Jose CARNEIRO Before We Are Born Essentials of Embryology & Birth Defects (Moore, Oersaud) (6 th Edition) Biochemical Interactions An electronic companion to: FUNDAMENTALS OF BIOCHEMISTRY (Donald voet, Judith G. voet, charlotte W. Pratt) (Version 1.02) اين CD شامل مباحث زير است: NUCLEOTIDES AND NUCLEIC ACIDS PROTEINS: PRIMARY STRUCTURE PROTEIN FUNCTION LIPIDS BIOLOGICAL MEMBRANES MAMMALIAN FUEL METABOLOSM: INTEGRATION AND REGULATION GLUCOSE CATABOLISM GLYCOGEN METABOLISM AND GLUCONEOGENESIS DNA REPLICATION REPAIR, AND RECOMBINATION PHOTOSYNTHESIS LIPID METABOLISM AMINO ACID METABOLISM NUCLEOTIDE METABOLISM NUCLEIC ACID STRUCTURE CITRIC ACID CYCLE TRANSLATION REGULATION OF GENE EXPRESSION ENZYME KINETICS, INHIBITION, AND REGULATION مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
291 INTROCUCTION TO METABOLISM ELECTRON TRANSPORT AND OXIDATIVE PHOSPORYLATION PROTEINS: THREE-DIMENSIONAL STRUCTURE TRANSCRIPTION AND RNA PROCESSING Bioconjugation Protocols (Strategies & Methods) (Christof M. Niemeyer) Bioinformatics (Genes, Proteins & Computers) (Christine Orengo, Janet Thornton, David Jones) Bioinformatics Computing (The Complete, Practical Guide to bioinformatics for life scientists) (Bryan Bergeron, M.D.) Bioinformatics for Geneticists /Michael R. Barnes, Lan C. Gray) BIOLOGY CONCEPTS & CONNECTIONS (Second Edition) (Richard M. Liebaert) (CAMPBELL.MITCHELL.REECE) 1. Introduction: The Sclentific Sindy of Life 3. The Life of the Cell 5. Cellular Repoduction & Genetics 7. Concepls of Evolution 2. The Evolution of Biological Diversity 4. Animals: Form & Function 6. Plants: Form & Function 8. Ecology Biopsy Pathology of the Breast (John P. Sloane) (Second Edition) BLADDER BIOPSY INTERPRETATIONS (Jonathan I. Epstein, M.D., Mahul B. Amin, M.D., Victor E. Reuter, M.D.) (SALEKAN E-BOOK) Normal Blodder Anatomy and Variants of Normal histology Flat Urothelial Lesions 21 Papillary Urothelial Neoplasms with Inverted Growth Patterns Invasive Urothelial Carcinoma Conventional Morphologic, Prognostic, and Predictive Factors and Reporting of Bladder Cancer Glandular Lesions Squamous Lesions Cystitis Mesenchymal Tumors and Tumor-Like Lesions Miscellaneous Nontumors and Tumors Second ary Tumors of the Bladder BLOOD PRINCIPLES AND PRACTICE OF HEMATOLOGY (SECOND EDITION) (ROBERT I. HANDIN SAMUEL E. LUX THOMAS P. STOSSEL) Part I: Fundamentals of Hmatology: Tools of the trade Part II: The Hematopoietic System Part III: Stem Cell Disorders Part IV: White Blood Cells Part V: Hemostasis Part VI: Red Blood Cells Part VII: Systemic Disease Part VIII: Hematologic Therapies Part VIIII: Appendices Bone Marrow Pathology (Barbara J. Bain David M. Clark) Bone Tumors (Howard D. Dorfman, Bogdan Czerniak) BRS Cell Biology CELL BIOLOGY AND HISTOLOGY (4 th edition) (Leslie P. Gartner, James L. Hiatt, Judy M. Strum) (LIPPINCOTT WILLIAMS & WILKINS) Plasma Membrane Nucleus Cytoplasm Extracellular Matrix Connective Tissue Cartilage and Bone Muscle Nervous Tissue Circulatory System Lymphoid Tissue Endocrine System Skin The Urinary System Female Reproductive System Digestive System: Oral Cavity and Alimentary Tract Special Senses Epithelia and Glands Blood and Hemopoiesis Digestive System: Glands Comprehensive Exam Carter, Patchefsky Tumors & Tumor-Like Lesions of the Lung (Darryl Carter, Arthur S. Patchefsky, Clifton F. MOD Tain) Case Studies in Genes and Disease A Primer for Clinicians (Bryan Bergeron) Cellular & Molecular Neurobiology (Second Edition) 1- Lonotropic and Metabotropic Receptors in Synaptic Transmission and Sensory Transduction 3- Neurons: Excitable and Secretory Cells that Establish Synapses 2- Somato-Dendritic Processing and Plasticity of Postsynaptic Potentials 4- Activity and Developmen of Networks: The Hippocampus as an Example Clinical Diagnosis & Management by Laboratory Methods (twentieth Edition) (john bernard henry) Clinical Hematology (A Victor Hoffbrand, John E Pettit) (Mosby) Normal Hemopoiesis and Blood Cells Leucocyte Abnormialities Hemostasis and Bleeding Disorders Bone Marrow Transplantation Parasitic Infections Diagnosed in Blood Anaemias Hematological Malignancies Coagulation Disorders Bone Marrow in Blood Transfusion Further Reading Acknowledgements Non-hemopoietic Disease مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
292 Clinical Immunology Color Atlas & Text of Pulmonary Pathology (Philip T. Cagle, Timothy C. Allen, Roberto Barrios) Color atlas of Cancer Cytology (Third Edition) (Masayoshi Takahashi) Color atlas of differential diagnosis in Exfoliative & Aspiration CYTOPATHOLOGY (Sudha R. Kini, M.D) COMMON PROBLEMS IN CLINICAL LABORATORY MANAGEMENT (Judith A. O'brien, M.S. CLSup (NCA)) (Salekan E-Book) COMPLYING WITH CLIA '88 MEETING TUBERCULOSIS CONTROL REGULATIONS WRITING MANUALS: THE STANDARD OPERATING PROCEDURE MANUAL (SOPM) ESTABLISHING A QUALITY ASSURANCE PROGRAM ENCOURAGING EDUCATION OVERCOMING OSHA'S OBST ACLES THE EXPOSURE CONTROL PLAN PROVIDING AND USING PERSONAL PROTECTIVE EQUIPMENT PASSING PROFICEINCY TEST SURVIVING INSPECTIONS AND ATTAINING ACCREDIANCE THE ACQUISTION AND MAINTENANCE OF LABORATORY INSTRUMENTATION Comprehensive Cytopathology (Marluce Bibbo) (Second Edition) 22 OVERCOMING OSHA'S OBSTACLES THE CHEMICAL HYGIENE PLAN WRITING MANUALS: THE GENERAL OPERATING PROCEDURE MANUAL ( GOPM) FULFILING QUALITY CONTROL GUIDELINES PURSUING PERSONNEL PERSPECTIVES MASTERING FINANCES: BILLING AND CODING Computer-Aided Drug Design (Methods & Applications) (Thomas J. Perun. C. L. Propst) Concise Histology (A data of multiple choice question in microscopic) (Bloom & Fawcett's) (Second Edition) TAMING TECHNOLOGY: LABORATORY INFORMATION SYSTEM (LIS) RE-ENGINEERING FOR THE FUTURE: THE CORE LABORATORY, AUTOMATION, OUTREACH NETWORKING, AND THE MILLENNIUM BUG GENERATING LABORATORY NUMBERS: STATISTICS LINEARITY, CALIBRATION, REFERENCE, AND CRITICAL VALUES: CALCULATIONS MANAGING THE PHYSICIAN OFFICE LABORATORY (POL) TAMING TECHNOLOGY: POINT OF CARE TESTING (POCT) Diagnostic and Laboratory Test Reference (Seventh Edition) (Mosby) (Salekan E-Book) (Kathleen Deska Pagana, PhD, RN, Timothy J. Pagana, MD, FACS) Dianostic Hematology This textbook, 'Diagnostic Hematology: A pattern approach', is accompanied by a CD-ROM with three knowledge-based systems applied to 237 case studies. The 3 knowledge-based systems are: 1. Professor Petrushka for peripheral blood analysis 2. Professor Fidelio for flow cytometry immunophenotyping 3. Professor Belmonte for bone marrow interpretation Discover Biology DNA Science A First Course (Second Edition) (David A. Micklos, Greg A. Freyer, witli David A. Crotty) DNA Topology (Andrew D. Bates, Anthony Maxwell) Electronic Atlas of Parasitology (John T. Sullivan) university of the Incarnate Word EMBRYO (CD Color Atlas for Developmental Biology) (Gary C. Schoenwolf) Chapter 1: Frog Embryos Chapter 2: Chick Embryos Chapter 3: Pig Embryos Chapter 4: Gametogenesis Essential Cell Biology Volume 1: Cell Structure A Practical Approach (John Davey and Mike Lord) Essential Cell Biology (with the voice of Julie Theriot designed and programmed by Christopher Thorpe) Experiments with Fission Yeast (A Laboratory Course Manual) (Caroline Alfa, Peter Fontes, Jeremy Hyams) Fields Virology (Forth Edition) (Volume 1) (Lippincott Williams & Wilkins) Section One: General Virology Chapter 1-22 Section Two: Specific Virus Families Chapter Functional HISTOLOGY WHEATER'S (FOURTH EDITION) (BARBARA YOUNG, JOHN W. HEATH) (ALAN STEVENS JAMES S. LOWE) (PHILIP J. DEAKIN) Fundamentals of Enzymology (The Cell and Molecular Biology of Catalytic Proteins) (Nicholas c. Pricc & Lewis Stevens) (Third Edition) Genetic Predisposition to Cancer (Second Edition) (R.A. Eeles. D.F. Easton) Genetics From Genes to Genomes (Ann Reynolds, Ph.D.) (University of Washington) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
293 (كنترل اوپرون لاكتوز سيگنال ترنسلاكشن و -5 Gen RegVlation (مباحث كاريوتايپ تكنيك نقشه ژن -4 Chromosomes FISH (مباحث جمعيت و تكامل و فركاش الكلها و...) Evolvtion -6 Poplations & ( Molecular Genetice 1- Transmission Genetics ( 2- Gentral Dogma اين CD شامل ٢٧ عدد ويدي و كليپ بصورت انيميشن از مباحثي همچون : مكانيسم رونويس توجه...ميتوزو ميوز PCR الكتروفورز موتاسيون و ترميم DVA هيپريداسيون كلرنينگ و... ميباشد كه تحت برنامة Quick time اجرا گردد. در پايان هر فصل خلاصة مباحث اراي ه شده است. داراي يك فصل مربوط به تعريف و ترشح لفات مشكل و تخصصي است. همچنين داراي تمرينات بصورت دو جانبه و فعال teractive) (In ميباشد. ا بشنهاي متنوع و زيبايي در اين CD بكار رفته است و جهت استفاده از CD لازم است بعد از نصب ا ن (با دو بار كليك كردن بر روي (Setup. exe و نصب برنامة Q.t. كه در خود CD موجود است مورد استفاده قرار ميگيرد. Genomics Applications in Human Biology (Sandy B. Primrose & Richard M. Twyman) Genomics Proteomics & Bioinformatics (A. Malcolm Campbell, Laurie J. Heyer) Genomics Proteomics & Vaccines (Gude Grandi, Chiron Vaccines., Siena. Ite) GnRH Analogs in Human Reproduction (Bruno Lunenfeld) Gram Stain TUTOR (ANINTERACTIVE TUTORIAL THAT TEACHES THE MICROSCOPIC EXAMINATION OF URINARY SEDIMENT) (Brad Cookson, MD, PHD, Ajit Limaye, MD, Lydia Matheson, BA) 1. Introduction 2. Morphology 3. Specimen Sites 4. Case Studies 5. Exam 6. Image Atlas Histology & Cell Bilogy (An Introduction to Pathology) (Abraham L. Kierzenbaum, MD) HISTOLOGY EXPLORER Microscope 3D Connective Tissue Proper Nervous Tissue The Digestive System The Reproductive System Glands The Endocrine Glands The Cell Blood and Bone Marrow The Circulatory System The Respiratory System The Mammary Giands Muscular Tissue The Ear Epithelium The Sketetal Tissues The Lymphoid Organs The Urinary System The Eye The Skin How the Human Genome Works HUMAN HISTOLOGY CD-ROM (Alan Stevens. James Lowe) Human Mulecular Genetics 3 Tom Strachan & Anderw P. Read) Images of Disease An image database for the teaching of Pathology (Nick Hawkins, Mark Dziegielewski) در اين CD در رابطه با تك تك بيماريها نمونههاي بافتي ارگان درگير بيماري بصورت ماكروسكوپي و ميكروسكوپي باب تصاوير رنگي واضح مورد بررسي قرار داده و ضمن اراي ه شرح حال case مورد نظر به توصيف ماكروسكوپي و ميكروسكوپي ضايعه ميپردازد اين CD بخصوص به دستياران پاتولوژي و پاتولوژيست دما در جهت تشخيص پاتولوژيك بيماريها كمك شايان ميكند و نمادهاي مختلف ميكروسكوبيك بيماريها را بصورت جداگانه مورد توجه قرار ميدهد. Immuno Biology the immune system in health & disease (6 th Editiion) (Chales A. Janeway, Paul Travers, Mark Walport, Mark J. Shomchik) Immunology (Blackwell Science) Interactive Color Atlas of Histology (Version 1.0) (Leslie P. Gartner James L. Hiatt) (LIPPINCOTT WILLIAMS & WILKINS) Interactive Embryology The Human Embryo Program (Jay Lash Ph.D.) Introduction to Immunocytochemistry (3 rd Edition) (J.M. Polak & S. Van Noorden) Introduction to PROTEIN SCIENCE (Architecture, Function, and Genomies) (Arthur M. Lesk) Laboratory Medicine: URINALYSIS (Chemical and microscopic examination of urine Atlas of Microscopic Analysis Procedures for Urinalsis) (Pesce Kaplan Pubishers Inc.) Method write-up for 15 chemical urinalysis procedures Interpretation of urine findings in common renal and lower urinary tract diseases Complete Specimen collection section Tables reviewing results of chemical urinalyses Male Infertility A Guide for the Glinician) (Anne M. Jequier) Extensive atlas of microscopic analysis: over 50 microphotographs of urine sediment, including cells, casts, and artifacts مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
294 Maternal- Fetal Medicine (4 th Edition) (Robert K. Creasey, Robert Resnik) Media Supplement for Biochemistry (FOURH EDITION) (Roy Tasker Carl Rhodes) 1. Reaction mechanisms 2. Metabolic Pathways 3. Membrane Processes 4. Protein Synthesis 5. Molecular Representations Menopause Biology & Pathobiology (Rogerio, Jennifer Kelsey, Robert Marcus) Methods in Enzymology Guide to Yeast Genetics & Molecular & Cell Biology Microbes in Motion III (Dr. Gloria Delisle and Dr. Lewis Tomalty Queen's University) ويروسشناسي راهها و روشهاي كنترل و مهار رشد باكتريها ميكروبهاي بيهوازي محيطي عملكرد ضد ميكروبها پاتوژنز اپيدوميولوژي انگلشناسي ميكروبيولوژي محيطي ايمونولوژي متابوليسم ميكروبي باكتريولوژي ژنتيك (بيوتكنولوژي ساختار DNA ترانسپوزورها و...) باكتريهاي گرم منفي مقاومت ضد ميكروبي قارچشناسي واكسنها باكتريهاي گرم مثبت Miscellaneous Microbial Genetics (Second Edition) (Stanley R. Maloy, John E. Cronan, Jr., David Freifelder) MICROBIOLOGY AND IMMUNOLOGY (KEN S. ROSENTHAL) (Mosby) 1. TUTORIAL: I. Topics II. Systems III. Random 2. TEST MICROBIOLOGY AND MICROBIAL INFECTIONS (Topley & Wilson's) (Albert Balows, Max sussman) (NINTH EDITION) Mind Maps in pathology (Michele Harrison, Peter Dervan) MODERN GENETIC ANALYSIS (Anthony J. F. Griffiths, William M. Gelbart, Jffrey H. Miller, Richard C. Lewontin) Introduction System Requirements Getting Started Reference Freeman Genetics Web Site Molecular Analysis & Genome Discovery (John Wiley & Sons, LTD) MOLECULAR BIOLOGY in Reproducteve Medicine (B.C.J.M. Fauser, Rutherford) Molecular Cell Biology (The immune system in health & disease) (6th Edition) (Charles A. Janeway, Paul Traversm, Mark Walport) MOLECULAR CELL BIOLOGY 4.0 (Paul Matusdaru, Amold Berk, S. lawence Zipufsky, David Baltimore, James Damell, Harey lodish) Molecular Cloning A Laboratory Manual (Joseph Sambrook, David W. Russell) (Third Edition) (Volume 1-3) Molecular Cloning (A Laboratory Manual) (Volume 2) (Joseph Sambrook, David W. Russell) (Third Edition) Molecular Cloning (A Laboratory Manual) (Volume 3) (Joseph Sambrook, David W. Russell) (Third Edition) Molecular Genetics of Bacteria (Larry Snyder & Wendy Champness) (Second Edition) Molecular Markers, Natural History & Evolution (John C. Avise) Molecuralar Genetics of Bacteria (Jeremy W. Dale, Simon F. Park) (Fourth Edition) Mouse Phenotypes (A Handbook of Mutation Analysis) (Virginia e. Papaioannou, Richard R. Behringer) MPP (Whitehead) (Mucosal Biopsy of the Gastrointestinal Tract) (Fifth Edition) Nanomedicine Volume 11A: Biocompatibility (Robert A. Freitas Jr., Research Scientist, Zyvex Corporation) NCCL INFOBASE Serving the World's Medical Science Community Through Voluntary Consensus Obstetrical & Gynaecological Pathology (Fifth Edition) (Haines & Tailor) PATHOLOGIC BASIS OF DISEASE (Robbins & Cotran) (7 th Edition) PATHOLOGIC BASIS OF DISESE Interactive Case Study Companion to ROBBIMS (W. B. Saunders Company) (Sixth Edition) Inflammation and Repair Fluid and Hemodynamic Disorders Genetic Disorders Diseases of Immunity Neoplasia Systemic Pathology مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
295 Infectious Disease Cardiovascular Diseases Hematopatholory Disorders Gastrointestinal Diseases Diseases of Liver, Galbladder, and Pancreas Diseases of Kidney Genitouinary, Breast, and Pregnancy Disorders Endocrine Diseases Skeletal Disorders Neuropathology PATHOLOGY (Alan Stevens. James Lowe) Pathology of Skin Atlas of Clinical-Pathologcical Corration (Robert M. Hurwitz, Antoinette F. Hood) Pathology of the Lungs (Bryan Corrin) Pathology of the Skin Atlas of Clinical-Pathological Correlation Robert M. Hurwitz, MD, Antoinette F. Hood, MD) Peripheral Blood TUTOR (ANINTERACTIVE TUTORIAL THAT TEACHES THE MICROSCOPIC EXAMINATION OF URINARY SEDIMENT) Introduction Cell Morphologies Disease Associations Atlas Final Exam Overview, Smear Preparation Stain Procedure, Smear Evaluation Cell Structure, Read Blood Cells, White Blood Cells, Platelets, Artifacts, Quiz 25 Red Blood Cells, White Blood Cells, Neoplastic Disorder Phage display A laboratory Manual (Carlos F. Barbas, Dennis R. Burton, Jamie K. Scott, Gergg) Phage Display (A Practical Approach) (Tim Clackson, Henry B. Lowman) Cell Morphology Disease Association Pharmaceutical Biotechnology (An Introduction for Pharmacists & Pharmaceutical Scientists) (2 nd Edition) (Daan J.A. Crommelin, Robert D. Sindelar) Phylogenetic Trees Made Easy (A How-To Manual) (Second Edition) Practical Breast Pathology (Tibor Tot, Peter B. Dean) (Thieme) Primers in Biology Protein Structure and Function (Gregory A Petsko Dagmar Ringe) Principles of Biochemistry (Molecular, Genetics) (Volume Three) Principles of Genome Analysis & Genomics (Sandy B. Primrose, Richard M. Twyman) PRINCIPLES OF Molecular Virology (THIRD EDITION) Contents Introduciton Particles Genomes Replication Expression Infection Pathogenesis Novel Infectious Agents Appendices Glossary, Abbreviations and Pronounciations Classification of Sub-Cellular Infections Agents The History of Virology Principles of VIROLOGY Molecular Bilogy, Pathogenesis, and Control (S.J. Flint, L.W. Enquist, R.M. Krug) Protein Bioinformatics (An Algorithmic Approach to Sequence & Struture Analysis) (Ingvar eldhammer, Inge Jonassen, William R. Taylor) Protein-Protein Interactions (Methods & Applications) PROTEINS (Structure & function) (John Wiley & sons, Ltd) Proteins and proteomics (A Laboratory Manual) (Richard J. Simpson) RAPID REVIEW HISTOLOGY AND CELL BIOLOGY (E. ROBERT BURNS, M. DONALD CAVE) (MOSBY) Rheumatology & Orthopaedics (Coote, Haslam) Samter's Immunologic Diseases (SIXTH EDITION) (K. Frank Austen, M.D, Michael M. Frank, M.D., John P. Atkinson, M.D., Harvey Cantor, M.D.) - تشخيص و شناسايي (ايمني ذاتي و اكتسابي ( - مكانيزمهاي مو ثر ايمني در ايمني ذاتي و اكتسابي - بيماري نقص ايمني اوليه - بيماريهاي ازدياد و تكثير سلولهاي ايمني - بيماريهاي سيستميك - بيماريهاي اختصاصي اندام - بيماريهاي ا لرژيكي - سيستم ايمني فعال و غير مو ثر - پيوند اعضاء - ايمني شناسي درماني اين CD داراي يك كتابخانه از تصاوير مربوط به هر فصل و هر موضوع ميباشد كه جداول و طرحوارههاي مربوطه را به نمايش ميگذارد. توانايي جستجو واژهها و لغات تخصصي و چاپ متون كتاب را دارد. قدرت بزرگنمايي تصاوير و نمايش منابع مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
296 Saunders Manual of Clinical Laboratory Science Short Protocols in CELL BIOLOGY (A Compendiuim of Methods from Current Protocols in Cell Biology) (Juan S. Bonifacino, Mary Dasso) 26 هر قسمت از كتاب از ويژگيهاي اين برنامه ميباشد. Short Protocols in Molecular Bilogy (A compendium of Methods from Current Protocols in Molecular Biology) (Fifth Edition) (Frederick M. Ausubel, Reger Brent )(Vol 1 & 2) SHORT PROTOCOLS IN MOLECULAR BIOLOGY FIFTH Edition A Compendium of Methods from Current Protocols in Molecular Biology Short Protocols in PROTEIN SCIENCE (A Compendium of Methods from Current protocols in protein science) (John E. Coligan, Ben M. Dunn) Silvergerg's Principles & Practice of SURGICAL PATHOLOGY & CYTOPATHOLOGY (Fourth Edition) (Steven G. Silverberg, Ronald A. Delellis) Statistical Methods in Genetic Epidemiology (Duncan c. Thomas) Sternberg's Diagnostic Surgical Pathology (Fourth Edition) (CD I, II, III) (Stacey e. Mills, Darryl Carter, Joel K, Greenson) Surgical Pathology (Rosai & Ackerman) (Ninth Edition) (Juan Rosai) (CD 1-4) Surgical Pathology of Non-Neoplastic Lung Disease (Third Edition) (Anna-Luise A. Katzenstein, M.D) (W.B. Saunders Company) The American Society of Hematology (41 st Annual Meeting and Exposition) The Cell 1.0 A Molecular Approach (Many Animations, Movies, Photos, and drawn images) (Geoffrey M. Cooper) Cell Overview Humman Genetic Diseases Floww of Information The Nucleus The Cell Cycle Protein Sorting and Transport Organelles & Energy Metabolism The Cytoskeleto The Plasma Membrane The Extracellular Machine Cancer-A Family od Diseases The Meiotic Divisions The Genetics of the Growth Hormone Axis (Albert Beckers) THE HUMAN GENOME PROJECT The Infertility Manual (2nd Edition) (Kamini A Rao, Peter R Brinsden, A Henry Sathananthan) The Metabolic and Molecular Bases of Inherited Disease The Microbial Models of Molecular Biology from Genes to Genomes (Rowland H. Davis) UNDERSTAND! Biochemistry (3/e Version) (Lehninger Principles of Biochemistry) 1. THE BACKGROUND 4. BIOENERGETICS 7. CELLULAR ARCHITECTURE AND TRAFFIC 2. THE MOLECULES OF LIFE 5. BIOSYNTHESIS 8. THE DIVIDING CELL 3. PROTEINS IN ACTION 6. NUCLEIC ACIDS AND THEIR EXPRESSION 9. SOME IMPORTANT TECHNIQUES UNDERSTAND! Biochemistry (VERSION 1.0) UNDERSTAND! Biology: Biochemistry (Molecules, Cell & Genes) CD فوق مشتمل بر مباحث زير ميباشد: Basic Chemistry Macromolecular assembly and modification Bioenegetics Signal transduction Enzymology The flow of genetic information Metabolism Molecular biology techniques Urinalysis TUTOR (ANINTERACTIVE TUTORIAL THAT TEACHES THE MICROSCOPIC EXAMINATION OF URINARY SEDIMENT) (Caria M. Phillips, MLM, MT(ASCP), Paul J. Henderson, MS, MT(ASCP), Claudia Bein, BS, MT(ASCP)) اين برنامه بصورت interactive در ٥ فصل روش ا زمايشات ميكروسكوپي نمونههاي ادراري را ا موزش ميدهد. مقدمه (عملكرد كليه تفسير و ارزيابي نتايج مكانيسم عملكرد ميكروسكوپي و نمونههاي ميكروسكوپي) ٣. ٢. فهرست تصاوير (تصاوير فصل دوم اين كتاب الكترونيكي در اين قسمت بصورت مجزا به نمايش درميا يد) ساختار و ماهيت رسوبات ادرار (بررسي سلولهاي موجود در ادرار كريستالها ارگانيزمها ا رتيفكتها) ٥. بيماريها (سندرم گلومرولونفريت. سندرم نفروتيك فيلونفريت عفونت لولة ادراري) ٤. امتحان پاياني (شامل دوسري امتحان A و B ميباشد. از هر بخش سو الاتي بصورت چند گزينهاي اراي ه شده است. هر سو ال به شكل نمايش يك تصوير ميباشد كه مورد سو ال قرار ميگيرد). Using Antibodies (A Laboratory Manual) (Ed Harlo, David Lanp) Ute Schepers RNA Interference in Practice (Principles, Basics, & methode for Gene Silencing in c. elegans, Drosophila and Mammals).١ مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
297 Viral Hepatitis (Third Edition) (Professor Howard Thomas, Professor Stanley Lemon, Professor Arie Zuckerman) Virus Life in diagrams (Hans-W. Ackermann, Laurent Berthiaume, Michel Tremblay) Volume I: Basic Technologies Bioinformatics from Genomes to Drugs (Methods & Principles in Medicinal Chemistry) (R. Mannhold H. Kubinyi) Volume II: Applications Bioinformatics from Genomes to Drugs (Methods & Principles in Medicinal Chemistry) (R. Mannhold H. Kubinyi) WHO Laboratory Manual for the examination of Human Semen and sperm-cervical mucus interaction (Fourth Edition) WHO Manual for the standardized investigation & diagnosis of the infertile couple (Patrick J, Rowe, Frank H. Conhaire, Timothy B. Hargreave) WHO Manul for the standardized investigation, diagnosis and management of the infertile male (Patrick J. Rowe, Frank H. Comhaire) عنوان CD A Slide Atlas of ATHEROSCLEROSIS Progression and Regression (Herbert C. Stary, MD) ٥- قلب سال انتشار اين نرمافزار با ٩٤ اسلايد تخصصي مراحل مختلف پيشرفت و پسرفت بيماري ا ترواسكلروزيس در سنين مختلف و قلب و عروق مختلف بدن را با تصاوير ميكروسكوپي و الكتروني به زيبايي به تصوير كشيده است. مطالعه اين نرمافزار به متخصصين پاتولوژي و قلب و عروق توصيه ميشود. A visible improvement in angina treatment (VCD) Post-EECP stress perfusion image, Markedly improved anterior, septal, and inferior wall perfusion. Advanced Echocardiography: Quantitaive 2-D & Doppler Ultrasoun (Miguel A. Quinones, William A. Zoghbl) Advanced Therapy in CARDIAC SURGERY (Kenneth L. Franco, Edward D. Verrier) ACCSAP (Adult Clinical Cardiology Self-Assessment Program) (C. Richard Donti, MD, Richard P. Lewis, MD) (AMERICAN COLLEGE of CARDIOLOGY) Acute Heart Failure (THE CLEVELAND CLINIC FOUNDATION) (W. Frank Peacock, MD) (The Emergency Department and the Economics of Care) American Heart Associations fighting Heart Disease and Stroke Abstracts from Scientific Sessions (Augustus O. Grant, Raymond J. Gibbons) -Basic Science -Clinical Science -Population Science Atlas of Transesophageal Echocardiography (Navin C. Nanda, MD, Michael J. Domanski) (Williams & Wilkins) 1. Normal Anatomy 3. Mitral Valve 5. Aortic Valve and Aorta 7. Tricuspid and Pulmonary Valves 2. Prosthetic Valves and Rings 4. Ischemic Heart Disease 6. Cardiomyopathy 8. Congenital Heart Disease All in One (Diabetes and the Heart) (MERCK) BEYOND HEART SOUNDS The Interactive Cardic Exam (John Michael Criley, MD) (VOL 1) Introduction to anscultation Hemodynamics tutorial The cardiac cycle Pulse Tutorial Frontal Chest Anatomy The Cardinal areas of anscultation Using the stethoscope Mitral and aortic valve flow Hemodynamic changes in disease Mitral Stenosis Aortic stenosis Introduction Carotid Pulses Jugular Venous Pulses BRAUNWALD'S HEART DISESE A Textbook of Cardiovascular Medicine (7 th Edition) (Douglas P. Zipes, Peter Libby) (Volume I, II) Cardiac Catheterization, Angiography, and Intervention (SIXTH EDITION) (LIPPINCOTT WILLIAMS & WILKINS) اين CD الكترونيكي شامل edition ششم كتاب... Cathetrization Grossmam's Cadiac و ٣٥ دقيقه فيلم بوده و كليه تصاوير به صورت رنگي ميباشد. وجه مشخصه اين كتاب الكترونيكي فيلم ويدي ويي شامل Case50 بيماريهاي قلبي و نرمال همراه با Procerdue- related Findinig ميباشد. مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
298 28 ١- ملاحظات كلي كاتتريزاسيون ٢- تكنيكهاي -Brachiel Cutdown Percutaneous approuch) Basic كاتترازيسون تشخيصي در كودكان و نوزادان) ٣- موارد هموديناميك (اندازهگيري فشار- اندازهگيري blood flow و output قلب و مقاومت عروق و...) ٤- تكنيكهاي ا نژيوگرافي ) ا نژيوكرونري ونتريكولوگرافي قلبي ا نژيوگرافي وپولمونري- ا نژيوگرافي ا ي ورت و شريانهاي محيطي) ٥- ارزيابي فانكشنال قلبي (استرس Test طي كاتترازيسيون قلبي اندازهگيري حجم بطنها Ejection Fraction وظيفه دياستولي و سيستولي بطنيها و...) ٦- Techniquse : Special Catheter (اكوكارديال بيوپسي- اولتراسونوگرافي داخل عروقي- قرار دادن deivce براي درمان ا ريتيميها - Pulsation intrathoracic balloon Counter و...) ٧- تكنيكهاي مداخلهاي (ا نتژيوپلاستي عروق كرونري- ا تروكتومي عروق كرونري و ترومبكتومي - Stentگذاري عروق كرونر مداخله در عروق محيطي و عروق كودكان) ٨- Profile در اختلالات اختصاصي: (طرز شناسايي و كاتتريزاسيون و ا نژيوگرافي بيماريهاي دريچهاي قلب بيماريهاي شراي ين كرونري- بيماري امبولي ريه و...) فيلمهاي ويدي ويي شامل ا نژيوگرافي كاتتريزاسيون و اقدامات درماني: - اختلالات ونتريكولوگرافي بطن چپ - ا نوماليها و CAD غير ا تروسكروتيك - كاتتريزاسيون Basic - اختلالات ا ي ورت و عروق محيطي - مداخلات درماني شامل Stent) گذاري- عوارض- بالونگذاري و والوپلاستي Rotabalator و...) ميباشد Cardiovascular Surgery (VCD) (CD I, II, III) Excerpted from "Medical & Surgical Controversies in CV disease: The Aorta and Peripheral Vessels" Course Directors: Thoralf M. Sundt III, MD and Peter C. Spittell, MD Cardiovascular Physiology Concepts (Richard E. Klabunde) Carotid Artery Stenting (Current Practice and Techniques) (Nadim Al-Mubarak, Gary S. Roubin, Sriram S. Layer, Jiri J. Vitek) CathSAP Cardiac Catheterization and Interventional Cardiology Self-Assessment Program (Carl J. Pepine, MD, Steven E. Nissen, MD) Challenging established treatment patterns in chronic heart failure A Satellite Symposium held during the ESC Heart Failure meeting Clinical TRANSESOPHAGEAL ECHOCARDIOGRAPHY (A PROBLEM- ORIENTED APPROACH) (Second Edition) (Steven N. Konstadt) Clinical Utility of Contrast Echocardiography Sonovue: An ideal contrast agent for Low MI myocardial Perfusion (Dr. Daniela Bokor, Bracco sa, Milano) What's new in cardic echography (Dr. Luciano Agati, University "La Sapienza Roma" Ischemic coronary artery disease (Dr. Harld Becher, John Radcliffe Hospital, Oxford) Congestive Heart Failure (NOVARTIS) (CD I, II) اين دو CD شامل كتاب الكترونيكي Ciba در مورد قلب ميباشد. مو لف كتاب Frank.H.Netter ميباشد. اين CD شامل عكسهاي رنگي Case report فيلم ويدي ويي و فايل صوتي ميباشد. در Case report ابتدا پزشك سو الاتي از بيمار ميكند و بيمار به سوالات جواب ميدهد. اطلاعات بيشتر توسط كاربر با كليك كردن بر روي دكمهها را ميتوان به دست ا ورد. سپس معاينه فيزيكي بيمار توسط فيلم نشان داده شده است. اين كتاب شامل multiple choice test و تشخيص افتراقي بيماري CHF ميباشد. فصول كتاب شامل : ١. عملكرد نرمال قلب و سيستم عروقي اين برنامه شامل دو بخش ميباشد: ١- ا موزش پزشكي ٢. اتيولوژي و تعريف بيماريCHF ٢- ا موزش باليني و بيماري.٣ پاتوفيزيولوژي CHF ٤. تشخيص management و درمان CHF ميباشد. بخش اول شامل: ١- ا ناتومي عروق كرونري ٢- ا ترواسكلروزيس ٣- انفاركتوس ميوكارد ٤- تشخيص و مديريت درمان هر يك از چهارفصل فوق داراي چندين زيرفصل ميباشد كه بصورت تصاوير همراه با توضيحات متني نمايش داده ميشود. در هر يك از اين موضوعات كاربر ميتواند يادداشت شخصي خود را اضافه و ذخيره نمايد Coronary Heart Disease (J. Hurley Myers, Ph.D., Frank H. Netter, M.D.) در بخش دوم: مباحث اراي ه شده شامل ١- مقدمه ٢- عروق خوني قلب ٣- چگونگي انسداد سرخرگهاي اكليلي ٤- پيگيري از بيماري انسداد عروق كرونر ٥- ا نژين صدري ٦- انفاركتوس ميوكارد ٧- روشهاي تشخيصي ٨- دارو درماني ٩- ا نژيوپلاستي و عمل جراحي (اين بخش داراي فيلمهاي كوتاه از ا نژيوگرافي قلب ميباشد) هر قسمت از عناوين فوق توسط گوينده (با پخش صدا) توضيح داده شده است. اين برنامه بصورت يك كتاب الكترونيكي مشتمل بر ٩ فصل است و تحت برنامة Current Diagnosis & Treatment in CARDIOLOGY (7 th Edition) (Michael H. Crawford. MD) Drugs for the Heart (Sixth Edition) (Salekan E-Book) (Lionel H. Opie, Bernard J. Gersh) Dynamic Practical Electrodiography (Lippincott Williams & Wilkins) 24.5 ECG (Jay W. Mason, MD) 25.5 ECG DIAGNOSIS MADE EASY ROMEO VEGHT Internet explorer اجرا ميشود. داراي ٣٥٠ عدد نمودار ECG گوناگون است. توانايي جستجوي نمودارهاي و چاپ و ذخيرة ا نها نيز وجود دارد. ٩ فصل اين كتاب شامل موارد مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
299 29 زير است: (... و نحوة ضبط.3 ECG نرمال موقعيت الكترودها دپولاريزاسيون عضله هدايت جريان الكتريكي ( Priciples.1 Basic Ischaemic (Coronary) heart disease 5. Conductin impairment 7. Rhythm disturbances 2. Hypertrophy 6. Chardiomyopathies and autoimmune disorders 4. Pericarditis, myocarditis and metabolic disorders 6. Pacemakers, ICDs and cardioversion Mixed ECG quizzes طريقة نصب: ابتدا CD را درون درايو قرار داده و سپس وارد my computer ميشويم. بعد وارد درايو CD شده و از ا نجا وارد شاخه Setup ميشويم. فايل Setup را اجرا ميكنيم. سپس Next را ميزنيم مسير نصب پرسيده ميشود در صورت توافق Next را ميزنيم برنامه نصب ميشود در پايان Finish را فشار ميدهيم ECG-SAP III (Jay W. Mason, MD, FACC) -Using ECG-SAP III -Standard Tracings -Syndromes -Computer Overreads -Serial Tracings -Stress Testing -ECG of the Month -Guidelines -Utilities 27.5 Echo Lecture (VIDEO SERIES) (7CD) (Mayo) اين مجموعه كه شامل ٧ سري CD به صورت فيلم ميباشد شرح عناوين ا ن به صورت زير است: 1. TEE in the Operating Room (Bijoy K. Khandheria, MD) Intraoperative echocardiography has become an essential component to the surgical approach to valvular disease. Dr. Bijoy Khandheria discusses the utility of intraoperative echocardiography and its impact on the surgical management of cardiovascular disease. 2. TEE in Adult Congenital Heart Disease (James B. Seward, M.D.) Dr. James Seward Presents Adult Congenital Heart Disease. A generation of Children Have Grown into adulthood and Present with postoperative congenital heart disease. Transesophageal echocardiography is extremely helpful but may not always be necessary in the assessment of adult congenital heart disease. Learn from the expert regarding appropriate use of transesophageal echocardiography and assessment of residua and sequela of adult congenital heart disease. 3. Understanding Operative Procedures for Patients with Univentricular Heart from Palliation to Fontan (James B. Seward, M.D.) Dr. Seward gives a detailed overview of complex anomalies and their applicable corrections. Topics included are Blalock, Mustard, Glen and Fontan corrections. Graphic depictions of each corrective procedure, possible complications and echocardiographic example are included. 4. Mitral Valve Regurgitation: Essential Measurements. Pitfalls and Limitations. (Fletcher A. Miller, Jr., MD) Dr. Fletcher Miller discusses and presents the current approach to the quantitative evaluation of mitral valve regurgitation. This is an excellent review of current quantitative assessment of mitral valve regurgitation including pitfalls and limitations. 5. Mitral Vale Regurgitation: Evidence-Based Practice (A. Jamil Tajik, MD) A Classic presentation by Dr. A. Jamil Tajik on a change in clinical practice with regard to the quantitation of regurgitation and then a change in medical management with early surgery and repair of the mitral valve Evaluating the Patient with Prothetic Valve (Fletcher A. Miller, Jr., MD) Dr. Fletcher Miller, an expert on the echocardiographic assessment of prosthetic valves, presents a detailed in-depth review of the quantitative echo Doppler approach to the prosthetic valve. It is important to understand the hemodynamic pitfalls and limitations of the echocardiographic assessment of cardiac prosthetic valves. 7. Stress Echocardiography and Contrast (Patricia A. Pellikka, M.D.) Stress Echocardiography and Contrast Using illustrative cases, Dr. Pellikka gives an expert presentation and discussion on the role of contrast in stress echocardiography. Pitfalls and limitations of contrast stress echocardiography are also discussed. New Horizons in Stress Echocardiography Dr. Pellikka, an expert in Stress echocardiography, discusses Dobutamine stress echocardiography and its role in preoperative risk stratification. Also discussed are new advances in stress echocardiography such as color kinesis and acoustic quantification, color Doppler imaging, and strain and strain rate imaging. ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (UPDATE NO. 1) (TRANSESOPHAGEAL- ECHOCARDIOGRAPHY) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 1) (VCD) (ECHOCARDIOGRAPHY Normal 2-D And M-MODE EXAM)) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 10) (VCD) (CARDIAC MASSES) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 11-A,B) (VCD CD I, ii) (ECHOCARDIOGRAPHIC ASSESSMENT OF PROSTHETIC HEART VALVES) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 12) (VCD) (INTERVENTIONAL ECHOCARDIOGRAPHY) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 2) (VCD) (DOPPLER AND COLOR FLOW IMAGING: PHYSICS, INSTRUMENTATIONS AND THE NORMAL EXAM) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 4) (VCD) (ECHOCARDIOGRAPHY IN AORTIC VAL VE DISEASE) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 5) (VCD) (ECHOCARDIOGRAPHY IN CORONARY HEART DISEASE) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 6) (VCD) (ECHOCARDIOGRAPHY IN CONGENITAL HEART DISEASE IN THE ADULT) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 7) (VCD) (ECHOCARDIOGRAPHY IN CARDIOMYOPATHIES: DILATED, RESTRICTIVE AND HYPERTROPHIC) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 8) (VCD) (ECHOCARDIOGRAPHY IN PERICARDIAL DISEASE) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME 9) (VCD) (ECHOCARDIOGRAPHY IN TRICUSPID AND PULMONIC VALVE DISEASE AND DESEASES OF THE AORTA) ECHOCARDIOGRAPHY 2-D/DOPPLER WITH COLOR FLOW IMAGING (VOLUME3) (VCD) (ECHOCARDIOGRAPHY IN MITRAL VALVE DISEASE) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
300 EchoSAP III (Echocardiography Self-Assessment Program)(Echocardiography Overview: Technique and Applications) (Volume 1) (Jemes D. Thomas, MD, Ellen Mayer-Sabik, MD) -Introduction and Overview -Examinations -Applications -Self-Assessment Questions -Evidence-Based Medicine -Conclusions EECP: Current Experience and Future Directions Electronic Image Collection of Comprehensive Vascular and Endovascular Surgery (John W. Hallet, Joseph L. Mills, Jonothan J. Eamsbaw, Jim A Reekers) 1. Background 3. claudication 5. Chronic Lower Extremity Ischemia 7. Acute Limb Ischemia 9. Upper Extremity Problems 2. Mesenteric Syndromes 4. Renovascular disease 6. Aneurysmal Disease 8. Cerebrovascular Disease 10. Venous Disease ENDOVASCULAR TECHNIQUES (Abdominal Aortic Aneurysms) (Workshop) (l. Flessenkämper) (15 th Endovascular Symposium Berlin) ESC Congress EVOLVING ISSUES IN THE MANAGEMENT CHD (National Lipid Education Council TM ) SECTION 1 SECTION II SECTION III SECTION IV SECTION V Emerging Evidence-Based Data From Clinical Trials PAD Lipids and Risk Inflammatory Markers: Anovel Approach Use of Genomics to discover new targets for therapy Case study: Diabetes NON-HDL-Case Secondary Targert of Therapy What is it's Role in clinical practice? Case Study: NON-HDL-C Lipid Management Though combination Therapy Case Study: Novel Risk Markers Case Study:Combination Therapy Examining the nonlipid effects of statins Feigenbun's Echocardiography Textbook & Video Library (Sixth Edition) (Harvey Feigenbaum, William F. Armstrong, Thomas Ryan) Grossman's Cardiac Catheterization, Angiography and intervention (Sixth Edition) (Donald S. Baim, William Grossman) 49.5 HEART DISEASE (FIFTH EDITION) A Textbook of Cardiovascular Medicine (W.B. SAUNDERS COMPANY) در واقع اين كتاب الكترونيكي (e-book) از ٤ كتاب مجزا تشكيل شده است. (Mendelsohn) Reviwe and Assessment Book -٤ (Hennekens) Clinical Trials in Cardiovascular Disease -٣ (chien) Molecular Basis of Heart Disase -٢ (Braunwald) Heart Disease -١ در ا خر هر فصل سوالات چند گزينهاي با جواب تشريحي و رفرانس كتاب ا ورده شده كه مشتمل بر ٧٠٦ سوال و جواب ميباشد. خصوصيت منحصر به فرد اين CD قابليت Search (جستجو) بخصوص براي متخصصين و رزيدنتهاي رشتههاي قلب و داخلي ميباشد كه در پيدا كردن موضوعي يا حتي كلمات كمك شاياني مينمايد. همچنين قابليت Search سريع و وسيع اين CD ميتواند در امتحانات ارتقاء و بورد و امتحانات درون بخشي كمك قابل توجهي نمايد. شكل و نمودارهاي اين (e-book) همگي رنگي است و ميتواند براي تدريس و يا كنفرانس و clubها مورد استفاده اساتيد و رزيدنتها و كاركنا ن بخشهاي قلب و CCU شود HEART SOUNDS HEART SOUNDS Basic Cardiac Auscultation Version 3.0 (Leonard Werner, M.D., Brian Pitts, David Gilsdorf) Heart Sounds Basic Cardiac Auscultation CD-ROM to Accompany (M.D., F.A/C.P., Brian Pitts, M.D., David Gilsdorf) (Lippincott Williams & Wilkins) Highlights ESC Congress HURST'S THE HEART (R. Wayne Alexander, Robert C. Schlant, Valentin Fuster كتاب الكترونيكي حاضر Edition نهم ميباشد كه علاوه بر Text كتاب Hurst مشتمل بر ١٦ فصل فصلي جداگانه براي شكلها و نمودارهاي كتاب و هم چنين فصلي ديگر براي صداهاي قلبي به صورت فايل صوتيCD دارد. در ا خراينCD تستهاي چند گزينهاي مربوط به هر فصل همرا با جواب گنجانده شده است. از اين CD علاوه بر استفاده شخصي ميتوان براي تدريس (بخصوص استفاده از شكلهاي تمام رنگي ا ن) استفاده كرد. Hypertension & Olmetec Interactive Atlas of Transesophageal Color Doppler Echocardiography (Raffaele De Simone) Interactive Atlas of Transesophageal Color Doppler Echocardiography (Raffaele De Simone) 58.5 Interactive Echocardiography: A Clinical Atlas (Th. Binder, M.D., G. Rehak,G. Porenta. M.D., Ph.D., M. Zengeneh, M.D., G. Maurer, M.D., H. Baumgartner, M.D.) University of Vienna, Austria مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
301 Interactive Echocardiography: Interactive ECG (J.H. Myers, A.F. Moukaddem, N. Tongsak) Interactive Electrocardiography on Cd-Rom (Curtis M. Rimmerman, Anil K. Jain) Interventional Cardiology Clinical Resource (Disc 1 & 2) (Evidence. Analysis. Recommendations. Consensus Reports) 62.5 Intra-Aortic Balloon Catheter Insertion and Removal Technique (ARROW) عناوين اين CD شامل: 1. INTRODUCTION 2. LAB SELECTION 3. LAB PREPARATION 4. LAB INSERTION 5. LAB CATHETER PREPARATION 6. LAB CATHETER INSERTION 7. LAB REMOVAL Manual of Cardiovascular Medicine (Second Edition) (Brian P. Griffin, Eric J. Topol) Mastering Auscultation An Audio Tour to Cardiac Diagnosis Clinical Findings Diagnosis Treatment Tutorial Text Reference (Dr. Anthony Don Michael's) Mechanical Support for Cardiac & Respiratory Failure in Pediatric Patients (Brain W. Duncan) 66.5 MVP Video Journal of Cardilogy (Maria-Teresa Olivari, M.D., Antonio M. Gotto, M.D., D. Phill.) اين برنامه از سري CDهاي ا موزشي MVP ميباشد كه به صورت يك فيلم ا موزشي (در قالب (VCD بهمدت ٤٥ دقيقه در سه قسمت مجزا اراي ه شده است. در هر قسمت يك موضوع به شكل مصاحبة علمي با يك متخصص به همراه نمايش اسلايد و نمودار بحث شده است. اين موضوعات به شرح زير است: مصاحبه شونده : دكتر 1-Determination of Rejection in the Cardiac transplant Recipient Maria-Teresa Olivari پيگيري و تشخيص رد پيوند قلب به كمك اكوكارديوگرافي اكوداپلر MRI روشهاي ايمونولوژيكي (ا نتي ميوزين) و ديگر روشهاي غيرتهاجمي همراه با نمايش اسلايد توضيح داده شده است. مصاحبه شونده : دكتر 2- Triglycerides, HDL and coronary Heat Disease Antonio Gotto كلية ريسك فاكتورها و عوامل مو ثر بر ا نها در عارضة رگهاي كرونري قلب بحث شده است. بيماري ديابت و روشهاي دارودرماني و رعايت اصول بهداشتي در زمينة عارضة عروق كرونري اراي ه شده است. مصاحبه شونده : دكتر 3- Management of Cardiac Disease in Pregnancy Carl E. Orringer در اين بخش فيزيولوژي قلب در زمان بارداري (برونده قلبي حجم ضربهاي ايست قلبي و...) علاي م قلبي - تنفسي سمع قلب در بيماران قلبي باردار تشخيص به كمك اكوكارديوگرافي داپلر MRI و... درمان دارويي بيماران قلبي باردار كارديوميوپاتي در بارداري افزايش فشار خون در بارداري و... همراه با نمايش اسلايد و نمودار بحث و بررسي شده است. MVP Video Journal of Cardiology (Anthony C. Pearson, M.D., Charles B. Higgins, M.D., William W. O'Neill, M.D.) (VCD) اين برنامه از سري CDهاي ا موزشي MVP ميباشد كه به مدت 40 دقيقه در سه قسمت اراي ه شدهاند. در هر قسمت يك موضوع به شكل مصاحبة علمي با يك متخصص به همراه نمايش اسلايه و فيلم و نمودار بحث و بررسي شده است. اين موضوعات به شرح زير است: مصاحبه شونده: دكتر 1- The stately Art of MR in Cardiovascuvlar Disease Charles P. Higgins در اين بخش تاريخچة MRI روشهاي متعدد تصويربرداري در كارديولوژي كاربرد MRI در بيماريهاي قلبي عروقي به همراه نمايش اسلايد و تصاوير MRI و... بحث شده است. مصاحبه شونده : دكتر 2. Arguing for Angioplasy in Acute Myocardial infction William w. ONeill تاريخچه انژيوپلاستي روش درماني Lone PTCA انديكاسيون انژيوپلاستي برا ورد ديسك ا نژيوپلاستي و به كمك نمايش اسلايد و فيلم مصاحبه شونده : دكتر : Pearson 3- Improved understanding of cardioembolic Stroke prorided by Transesophageal Echoecardiography Anthony C. تاريخچة درمان ا مپوليها تاريخچه تكنيك TEE مقايسه روش TEE و TEE به همراه نمايش و توضيح اكوكارديوگرام TEE از چندين Case مختلف بحث و بررسي شده است. MVP VIDEO JOURNAL OF CARDIOTHORACIC SURGERY (VIDEO SEGMENT I & II) Thromboexclusion for Treatment of Descending Aortic Dissection (John A. Elefteriades, MD) Nicorandil in Angina Pectoris from symptom Management to Cardioprotection (Professor Derek, Professor James M Downey, PD Dr. Med, Christian Schneider) Perioperative Transesophageal Echocardiography (Patricia M. Applegate, Richard L. Applegate, I) 1. Basics of Echocardiography 2. Clinical TEE Examination 3. Clinical Uses of Perioperative TEE 4. Unknowns 5. Perioperative Perioperative Transesophageal Echocardiography (Patricia M. Applegate, M.D., Richard L. Applegate, II) PLUMER'S PRINCIPLES & PRACTICE OF INTERAVENOUS THERAPY (SEVEN EDITION) (Sharon M. Weinstein) Practical Perioperative Transoesophageal Echocardiography Introduction, instructions and acknowledgements (David Sidebotham, John Faris, Alan Merry, Andrew Kerr) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
302 TEE An Intractive Exam Review on CD-ROM (CD I, II) (Lippincott Williams & Wilkins) TEXTBOOK OF CARDIOVASCULAR MEDICINE (2 nd Edition) (ERIC J. TOPOL) CD حاضر يكي از بهترين كتابهاي الكترونيكي است كه علاوه بر Text داراي قابليتهاي فيلم عكس و فايلهاي صوتي در مورد بيماريهاي قلب ميباشد. اين CD شامل كتاب دو جلدي Text book of Cardiovascular Medicine است كه وجود صدها عكس و كليپ ويدي وي ي كتاب را به صورت يك مجموعة زنده در ا ورده است. (به عنوان مثال در مورد تنگي دريچه ميترال در بخش مربوطه علاوه بر متن عكسهاي رنگي در ضايعه تصويربرداريها (اكو...) و فايلهاي صوتي صداي ECG,M.S و كاتتريزاسيون ا ن به صورت ويدي وكليپ نشان داده شده است. مباحث كتاب شامل : ١- تاريخچه علم كارديولوژي و شخصيت بيماران قلبي نوتواني بيماريهاي قلبي) ٢- كارديولوژي پيشگيري (شامل: بيولوژي اتروسكلروز رژيم غذايي و چاقي و اختلالات چربي ورزش فشار خون و پاتوفيزيولوژي ا ن سيگار كشيدن ديابت استروژن جنس زن و بيماريهاي قلبي اتانول و قلب رفتار ٣- كارديولوژي باليني: (شامل تاريخچه معاينات باليني و بيماريهاي ايسكمي دريچهاي عفوني مادرزادي تومورال قلب و پردههاي ا ن ميباشد هم چنين شامل قلب و حاملگي پيري كليه ورزش و تروما ميباشد.)- مشاوره نويسي - داروهاي قلبي - اشتباهات پزشكي ٤- تصويربرداري قلبي: شامل عكس و فايل صوتي و ويدي و كليپ: (تفسير عكس ساده ريه ECG در حين ورزش اكوكارديوگرافي transthoracic استرس اكوكارديوگرافي ارزيابي با داپلر - اكوكارديوگرافي -transesophageal تكنيكهاي تصويربرداري هستهاي MRI CT, PET, قلب اكوكارديوگرافي ). intraoperative ٥- الكترو فيزيولوژي و Pacing شامل : (مكانيسم و فيزيولوژي ا ريتميها تستهاي الكتروفيزولوژيECG ضايعات قلبي ايسكميك و غيرايسكميك طرز گذاشتن Pacemaker و فيبريليتورها) ٦- كارديولوژي invasive و تكنيكهاي جراحي: شامل عكس و فيلم Restenosis اپيدميولوژي و درمان approach به بيماران كه قب لا بايپس شدهاند اولتراسونوگرافي داخل عروقي و ا نژيوسكوپي و الولوپلاستي طرز كاتتريزاسيون در بيماريهاي مادرزادي قلبي) ٩- واسكولر بيولوژي ١٠- :Multimedia شامل عكس و صداهاي قلبي (نرمال و ابنرمال) و كليپهاي ويديوي ي. (ا نژيوگرافي كرونري- كاتتريزاسيون قلبي Percutaneos Procedures بايپس قلب ٧- نارسايي قلب و پيوند قلب عكس: كاتتريزاسيون CT/MRI - اكوكارديوگرافي ECG - اولتراسونوگرافي intravascular نوكلي ار پاتولوژي معاينات باليني جراحي- چشم و بيماريهاي قلبي عروقي. صداهاي قلبي: نرمال و ابنرمال ويدي وكليپ: كاتتريزاسيون CT/MRI اكوكارديوگرافي الكتروفيزيولوژي و Pacing و اولتراسونوگرافي داخل عروقي تصاوير هستهاي جراحي. فصلهاي جديد كتاب نسبت به ويرايش قبلي كتاب و CD شامل: Endof-Life Care قلب ورزشكاران ارزيابي باليني سيستم عصبي اتونوم. : TEXTBOOK OF CARDIOVASCULAR MEDICINE طريقه نصب Percutaneous Coronaryintervantion ملاحظات جراحي در درمان نارساي ي قلب ژنتراپي و پيشرفتهاي ملكولي در مورد قلب ٨- كارديولوژي ملكولي براي نصب برنامة Cardiovascular Medicine ابتدا CD را درون درايو قرار داده و در پنجره اي كه با عنوان Flash باز شده بر روي كادر سمت چپ تصوير گزينة Install TOPOL را انتخاب كرده سپس پنجرة محاورهاي ديگري باز ميشود (حدود ا ٤٠-٣٠ ثانيه بعد) و مسير نصب برنامه را مشخص ميكند. اين مسير بصورت پيش فرض C:\Program files\cardiovascularmedicine است در قسمت پايين برروي دكمة Install كليك كنيد (اگر خواستيد مسير فوق را به دلخواه ميتوانيد تغيير دهيد) پس از كليك برروي Install پنجرة ديگري باز ميشود و برنامه خودبخود نصب مي شود پس از حدود ٢٠ ثانيه پنجرة ا خر بنام Install complete مي ا يد برروي دكمة Done در انتها كليك كنيد. پس از ا نكه مراحل فوق انجام پذيرفت برنامه نصب شده است ولي براي اجراي ا ن نياز است دو برنامة كمكي ديگر نيز بر روي سيستم عامل نصب شود كه عبارتند از:.Quick Time, Internet Explorer براي نصب اين برنامه از اينترنت اكسپلورر باورژن 5.5 به بالا ميتوان استفاده كرد. ضمن ا سيستم عاملهاي پيشنهادي براي اين برنامه ويندوزهاي ME,,98 95,2000 NT, است يا 200 MHZ پردازشگر و حداقل 32 مگابايت حافظه. در پنجره اي كه پيش روداريد (اولين پنجره هنگام قراردادن (CD گزينة Internet Explore 5.5 را كليك كنيد. در پنجره اي كه پيش روي شما باز مي شود در قسمت I accept the agreement كليك كنيد و دكمة Next از پاي ين را فشار دهيد. برنامه مشغول چك كردن سيستم و محتواي فايلها ميشود. سپس پنجرة جديدي باز ميشود كه بصورت پيش فرض دكمة بالايي فعال است و شما بايد دكمة Next را فشار دهيد. حال بايد منتظر بمانيد تا برنامه بصورت كامل نصب گردد سپس پنجرة ديگري باز شده دوباره Next را فشار داده و دكمة finish در انتها زده شود. در اين موقع ويندوز خودبخود restart ميشود. دوباره CD را اجرا كنيد (اين كار را مي توانيد با زدن دكمة Eject درايو CD و فشردن مجدد CD به درون درايو و يا باز كردن CD و اجراي ا ن انجام دهيد) حال به قسمت سوم نصب ميرسيم. بايد از پنجرة بازشده (پنجرة اول هنگام قراردادن ( CD بر روي گزينة Quick time 5 كليك كنيم. پنجرة جديدي ميا يد دكمة Next را فشار مي دهيم. پنجرة بعدي هم بايد Next را بزنيد تا پنجرة ديگري باز شود حال دكمة Agree را انتخاب كنيد مسيري را مي بينيم اگر موافق بوديد Next را بزنيد و در پنجرة جديد بصورت پيش فرض دكمة دوم از بين سه دكمه در بالاي كادر فعال است مجدد ا Next را بزنيد و باز نيز Next را انتخاب كنيد در پنجرة جديد نيز Next را فشار دهيد پنجرة بعدي سريال و نام شركت را ميپرسد نيازي به پركردن ا ن نيست Next را زده تا برنامه نصب شود بر روي پنجرة فعال ما پنجرة جديدي باز ميشود ا ن را نيز Next بزنيد دو باركه Next كرديد اين پنجره را finish كنيد تا به پايان كار برسيم ا خرين پنجره را با برداشتن تيكهاي دو كادر بالا Close كنيد. تمام پنجره ها را برروي صفحة Desktop ببنديد برروي دكمة Start كليك كرده وارد Programs شويد و از منوي Cardio Vascular Medicine برنامة Cardio Vascular CD را اجرا كنيد و سپس برنامة internet explorer را باز كرده و در قسمت Address خط زير را تايپ كنيد. برنامه در محيط internet explorer اجرا ميشود The Echo Manual (Second Edition) (Jae K. Oh, MD, James B. Seward, MD, A. Jamil Tajik MD) The Netter Presenter Cardiovascular and Renal Edition Images from the Netter Collection (NOVARTIS) 78.5 The Physiological Orgins of HEART SOUNDS and MURMUS (John Michael Criley, M.D., Conrad Zalace, David Creley) 2003 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
303 General Tutorials: Inspection and Palpation Intriduction to Auscultation Effect of Maneuvers and Perturbations Hemoduction to Cardiac Imaging Modalities Timing of Heart Sounds Valve Closure Sounds and Splitting of Sounds Opening Sounds Third Sounds Fourth sounds Ejection Sounds Mid-Systolic Clicks 33 Timing of Murmurs Systolic Murmurs Diastolic Murmurs Continuous Murmurs vs. To and Fro Murmurs Friction Rubs Catalog of Lesions Normal Valvar Lesions Pericardial Disease Congenital Heart Disease Cardiomyopathies Myxoma Valvular Heart Disease (Third Edition) (Joseph S. Alpert, James E. Dalen, Shahbudin H. Rahimtoola) Vascular Vision (A Liberating Approach to Vascular health Expert Opinions in Dyslipidaemia) (Professor Philip Barter, Dr. John Kastelein, ) VJC Video Journal of Cardiology (LAWRENCE S. COHEN, M.D, JOHN ELEFTERIADES, M.D.) (VCD) 1. From a new perspective: mitral valve prolapse aortic dissections and aneurysms 2. Surgical and medical management of ascending and descending aortic dissections liporoten (A): a cardiovascular risk factor VJC Video Journal of Cardiology (Christopher White, M.D, Michael E. Cain, M.D., Bruce D. Lindsay, M.D., Herbert Geschwind, M.D.) (VCD) 2005 اين برنامه از سري CDهاي ا موزشي VJC ميباشد كه به صورت فيلم ا موزشي در قالب VCD به مدت متعدد بحث و بررسي شده است. موضوعات هر بخش به شرح زير است: 50 دقيقه در سه بخش اراي ه شده است. در هر بخش يك موضوع به شكل مصاحبة علمي با يك متخصص به همراه نمايش اسلايد و فيلم و نمودارهاي مصاحبه شونده : دكتر : 1-Cold lege : The Approach to Acvte and progressive Peripheral Vascular Disease christoher white عوارض مربوط به عروق محيطي و روشهاي درماني ا نها بحث شده است. مراحل انجام ا نژيوگرافي به همراه نمايش تصاوير ا نژيوسكوپيك و ا نژيوگرام اراي ه شده است. كاربردهاي Urokinase استرپتوكيناز ا نژيوپلاستي ليزري و... نيز مورد بررسي قرار گرفته است. الكتروكاردويوگرام باليدگذاريهاي مختلف ECGهاي در فيبريلاسيون و بلوك AV و... مصاحيه شونده : دكتر : Cain 2- RADiofrgvency ablation : Ablation of AVNode reentry tachycardias Michael E. همراه با نمايش اسلايدها و راديوگرامهاي متعدد بررسي و توضيح داده شده است. مصاحبه شونده : دكتر : Geschwind 3- Laser Angioplasty for coronary Atherosclerotic Disease Herbert مكانيزم عمل سيستم ليزر در ا نژيوپلاستي كاربرد Pulser طول برج بهمينه ) ماوراء مادون قرمز) اهداف استفاده از ا نژيوپلاستي ليزري و عوارض ا ن مزيت ها و محدوديتها اين روش و مقايسه ا ن با PTCA و... مورد بحث و بررسي قرار گرفته است. What's What A guide to acronyms for cardiovascular trials عنوان CD 20 Common Problems Dermatology (Alan B. Fleischer, Steven R. Feldman) American Cancer Society Atlas of Clinical Oncology Skin Cancer (Arthur J. Sober, MD, Frank G. Haluka, MD, phd) (Bc Decker Inc) ٦- پوست و مو سال انتشار 2001 همچنانكه وارد قرن ٢١ ميشويم شايعترين شكل سرطانها كانسرهاي پوستي ميباشد و به علت اينكه بر خلاف كانسرهاي ديگر كانسرهاي پوست در معرض ديد ميباشد سريعتر و راحتتر قابل تشخيص است. در نتيجه دانش تشخيص و درمان و جلوگيري از سرطانهاي پوستي موجب نگارش اين كتاب گرديده است. مشخصة اين كتاب تا كيد بر نماهاي باليني Skin cancer ميباشد چون علم درماتولوژي بر پاية مشاهده بنا شده است بنابراين كتاب داراي تصاوير زياد با كيفيت بسيار بالاست و هر جا كه عكسها در اراي ه مطلب كمككننده نبوده text اضافه شده است. و علاوه بر اين نكات تشخيصي اپيدميولوژي درماني و پيشگيري در كتاب گنجانده شده است. اين كتاب به ٤ قسمت تقسيم شده است: بخش ١: Concept Basic شامل اپيدميولوژي ژنتيك كانسرهاي پوستي و عوامل خطرزا ميباشد. بخش ٢: تظاهرات باليني: در هر فصل جداگانه نماي باليني ملانوم (فصل ٤ و) BCE (فصل ٥ و) Scc (فصل ٦) لمفومهاي پوستي (فصل ٧ و) مالينگنانسيهاي پوستي ناشايع (فصل ٨:١) Carcinoma Merckle cell (فصل ( ٨:٢ و كاپوسي ساركوم (فصل ٨:٣) اشاره شده است. بخش : ٣ Management كه شامل: تكنيك بيوپسي از ملانوم (فصل ٩) تدابير جراحي ملانوم پوستي (فصل ١١) ارزيابي لمفنودها و بيوپسي از لمفنود در ملانوم (فصل ١١) therapy adjuvant در ملانوم (فصل ١٢) ايمونوتراپي در ملانوم (فصل ١٣) و كموتراپي سيتوكين تراپي و بيوكموتراپي در ملانوم (فصل ١٤) ميباشد. همچنين درمان لمفوم پوستي اوليه [MF] (فصل ١٧) ميباشد. مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
304 بخش : ٤ در مورد پيشگيري از كانسرهاي پوستي بحث كرده است. AQUAMIDE; Poly Acryl Amide Ged (an injectable gel for correction of soft Tissue Deficiencies) در اين ويدي و CD در مورد يكي از مواد filler به كار رفته در Cosmetic Surgery توضيحاتي داده شده است. در ابتدا خواص ژل Aquamide و كاربردهاي ا ن مورد بحث قرار گرفته و سپس طريقه تزريق اين ژل در اصلاح چين نازوبيال تغيير شكل ناهنجاريهاي بيني از بينبردن چينهاي پيشاني و اطراف لب پركردن و اصلاح ضايعات ا تروفيك ناشي از اسكار ا بلهمرغان يا تروماها گونهگذاري و خط لب به صورت نوار ويدي وي ي مورد بحث قرار گرفته است. Atlas of Clinical Dermatology (Third Edition) (Anthony du Vivier) ATLAS OF COSMETIC SURGERY (MICHAEL S. KAMINER, MD, JEFFREY S. DOVER, MD, FRCPC, KENNETH A. ARNDT, MD) (W.B. SAUNDERS COMPANY) (Salekan E-Book) اطلس حاضر تا ليف ديگري از Dr. Kenneth. Arndt ميباشد. در مقدمه كتاب Dr. Leffell (استاد درماتولوژي و جراحي پلاستيك دانشگاه (Yale مينويسد: '"اين كتاب الكترونيكي فوقالعاده جمعا وري تجارب مو لفين بوده و بيشتر به موارد كاربردي اشاره شده است به طوريكه به شما كمك ميكند چگونه با موفقيت يك عمل Cosmetic را بر روي بيمار خود انجام دهيد. Dr. Arndt سردبير مجله Archives of Dermatology تقريب ا به مدت ٢٠ سال احاطة وسيعي در جراحيهاي Cosmetic داشته و در شكيلبودن كتاب سهم بسزايي دارد" ويژگي اين كتاب نسبت به موارد مشابه تجربيات مو لفين ميباشد كه همگي به عنوان رفرانس ديگر كتب و مجلات پزشكي به كار ميرود (براي مثال چگونگي تزريق Botox و درمان اسكارهاي ا كنه كه در مجلات Archive و 2001 AAD و 2002 چاپ شده است) مو لفين هدف از تا ليف اين كتاب را بيان تجربيات كاربردي خود در بيمارستان Harvard (با ١٣ ليزر پوست و ١٢ اطاق عمل جراحي كام لا مجهز) بيان نمودهاند. براي مثال مباحث تزريق Botox ليزردرماني ضايعات پوستي و Scar management و بلفاروپلاستي اين كتاب كاربرديترين و به اذعان متخصصين و دستياران پوست بهترين كتاب چاپ شده در اين مورد ميباشد استفاده از شكلهاي ساده براي ا موزش و بعض ا رنگي به كيفيت و راحتي ا موزش تكنيكها كمك شاياني در اين كتاب كرده است. كتاب Laser in Dermatology مو لف Arndt" "Kenneth, بزودي اراي ه ميشود. اين كتاب منحصربه فرد شامل مباحث زير ميباشد: PART I EVALUATION OF THE COSMETIC SURGERY PATIENT 1 The History of Cosmetic Surgery 2 The History of Cosmetic Dermatologic Surgery 3 Evaluation of the Aging Face, 4 Photoaging: Mechanisms, Consequences, and Prevention 5 Beauty and Society 6 Psychosocial Issues and Their Relevance to the Cosmetic Surgery Patient PART II ANESTHESIA 7 Regional Anesthesia for Aesthetic Surgery 8 Office-Based Sedation and Monitoring 9 Postoperative Pain and Nausea Management Atlas of Dermatology (Jhon's Hopkins) (SALEKAN E-BOOK) (CD I, II) اطلس فوق شامل بيش از ٢٥٠٠ تصوير كام لا جالب با رزولوشن بالا در خصوص انواع ضايعات پوستي ميباشد كه بر طبق حروف الفبا Sort گرديده و محصول سال ٢٠٠٣ دانشگاه Jhon's Hopkins ميباشد. Atlas of Dermatology (T.L.Diepgen, M. Simon, A. Bittorf, M. Fartasch, G. Schuler) (with the DOIA team G. Eysenbach, J. Bauer, A. Sager) (springer) تاريخچة اطلس درماتولوژي برميگردد به سال ١٩٩٤ كه شبكة سراسري جهاني انيترنت (www) ايجاد شد. از ا ن سال به بعد از سراسر جهان تصاوير ضايعات درماتولوژي در اين شبكه در محل (DOIA) Dermatology online Atlas گنجانده شده است. در اين سايت اينترنتي علاوه بر ٣٠٠٠ تصرير با كيفيت بسيار بالاي بيش از 600 DPI تشخيص درماتولوژي اراي ه سخنرانيها Case report صوتي و... گنجانده شده است. بنابراين اطلس فوق به صورت Offline از DOIA تهيه شده كه قابليت اتصال در هر زمان به صورت online را دارد. Atlas of Differential Diagnosis in DERMATOLOGY (Klaus F. Helm, M.D., James G. Marks, Jr., M.D.) اين CD بر خلاف اطلسهاي ديگر كه بيماريها را بر اساس حروف الفبايي يا پاتوفيزيولوژي تقسيمبندي كرده تا كيد بيشتر به تشخيص باليني و افتراق بيماريهاي از يكديگر به صورت تشخيصهاي افتراقي دارد. به طريكه در مورد تشخيص يك بيمار تصاوير بيماريهاي ديگر كه با ا ن بيمارييي اشتباه ميشود گردا وري شده و به صورت يك اطلس Problem-oriented تنظيم گرديده است. اين CD راشها و ني وپلاسمها را بر اساس شكل و محل به ١٦ فصل تقسيمبندي شده در اول هر فصل ابترا الگوريتم رسيدن به تشخيص نشان داده شد و سپس در جداول مقايسهاس تشخيص افتراقيهاي اين ضايعات نمايش داده ميشود و سپس تصاوير با كيفيت بالا به صورت مقايسهاي نشان داده ميشود. در ا خر هر فصل نيز اتيولوژي نكات مهم باليني و درمان براي هر بيماري به صور جداگانه اراي ه شده است. اين CD در برنامه Acrobat reader اراي ه شده است. در ابتدا يك برنامه مالتي مديا ) به صورت (animation براي ا شنايي با محتويات CD و چگونگي كار اراي ه شده است. در اين image gallery.cd وجود دارد كه تصاوير بدون توضيح اراي ه شده و از ا ن به عنوان quiz و ارزيابي شخصي ميتوان استفاده كرد. از index incon كه بر اساس حروف الفباي انگليسي بنا شده ميتوان به راحتي براي جستجوي موضوع بيماري كمك گرفت. Botulinum Toxin Aesthetic Indications (Mauricio de Maio, Segio Talarico, Benjamin Ascher, Nam Ho Kim South) Clinical Dermatology ( A Color Guide To Diagnosis And Therapy) (Fourth Edition) (Thomas P. Habif) PART III COSMETIC SURGERY PROCEDURES AND TECHNIQUES 10 Topical Skin Care 11 Lasers in the Treatment of Vascular Lesions 12 Lasers in the Treatment of Pigmented Lesions 13 Laser Hair Removal 14 Liposuction 15 Hair Transplantation 16 Soft Tissue Augmentation 17 Botulinum A Exotoxin Injections for Photoaging and Hyperhidrosis, 18 Chemical Peels 19 Lasers in Skin Resurfacing 20 Blepharoplasty 21 Surgical Rhytidectomy: Face Lifts and the Endoscopic Forehead Lift 22 Leg Vein Management: Sclerotherapy, Ambulatory Phlebectomy, and Laser Surgery 23 Scar Management: Keloid, Hypertrophic, Atrophic, and Acne Scars مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
305 Color Atlas and synopsis of Clinical Dermatology Common and Serious Diseases Thomas B. (Fitzpatrick, M.D. Richard Allen Johnson, M.D. Dick Suurmond, M.D) COLOR ATLAS OF CLINICAL DERMATOLOGY COMMON AND SERIOUS DISEASES (Salekan E-Book) (Thomas B. Fitzpatrick, MD, Richard Allen Johnson, MD, Klaus Wolff, MD, Dick Suurmond, MD) Color Atlas of Cosmetic Oculofacial Surgery (William PD Chen, Jemshed A Khan, Clinton D McCord) Color Atlas of Dermatoscopy (2 nd, enlarged and completely revised edition) (Wilhelm stolz, Otto Braun-Falco) Color Atlas of Dermatoxcopy 2 nd, enlarged and completely revised edition (Wilhelm Stolz. Otto Braun-Falco) (Salekan E-Book) Comprehensive Facial Rejuvenation (A Practical & Systematic Guide to Surgical Managemet of the Aging Face) (Edwin F. Williams III, Samuel M, Lam) Consult a Physician Before Beginning any new Exercise Program Rejenuve FACIAL MAGIC (Gynthia Rowland) Correction of Wrinkles & Augmentation of lip and cheek with Restylane & Perlane (Natural beauty for as long as you like) يكي از بهترين Skin filler ها براي رفع چين و چروكهاي صورت كه سازگاري ا ن با بافت انسان ١٠٠% است. هيانوروتيك اسيد توليد شده توسط تكنيك recombinant ميباشد. اين ماده توسط كشور سوي د در سه غلظت به نامهاي Restyalne, Restyane fine و perlane ميباشد كه بر حسب نوع خطوط صورت (ظريف يا عميق) در سطوح مختلف درم تزريق ميشود. در اين : VCD ابتدا مروري بر چگونگي ساخت اين سه ماده دارد و سپس موارد استفاده و چگونگي تزريق و تكنيكهاي تزريق را جداگانه با تصاوير كام لا واضح نشان داده شده است. ٢. در قسمت بعدي به صورت animation عمق و محل تزريق هر يك از اين سه محصول را در درم نشان ميدهد. ٣. در اين قسمت طريقة بيحسي موضعي به نمايش گذاشته ميشود. ٣. در اين قسمت تكنيك تزريق Reslane fine و محل تزريق نشان داده شده است. ٤. در اين قسمت تكنيك تزريق Restylana و محل تزريق نشان داده ميشود. ٥. در اين قسمت تكنيك تزريق Perlane براي رفع چينهاي عمقي (مانند نازوشيال) و fonciel contouring مانند cemenl) Lip enhan و (cheek enhancmeat و درمان oral Commisure نشان داده ميشود. ٦. در اين بخش تركيبي از تزريقات بالا را در يك بيمار نشان ميدهد. ٧. در بخش انتها followup بيمار توضيح داده شده است. ٨. در انتهاي هر قسمت تصاوير قبل و بعد از تزريق نشان داده است. Cosmetic Dermatology (Leslie Baumann, MD) COSMETIC LASER SURGERY PERFECT THE TECHIQUES, REDUCE THE RISKS, AND ENJOY THE RESULTS WHEN PERFORMING COSMETIC LASER SURGERY (Richard E. Fitzpatrick Mitchel P. Goldman) COSMETIC LASER SURGERY For Face and Body Cosmetic Surgery An Interdisciplinory Approach BASIC AND CLINICAL DERMATOLOGY (ALAN R. SHALITA, M.D., DAVID A. NORRIS, M.D) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده به گفته مو لف كتاب كمتر كتابي است كه تلفيقي از دانش درماتولوژي ماگزيلوفاشيال و جراحي پلاستيك را در خود گنجانده است. اين كتاب حدود ١٠٠٠ صفحهاي ا خرين تكنيكهاي در دسترس در جراحيهاي زيبايي را گردا وري نموده تا براي هر بيمار به صورت انفرادي تكنيك مناسب تصميمگيري و به كار رود. اين كتاب داراي فصولي است كه توسط درماتولوژيستها جراحان پلاستيك و جراحان فك و صورت نوشته شده است. اين كتاب Procedure هاي جراحي را قدم به قدم توضيح داده و تمام جنبههاي تكنيكهاي جراحي را توضيح داده است. اطلاعات Pre-op و Post-op و فرم رضايتنامه در هر فصل ا ورده شده. در هر فصل انديكاسيون و كنتراانديكاسيونهاي هر تكنيك جراحي و محدوديتهاي درماني و عوارض و درمان عوارض و درمان عوارض بحث شده است. به گفته مو لف كتاب چون هر فصل كتاب توسط مجربترن افراد در زمينه كاري خود نگارش يافته است نكات كليدي و تكنيكهاي اختصاصي و اطلاعات كوچك ولي باارزش در مورد تكنيكها و روش عمل ا ورده شده است. در فصل ١- طراحي مناسب براي يك جراحي بحث شده. فصل ٢- ا ناليز زيبايي شناختي در مورد درمان صورتهاي پير ا ورده شده. فصل ٣ تا Peel ٦ سطحي و عمقي و تركيب Peel ها و علاوه بر ا ن total body peel (گردن. Chest و دستها و مناطق ديگر) نيز توضيح داده شده است. در فصل ٦ كمپليكاسيون و درمان به طور جداگانه بحث شده است. در فصول ٧ و ٨ و ٩ و ٢٢ و ٢٤ و ٣٧ در مورد انواع درمانها و تكنيكهاي ليزر ) 2 Er: YAG, Co ضايعات عروقي tattoo و ضايعات پيگمانته ( hair removal مورد بحث قرار گرفته است. در فصل ٩ در مورد مو ثر بودن ليزرهاي Resurfacing صحبت نموده است. فصل ١٠ به Dermabrasion اختصاص داده است. فصل ١١ الي ١٦ در مورد دفع چين و چروكها توسط Skin filler ها Restiylans) وPerlane inerrall, كلاژن و...) و تزريق چربي و در فصل ١٥ اختصاص ا به چگونگي استفاده از Gortex اشاره شده است. فصل ١٧ به BotulinumsToxin اشاره شده است. در فصل ١٨ چگونگي جراحي خالها Cyst اسكار بحث شده است. فصل ١٩ اختصاص به انواع flap و Graft ها دارد. فصول ١٢ و ١٣ و ٢٥ به ليپوساكشن و ليپوانفوزيون و tumescent اختصاص دارد. در فصول ٣٣ تركيب procedure هاي زيبايي مورد بحث قرار گرفته است. در فصول ٣٢-٢٩ fac, Neck و lifling بحث شده و روشهاي در بلفاروپلاستي Brow Reyirvenation ا ررده شده است و در فصل ٣١ بلفاروپلاستي پلك بالا و پايين از ديد افتالمولوژيستها مورد بحث قرار گرفته است. در فصل ٢٧ كتاب روش اختصاصي.D Cook به نام The cook weekend Altrnative to face lift اشاره شده است. فصل ٣٤ به كاشت مو و Alopecia Redechion اختصاص دارد. فصل ٣٨ كتاب به تكنيكهاي عكاسي در مطب براي كارهاي زيبايي اشاره دارد. فصل ٣٩ به چگونگي برخورد و درمان بيماران مشكلا فرين و ناراضي اختصاص دارد. فصل ٤٠ و ٤١ اختصاص به ايمپلانتهاي صورت و كارهاي زيبايي جراحيهاي ماگزيلوفاسيال و دهان مورد بحث قرار گرفته است Cosmetic Surgery for FACE and BODY 24.6 Cutaneous Laser Surgery (Second edition) The Art and Science of Selective Photothermolysis (Goldman, Fitzpartick) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترنيكي گرديده مكمل بر كتاب Cutaneous Laser Surgery چاپ همين مو لفين ميباشد. كتاب Cutaneus Laser يك كتاب text در زمينة ليزر ميباشد و هر نوع از تكنولوژي ليزر براي درمان ضايعات پوستي را توضيح داده است ولي كتاب Cosmetic Laser Surgery كمكي است براي پزشكان با تا كيد بيشتر بر برخورد درماني با بيمار. فصل اول كتاب مروري بر Laser tissue interaction ميباشد كه مي توان به عنوان يك mini text book از ا ن استفاده كرد. فصل درخشان كتاب فصل Wuond healing ميباشد به گفته مو لفين استفاده از بهترين ليزرها و بهترين تكنيك ها بدون توجه به مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
306 36 Post procedural wound healing منجر به كمترين نتيجه ميشود. فصل ٣ و ٤ و ٥ و ٦ و در مورد استفاده و توضيح كمپليكاسيون از ليزرهاي co 2 و Erbium:Yag در resurfacing و Er:yag صورت و گردن و chest ميباشد و همچنين در مورد استفاده از ليزر carbon Dioxide ultrapulse و Er:yag در اطراف چشم شرح داده شده است. يكي از فصول تازه كتاب استفاده Nonablative Laser در مورد چين و چروك هاي صورت ميباشد كه مقبوليت روزافرون پيدا كرده است و در فصل incisional laser Surgery ٩ براي موارد استفاده در جراحي پلاستيك و بلفاروپلاستي توضيح داده شده است. در فصل ١٠ كتاب Tinas.Alster مو لف كتاب manual of cutaneous laser techniques استفاده از ليزر در Scar revision را شرح داده است. در فصل ١١ جديدترين تكنيكهاي مورد استفاده در hair removal [مقايسه ا نها و طرز كار و معرفي ليزرهاي معتبر از كارخانه هاي معتبر] مورد بحث قرار گرفته است واستفاده از mtense light source در hair transplant صحبت شده است. در فصل ١٢ استفاده جديد از ليزر Co 2 و Er:yag در hair transplant (كاشت مو) بحث گرديده است. در فصل ١٣ كتاب درمان Leg vein با استفاده از ليزر ا ورده شده است. در ا خر مو لفين اين كتاب را به كاربردهاي ليزر به عنوان يك راهنما در انتخاب مناسبترين تكنيكها توصيه مينمايند. Cutaneous Medicine Cutaneous Manifestations of Systemic Disease (THOMAS T. PROVOST, MD, JOHN A.FLYNN, MD) (Johns Hopkins Medical Institutions Baltimore, Maryland) به گفتة مو لفين اين كتاب ا رم و مشخصه دپارتمان درماتولوژي دانشگاه جان هاپكينز ميباشد. اين كتاب به علم درماتولوژي يك نظر كلي نه فقط به عنوان پوست و ضماي م بلكه با توجه به تظاهرات ديگر بيماري در بدن اشاره دارد. اين ٧٨٢ صفحهاي با ٧٣ فصل با عكسهاي با كيفيت عالي به راهنمايي براي درماتولوژيستها و متخصصين داخلي ميباشد. نكتة بارز اين كتاب ا وردن نكات مهم كتاب در حاشيه صفحات ميباشد. اين كتاب بيماريهاي داخلي كه تظاهرات پوستي دارند و بيماريهاي پوستي كه ميتواند علاي م عمومي پيدا كند را توصيف كرده است. تكيه اين كتاب به موارد كليد كه در تشخيص و درمان كمك ميكند ميباشد و از مباحث غيرضروري اجتناب كرده است. Sir Willamosler در مورد اين كتاب گفته است: در گذشتة اكثر درماتولوژيستها به علت شيوع سيفيميس با بيماريهاي داخلي ا شنا بوتدهاند زير به قول (AAD) American etcademy of Dermatology در مجلة Dr. Richard Dobson دانستن سيفيميس دانستن علم پزشكي است. با وجود اينترنت Procedureهاي جراحي در علم درماتولوژي به نظر من medical Dermatologist در ا ينده از جايگاه ويژهاي برخوردار خواهند بود زير ابا وجود تظاهرات پوستي بيماري AIDS و پيشرفت دانش پزشكي در كاربرد سيتوكسينها ا نتيبيوتيك كموتراپي و ايمونوساپرسيوها علم درماتولوژي باليني به افرادي براي پر كردن خالي در مراكز علمي و درماني احتياج دارد Dermatology: A Multi-Media Teaching File (Disc 1,2) (Gross & Microscopic Symposium) (Mosby) 27.6 Diagnosis & Management Anevidence-Based Approach (Robert T Brodell, Sandra Marchese Johnson) 28.6 EVIDENCE-BASED DERMATOLOGY (Howard I. Maibach, MD, Sagib J. Bashir, BSc (Hons), MB, ChB, Ann McKibbon, BSc, MLS) اين كتاب الكترونيكي بر اساس علم (Evidence- Based Heatlth Care) EBMC بنا نهاده شده است. EBHC چهارچوبي براي تصميمگيري در باليني و تحقيقي اراي ه ميدهد. و ٥ مرحله دارد: ١- ايجاد سو ال ٢- پيدا كردن مدارك معتبر براي جواب به ا ن سو ال ٣- ارزيابي اينكه اين منابع و مدارك ا يا معتبرند يا خير ٤- استفاده از اين مدارك براي تصميمگيري در درمان بيمار. اين كتاب روشي منطقي براي پيداكردن سو الات به وجود ا مده در حين كار باليني اراي ه ميدهد. در فصل اول كتاب هر يك از اين مرحله به تفضيل شرح داده شده است كه چطور ميتوان متوجه معتبر بودن يك فرضيه يا مقاله گرديد و... در فصل دوم كاربرد اين علم EBME در درماتولوژي بيان شده است. و در فصلي جدا منابع معتبر و قابل توجهي ا درس اينترنتي با مشخصات كامل براي به روزبودن اطلاعات درماتولوژيستها ا ورده شده كه در نشر كتابي اين منابع باارزش مشاهده ميشود Facial Lifting by "APTOS" threads Clinic of Plastic and Aesthetic Surgery 30.6 Hair Removal with Intense Pulsed Laser (IPL) (طريقة استفاده از ليزر- محلهايي كه براي موهاي زاي د به كار ميرود- انديكاسيونها) + فيلم ا موزشي امروزه روشهاي وقتگير و بعض ا با عارضه براي از بينبردن موهاي زاي د مانند sharing موبرها الكتروليز و... كمتر مورد استفاده قرار ميگيرد. ليزرهاي از بينبرنده موهاي زاي د با وقت كمتر كاراي ي بيشتر و عوارض مختصر كمك شاياني در يك زندگي با كيفيت مطلوب براي مراجعين به پزشكان بخصوص درماتولوژيستها و كلينيكهاي زيباي ي دارد. از جمله جديدترين ليزرهاي بكاررفته ليزر IPL ميباشد. فواي د اين ليزد در استفاده اين ليزر در بيماران با Skin type بالا Spot size بزرگتر و در نتيجه طول مدت كمتر درمان Therapeatic window بزرگتر كه موجب عارضه كمتر و كارمدي بيشتر ميشود. در اين CD كه به سفارش كمپاني Ellipse توليد شده است. معرفي ليزر IPL چگونگي استفاده از ليزر فواي د ليزر IPL مناطقي كه در ا ن از ليزر IPL براي رفع موهاي زاي د استفاده شده است. در هر بخش كليپ ويدي وي ي از بيماريان و نحوه درمان و نتايج درمان با عكس و clip نشان داده شده است HAIR TRANSPLANTATION (The Art of Micrografting and Minigrafting) (Salekan E-Book) ANATOMY AND PHYSILOGY OF HAIR PATIENT EVALUATION PLANING AND PATIENT INSTRUCTUIONS TECHNIQUE COMBINED FACE LIFT AND HAIR TRANSPLAYTATION REOPERATIVE SURGERY SPECIAL APPLICATIONS 32.6 HANDBOOK OF ORAL DISEASE DIAGNOSIS AND MANAGEMENT Cripian Scully (MARTIN DUNITZ) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده شامل ٤٢٠ صفحه متن به همراه بيش از ٤٠٠ تصوير رنگي از ضايعات دهاني مورد استفاده درمالوژيستها و دندانپزشكان ميباشد. اين كتاب يه تنها به عنوان اطلس بلكه از جنبة اتيولوژي كليدهاي تشخيصي درمان و در صورت امكان پيشگيري نيز به ضايعات دهاني پرداخته است. بيماريهاي شايع و مهم بافتهاي نرم دهاني در اين كتاب بحث شده است علاوه بر اين تعدادي موارد نادر كه در سطح جهان رو به افزايش است مورد بررسي قرار گرفته است. فصل اول كتاب شامل بررسي symptom, sign ضايعات دهاني ميباشد. فصول بعدي شامل دردهاي ناحية دهان با منشاء عروقي يا عصبي شكايات دهاني با منشاء رواني ضايعات مخاطي بزاقي ضايعات لثهها ضايعات لب و كام و ضايعات دهاني ميباشد. در هر فصل ابتدا ضايعات بر اساس الفباي انگليسي تنظيم و سپس بر اساس management Diagnosis Clinical feature Aetiology Sexmainly affected Agemainly affected incidence Defintion تقسيمبندي شده است Laser & Lights (Volume 1 & 2) (CD I, II) (Rejuvenation, Resurfacing, Hair Removal, Treatment of Ethnic Skin) 34.6 Laser Hair Removal (David J. Goldman) (Martin Dunits) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده مروري بر ليزرهاي مورد استفاده براي برداشت موها removal) (hair ميباشد. نخستين فصل كتاب اختصاص به بيولوژي مو دارد. فصل بعدي كتاب مروري گذرا به فيزيك مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
307 ليزر و كاربرد ا ن در hair removal ميباشد. فصل بعدي كتاب به چگونگي ا نجام الكتروليز در رفع موهاي زاي د و مقايسة ا ن با ليزر ميپردازد. در فصول ديگر كتاب انواع مختلف ليزرها كه براي رفع موهاي زاي د به كار ميروند بررسي ميگردد: 1- Normal mode Ruby laser 2- Normal mode alexandrite laser 3- Diode laser 4- ND: YAG laser 5- Intense pulsed light در هر بخش مقالات تحقيقي و طرق استفاده از هر يك از دستگاههاي ايزر ا ورده شده و در ا خر هر فصل نظر مو لف در خصوص هر يك از اين سيستمها مطرح شده است. يكي از نكات منحصر بهفرد كتاب معرفي ليزرهاي معتبر از شركتهاي معتبر و مقايسة ا نها با يكديگر ميباشد كه پزشك را در انتخاب دستگاه ليزر مناسب ياري ميكند كه در نهايت با انتخاب صحيح به حصول نتيجة خوب كمك شاياني مينمايد. MANUAL OF CHEMICAL PEELS Superficial and Medium Depth (Mark G. Rubin, MD) MANAGEMENT OF FACIAL LINES AND WRINKLES (ANDREW BLITZER, WILLIAM J. BINDER, J. BRIAN BOYD ALASTAIR CARRUTHERS) (SALEKAN E-BOOK) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده شامل ٢٢ فصل اطلاعات جالبي در مورد درمان و نوع برخورد با چين و چروكها Wrinkle) (Line 8 مورد بحث قرار گرفته و سپس با استفاده از فصول مجزا exfoliants يا Superfical peel مرطوبكنندة ا نالوگهاي Chemical Vitamins بافنول و TCA مقايسه Peel شيميايي و ليزر Dermabrasion استفاده از انواع implant هاي صورت استفاده از Dermal Allograft طريقة گذاشتن GORTEX تزري كلاژن و چربي Directexcision چين و چروكها تصحيح جراحي facelifting, endoscopic Browloft Skeletal frame بلفاروپلاستي. يك فصل از اين كتاب اختصاص به مرور فيزيولوژي و كاربرد درمان توكسين بوتولينيوم در پزشكي و فصل ديگر به طريقة استفاده از تزريق Botulinium Toxin براي درمان چين و چروكها بحث مينمايد. سپس در فصل ٢٠ طريقة استفاده از ليزر و Botulinumtoxin در رفع خطوط در چشم توضيح داده شده است. در فصل ٢١ طريقة عكس گرفتن از بيمار به عنوان يك سند پزشكي و Computer imaging با دوربينهاي ديجيتالي مورد بحث قرار گرفته است. MANUAL OF CUTANEOUS LASER TECHNIQUES (Second Edition) (Tinal S. Alster, M.D.) (SALEKAN E-BOOK) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده شامل ١٢ فصل است كه يكي از كاربرديترين كتابها در زمينة درمان ضايعات پوستي با ليزر ميباشد. نگاه اين كتاب بيشتر بر نكات عملي ليزر و تكنيكها و مشكلاتي است كه حين و بعد از عمل ايجاد ميشود متمركز شده است. در اين كتاب توضيحاتي كه به بيمار قبل از عمل و بعد از عمل بايد داده شود و همچنين چگونگي انتخاب بيمار مناسب selection) (Patient به طور كامل شرح داده شده است. در بعضي از فصول كتاب به معرفي تكنيكهاي به كارگيري ليزرها و معرفي دستگاههاي ليزري معتبر و مقايسة دستگاههاي ليزر و روش انجام كار به طور جداگانه براي ليزرهاي اختصاصي پرداخته است. در فصول جديد كتاب نسبت به edition قبل شامل erbium :YAG laser و Resurfacing بلفاروپلاستي با ليزر و ليفتگ پيشاني همزمان با ليزر و ليزرهايremoval hair اضافه شده است و در فصول ا خر كتاب عوارض ليزر و چگونگي درمان ا نها در مورد هر ليزر به طور جداگانه بحث شده است. Minor Surgery a text and atlas Fourth edition (John Stuart Brown) PHYSICAL SIGNS IN DERMATOLOGY (SECOND EDITION) Clifford M Lawrence Neil H Cox (Joseph L Jorizzo) (SALEKAN E-BOOK) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده شامل بيش از ٧٠٠ تصوير تمام رنگس از ضايعات مختلف پوستي ميباشد كه بر اساس شكل و رنگ و محل ضايعات تقسيمبندي شده و تشخيصهاي افترافي ا ورده شده است. اين كتاب به خواننده اين امكان را ميدهد كه با ا ناليز در مشاهدة باليني و استفاده از معلومات به تشخيص صحيح ضايعات برسد. اين كتاب بيماريها را بر اساس فيزيوپاتولوژي (عفوني اتوايمون و... ( تقسيم بندي نكرده بلكه بر اساس شكل و محل ضايعات فصل بندي شده است. كه براي دانشجويان درماتولوژي يك approach عملي براي رسيدن به تشخيص ضايعات را فراهم ميكند. اين كتاب هر چند به عنوان يك كتاب test درماتولوژي نميباشد ولي تمام مباحث مهم و بسياري از موارد نادر درماتولوژي در ا ن گنجانده شده است. يكي از نكات ممتاز در ويرايش جديد اين كتاب ا وردن جداولي است كه در ا نها نكات كليدي در تشخيص و pitfallsهاي تشخيصي بيان گرديده است. در حقيقت اين كتاب شامل اطلس رنگي ضايعات پوستي و شرح و ا ناليز رسيدن به تشخيص ضايعات و جداول كمك كننده در تشخيص ميباشد كه موجب شده يك كتاب باارزش نه تنها براي درماتولوژيستها بلكه براي ساير پزشكان كه با بيماريهاي پوستي كمتر ا شنايي دارند به كار رود. به گفتة Dr. Joav Merick تصاوير ا ن چنان كيفيتي دارندكه گويا بيمار در مقابل شما ايستاده است. به علت اهميت اين كتاب بايد هر درماتولوژيستي اين كتاب را همراه داشته باشد و ساير خانوادههاي پرشكي متخصيصين اطفال و داخلي در فعاليت باليني به اين كتاب احتياج پيدا خواهند كرد. هر كتابخانة پزشكي بايد اين كتاب را در قفسههاي خود جاي دهد... Practical MINOR SURGERY Primer of Dermatopathology (Third Edition) (Antoinette F. Hood, Thedore H. Kwan, Martin C. Mihm, Jr., Thomas D. Horn, Bruce R. Smoller) 1. Introduction 3. Basement Membrane Zone, Oaoillary Dermis, and Superficial Vascular Plexus 4. Reticular Dermis 7. Bonus Quizzes 2. Epidermis 5. Appendages 6. Panniculus Photoaging (Darrell S. Rigel, Robert A. Weiss) Radiosurgical Treatment of Superficial Skin Lesions (S. Randolph Waldman, M.D.) Radiosurgical Vaporization of Dermatologic Lesions (Dr. Stephen Chiarello) 1- Rhinophyma 2- Keratosis Removal 3. Scar Revision (Back) 4. Basel Cell Carcinoma (Nasal Tip) 5. Scar Revision (Nose) 6. Basal Cell Carcinoma (Nasal Bridge) 7. Scar Revision (Lower Forehead) 8. Radiosurgery in ENT 9. Turbinate Shrinkage 10. Rhinoplasty 11. Tonsillectomy 12. Tympanoplasty Reconstructive Facial Plastic Surgery (SALEKAN E-BOOK) (طريقة استفاده از ليزر- محلهايي كه براي موهاي زاي د به كار ميرود- انديكاسيونها) + فيلم ا موزشي امروزه روشهاي وقتگير و بعض ا با عارضه براي از بينبردن موهاي زاي د مانند sharing موبرها الكتروليز و... كمتر مورد استفاده قرار ميگيرد. ليزرهاي از بينبرنده موهاي زاي د با وقت كمتر كاراي ي بيشتر و عوارض مختصر كمك شاياني در يك زندگي با كيفيت مطلوب براي مراجعين به پزشكان بخصوص درماتولوژيستها و كلينيكهاي زيباي ي دارد. از جمله جديدترين ليزرهاي بكاررفته ليزر IPL ميباشد. فواي د اين ليزد در استفاده اين ليزر در بيماران با Skin type بالا Spot size بزرگتر و در نتيجه طول مدت كمتر درمان Therapeatic window بزرگتر كه موجب عارضه كمتر و كارمدي بيشتر ميشود. مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
308 38 در اين CD كه به سفارش كمپاني Ellipse توليد شده است. معرفي ليزر IPL چگونگي استفاده از ليزر فواي د ليزر IPL مناطقي كه در ا ن از ليزر IPL براي رفع موهاي زاي د استفاده شده است. در هر بخش كليپ ويدي وي ي از بيماريان و نحوه درمان و نتايج درمان با عكس و clip نشان داده شده است REFINEMENT IN HAIR TRANSPLANTATION: Micro and minigraft Megasession (Alfonso Barrera, M.D.) اين كتاب الكترونيكي در مورد پيوند مو به روش ميكروگرافت (گرافت ٢-١ مو) و مينيگرافت (گرافت ٤-٣ مو) براي طاسي مردانه و ديگر اختلالات ريزش مو ميباشد. علاوه بر تصاوير رنگي تصاوير گرافيكي براي فهم مطالب به كار رفته است. فصل ١- در مورد ا ناتومي و فيزيولوژي مو ميباشد تا اطلاعات پايهاي قبل از انجام اعمال پيوند به نوا موزان بدهد. فصل ٢- اطلاعات سودمندي در مورد الگوهاي مختلف ريزش مو و جراحي و ارزيابي مشكلات فردي بيمار و بهترين روش براي برطرفكردن ريز مو كمك ميكند. فصل ٣- در مورد تجهيزات لازم براي انجام پيوند مو و همچنين اطلاعاتي كه بايد به بيمار قبل از انجام جراحي داده شود. فصل ٤- توضيح قدم به قدم توسط تصاوير واقعي و گرافيكي انجام اعمال جراحي پيوند مو ا ورده شده و سپس تصاوير Caseهاي جراحيشده از ابتدا تا انتهاي عمل نشان داده شده و در مورد نتايج هر يك بحث ميشود. فصل ٥- تركيب جراحي پيوند مو با تكنيكهاي ديگر مانند face lifting ميباشد. در اين فصل Caseهاي مختلف كه قب لا توسط روشهاي ديگر براي طاسي سر جراحي شدهاند نشان داده شده و ترميم ا نها به روش ميني و ميكروگرافت ا ورده شده است. فصل ٦- كاربردهاي ديگر ميكروگرافت و مينيگرافت در كارهاي زيبايي و جراحي پلاستيك شرح داده شده است. فصل ٧- كتاب كاربرد ميكروگرافت و مينيگرافت در پنهانكردن اسكارهاي Scafp اصلاح خط ريش بخصوص بعد از face lift كاشت ابرو سبيل ريش درمان ا لپوسپي به علت سوختگي و كاشت مژه ا ورده شده است. فصل ٧ برجستهترين فصل كتاب ميباشد كه اين كتاب راز كتب مشابه پيوند مو را متمايز ميكند Surgery of the Skin Procedural Dermatology (June K. Robinson, C. William Hande, Roberta D. Sengelmann, Daniel M. Siegel) (CD I- VI) Clip 1 Clip 2 Clip 3 Clip 4 Clip 5 Clip 6 Skin Structure and Surgical anatomy Layered closures, complex Axial pattern flaps Chemical peels Laser & light treatment of acquired Rejuvenation of the neck Anesthesia and analgesia closures with suspension sutures Skin grafting Cyhin Implants & congenital vascualr lesions using liposuciton and othe Dressings & Postoperative Care & plication of SMAS Regional reconstruction: trunk, extremities, Use of Botulinum Toxin Type Endovenous ablation techniques technuques Electrosurgery, electrocoagulation, Repair of the split earlobe, ear hands, feet, face (perioral, periorbital, cheek, A in facial rejuvenation with ambulatory phlebectomy for Nail surgery electrofulguration, electrosetion, piercing & earlobe reduction nose, forehead, ear, neck & scalp) Liposuction varicose veins Legucer management electrocautery Random pattern cutaneous flaps Scal revision Autologous fat transfer: Minimum incision face lift Benign subcutaneous lesions: Cryosurgery Soft tissu augmentation evolving concepts & techniques Blepharoplasty & brow lift cysts & lipomas Skin Biopsy Techniques Follicular unit hair Suturing technique & other closure transplantation materials Microdermabrasion & Hemostasis dermabrasion Ellipse, ellipse variations & dos-ear Laser treatment of tattoos & repairs pigmented lesions Laser Skin resurfacing: ablative and non-ablative Skin Resurfacing (William P. ColemanIII, Naomi Lawrence) Skin Rejuvenation with skin filler (E.E.A. Derm) CD حاضر روش انتخاب ا نستزي و تزريق Juvederm ميباشد. در اين ويدي و CD نحوة ا نستزي بدون اينكه ا ناتومي محيط ناحيه تزريق از بين برود نشان داده شده است. سپس پركردن چين نازوبيال با Juvederm30 و سپس افزايش حجم لب با Juvederm24 و از بينبردن چروكهاي ظريف با Juvederm18 نشان داده شده است. Techniques in Dematologic Surgery (Keyvan Nouri MD, Susana leal-khouri MD) Textbook of Dermatology (Sixth Editions) (R.H. CHAMPION, J.L. BURTON, D.A.BURNS, S.M.BREATHNACH) (ROOK) (Software c Gention I.T. Consuliants Ltd.,) Version ويرايش ششم كتاب درماتولوژي Rook شامل ٤ جلد و ٣٦٨٣ صفحه ميباشد در اين ويرايش تمام فصلها مرور شده و ا خرين اطلاعات اضافه گرديده است. بسياري از فصلها بازنويسي شده و در حدود ٣٠-٢٥ % رفرانسها جديد ميباشند. در هر فصل تصاوير با كيفيت بالا اراي ه شده است. استفادهكنندگان از CD اين كتاب ميتوانند از عكسهاي كتاب به عنوان Slide Conference استفاده نمايند. كتاب حاضر رفرانس دستياريان پوست و Board certification ميباشد Textbook of Dermatology (Rook's) (Seven Edition) (Volume 1-4) (E-Book) 53.6 Textbook of Pediatric Dermatology (JOHN HARPER ARNOLD ORANJE NEIL PROSE) (VOLUME 1, 2) كتاب فوق كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده در خصوص Pediatric dermatology است كه در اكثر كشورها يك Subspeciality جداگانه ميباشد. مو لفين اين كتاب يك encyclopedic text در درماتولوژي اطفال به كمك 185 محقق از سراسر جهان گردا وري كردهاند كه به عنوان board cerificaition در درماتولوژي اطفال پذيرفته شده است. روش نگارش كتاب كام لا مشابه به روش نگارش كتاب (RooK) text book of general dermatology ميباشد. اين كتاب در بر گيرندة درماتولوژي از دورة پرهناتال تا adolescent ميباشد. كتاب مشتمل بر ٢٩ فصل بوده كه شامل بيماريهاي شايع مانند Psoriasis و بيماريهاي نادر ميباشد. همچنين ا خرين پيشرفت در ژنتيك ملكولي و روشهاي درماني در اين كتاب گنچانده شده است. در بخش عفوني كتاب بيماريهاي اندميك مانند لپروزي و ليشمانيوز و اندميك ترپونوماتوز و... كه در كتابهاي درماتولوژي ديگر به اختصار بحث شده است توسط افراد ftrsthand knowledge تحرير گرديده است. در بخش ليزر كتاب استفاده ليزر براي درمان ضايعات پيگمانته و عروقي گنجانده شده است و روشهاي Sedation و بيهوشي در اطفال در فصل Surgery كتاب بحث شده است. در فصل Surgery تكنيكهاي ساده و پيچيدة جراحي مشتمل بر tissue expansion و انواع مختلف graft كشت كراتينوسيتها تدابير درماني كلوي يد اسكار و سوختگي شرح داده شده است. مشخصة منحصر به فرد كتاب عكسهاي متنابه با كيفيت بالا بوده كه به عنوان يك اطلس پوست در Pediatric dermatology كاربرد دارد. و به گفتة مو لفين تلاش زياد شده كه تظاهرات مختلف پوستي در نژادهاي مختلف حداقل در مورد بيماريهاي شايع جمعا وري گردد The Aging Face A Systematic Approach (Calvin M. Johnson, Jr., Ramsey Alsarraf) (CD I, II) The Coronal Browlift: 1. Introduction 2. The Incision 3. The Corrugator Muscles 4. The Procerus and frontalis 5. Closure Blepharoplasty: 1. Uooer Lids 3. Marking and Incision 5. Skin and Muscle 7. Fat Removal 9. Closure مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
309 Lower Lids 4. The Incision 6. Fant Removal 8. The Skin Pinch -The Deep Plane Facelift -Marking and Incision -Skin Elevation -The Deep Plane -The Submental Region -Resuspension -Closure Treatment of Skin Disease Comprehensive therapeutic Strategies (Mark G Lebwohl Warren R Heymann, John Berth-Jones, Ian Coulson) (SALEKAN E-BOOK) (MOSBY) كتاب الكترونيكي حاضر شامل اطلس + استراتژي درماني + دارودرماني بيماري پوست ميباشد) مشكل اصلي پزشكان در مواجهه به يك بيماري بعد از تشخيص management بيماري ميباشد. چه سو الاتي بايد از بيمار پرسيده شود و چه ا زمايشاتي بايد درخواست گردد. هر فصل از اين كتاب شامل يك بيماري (به ترتيب حروف الفبا براي دستيابي به ا سان به بيماري) بوده و هر فصل و شامل: ١- خلاصهاي از بيماري ٢- استراژي درمانيstrategy management (در بالين و معاينه و شرح حال بايد چه نكاتي جستجو شود) ٣- جدول براي اينكه پزشك چه ا زمايشات پاراكلينيكي را درخواست كند investigations) (specific ٤- درمان (به ترتيب خط اول خط دوم خط سوم درمان) نكتة متمايزكننده اين كتاب نسبت به كتابهاي درماني ديگر پوست الويتبندي درمان ميباشد. اين الويتبندي بر اساس evidence-based ميباشد و الويت بر اساس نوع مطالعات انجامشده در مقالات از A-E نامگذاري شده است. به عنوان مثال در درمان ا كنه اتروژسنهاي خوراكي (A) و اسپيرونواركتون (B) نامگذاري شده كه (A) مشخصه study) (double blind بوده و (B) مشخصه trial) (Clinical ميباشد كه به پزشك كمك ميكند تا بتواند ارزش دارودرماني را بر اساس نوع مطالعه بيان كند. سپس خلاصه مقالات در ادامه درمان ذكر شده است. اين كتاب شامل ٢١٣ بيماري همراه با عكسهاي كام لا رنگي ميباشد. USING BOTULINUM TOXINS COSMETICALLY (Jean Carruthers, Alastair Carruthers) Introduction Horizontal Forehead Lines Periorbitalarea Infraorbital Orbicularis Oculi MID and Lower Face Perioal Rhytides Brow Injections Brow Lift Periorbitalarea Lateral Orbital Wrinkles MID and Lower Face Perioral Rhytides MID and Lower Face Nasalis Cervical Injections Vertical Platysmal Bands Acknowledgemetns MID and Lower Face Mouthe Frown and Mentalis Cervical Injections Horizontal Necklace Lines عنوان CD A New Generation in Cemented Hip Design (VCD) (Part I, II) (David S. Hungerford, Clayton R. Perry) Segment I: Core Decomtpression Segment II: Trauma Case Studies: Retrograde Femoral Nailing AO Image Collection AO Principles of fracture Management (T.P. Ruedi, W.M. Murphy) AO International AO Teaching Series-LCP (Thomas P. Ruedi, Prof. Michael Wagner) Foreword-Basics LCP system LCP cases Literature and studies Methods of osteosynthesis AO Principles Biomechanical Principles Surgical techniques Description Implants and instruments Application Indications Operating techniques Humerus Forearm Pelvis and acetabulum Femur Tibia Periprosthetic Related Literature Study results AO Principles of Fracture Management (Thomas P. Ruedi, William M. Murphy) (CD I, II) 1- AO philosophy and Its basis 2- Decision making and planning 3- Reduction and fixation techniques 4- Specific fractures 5- General topics 6- Complications Arthroscopic Surgery (Michael J. Strobel) Artthrex Techniques Transfix ACL Reconstruction (Eugene M. Wolf, San Francisco.CA) Atlas of ORTHOPAEDIC Surgery A multimedia Refefence (Kenneth J. Koval, Joseph D. Zuckerman) (Textbook & Videos) Atlas of Orthopaedics Surgery (Disk 1-6) Disk 1: Condylar Plate Fixation in the Distal Femur, Malleolar Fracture Fixation, Malleolar Fracture Type B, Malleolar Fracture Type C, Tension Band Wiring on the Elbow Femoral Neck Rfacture Large Cannulated System, Fracture of the Radius Shaft 3.5 LC-DCP, Screw Fixation and Plating Disk 2: Techniques of Absolute Stability, Proximal Humerus Fracture, Reduction with Clamps, Posterior Wall Fracture, Posteror + Transverse Wall Fracture, Undeamed Tibial Nail (UTN), Intraaticular Fracture of the Distal Humerus Disk 3: Fracture of the Tibiaplateau, Tibia Fracture in Foarm LEG UTN, Reduction Techniq, The Undeamed Femoral Nail System, Dynamic Condylar Screw (DCS), Dynamic Hip Screw (DHS), Pilon Tibial Fractures (Foamed Foot) Disk 4: Application of Large Distractor, AO Asif External Fixator, PC-FIX Point Contact Fixator an Internal Biologicl, The Proximal Femoral Nail (PFN), Bicondylar Fracture of Tibia Plateau, Minimal Invasive Plating of the Tibia ٧- ارتوپدي سال انتشار مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
310 Disk 5: Direct and Indirect Reduction Techniques, Short Oblique Radius Fracture, Small External Fixator, Intraarticular Fracture Distal Radius, Distal Radius, Open Reduction & Fractures of the Calcaneus, Postoperative Treatment, Internal Fixation of a Humeral Shaft Fracture Disk 6: High Cinematography of a Butterfly Fracture, Posterior, Pelvic Fixations Symphysis Pubis & Pubic Rami, Pelvic Fixations, Anterior Plate Fixation 53028, The Pelvic C-Clamp, Liss Less Invasive Stabilization System, LCP Locking Compression Plate Body in Motion (Susan K. Hillman) -Anatomy -Content -Everything -Anatomy Text -Surface Anatomy Videos -Muscle Aciton Videos Bone Tumors (Howard D. Dorfman, Bogdan Czerniak) CCC (Core Curriculum in Primary Care) Orthopedics/Sport Medicine Section 1- Introduction 2- Orthopedic Procedures: A Rheumatology's Perspective 3- Xercise and Aging A Prescripton for life 4- Foot and Ankle Problems Part Two Click'X VenttoFix SynCage (J. Webb, O. Schwarzenbach J. Thalgott) (VCD) (AO ASIF OFFICIAL TAPE) Diel's Knee Injuries (Ligament & Cartilage, Structure, Function, Injury, and Repair) (Second Edition) Double Socket Technique ACL/PCL Reconstruction Using Bio-Interference Screw Fixation & Anterior Tibialis Allograft (David Caborn) FRACTURES IN ADULTS (ROCKWOOD AND GREEN'S) 1- General Principles 2- Upper Extremity 3- Spine 4- Lower Extremity FRACTURES IN CHILDREN General Principlse Upper Extremity Spine Lower Extremity (ROCKWOOD AND WILKINS) (James H. Beaty, James R. Kasser) FRACTURES OF THE PELVIS AND ACETABULUM (G.F. Zinghi, A. Briccoli, P.Bungaro) (Salekan E-Book) Gait Analysis an introduction (Third Edition) An interactive multi-media presentation produced using polygon software (Micheal W. Whittle) Green's OperativeHand Surgery (Fifth Edition) (David P. Green, Robert N. Hotchkiss) (CD I, II) Imaging of Spinal Trauma in Children (Lawrence R. Kuhns, M.D.) (University of Michigan Medical Center) Principles AND TECHNIQUES ATLAS OF SPINAL INJURIES IN CHILDREN Epidemiology Normal Spine Variants and Anatomy Special Views and Techniques Cervcal Spine Lumbar Spine Measurements Mechanisms and Patterns of Injury Experimental and Necropsy Data Thoracic Spine Sacrococcygeal Spine Occipitocervical Injuries Thoracic Spine Injuries Sacral Injuries Lumbar Semi-Tendinous & Gracilis ACL Reconstruction with Gio-Interference Screws (Champ L. Baker, M.D) Surgical Exposures in ORTHOPAEDICS The Anatomic Approach (Stanley Hoppenfeld, Piet Deboer) Techniques for Performing Hip Arthroscopy (Joseph McCarthy, Boston, Massachusetts) Interactive orthopaedics and Sport Medicine 1. Interactive Spine 2. Interactive Hand 3. Interactive hand therapy 4. Interactive Hip 5. Interactive Shoulder 6. Interactive Knee 7. Sports Injuries The Knee 8. Interactive Food and Ankle 9. Interactve Skeleton 10. Interactive HAND Therapy Edition (Version 1.1) (J C Colditz, D A McG Routher, J M Harris) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
311 Internal Fixation of a Humeral Shaft Fracture with the UHN (P.M.Rommens, J. Blum) -Technical Information -Operation -Postoperative Concept -Poat-op X-ray control - Poat-op treatment Magnetic Resonance Imaging in Orthopedics and Sport Medicine (David W. Stoller) اين نرمافزار در ارتباط با كاربرد MRI در ارتوپدي و طب ورزش ميباشد و شامل مباحث زير است: ١- تهية تصاوير MRI ٦- اثرات بيولوژيك و ايمني در MRI ١١- تكنيك بازسازي جهت MRI سهبعدي ١٦- تومورهاي استخوان و بافت نرم ٢- اصول تصويرسازي Echo-Planar جهت سيستم موسكولواسكلتال ٧- MRI عضروف مفصلي و دژنراسيون عضروفي ١٢- مفصل ران (Hip) ١٧- MRI ا سيبهاي عضلاني ٣- زانو ٨- مچ پا و پا ١٣- شانه ٤- ا رنج ٩- مچ دست و دست ١٤- مفصل كمپورومانديبولار (TMJ) Kinematic MRI -٥ ١٠- ستون فقرات ١٥- تصويربرداري MRI از مغز استخوان MASTER TECHNIQUES IN ORTHOPAEDIC SURGERY RECONSTRUCTIVE KNEE SURGERY Southern California Center for Sports Medicine Long Beach, California (DOUGLAS W. JACKSON, M.D.) اين CD كه شامل كل متن كتاب فوقالذكر است كه در مركز خدمات فرهنگي سالكان تبديل به ebook گرديده و شامل تمامي مباحث كتاب به صورت TEXT بوده و قابليت serch مطالب در ا ن ميباشد. مباحث اين CD شامل: Operating Room Environment PART I EXTENSOR MECHANISM PATELLOFEMORAL PROBLEMS Arthroscopic Lateral Release of the Patella with Electrocautery Anteromedial Tibial Tubercle Transfer Patellectomy PART II MENISCUS SURGERY Meniscus Repair: The Outside-In Technique Meniscus Repair: The Inside-Out Technique Meniscus Repair: The All-Inside Arthroscopic Technique PART III LIGAMENT INJURIES AND INSTABILITY Anterior Cruciate Ligament Reconstruction Arthroscope-Assisted Posterior Cruciate Ligament Repair/Reconstruction Posterolateral Corner Collateral Ligament Reconstruction Surgical Technique for Knee Dislocations High Tibial Osteotomy in Knees with Associated Chronic Ligament Deficiencies MATHYS ORTHOPAEDICS (VCD) (Video-Atelier Othmar Keel AG) -CCA - Straight Shaft -CCE -Vault Pan -CCB -Socket -CBC Stem -RM Cup MATHYS-ORTHOPAEDICS HIP PROSTHESES (VCD) PART IV INTRAARTICULAR FRACTURES OF THE TIBIA AND PATELLA Arthroscopic Management of Intraarticular Tibial Fractures Arthroscopically-Assisted Fixation of Patella Fractures Open Reduction Internal Fixation of Intraarticular Fractures of the Tibia PART V ARTICULAR CARTILAGE AND SYNOVIUM Arthroscopic Chondroplasty Osteochondritis Dissecans Arthroscopic Synovectomy 1. Cemented Stem-CCA 2. Cemented Cup-CCB 3. Cementless Steam-CBC 4. Cementless Cup-RM Cup OPERATIVE ORTHOPAEDICS (CAMPBELL'S) (Tenth Edition) (Volume 1-4) (E-Book) (S. Terry Canale, MD) Operative Arthroscopy (Third Edition) (John B. McGinty) (Lippincot, Williams & Wilkins) Shoulder: Arthroscopic Cuff Repair: -Mssive U-Shaped Tear: Subscapulais, Infraspinatus and Biceps (Stephen S. Burkhar, MD San Antonio, Texas) -Partial: Repair of Oartial Articular Sufrace Rotator Cuff Tear (Stephen S. Burkhar, MD San Antonio, Texas), San Antonio, Texas Slap Lesions: -Arthroscopic Repair of the Slap Lesion (Stephen S. Burkhar, MD San Antonio, Texas) Operative Arthroscopy (Third Edition) (John B. McGinty) (Lippincot, Williams & Wilkins) Hip: Southern Sport Medicine & Orthopaedic Center Operative Hip Arthroscopy: -Dense Soft Tissue Envelope -Constrained Ball and Socket Anatomy -Thick Capsule, Limited Compliance Operative Arthroscopy (Third Edition) (John B. McGinty) (Lippincot, Williams & Wilkins) Ankle: Ankle Arthroscopy (James Tasto M.D.) - Ankle & Subtalar Arthroscopy مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
312 Operative Arthroscopy (Third Edition) (John B. McGinty) (Lippincot, Williams & Wilkins) Wrist: Wrist Arthroscopy (Robert Richards MD FRCSC) -Portal Markings -Establishing the 3/4 Portal -Radiocarpal Arthroscopy Carpal Tunnel Release Operative Arthroscopy (Third Edition) (John B. McGinty) (Lippincot, Williams & Wilkins) Knee (CD-1): Arthroscopic meniscal repair: -suture repair -implantable fixation Knee (CD-2): -ACL -Complex articular surface injuries -Fractures -Patellofemoral Operative Arthroscopy (SECOND EDITION) (John B. McGinty) 1- Basic Principles 2- The Knee 3- The Shoulder 4- The Elbow 5- The Wrist 6- The Foot and Ankle 7- The Temporomandibular Joint 8- The Spine 9- The Hip Operative Orthopaedics (Ninth Edition) (CAMPBELL'S) (S. TERRY CANALE) OPERATIVE ORTHOPAEDICS (CAMPBELL'S) اين CD شامل TEXT كامل كتاب كمپل ارتوپدي ميباشد و قابليت Serch چاپ با تمامي تصاوير مرتبط با كتاب ميباشد. اين CD شامل عملهاي جراحي مرتبط با TEXT كتاب كمپل ميباشد كه فيلمهاي اين CD شامل: Trochanteric osteotomy-hip revision Arthroscopic assisted ACL reconstruction Screw fixation SCFE Intramedullary nailing forearm fracture Reconstruction nailing femoral fracture Chevron osteotomy hallux valgus Ligament balancing Knee arthroplasty ORIF calconeal fracture Anterior Cervical discectomy & fusion ORTHOPAEDIC SURGERY (Third Edition) (CHAPMAN) Surgical Principles and Techniques - Fractures, Dislocations, Nonunions and Malunions - The Hand - The Foot - Sport Medicine - Neoplastic, Infectious - Neurologic and Other - Joint Reconstruction, Arthritis, and Arthroplasty - Skeletal Disorders - The Spine - Pediatric Disorders PEDIATRIC ORTHOPAEDICS (Lovell and Winter's) (Fifth edition) (Salekan E-Book) (Volume II) KYPHOSIS THE UPPER LIMB SLIPPED CAPITAL FEMORAL EPIPHYSIS SPONDYLOLYSIS AND SPONDYLOLISTHESIS DEVELOPMENTAL HIP DYSPLASIA AND DISLOCATION DEVELOPMENTAL COXA VARA, TRANSIENT SYNOVITIS, AND IDIOPATHIC CHONDROLYSIS OF THE HIP THE CERVICAL SPINE LEGG-CALVE-PERTHES SYNDROME THE LOWER EXTREMITY LEG LENGTH DISCREPANCY THE FOOT THE LIMB-DEFICIENT CHILD SPORTS MEDICINE IN CHILDREN AND ADOLESCENTS MANAGEMENT OF FRACTURES THE ROLE OF THE ORTHOPAEDICS IN CHILD ABUSE PEDIATRIC Fractures & Dislocations (Lutz von laer, Former Director of trauma division basel pediatric hospital) Photographic manual of Regional Orthopaedic and Neurological Tests اين CD شامل بيش از ٨٥٠ تصوير ميباشد كه نحوة انجام تمام معاينات نورولوژيك و ارتوپديك را با جزي يات تمام روشن ميسازد. در مواقع لزوم تصاوير ا ناتوميك ضروري نيز اضافه شدهاند. فصول بر اساس محل مورد معاينه طراحي و قسمتبندي شدهاند. معاينات از فقرات گردني و اندام فوقاني شروع و به فقرات كمري و اندامهاي تحتاني ختم ميشوند. هر Test در يك صفحه يا دو صفحه مقابل هم با عكسهايي كه نحوة انجام معاينه را بوضوح نشان ميدهند توضيح داده شده است. در ضمن يك Sensitivity/Relialility Scale نيز براي هر معاينه تعريف شده است كه ميزان حساسيت و قابليت اعتماد به ا ن معاينه را مشخص ميسازد. اين اطلاعات در بكارگيري تستهاي حساستر و اختصاصتر كمك فراوان به پزشك مينمايد. Podiatric Medicine and Surgery (Stephen Kriss, Alan Sherman, Harold W. Vogler, Trevor Prior) Practical Otrhopaedic Medicene (Brain Corrigan, G.D,. Maitland) Prosthetics & Orthotics Lower Limb & spinal (Ron Seymour) Radiology imaging Bank: Orthopeadic 1. Section 2. History 3. Findings 4. Diagnosis 5. Images 6. Classification 7. Imagenumber مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
313 Range of Motion-AO Neutral-O Method Shoulder Arthroscopy (DR. L. Lafosse Annecy) SPINE (VCD 1-A) (J. o' Dowd, P. Moulin, E. Morscher P. Moutin, J. Webb, M. Aebi) 47.7 Pedicie Identification (Conultant: J. O'Dowd) Cervical Spine Locking Plate: Corporectomy C6 (P. Moulin) Cervical Spine Locking Plate Vertebrectomy C6 (J. Webb, M. Aebi) CS-Titanium Locking Plate (E. Morscher P.Moutin) Cervical Spine Locking Plate (P. Moulin) Posterior Cervical Plate Fixation ( C2-T1) ( j.webb, M.Aebi) SPINE (VCD 1-B) (M. Aebi, J. Webb, Ghr. Ulrich, J. Nothwang, B. Jeanneret, M. Aebi J. Webb, J. Webb, M. Aebi P. Bryne) Posterior Plating Technique C6 to T1 (J. Webb, M.Aebi) 48.7 AnteriorFixation of the Dens with Cannulated Screws ( M. Aebi, J. Webb Ghr. Ulrich, J. Nothwang) U.S.S: Lumbosacral Stabilisation: Back-Opening Pedicte Screws (M. Aebi J. Webb) Cervix: Fixation C3-C7 in Presenceb of a Laminectomy ( B. Jeanneret) USS: Lumbosacral Fusion Sacral Implants (J. Webb M.Aebi P.Bryne) U.S.S: Lumbar Degenrrative Scotiosis Side-Opening Pedicte Screws (M.Aebi J.Webb) SPINE (VCD 1-C) (J. Webb, M. Aebi, G.Wisner, J. Webb M. Aebi, J. Webb M. Aebi, J. O'Dowd) 49.7 USS: Lumbosacral Stabilisation Side Opening Pedicle Screws (J.Webb, M.Aebi, G. Winsner) Universal Spine System Thoraco - Lumbar Fractures (J. Webb M. Aebi) SPINE (VCD 1-D) (J. Webb, O. Schwarzenbach, J. Thalgott & J. Webb, J. Webb) Universal Spine System: Right Thoracic Scoliosis: Side Opening hooks & Screws (J.Webb, M.Aebi, J.O'Dowd) 50.7 Click'X (J.Webb) The Snterior Rod System (J.Thalgott & J.Webb) Contact Fusion Cage (J.Webb) SPINE implants (CD I, II) Surgery of the Foot and Ankle (Michael J. Coughlin, Roger A. Mann) : در اين CD نحوة جراحي و بهكارگذاشتن پروتزهاي مهره نشان داده ميشود و اطلاعات كاملي راجع به پروتزهاي جانشين جسم مهره داده ميشود. در اين CD نحوه جراحي و بكارگذاشتن دستگاه Diapasone-hook بر روي مهرههاي كمري در درمان موارد تروماتيك و اسكوانيور نشان داده ميشود Volume One: 1. General Considerations 2. The forefoot 3. Postural Disorders 4. Neurologic Disorders 5. Arthritic Conditions Volume Two: 1. Miscellaneous Disorders 2. Sports Medicine 3. Pediatrics 4. Trauma 52.7 Surgery of the Knee (Third Edition) (John N. Insall, W. Norman Scott) CD I : CD II VIDEO 2- PHOTOS 3- ILLUSTRATIONS 4-3D KNEE 5-IMAGING - Anatomy -Anatomical Aberrations -Biomechanics -Imaging -Surgical Approaches The Adult Hip On CD The Shoulder (2 nd Edition) (Rockwood and Matsen) 1- Disorders of the Acromiocavicular Joint 2- Disorders of the Sternoclavicular Joint 3- Glenohumeral Instability 4- Glenohumeral Arthritis and Its Management The Unreamed Femoral Nail System (N. Sudkamp P. Duwelius) Video Collection Labor for Experimental Orthopaedics Surgery AO/ASIF VCD (CD 1-10) VCD 1-A ( R Texhammar, P Holzach) AO/ASIF Instrumentation Care and Maintenance PreOperative Preparation of the Patient Approaches to the Femur, Pelvis Knee and Elbow مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
314 44 VCD 1-B (P Matter M.D., S.M. Perren, B Noesberger) Approach to the Proximal Femur and Elbow After-Care Following Lower Leg Surgery Dynamic Compression Unit Approaches to the Upper Limb Reduction Techniques DCP 4.5 Compression Tibial Shaft VCD 1-C (B Noesberger, J.Stadler, P. Holzach, Th. Ruedi) DCP 4.5 Butterss Tibial Plateau LC-DCP 4.5 for the Distal Tbia DCP 3.5 Radius Shaft 3.5 LC-DCP DCP 4.5 Neutralization Plate of a Spiral Fracture Fracture of the Radius Shaft 3.5 LC-DCP with Shaft screws VCD 2-A (S.M. Perren, K.M. Pfeiffer M.D.). Correctional Osteotomy (dist. Radius). Basic Lag Screw Techniques. Internal Fixation of a Closed Butterfly Fracture of Right Tibia (Operation Video) VCD 2-B (Th. Ruedi, J. Mast M.D., P.E Ochsner) Fracture of the Lateral Tibiaplateau Indirect Reduction and Plate Fixation of a Pilon Fracture Malleolar Fracture Type B Pilon Fracture Malleolar fracture Type A Malleolar Fracture Type C VCD 2-C (T.Ruedi, P.Holzach, Th. Ruedi M. Schuler, P. Hozach, P Regazzoni, Th. Ruedi M.D.) Proximal Humerus Fracture Tension Band Wiring of the Elbow Intaarticular Type C Fracture of the Distal Humerus Condylar Plate Fixation in the Distal Femur Distal Humerus Fracture Type C 1.3 Dynamic Hip Screw Dynamic Condylar Screw (DCS) Proximal Femur VCD 3-A (R. Ganz R.P. Jakob P.Koch, Th Ruedi M.D., P.Regazzoni) Condylar Plate Proximal Femur Large Cannulated Screw System AO/ASIF External Fixator VCD 3-B Small External Fixator Distractor Handling Consultant Seija Pearson Using the Small Air Drill Compact Air Drive Basic Operating Procedure & Working with attachments Intramedullary Nailing with the AO/ASIF Universal Femoral Nail AO Universal Femoral Nail With Distractor VCD 3-C (R. Frigg, D. Hontzsch, Th. Ruedi) The Interlocking of the Universal Femoral Intramedullary Nail Opening Procedure of the Tibial Cavity for Intramedullary Nailing The Universal Tibial Nail Intramedullary Nailing of the Tibia Intramedullary Nailing of the Tibia with a Pseudarthrosis Mid-Shaft Tibial Fracture Locked Universal Nail VCD4 (R. Frigg, Ch. Krettek) UTN Unreamed Tibial Nail عنوان CD AMERICAN ACADEMY OF OPHTHALMOLOGY BASIC AND CLINICAL SCIENCE COURSE Section 1: Section 2: Section 3: Section 4: Section 5: Section 6: Section 7: Update on General Medicine Fundamentals and Principles of Ophthalmology Optics, Refraction, and Contact Lenses Ophthalmic Pathology and Intraocular Tumors Neuro-Ophthalmolog Pediatric Ophthalmology and Strabismus Orbit, Eyelids, and Lacrimal System Distal Aiming Device for UTN ٨- چشمپزشكي سال انتشار مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
315 Section 8: Section 9: Section 10: Section 11: Section 12: Section 13: Section 14: INDEX External Disease and Cornea Intraocular Inflammation and Uveitis Glaucoma Lens and Cataract Retina and Vitreous International Ophthalmology Refractive Surgery Master INDEX A Color Atlas of CORNEAL DYSTROPHIES & DEGENERATIONS (T.A. Casey, K.W. Sharif) A Color Atlas of UVEITIS (J. Michelson) (Second Edition) A Practical Guide to Minimal Surgery for Retinal Detachment (Ingrid Kreissig) Atlas of Clinical Oncology Tumors of the Eye and Ocular Adnexa (American Cancer Society) (Devron H. Char, MD) اين CD شامل مباحث زير ميباشد: LID AND CONJUNCTIVAL TUMORS 2- UVEAL AND INTRAOCULAR TUMORS 3- RETINAL AND OPTIC NERVEHEAD TUMORS 4- ORBITAL TUMORS ATLAS OF OPHTALMOLOGY (RICHARD K. PARRISG II) (CD I, II) (Mosby) ATLAS OF OPHTHALOMOLGY (SUE FORDRONALD MARSH) (Mosby) ارزش يك اطلس خوب در تمامي شاخههاي علم پزشكي خصوص ا چشمپزشكي كام لا معلوم و مشخص بوده مطالعة كتب text بدون همراهي اطلسهاي مربوطه تا ثير و كارا ي ي لازم را نخواهد داشت. CDهاي ذيل كه حاوي معتبرترين و شناختهشدهترين اطلسهاي چشمپزشكي ميباشند علاوه بر تواناي ي بزرگنمايي تصاوير تا چندين برابر بدون كاستهشدن از كيفيت بينظير ا ن داراي قابليت Search و جستجوي Case مورد نظر در كمترين زمان ممكن ميباشند. در كنارداشتن اين اطلسها چه به هنگام ا موزش و يادگيري در دورة دستياري و چه به هنگام Practice و مواجه به Caseهاي نسبت ا نادر در كلينيك بسيار مفيد و كمككننده خواهد بود. Basic and Clinical Science Course Retina and Vitreous (Section 12) (American Academy of Ophthalmology) (SALEKAN E-BOOK) Basic Ophthalmology Physiology of the Eye OPHTHALMOLOGY (Myron Yanoff.Jay S. Duker) (Mosby) اين CD ٣ به توضيح ا ناتومي و فيزيولوژي چشم و راههاي بيناي ي مكانيسم عيوب انكساري و نيز بيماريهاي چشم در سطح نياز دانشجويان پزشكي پزشكان عمومي و پزشكان متخصص در ساير رشتههاي پزشكي ميپردازد. ديدن اشكال شماتيك زيبا و نيز تصاوير بيماريهاي مختلف چشمي موجود در اين CDها براي متخصصين محترم چشمپزشكي نيز خالي از لطف نخواهد بود Cataract Surgery & Intraocular Lenses (Second Edition) (Jerry G. Ford, Carol L. Karp) Clinical update course on Retina CD فوق از سري CDهاي ا موزشي (Lifelong education for the ophthalmologist) LEO متعلق به ا كادمي چشمپزشكي ا مريكا (AAO) ميباشد كه در قالب Lecture ١٥ و فيلم ا موزشي مروري دارد بر جديدترين متدهاي درماني در فيلد و تيره و رتين. از جمله مباحث مطرحشده در اين CD ميتوان به شيوههاي درمان endophthalmitis macular hole BRVO DR AMD و... اشاره نمود. Clinical Update Course on Neuro-ophthalmology (Peter J. Savino, MD, Steven E. Feldon. MD, Barrett Katz, MD, Thmas L. Slamovits, MD) اين CD به معرفي روشهاي تشخيصي و درماني گلوكوم و ا خرين پيشرفتهاي حاصله در ا نها ميپردازد كه در قالب LTP Perimetry و CPC اشاره نمود. Lecture ٩ از استادان صاحبنام اين رشته ا ورده شده است. از جمله مباحث مهم ا موزش داده شده در اين CD ميتوان به Clinical Orthptics (Second Edition) (SALEKAN E-BOOK) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
316 Clinical Pathways in Bitreoretinal Disease (Scott M. Steidl, Mary Elizabeth Hartnett) Clinical Practice in Small Incision Cataract Surgery (Phaco Manual) (VCD I, II) Complications in Phacoemulsification (SALEKAN E-BOOK) به قلم برجستهترين phacosurgen هاي حال حاضر در دنيا منجمله,.H Gimbel.H Fine تمام ا به توضيح تكنيكهاي مختلف عمل جراحي Phaco عوارض احتمالي شيوة تشخيص به موقع و چگونگي برخورد با ا نها ميپردازد. اشكال شماتيك و تصاوير رنگي ا ن در درك مكانسم و علت بروز عوارض و چگونگي پيشگيري و نيز management ا نها بسيار كمككننده و در نوع خود بينظير است. CONTACT LENS COMPLICATIONS Efron Grading Morphs For the clinical assessment of contact lens complications (NATHAN EFRON, PHILIP MORGAN) اين CD عوارض مختلف ناشي از كاربرد لنزهاي تماسي و چگونگي پيشرفت و سير ا نها را به صورتي بسيار زيبا و بيادماندني نمايش ميدهد بطوريكه تشخيص و Grading عوارضي چون papillary epithelial microcystes epithelial polymegethism conjunctivitis و... ميسر ميگردد. Cosmetic Blepharolasty & Facial Rejuvenation (Stephen L. Bosniak, M.D.,) Dodick Laser Photolysis (Ultra Small Incision Cataract Surgery) (Jack M. Dodik) Journal of Cataract & Refractive Surgery Surgical Cases Provided by Photolysis System Manufacturer Diabetes And The Eye (Hamish MA Towler, Julian A Patterson, Susan Lightman) Department of Clinical Ophthalmology Institute of Ophthalmology University College London اين CD ا موزش جامعي از مقولة diabetic retinopathy اراي ه مينمايد. پاتوفيزيولوژي روشهاي تشخيصي منجمله Fluorescein angiography و بالاخره ليزرتراپي به عنوان يك روش درماني مهم به كمك عكس و text ا موزش داده شده است. همچنين CD مذكور داراي قابليت Seff-test از مطالب موجود در ا ن ميباشد. Diagnosing & Treating Computer-Related Vision Problems (Sheedy, Shaw-McMinn) DICTIONARY OF VISUAL SCIENCE AND RELATED CLINICAL TERMS (Henry W. Hofstetter, John R. Griffin, Morris S. Berman, Ronald W. Everson) Diseas of the Orbit A multimedia Approach (second Edition) Duane s Ophthalmology (Foundations of clinical Ophthalmology) (LIPPINCOTT-RAVEN) Endoscopic Dacryocystorhinostomy (DCR) Advantages and Indications (David I. Silbert, MD FAAP) (CD I, II) EENT Welch Allyn Institute of Interactive Learning European Society of Cataract & Refractive Surgeons ROME 9 th ESCRS Winter Refractive Surgery Meeting Endoscopic Laser Assisted Lacrimal Surgery (Russel S. Gonnering, MD) (VCD) 46 جراحي سيستم لاكريمال به كمك تكنيك نسبت ا جديد endoscopic laser بحثهاي زيادي برانگيخته و مخالفان و موافقان زيادي دارد. اين VCD به ا موزش اين شيوه كمتر تهاجمي در جراحي مجاري اشكي پرداخته فوايد ا ن را بررسي مينمايد. Enucleation Techniques With MEDPOR Orbital Implant MCP Placement in a Vascularized MEDPOR Implant (VCD) (Charles N. S. Soparker, Peter A. D.) Natural Movement For Artificial Eyes With MEDPOR Biomaterial Orbit Implants ans the MEDPOR MPC Motility Coupling Post (VCD) (POREX) Orbital Floor reconstruction using MEDPOR surgical implants VCD ٣ فوق مجموعا تكنيكهاي كاشت ايمپلانتهاي MEDPOR را در جراحيهاي ترميمي اربيت ا موزش ميدهند. CD ٢ اول ابتدا به روشهاي enucleation سپس به طريقة كاشت ايمپلانت MEDPOR و در انتهاب به MEDPOR Surgical implant drilling ا ن و قراردادن پروتز مربوطه روي مجموعة implant و ا موزش داده ميشود. MCP ميپردازد و Motility قابل قبول ا ن را نمايش ميدهد در CD سوم چگونگي ترميم و بازسازي دفكتهاي كف اربيت به كمك Essentials of Ophthalmic Lens Finishing (Clifford W. Brooks) 16.2 Facial Plastic & Reconstructive Surgery (Terence M. Davidson, MD) (VCD I, II) 49.8 FUNDAMENTALS OF CORMEAL TOPOGRAPHY اين دو CD جمع ا ا موزش كاملي از توپوگرافي قرنيه اراي ه ميدهند. مكانيسم و چگونگي عملكرد دستگاه نحوة تفسير توپوگرافي قرنيه انواع موارد طبيعي و غيرطبيعي artefactهاي احتمالي و نيز سير تغييرات توپوگرافي و حالات و بيماريهاي مختلف قرنيه بطور مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
317 Glaucoma Basic and Clinical Science Course (Section 10) (Salekan E-Book) Hereditary Retinal Dystrophies (Ulrich Kellner, Markus Ladewing, Christoph Heinrich) 47 جامع و قابل استفادهاي ا ورده شده است. بهرهگيري از اين دو CD علاوه بر كاربرد كلينيكي ا ن جهت شركت در امتحانات OSCE توصيه ميشود. Highlights of the XVIIth Congress of the ESCRS VIENNA'99 (EUROPEAN SOCIETY OF CATARACT & REFRACTIVE SURGEONS) 1. Intrastromal Corneal Rings 2. Multifocal IOLs 3. Cataract Technidues 4. LASIK: Muopia & Mixed Astigmatism 5. Phakic IOLs Illustrated Tutorials Clinical Ophthalmology (Jack J Kansski, Anne Bolton) Implantation of AcryFlex Foldable Lens (Surgery Performed by Dr. Jagdeep M Kakadla) (VCD) IMPLANTE MEDPOR MANDIBULAR (VCD), (AJL OPHTHALMIC, S.A.) Cataract & Refractive Sugery Highlights of the ASCRS 1995 Annual Meeting Highlights of the ASCRS 1996 Annual Meeting Highlights of the ASCRS 1997 Annual Meeting Highlights of the ASCRS 1998 Annual Meeting Highlights of the ASCRS 1999 Annual Meeting Highlights of the ASCRS 2000 Annual Meeting Highlights of the ASCRS 2001 Annual Meeting Highlights of the ASCRS 2003 Annual Meeting Highlights of the ASCRS 2005 Annual Meeting CD هاي مقابل حاوي دهها Lecture در باب Cataract & refractive Surgury از برجستهترين اساتيد مانند Robert J. Cionni Roger F. Steinert ouglas D. Koch I.Howard Fine و... ميباشد كه به كمك فيلم جراحيهاي انجامشده توسط اين استادان ا خرين تكنيكهاي جراحي كاتاراكت بروش Phacoemulsification و نيز جراحي كراتورفراكتيو شامل LASIK و PRK را ا موزش ميدهد. مجموعه CDهاي مذكور به منزلة كارگاه ا موزشي ارزشمندي چه به منظور ا موزش اولية Phaco و LASIK و چه جهت به روزدرا وردن اطلاعات و مهارتهاي قبلي ميباشد. IMPROVING SUCCESS IN FILTRATION SURGERY American Academy of Ophthalmology (BRADFORD J. SHINGLETON) اين CD يك دورة كامل ا موزشي در مورد تكنيكهاي مختلف Filstratioh Surgery ميباشد و جزي يات هر كدام از روشها را با كمك فيلمهاي تهيهشده از اعمال جراحي مربوطه ا موزش ميدهد. اين CD همچنين به معرفي دو شيوة جديد درمان جراحي بيماران گلوكومي يعني Incomitant Deviatons (4 th edition) a supplement chapter 17 of Pickwell's Binocular Vision Anomalies oblique و Deep Sclerectomy و Viscocanalostomy ميپردازد. اين CD مجموعهاي كمنظير جهت كمك به درك بهتر و عميقتر انواع مختلف انحرافات چشمي Comitant منجمله پركاري كمكاري و فلج عضلات مكانيسم پاتوفيزيولوژي طبقهبندي و تشخيص افتراقي هر نوع انحراف به معرفي چندين Case به صورت فيلم براي هر كدام از ا نها ميپردازد. rectus و نيز سندرمهاي Brown's Duane's و... ميباشد كه علاوه بر توضيح و تشريح Intraocular Inflammation and Uveitis (Section 9) (SALEKAN E-BOOK) Lasek, PRK, & Excimer Laser Stromal Surface Ablation (Dimitri T. Azar, Massimo Camellin, Rochard W. Yee) LEO Clinical Update Course on Retina (H. Michael Lambert, Charles. Arr, J. Paul Diechert, Mark W. Johnson, James S. Tiedeman) LEO Clinical Update Course on Cataract (Stephen S. Lane, MD, Alan S. Candall, MD, Douglas D. Koch, MD, Roger F. Steinert, MD) 71.8 LEO Clinical Update Course on Pediatric Ophthalmology and Strabismus THE AMERICAN ACADEMY OF OPHTHALMOLOGY (American Academy of Ophthalmology) CD فوق از سري CDهاي ارزشمند و معتبر (Lifelong education for the ophthalmologist)leo متعلق به ا كادمي چشمپزشكي ا مريكا (AAO) ميباشد كه شامل Lecture ١٣ همراه با اسلايد و فيم ا موزشي از استادان معروفي همچون K.W.Wright و M.X.Repka است. از سري مباحث مطرحشده در اين CD ميتوان به ا مبليوپي گلوكوم و كاتاراكت اطفال ROP انسداد مجراي اشكي مادرزادي و همچنين انواع مختلف انحرافات چشمي و روشهاي درمان ا نها اشاره كرد مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
318 Loeil Prental Endoscopie du Vitre Phaco Chop (VIDEO Media) (Roussat B. Choukroun J, Boscher C, Lebuisson DA, Amar R, Escalas P) - Reconnaissance des structures oculaires - Lors des echographies prenatales - Possibilites et limites actuelles Roussat B, Choukroun J (Paris) - Anatomie endoscopique normale et Pathologique de la base du vitre anterieur Boscher C, Lebuisson DA, Amar R (paris) - Le Phaco Chop: Pour que les noyaux durs deviennet un plaisir Escalas P (Nantes) Management of Strabismus & Amblyopia A Practical Guide (Second Editon) (John A. Pratt-Johnson, Geraldine Tillson) Manual of Eye Emergencies Diagnosis & Management (Lennox A. Webb, Jack J. Kanski) Manual of Oculoplastic Surgery (Third Edition) (Mark R. Levine) MOVIMIENTQ NATURAL PARA EL OJO ARTIFICIAL (VCD), (AJL OPHTHALMIC, S.A.) MVP VIDEO JOURNAL OF OPHTHALMOLOGY New England Eye Center Imaging in Glaucoma اين CD شامل عناوين زير ميباشد: CD فوق به معرفي جديدترين تكنيكهاي تصويربرداري رتين و Optic nerve با توجه ويژه به كاربرد ا نها در بيماران گلوكومي ميپردازد. از جملة اين روشهاي تصويربرداري ميتوان به OCT SLO و نيز بيوميكروسكوپي اولتراسوند اشاره كرد. New England Eye Center Photorefractive Keratectomy (PRK) Course (Helen K. WU, MD, Roger F. Steinert, MD, Michael B. Raizman, MD) CD فوق كه توسط مركز چشمپزشكي New England تهيه و اراي ه شده است در واقع يك كارگاه ا موزشي PRK به شمار ميرود كه از طريق رفته Patient sclection تا تكنيكهاي عمل و بالاخره عوارض احتمالي و راههاي پيشگيري و درمان ا نها را ا موزش داده است. Lecture ١٥ كه عمدت ا از دكتر Roger.F Steinert ميباشد كلية مساي ل و مباحث PRK از مشخصات ليزر به كار Ocular Pathology (FIFTH EDITION) (MYRON YANOFF, MD AND BEN S. FINE, MD) (Mosby) (SALEKAN E-BOOK) Basic Principles of Pathology Surgical and Nonsurgical Trauma Skin and Lacrimal Drainage System Congenital Anomalies Nongranulomatous Inflammation: Uveltis, Endophthalmitis, Panophthalmitis, and Sequelae Granulomatous Inflammation. Conjunctive Cornea and Sclera Uvea Lens Neural (Sensory) Retina Vitreous Optid Nerve Orbit Diabetes Mellitus Glaucoma Ocular Melanotic Tumors Retinoblastoma and Pseudoglioma Ocular Syndromes and Systemic Disease (Frederick Hampton Roy) (SALEKAN E-BOOK) Ocular Therapeutics Handbook A Clinical Manual (Bruce E. Onofrey, Leonid Skorin.Jr., Nicky R. Holdeman) (SALEKAN E-BOOK) Ophthalmic & Facial Plastic Surgery (Frank A. Nasi., Geoffrey J. Gladstone, Brian G. Brazzo) Ophthalmic Lenses & Dispensing (Mo JALIE) CD فوق از طريق تصاوير شماتيك به ا موزش مفاهيم پايه و كاربردي Optic و Refraction پرداخته جزي يات و نكات مربوط به تجويز لنز و پريسم جهت اصلاح عيوب انكساري و انحرافات چشمي را مورد بررسي قرار ميدهد. Ophthalmic Surgery: principles and Techniques (BLACKWELL SCIENCE) (SALEKAN E-BOOK) Ophthalmology A multimedia tutorial for Primary care physicians and medical students (Robert Johnston FRCOpth, Jonathan Boulton MA MRCP FRCOpth) Optometric Practice Management (Irving Bennett) (Second Edition) Orbital Floor Reconstruction Using Medpor Surgical Implant (Joseph M. Serletti, MD, Paul Manson, MD) (VCD) PHACO TODAY (The Latest Development in Phacomulsification and Small Incision Cataract Surgery) (HOWARD FINE, MD) اين تك CD در قالب Lecture ١٤ و اسلايد كه عمدت ا توسط.I Howard Fine ايرادشده است سير جراحي كاتاراكت به روش فيكو را مرور كرده تكنيكهاي جديد Incisions Anesthesin و phacoemulsfication را ا موزش ميدهد. اشكال مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
319 Phacoemulsification Step by Step (Video & Textbook) (Ric Caesar, Larry Benjamin) شماتيك و تصاوير ا ورده شده در ا ن به درك بهتر مكانيسمها و تكنيكهاي جراحي در فيكو كمك زيادي مينمايد. Phakic Intraocular Lenses (Principles & Practice) (David R. Hardten. MD. FACS, Richard L. Lindstrom, Elizabeth A. David, MD, FACS) (SALEKAN E-BOOK) PhcoChop (Mastering Techniques, Optimizing Technology, and Avoiding Complications) (Text & Video clip) (David F. Chang) (CD I, II, III) Phacoemyulsification Cataract Surgery (Multimedia Oculosurgical Module) (Robert M. Schertzer, David X. Pang, MSE, Luanna R. Bartholomew, PhD) (Mosby) "Scleral tunnel" به مثابة كارگاه ا موزشي كمنظيري در زمينة جراحي كاتاراكت بروش CD ميباشد. اين Mosby متعلق به انتشارات (Multimedia Oulosurgical Module) MOM ا موزشي معروف و معتبر فوق از سري CDهاي CD phacoemulsification است كه در قالب فيلم و text كليه مراحل عمل را به صورتي كام لا كاربردي و قابل استفاده ا موزش ميدهد. Physiology of the Eye Anatomy of the Eye 3-D Tour of the Eye Development of Vision Physics of Light & Color Illusions & Your Vision Common Eye Conditions Practical Viewing of the Optic Disc (KATHLEEN B. DIGRE, M.D., JAMES J. CORBETT, M.D. Getting Ready-Preparing to View the Opic Disc What Should I Look for in the Normal Fundus? Is the Disc Swollen? Is the Disc Pale? Amaurosis Fugax and Not So Fugax-Vaxcular Disorders of the Eye White Spots-What Are They? Hemorrhage Pigment What is That in the Retina? Macula Practical Viewing in Children What to Look for in the Aging Viewing the Disc in Pregnancy Practical Viewing of the Optic Disc and Retina in the Emergency Department PROVISION INTERACTIVE: Clinical Case Studies (AAO) (Thomas A. Weingeist, MD., ph, D) RECONSTRUCCIÓN DE BASE ORBITAL CON IMPLANTE MEDPOR (VCD), (AJL OPHTHALMIC, S.A.) Review of Ophthalmology (Friedman, Kaiser, Trattler) Refractive Surgery First interactive Symposium (Marguerite B. McDonald, MD) (American Academy of Ophthalmology) Lecture از استادان صاحبنام اين رشته منجمله: Roger.F Steinert Jack.T Holladay و Refractive Surgery in the new millennium..prk و LASIK phacoemulsification Evolution in LASIK LASIK: Customized Ablations and Quality of Vision CD فوق يكي از مجموعة دو CDتهيه شده از اولين سمپوزيوم جراحي رفراكتيو انجمن ASCRS به سرپرستي دكتر Manus.C Kraff ا ست كه دربرگيرندة دهها... ميباشد. مجموعة سخنرانيها به همراه فيلم و اسلايدهاي اين مجموعه مروري دارد بر اخرين و جديدترين پيشرفتها در زمينة جراحي كاتاراكت به روش مجموعة اين CD ٣ كه از سري CDهاي معتبر Interactive) (Ophthalmology متعلق به ا كادمي چشمپزشكي ا مريكا انجام ا ن و بالاخره عوارض احتمالي و طرق پيشگيري و درمان ا نها است (AAO) ميباشد دورة جامع ا موزش LASIK به شمار ميرود و شامل تمامي مباحث از معاينات مقدماتي Patient Selection تا تكنيك RETINA (Stephen J. Ryan, M.D., Thomas E. Ogden, M.D.,) Retina and Optic Nerve Imaging (Thomas A. Ciulla, Carl D. Regillo, Alon Harris) RETINA LIBRARY Retina & Vitneous Hereditary retinal dystrophies CD فوق يكي از جامعترين مراجع معتبر در باب انواع مختلف ديستروفيهاي رتين است. تمامي انواع ديستروفيهاي رتين از شايعترين تا نادرترين ا نها در قالب Case ٤٦٧ و بالغ بر ١٧٠٠ تصوير با كيفيتي كمنظير مورد بحث و بررسي قرار گرفتهاند. داشتن اين CD به عنوان رفرانسي مصور در مواجه با موارد گوناگون ديستروفيهاي رتين در كلينيك ضروري مينمايد Refractive Surgery: A Guide to Assessment and Management (Shehzad A Naroo) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
320 Stereoscopic Atlas of Macular Diseases: diagnosis and treatment (Fourth Edition) (J. Donald M. Gass, M.D.) (Mosby) Subjective Refraction: Cross Cylider Technique SURGICAL TECHNIQUES WITH MEDPORIMPLANTS AND THE MCP (VCD), (AJL OPHTHALMIC, S.A.) ADVANCED CONCEPTS IN CATARACT SURGERY The American Society of Cataract and Refractive Surgery (ASCRS) Clinical Update Course on Glaucoma (Mark B. Sherwood, MD, James D. Brandt, MD, Neil T. Choplin, MD, Joel S. Schuman, MD) Techniques in CLEAR CORNEAL CATARACT SURGERY OPHTHALMOLOGY Interactive) تمامي مراحل جراحي كاتاراكت بروش "Clear cornea" Phacoemulsification شامل انتخاب بيمار بيحسي تاپيكال و Prep & drape intracameral انسزيون capsulorrhexis Clear cornea و ظرايف مربوطه setting hydrodissection فيكو در انواع مختلف كاتاراكت كاشت Foldable IOL و بالاخره عوارض احتمالي و طريقة برخورد با ا نها در مجموعة CD٣ فوق از طريق Lecture تصاوير شماتيك و فيلم جراحيهاي انجامشده توسط استادان بنام اين رشته بطور كامل ا موزش داده ميشود. Technique of Cosmetic Eyelid Surgery (A Case Study Approach) (Joseph A. Mauriello, Jr., M.D.) TEXBOOK OF OPHTHALMOLOGY (KENNETH W.WRIGHT) REVIEW QUESTIONS IN OPHTHALMOLOGY (KENNETHC. CHERN.KENNETH W. WRIGHT) در دسترس بودن كتب مرجع بصورت لوح فشرده (CD) ارزش ا نها را دو چندان ميكند زيرا علاوه بر اشغال فضاي كمتر و حمل و نقل راحتتر امكان جستجوي سريع مطلب مورد نظر و احيان ا تهية Print از ا ن نيز فراهم است. از سوي ديگر بهاي CD حتي با كتب text معادل ا ن كه در داخل كشور افست شده قابل مقايسه نميباشد. دو نمونه از كتب مرجعي كه ذي لا بصورت CD معرفي ميگردد انحصار ا توسط شركت خدمات فرهنگي سالكان با دقتي وسواس گونه از روي ا خرين تجديدنظر كتب text تهيه شده است بطوريكه تصاوير و عكسهاي موجود در ا نها داراي قابليت بزرگنماي ي بوده از نظر كيفي بهيچ عنوان با كتب افست موجود در داخل كشور قابل مقايسه نيست. THE FAILING GLAUCOMA FILTER: EARLY IDENTIFICATION & TREATMENT (Bradford J. Shingleton, MD) CD فوق تمام ا به مقولة Failing Filtration Surgery پرداخته و علل عوامل مستعدكننده راههاي پيشگيري و بالاخره درمانهاي طبي و جراحي ا ن را از طريق چندين Lecture و فيلمهاي ا موزشي مربوطه مورد بررسي قرار ميدهد. در اين CD تكنيكهايي مانند Choroidal tap و bleb revision كه دانستن ا نها براي هر جراح گلوكومي كام لا ضروري ميباشد بخوبي ا موزش داده شده است. The Multimedia Atlas of Videokeratography Basics of Map Interpretation (MICHAEL K. SMOLEK, PH. D.) The Retina ATLAS ( Yannuzzi,Green) (Mosby) The Wills Eye Manual office & eoffice & emergency rom diagnosis & treatment of eye disease (Derek &. Kunimoto, Kunal D. Kanitkar) THE VIDEO ATLAS OF COSMETIC BLEPHAROPLASTY (8 CDs) (S.LBosniak) مجموعة VCD ٨ فوق يك دورة كامل ا موزش جراحي پلك ميباشد كه توسط استاد برجسته S.LBosniak ا موزش داده ميشود و شامل تمامي مباحث از ا ناتومي پلك و روشهاي مختلف بيحسي تا جديدترين تكنيكهاي جراحي در اصلاح و ترميم كلية مساي ل و مشكلات پلكي منجمله ا نتروپيون اكتروپيون پتوز درماتوشالازيس و... ميباشد. استفاده از اين مجموعه را بايد به منزلة گذراندن يك دوره كارگاه ا موزشي بلفاروپلاستي دانست. Vitreoretinal Course Bascom Palmer Eye Institute's (William E. Smiddy, Philip Rosenfeld, Patrick E. Rubsamen, Janet L.) CD فوق از سري CDهاي ا موزشي (Ophthalmology interactive) OI متعلق به ا كادمي چشمپزشكي ا مريكا (AAO) حاوي Lecture ١٦ به همراه اسلايد و فيم از استادان برجستهاي چون W.E.Smiddy و H.W.Flynn ميباشد كه به مرور و معرفي ا خرين دستاوردها در مورد مباحث مختلف جراحي سگمان خلفي چشم ميپردازد. از جمله موضوعات مورد بحث در اين CD ميتوان: Macular hole Giant retinal tear Dislocated IOLs AMD, ROP Endophthalmitis و... را نام برد. VJO Ophthalmology (I, I, III,) (VCD) (Charles, H. Cozean, James S. Lewis, Richard J. Mackool) Wavefront Analysis Aberrometers & Corneal Topography (Benjamin F. Boyd, M.D.,FACS) (SALEKAN E-BOOK) عنوان CD 5 Minute Neurology Consult (SALEKAN E-BOOK) (D. Joanne Lynn) اين CD كه براي استفاده نورولوژيستها رزيدنتها و متخصصين داخلي است. به عنوان رفرانس سريعي ميباشد كه در قالب سري 5-Minute طراحي شده است فرمت دوصفحهاي استفاده بلافاصله و سريع از ا ن را راحت كرده است. شامل بيش از ٢٠٠ بيماري ميباشد كه در كار باليني به طور شايعي با ا نها مواجه ميشويم. هر مبحث شامل Follow up Medications Management Diagnosis Basics و Miscellaneous ميباشد. CD شامل فصول زير ميباشد. -Neurologic Symptoms and Signs -Neurologic Diagnostic Tests -Neurologic Diseases and Disorders -Short Topics ٩- مغز و اعصاب سال انتشار 2004 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
321 اين نرمافزار شامل Full text تمام مقالات و th Annual Meeting March 29-Aprill 5, American Academy of Neurology (HAWAII) Presentation هاي اراي ه شده در كنگره ا كادمي نورولوژي امريكا در ا وريل 2003 در هاوايي ميباشد. Abnormal Psychology LIVE and interactive tutorial (Barlow/Durand's, Durand/Barlow's, Trull/Pharcs) CD مولتيمديا و اينتراكتيو در زمينه مفاهيم نابهنجاري شامل سه قسمت: ١- روانشناسي ناهنجاري: رويكرد التقاطي ٢- روانشناسي ناهنجاري: مقدمه ٣- روانشناسي باليني Advanced Therapy of HEADACHE CONQUERING HEADACHE (SECOND REVIED EDITION) An Illustrated Guide to Understanding The Treatment and Control of Headache (Alan M. Rapoport, Fred D. Sheftell) ١) متن فايل PDF كتاب (1999) headache Advanced Therapy of توسط Alan rappaport (استاد نورولوژي دانشگاه Fred sheftell ( Yale (استاد بخش روانپزشكي دانشگاه ( Newyork نوشته شده است. شامل 48 مبحث پايه و كاربردي مربوط به اصول تي وري و عملي انواع مختلف سردرد از جمله تشخيصهاي پيچيده درمان شامل درمانهاي جديد و نيز management بيماران ميباشد. ٢) متن فايل PDF كتاب Conquering headache nd edition از نويسندگان فوق كه اطلاعاتي در ا ن جهت مقابله با سردرد و بهبود نحوة زندگي اراي ه شده است كه همراه با ا خرين اطلاعات راجع به تقسيم بندي سردردها- درمانهاي دارويي - تي وريهاي جديد- اصول تغذيهاي ورزشي- خواب- روشهاي غير دارويي ديگر اراي ه گرديده است. ٣) متن PDF جملة Seminars in Headache mamagement كه توسط James W.Lance اداره ميگردد و شامل سه سال از سال ميباشد. مباحث اراي ه شده عبارتند از: تشخيص- درمان حاد ميگرن و درمان پروفيلاكتيك مباحث سردردهاي كلاستر- Post traumatic ايسكمي مغزي ناشي از ميگرن- ميگرن و هورمونهاي جنسي. American Academy of Neurology 2004 Syllabi اين CD كه حاصل مقالات ا خرين كنگره ا كادمي نورولوژي امريكا در سال ٢٠٠٤ ميباشد شامل بيش از ١٦٠ موضوع در زمينههاي مختلف طبابت باليني نورولوژي ميباشد كه هر موضوع شامل چند مقاله و مبحث ميگردد. بعضي از مقالات اراي هشده همراه با فايلها و اسلايدهاي Presentation نيز ميباشد كه كاربرد ا ن را براي تدريس و اراي ة مجدد دوچندان ميسازد. فايلها از طريق Java و به صورت Autorun اجرا ميگردند قابليت Search بر اساس موضوع و نويسنده از مزاياي اين نرمافزار است. مباحث مهم مطرحشده عبارتند از: Seizure and antiepilep drugs Bedside Neurology Balance and gaif disorder Botutinum Toxin Injection Stroke Child Neurology Clinical EEG Clinical EMG Movement disorders Demyelinating dyorden Aphasia & Related Neurogenic Language Disorders (Third Edition) (Leonard L. LaPointe, Ph.D.) Atlas of Functional Neuroanatomy (Dr. Walter J. Hendelman) Boehringer Ingelheim Satellite Symposium Interanational Stroke Conference (Phoenix, Arizona) Brainiac! TM Medical Multimedia Systems Presents (Version 1.52) (An interactive digital atlas designed to assist in learning human neuroanatomy) Case Studies in Genes & Disease (A Primer for Clinicians) (Bryan Bergeron) CD 1. BOTOX Injection Tracking Tool CD 2. The Movement Disorder Society's Guide to Botulinum Toxin Injections Cerebral Palsy Resource Guide for Speech-1-anguage Pathologists Clinical Electromyography Nerve Conduction Studies (Third Edition) Clinical Neurology (G David Perkin Fred H Hochberg Douglas C Miller) Comprehensive Handbook of PSYCHOTHERAPY (Florence W. Kaslow, Jeffrey J. Magnavita) (Volume 1-4) كتاب مرجع جامع رواندرماني قابل استفاده براي روانپزشكان و روانشناسان باليني دربرگيرندة مفاهيم و تكنيكهاي مورد استفاده در انواع رواندرماني : CD I رويكرد سايكوديناميك : CD II رويكردهاي رفتاري- شناختي (CBT) : CD III رواندرماني بين فردي و رويكردهاي انسانگرايي (humanistic) و اصالت وجود (existential) : CD IV رويكردهاي تلفيقي و التقاطي Comprehensive Textbook of PSYCHIATRY (Seventh Edition CD-ROM) (Benjamin J. Sadock, MD Virginia A. Sadock, MD) ( LIPPINCOTT WILLIAMS & WILKINS) اين CD بصورت يك كتاب الكترونيك مشتمل بر ٥٥ فصل ميباشد. همچنين حاوي ٦٥٠ تصوير ا موزشي و نيز جداول متعددي است كه كام لا از وضوح بالايي برخوردارند. اين كتاب الكترونيكي يك كتاب جامع و مرجع در زمينة روان پزشكي است. تصاوير متعدد ا موزشي MRI طرحوارهها و تصاوير برخي از دانشمندان اين رشته اراي ه كامل منابع در پايان هر فصل فهرست كامل موضوعات اراي ه داروهاي روانپزشكي و اشكال داروي ي مختلف به همراه تصوير ا نها از ويژگيهاي اين برنامه ميباشد. برخي از فصول اين كتاب به شرح ذيل ميباشد. ١- روانپزشكي اعصاب و رفتار ٢- علوم اعصاب ٣- تي وريهاي شخصيت و ا سيبشناسي ا نها ٤- روشهاي تشخيص در روانپزشكي ٥- طبقهبندي بيمارهاي مغزي ٦- بيماريهاي شناختي Dementin, ((Delirium ٧- اسكيزوفرني ٨- بيماريهاي اضطراب ٩- بيماريهاي ١٠- Mood بيمارهاي رواني خواب ١١- بيماريهاي ١٢- Dissociative خودكشيها ١٣- روان پزشكي اطفال ١٤- بيمارهاي يادگيري ١٥- بيماريهاي ارتباطي ١٦- بيماريهاي Tic عصبي ١٧- بيماريهاي اضطراب در كودكان مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
322 ١٨- Adoption ١٩- روانپزشكي (گذشته در ا ينده) و... اين برنامه توانايي جستجو بر اساس واژههاي تخصصي و اسامي داروها را داراست. جستجوي تصاوير توانايي چاپ متن و تصاوير اضافه نمودن يادداشتهاي شخصي از ويژگيهاي ديگر اين برنامه است. Computational Neuroscience Realistic Modeling for Experimentalists (Erik De Schutter) Introduction to Equation Solving and Parameter Fitting Modeling Networks of Signalling Pathways Modeling Local and Global Calcium Signals Using Reaction-Diffusion Equations Monte Carlo Methods for Simulating Realistic Synaptic Microphysiology Using Mcell Which Formalism to Use for Modeling voltage-dependent Conductances? Accuate Reconstruction of Neunal Morphology Modeling Dendritic Geometry and the Development of Nerve Connections Passive Cable Modeling-A practical Introduction Modeling Simple and Complex Active Neurons Realistic Modeling of Small Neuronal Circuits Modeling of Interactions Between Neural Networks and Musculoskeletal System CONTEMPORARY NEUROSURGERY A BIWEEKLY PUBLICATION FOR CLINICAL NEUROSURGICAL CONTINUING MEDICAL EDUCATION (Ali F. Krisht, MD) Core Curriculum in Primary Care Psychiatry and Pain Management Section (Micheal K. Rees, MD, MPH, Robert Birnbaum, MD, PHD, James A.D. Otis) اين CD از سري CCC عمدتا جهت پاسخگويي به نيازهاي ا موزشي پزشكان طراحي شده است كه عمدة فعاليتشان در زمينههاي باليني و بيماران سرپايي است به طوريكه تمام مباحث و مفاهيم اراي ه شده براي اجراي عملي در كلينيك جهتدهي شدهاند و ا خرين اطلاعات باليني را با شعار" therapy "Current best Standard of اراي ه مينمايند. شامل دو مبحث زير ميباشد: ١- Medicine : Psychopharmacology for primay Care كه توسط دكتر Robert Birnbaum از دانشگاه Harvard Medical School اراي ه ميگردد و شامل سر فصلهاي زير است: Anxiety disorder- Panic disorder- Social phobia- Specific phobia- Obcessive & Compulsire disorder- PTSD- Generalized Anxiety disorder- Depression-Dysthymia ٢- Management : Pain كه توسط دكتر James A.D. otis از دانشگاه Boston اراي ه ميشود و ارزيابي- تشخيص دستهبندي- انواع درمانهاي درد (دارويي- مخدر- رواندرماني- جراحي) مورد بحث و بررسي قرار گرفته است. متن سخنرانيها در فايل جداگانهاي ا ورده شده است و قابل print ميباشد. تعدادي سوال در رابطه با مبحث اراي ه شده مطرح و پاسخ داده شده است. نرمافزار اين CD قابليت انتخاب اسلايدهاي دلخواه جهت اراي ه و كنفرانس جداگانه نيز ميباشد. Corel Medical Series Epilepsy (Alan Guberman MD, FRCP (C)) (Professor of Neurology University of Ottawa توسط دكتر Allan Guberman از دانشگاه اتاوا طراحي و اجرا شده است. در اين نرمافزار سعي شده است كه يكسري از مشكلات شايع بيماران مبتلا به صرع شرح داده شود: سر فصلهاي مربوطه ا ناليز گردد و با تصاوير- انيميشن و قطعات ويدي ويي و Quiz كامل گردد. Search قوي- اطلاعات بيماران و توانايي بازگشت مطالب و قابليت Print تمامي مطالب از نقاط قوت اين نرمافزار محسوب ميگردد. سعي در ا موزش و review به صورت problem based interactive بوده است. شامل سر فصلهاي زير است Definitions Topic index Epilepsy Notes Patient & Family information Epilepsy Case Study Video Reference list Epilepsy Facts What is Epilepsy Learning Objectives CRANIAL NERVES in health and disease (Second Edition) اين CD شامل متن PDF كتاب فوق چاپ 2002 ميباشد كه توسط جمعي از اساتيد جراح و نورولوژيست دانشگاههاي كانادا نوشته شده است. شامل تصاوير عالي ا ناتوميك و طراحيهاي رنگي از مسيرهاي اعصاب كرانيال از اطراف به مغز و از مغز به اطراف ميباشد كه در قالب متن سناريوهاي باليني و تستهاي خودا زمايي ميباشد. چند تصوير animation جهت درك بهتر روابط ا ناتوميك و اثرات فيزيولوژيك در CD گنجانده شدهاند. اصول بحث بر مبناي Problem-oriented مطرح شده و لذا براي دانشجويان و رزيدنتها و متخصصين رشتههاي نورولوژي جراحي فك و صورت ENT و چشم پزشكي بسيار مفيد و ضروري به نظر ميرسد. در قسمت ديگر فيلم معاينات باليني هر كدام از اعصاب بصورت تك تك گنجانده شده است. Critical Decisions in Headache Management (Giammarco. Edmeads. Dodick) (SALEKAN E-BOOK) CURRENT MANAGEMENT IN CHILD NEUROLOGY (SECOND EDITION) (Bernrd L. Maria, MD, MBA) Section 1: Clinical Practice Trends Section 2: The Office Visit Section 3: The Hospitalized Child DICTIONARY OF MULTIPLE SCLEROSIS (Lance D Blumgardt) (Martin Dunitz) DISORDERS OF COGNITIVE FUNCTION (VCD-I) (AMERICAN ACADEMY OF NEUROLOGY) (CONTINUUM) Severe Amnesic Syndrome: Anterograde and Retrograde Amnesia Perseverative Verbal Behavior in Amnesia Semantic Memory Loss Fluctuativng Sensorium in Dementia With Left Spatial Neglect Eye Movements in Severe Left Spatial Neglect Anosognosia for Hemiparesis Paraphasias Broca's Aphasia Lewy Bodies Impaired Verbatim Repetition DISORDERS OF COGNITIVE FUNCTION (VCD-II) (AMERICAN ACADEMY OF NEUROLOGY) (CONTINUUM) Wernicke's Aphasia Dysexecutive Syndrome Disinhibited Behavior Grasp Response and Imitation Behavior Positive Signs of Executive Dysfunction Progressive Apraxia Negative Signs of Executive Dysfunction Prosopognosia and Visual Agnosia Simultanagnosia Optic Ataxia Ocular Apraxia DISORDERS OF COGNITIVE FUNCTION (VCD-III) (AMERICAN ACADEMY OF NEUROLOGY) (CONTINUUM) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
323 Basic Mental Status Examination Token Test for Auditory Comprehension Confrontation Naming Finger Constructions Luria 3-Step Test Line Cancellation Gestural Praxis Electromyography & Neuromuscular Disorders Clinical Electrophysiologic Correlations (David C. Preston, Barbara E. Shapiro) EMG Training (Kenneth Ricker, M.D.) اين نرمافزار كه جهت ا موزش الكتروميوگرافي توسط شركت TOENNIES تهيه شده است. ٧٥ مورد EMG از ٢٧ بيمار مختلف را همانگونه كه مانيتور مشاهده ميگردد به تصوير كشيده و صداي ا ن را پخش ميكند. متن همراه اين نرمافزار توضيحات كافي در مورد نحوة كار را اراي ه كرده است و سو الاتي را مطرح نموده و پاسخ داده است. هر Case به صورت يك فايل مستقل اراي ه ميگردد. EMG glossary امكان Search فايلها را فراهم ميا ورد اين CD براي مبتديان و نيز افراد مجرب در اين زمينه جالب توجه خواهد بود. ENS Teaching Course اين CD كه شامل مقالات دورة ا موزشي كنگره ENS در سال ٢٠٠٣ ميباشد اطلاعات بهروز را در مورد مباحث عمده و بحثانگيز نورولوژي جديد و نيز ديدگاه جديد نسبت به بيماريهاي شايع نورولوژي را اراي ه ميدهد. عمدة مباحث مطرحشده تحت عناوين زير قرار ميگيرند كه هر كدام شامل چند Title مختلف نيز ميباشد. Dizziness and vesthg Clinical Neurophysiology Clinical Neuropathology Sleep Disorder Stroke Neurogenetics for Clinicians NeuroSurgery for Neurologist Epilepsy Multiple Sclerosis Muscle disorders Neuroimaging Neurology of Systemic disease Parkinson's diseane Ultrasound in Neurology Dementia ICU in Neurology Movement discords Neuroplathies Current Treatments Neurology EPILEPSY The Comprehensive CD-ROM (Jerome Engel, Jr., M.D., Ph.D., Timothy A. Pedley, M.D.) Lippincott Williams & Wilkins اين CD كه براساس كتاب Epilepsy: A comprehensive textbook طراحي شده است. Full text كتاب را در برميگيرد كه مشتمل بر ٢٨٩ سرفصل ميباشد. Weblink- Seasch و خلاصه مقالات بيش از ٥٠٠ رفرانس كه توسط نويسنده جمعا وري گرديده است از نقاط قوت اين نرمافزار محسوب ميگردد. همچنين ٨٠٠ عكس و imaging در CD گنجانده شده است. توانايي Essentials of Clinical Neurophysiology (Karl E. Misulis MD. PhD, Thomas C. Head MD) Foundations of NEUROBIOLOGY اين CD به منظور Self evaluattion و تكميل اطلاعات افرادي كه با علوم مربوط به اعصاب و بيولوژي سروكار دارند طراحي شده است و شامل ٥ قسمت زير است. ١- خودا زماييها كه فهرستبندي شده و جهت دارند. ٢- انيميشنها و فيلمهاي ويدي ويي ا موزنده و بيادماندني به همراه توضيحات كتبي راجع به هر قطعه فيلم. ٣- Module ٤- Expansion ا مادگي سخنراني كه به ما امكان ميدهد با اشكال و فيلمهاي موجود در play list CD مخصوص به خود را ساخته و جهت اراي ه در كنفرانسها يا تدريس از ا نها بهره ببريم. در بخش ديگري از CD سايتهاي مربوط به علوم Neurobiology معرفي شدهاند و لينكهاي متعدد اراي ه گرديدهاند. Foundations of Behavioural Neuroscience -Neural Communication - Central Nervous system -Research methods -Visual System - Control of movements حاوي تصاويري با طراحي عالي و استفاده راحت جهت فهم جزي يات پيچيده و ريز ساختمانهاي نوروني ميباشد. مطرح شدهاند كه جهت تكميل ا موختهها و يادگيري مناسب است. اين CD كه شامل ا خرين Guidline هاي تشخيصي درماني ا كادمي نورولوژي ا مريكا ميباشد به صورت فايل قابل Search در قالب همراه با موتور glossary, Search كامل ميباشد. فهرست درختچهاي مطالب كمك مهمي به يادگيري علوم پايه اعصاب مينمايد. در چند فصل سوالاتي به عنوان Quiz FUNDAMENTALS OF HUMAN NEURAL STRUCTURE (S. Mark Williams) (Sylvius TM 2.0) General depression and its pharmacological treatment (Professor Brain Leonard) (VCD) Guidelines (American Academy of Neurology) (SALEKAN E-BOOK) Salekan E-Book در ا مده است كه كليه مقالات را به صورت Offline با دسترسي ا سان در اختيار كاربر قرار ميدهد. - Brain Injury & Brain Death - Child Neurology - Dementia - Epilepsy - Headache - Movement Disorders - Multiple Sclerosis - Neuroimaging - Neuromuscular - Stroke and Vascular Neurology -Technology Assessment Human Brain Cancer: Diagnostic Decisions (Lauren A. Langford, MD, Dr. med,) American Medical Association در اين CD كه جهت استفاده پزشكاني كه با بيماران بدحال و بستري در ICU سروكار دارند طراحي شده است ا خرين مقالات منتشره و نيز مقالات مهم قبلي در زمينههاي مختلف ICU Patient Care از منابع و مجلات مختلف تا سال قابليت Search قوي اجرا شده است. سرفصلهاي عمده عبارتند از: ICU Syllabus ٢٠٠٤ جمعا وري و به صورت فايل PDF با Anemia and blood Transfusion ARDS Ethics Fever Wokup Hemodynamics RARS Weaning Hyperghycemia and Ihsulia Hypothermia for cardiac arrest Impaired cognition Liver disease Mechanical Vetitation Sedation From Mechanical Vetitation Non invasive Ventilation Nutritions Pneumonia Pulmonary Embolism Renal failure Sepsis Interactive Guide to Human Neuroanatomy (Mark F. Bear, Barry W. Connors, Michael A. Paradiso) Atlas: -Surface Anatomy of Brain -Cross-Sectional Anatomy of Brain -The Spinal Cord -The Anatomy Nervous System -The Cranial Nerves -The Blood Supply to the Brain مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
324 Exam:I -Surface Anatomy of the Brain -Cross-Sectional Anatomy of the Brain -Comprehensive Exam InterBRAIN (Martin C. hirsh) (Springer) 1. Gross Anatomy 2. Vessels and Meninges 3. Brain Slices 4. Microscopical Sections 5. Functional Systems International Symposium ON 10 Years Betaferon CD فوق كه ماحصل سمپوزيوم پراگ در سال ٢٠٠٣ در مورد تجربه دهسالة مصرف بتافرونها در درمان MS ميباشد شامل تمام مباحث مطرحشده در اين كنگره است. عناوين مباحث عبارتند از: اهميت باليني يافتههاي نروپاتولوژيك MS ا موختههاي مالوز مطالعات باليني دربارة فاكتورهاي پروگنوستيك Geomics and Proteomics درمان سمپتوماتيك و توانبخشي در MS Aggressive MS در درمان Stem Cell Transplant اينترفرون دوز بالا يا پايين نتايج مطالعات BENEFIT و BEYOND افقهاي جديد تاريخچة درمان مدرن MS بتافرون در درمان نقش Primary Progressive MS Kaplan & Sadock's STUDY SUIDE & SEIF-EXAMINATION REVIEW IN PSYCHIATRY (Seventh Edition) (Benjamin James Sadock) اين كتاب در برگيرندة مباحث باليني كتاب Synopsis كاپلان (٢٠٠٣) است كه به طور خلاصهترينها بر مباحث باليني تمام اختلالات روانپزشكي به همراه اطلاعات تازهتر و بهروزشدهتر مرتبط با ا نها در قياس با كتاب Synopsis را پوشش ميدهد. جنبههاي باليني ا ن براي تمام رزيدنتهاي روانپزشكي دانشجويان پزشكي روانشناسي مددكاري اجتماعي روانپرستاري كاردرماني و ساير حرفههاي مرتبط با سلامت روان كاربرد دارد. CD مولتيمديا و كاربردي براي كنترل استرس شناسايي استرس تطابق با استرس ايجاد و تناوب و تعادل رواني قابل استفاده در محيطهاي درماني فردي و گروهي CD صوتي حاوي ا هنگهاي ا رام تا ييدشده براي استفاده در ا رايههاي درماني و رفتاري و نيز مناسب جهت استفاده شخصي براي كسب ا رامش و كنترل استرس. MANAGE STRESS MANAGING STRESS (Audio CD) Manual of Nerver Conduction Study & Surface Anatomy for Needle Electromyography (Hang J. Lee, Joel A. Delisa) (Fourth Edition) Manual of Neurologic Therapeutics (seventh edition) (Martin A. Samuels, Brigham & Women's Hospital, Harvard Medical School) Manual of Pain Management (Carol A. Warfield, Hilary J. Fausett) (Second Edition) (SALEKAN E-BOOK) اين CD با فرمت خاص خود كه نحوة استفاده از ا ن را راحت نموده است. زمنية كاملي براي مطالعه نحوة اداره بيماران مبتلا به دردهاي قسمتهاي مختلف بدن را فراهم ميا ورد. در فصل اول نظريههاي عمدة فيزولوژي درد مطرح شده است. عمده اين CD توصيفي از سندرمهاي شايع درد است كه بر اساس ا ناتومي باليني كلاسهبندي شدهاند. فصل بعدي بر روي درمانها و Procedureهايي كه بر روي بيماريان دردمند به كار ميروند متمركز كرده است. درمان درد كودكان سالمندان و نيز بيماران مبتلا به HIV نيز ا ورده شده است. -Understanding pain -Pain by Anatomic Location -Common Painful Syndromes -Pain Management Merritt's Neurology (Eleven Edition) (Lewis P. Rowland) Microneurosurgery (M. G. Yasargil) Cassette 1 Aneurysms (VCD) (Thieme AV) (CD I, II, III, IV) Migraine Current Approaches To Treatment (Dr. Andrew Dowson) Motor Speech Disorders (Joseph R. Duffy, PHD) Movement Disorders Society Official Journal of The Movement Disorder Society Published by John Wiley & Sons, Ins VCD (I, II) Needle Electromyography (Daniel Dumitru, M.D., PhD.) اين CD كه بر اساس كتاب Needle EMG نوشتة Daniel Dumitru در سال ٢٠٠٢ طراحي و اجرا گرديده است. شامل متن كتاب بعلاوة EMG Video Library است. ٣٣ فايل مختلف شامل امواج نرمال و غيرنرمال مختلف اراي ه گرديده است. تصاوير اراي هشده اطلاعات كافي در مورد نحوة اجراي EMG و Pitfullهاي ا ن در اختيار قرار ميدهند. قابليت Glossary, Search قوي نيز از مزاياي نرمافزار فوق محسوب ميگردد. NEUROANATOMY-3D-Stereoscopic Atlas of the Human Brain (Martin C. Hirsch, Thomas Kramer) (Springer) در اين نرمافزار تصاوير سه بعدي و بسيار دقيقي از سيستم عصبي مركزي اراي ه شده است كه با توجه به قدرت بالاي نرمافزار قادريم از هر جهت دلخواه به تصوير Gross مغز بنگريم. با درنظرگرفتن اينكه تك تك اجزاي سيستم عصبي را مرحله به مرحله ميتوان به تصوير قبلي اضافه و يا كم كرد جزي يات ارتباطات سيستمهاي عملكردي مختلف به وضوح مشخص ميشود. تصاوير و برشها بسيار هوشمندانه و هنرمندانه طراحي گشتهاند و دانشجويان پزشكان و متخصصين درگير با سيستم عصبي ا نرا تجربة جديدي ارزيابي كردهاند. Neurofunctional Systems 3D Neurological surgery (julian R. Youmans, MD Editor-in-Chief) (Fourth Edition) (Y.O.U.M.A.N.S) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
325 Neurology (Baker's clinical on CD-ROM) New Analgesic Options: Overcoming Obstacles to Pain Relief - MD, NP, PA, RN Answer Sheet -Pharmacist Answer Sheet -Back Pain -Fibromyalgia -OA Pain -Post Op Pain -Trauma -References Photographic manual of Regional Orthopaedic and Neurological Tests 55 اين CD شامل بيش از ٨٥٠ تصوير ميباشد كه نحوة انجام تمام معاينات نورولوژيك و ارتوپديك را با جزي يات تمام روشن ميسازد. در مواقع لزوم تصاوير ا ناتوميك ضروري نيز اضافه شدهاند. فصول بر اساس محل مورد معاينه طراحي و قسمتبندي شدهاند. معاينات از فقرات گردني و اندام فوقاني شروع و به فقرات كمري و اندامهاي تحتاني ختم ميشوند. هر Test در يك صفحه يا دو صفحه مقابل هم با عكسهايي كه نحوة انجام معاينه را بوضوح نشان ميدهند توضيح داده شده است. در ضمن يك Sensitivity/Relialility Scale نيز براي هر معاينه تعريف شده است كه ميزان حساسيت و قابليت اعتماد به ا ن معاينه را مشخص ميسازد. اين اطلاعات در بكارگيري تستهاي حساستر و اختصاصتر كمك فراوان به پزشك مينمايد. Principles of Neurology (6 th Edition) (Raymond D. Adams, M.A., M.D.) PROFESS اين CD كه ماحصل سمپوزيوم پيشگيري از سكتههاي مغزي در International Stroke Conference درا ريزوناي امريكا در سال ٢٠٠٣ ميباشد چالشهاي پيشرو در درمان و پيشگيري از سكتههاي مجدد مغزي را مطرح كرده و ا خرين رژيمهاي درماني ويروتركلهاي موجود را در قالب Lectureها سو ال و جواب و خلاصه مقالات اراي ه كرده است. فهرست سخنرانيها عبارتند از: - اطلاعاتي كه دربارة ديپريدامول وجود دارد. مباحث اين CD شامل: - چرا برخورد با CVA متفاوت از MI است. - ا يا درمان مركب ا نتيپكدتي خطرناك است يا مفيد - ا يا ا نژيوتانين II ديسكافاكتور مستقلي براي سكته است - رژيم درماني پيشگيري از سكته دوم. Recognizing Extrapyramidal Symptoms (VCD) - Clinical Examples of Acute Dystonia - Akathisia - Parkinsonism - and Tardive- Dyskinesia Rune Aaslid TCD Simulator Version 2.1 اين نرم افزار يك شبيه ساز بررسيهاي داپلر اينتراكرانيال واكستراكرانيال ميباشد كه توسط مخترع TCD ا قاي Rune Aaslid در اين CD اراي ه گرديده است. شامل متني است كه نحوة استفاده از CD را ا موزش ميدهد. اصول داپلر سونوگرافي- ا ناتومي- هموديناميك و موارد پاتولوژي عروق مغزي را توضيح ميدهد. قابليتهاي فراواني از جمله اين موارد را دارا است: نمايش اسپكتروم داپلر- نمايش محل تابش و زاويه تابش امواج- مونيتورينگ- تصوير CBF ا ناتومي و پاتولوژيهاي مختلف كنترل كارديو واسكولار- تا ثير تغيير ضربان قلب- تا ثير تغيير تنفس- HITS و بالاخره ديد سه بعدي كه تجسم موقعيت فضايي عروق در داخل جمجمه را سهل مينمايد. اين CD يكي از بهترين و مو ثرترين ابزارهاي ا موزش TCD است كه توسط اساتيد و دانشجويان مورد استفاده قرار ميگيرد. مفاهيم پيچيده داپلر عروق مغزي را بصورت ملموس در اختيار علاقهمندان قرار ميدهد. SHAME & Guilt (June Price Tangney, Ronda L. Dearing) Stroke Overview of Stroke: 1. Stroke in Perspective 2. Pathogenesis & Pathophysiology 3. Evaluation & Diagnosis 4. Interventions 5. Thrombolytic Therapy Studies IV Tissue Plasminogen Activator(t-PA) Studies: 1. Recent Multicenter, IV Streptokinase (SK) Studies Ultra Rapid Response: 1. Increasing Public/Professional Awareness 2. Modifying Care Patterns 3. Stroke Care Systems 4. Assessing Critical Resources Case Studies TEXTBOOK of CLINICAL NEUROLOGY (Christopher G. Goetz, MD, Eric J. Pappert, MD) (W.B. Saunders Company) Textbook of CRITICAL CARE (Salekan E-book) SECTION I RESUSCITATION AND MEDICAL EMERGENCIES SECTION II TRAUMA SECTION III IMAGING SECTION IV CELL INJURY AND CELL DEATH SECTION V INFECTIONS DISEASE SECTION VI ENDOCTINOLOGY, METABOLISM, NUTRITION, PHARMACOLOGY SECTION VII CARDIOVASCULAR SECTION VIII PULMONARY The Cerefy TM Atlas of Brain Anatomy An interactive tool for students, teachers, and researchers (Wieslaw L. Nowinski, A. Thirunavuukarasuu, R. Nick Bryan) اين نرمافزار با استفاده از تصاوير MRI در سه جهت طراحيهاي رنگي و سيستم نامگذاري ما را قادر ميسازد براحتي هر ساختمان داخلي مغزي را در ٣ جهت بطور همزمان مشاهده نماييم. جهت تجسم فضايي بهتر و عمليات استرتوتاكسي ميتوان Grid خاصي را بر روي تصوير قرار داد و فاصلههاي دلخواه را اندازهگيري نمود. در قسمت تست كه به صورت interactive و بسيار جذاب طراحي شده است ارزيابي مفاهيم و ا موختهها مقدور ميگردد. در قسمت Glossory توضيح كاملي راجع به هر كدام از مناطق ا ناتوميك مورد اشاره اراي ه شده است. اين CD مورد استفاده افراديكه نوروا ناتومي نرولوژي- جراحي اعصاب- نروراديولوژي- علوم نروساينس و روانپزشكي ميا موزند يا ا موزش ميدهند قرار ميگيرد. The Clinical Atlas of Parkinson's Disease (D.J. Nicholl & A. Williams) The Clinical Diagnosis of Alzheimer's Disease (An Interactive Guide for Family Physician) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
326 توسط گروه Alzheimer disease group بيمارستان RiverView كانادا تهيه گرديده است. چندين قطعه فيلم ا موزشي راجع به نحوة مصاحبه با بيماران مبتلا به ا لزايمر و Flowchart تشخيصي و درماني چندي ميباشد. شامل ٨ مبحث عمدة زير است: تشخيص باليني بررسي ا زمايشگاهي معاينات باليني معرفي Case Studies بررسي راديولوژيك بررسي شناختي شرح حال THE HUMAN BRAIN (Marion Hall David Robinson) THE HUMAN NERVOUS SYSTEM (Springer) The Massachusetts General Hospital Handbook of Pain Management (Second Edition) (Jane Ballantyne, Scott M. Fishman, Salahadin Abdi) (SALEKAN-E-book) I. General Considerations II. Diagnosis of Pain III. Therapeutic Options: Pharmacologic Approaches IV. Therapeutic Options: Nonpharmacologic Approaches V. Acute Pain VI. Chronic Pain VII. Pain Due to Cancer VIII. Special Situations - Apendices - Subject Index The Movement Disorder Society's Guide to Botulinum Toxin Injections CD اول: نرمافزار ا موزش نحوة تزريق بوتولينوم توكسين ميباشد. در كادر اول تصوير كلي بدن اراي ه شده كه قسمت مورد نظر جهت تزريق را انتخاب مينمايي. عضلات و سندرمهاي باليني مربوط به ا ن قسمت فعال ميشوند. با انتخاب سندرم باليني يا عضلة دلخواه از ليست فيلم نحوة تزريق بهمراه دياگرام ا ناتوميك نمايش داده ميشوند. جزي يات تكنيك تزريق مانند نحوة نشستن بيمار- نحوة يافتن عضله- مشخصات سوزن و نحوة فعالكردن عضله- نحوة ورود سوزن- تعداد تزريقات و احتياطات لازم نيز اراي ه گرديدهاند. CD دوم: نرمافزار استفاده از بوتولينوم توكسين در كلينيك ميباشد كه بانك اطلاعاتي در مورد هر بيمار را تشكيل داده و با قابليت Search بر حسب الفبا دستيابي به سوابق بيمار را ممكن ميسازد. در چارتهاي رنگي مربوط به هر بيمار محل و مقدار تزريق مشخص شده و در حافظه ذخيره ميگردند. فايل PDF ا موزشي جهت راهنمايي بيماران و اطلاعات بيشتر در CD موجود است. اين CD به پزشكان در جمعا وري يافتهها و كلاسهبندي ا نها جهت استفاده بعدي و تحقيقات كمك شاياني ميكند. The Washington Manual Survival Guide Series Neurology Survival Guide (Dave A. Rengachary, Tammy L. Lin, Daniel M. Goodenberger) Thinking a head (Critical question in ms therapy) The John Hopkins Neuroradiology Review Video CD Collection VCD 1.1: Neuroradiology Practice Techniques VCD 1.2: MR Spectroscopy Techniques VCD 1.3: Oral Cavity VCD 2.1: I- Oral Carity II- Imaging the Larynx VCD 2.2: I- Extramucosal Spaces (Suprahyoid) II- Extraaxial Adult Tumors III- Head and Neck Case Review VCD 3.1: I- Head and Neck Case Review II- Vascular Disease VCD 3.2: I- Stroke Imaging (CT, CTA, CTP) II- AVMS VCD 5.1: I- Spinal Interventions II- Brain Case Review VCD 5.2: I-Temporal Bone External and Middle Ear II- Irbit VCD 6.1: I-Orbit II- Temporal Bone Inner Ear VCD 6.2: Spaces of the Neck (Infrahyoid) VCD 6.3: Head and Neck Case Review VCD 7.1: I- Cancer of the Nesopharynx II- Brain Case Review VCD 7.2: I- Brain (Molecular Imaging II- Congenital Imaging (part 1) VCD 8.3: I- Demyelinating Disorders II- Congenital Imaging (part 2) VCD 8.4: I- Carotid Imaging (part 1) II- Pediatric Brain Tumors VCD 9.1: I- Pediatric Brain Tumors II- Hemorrhage/Head Trauma VCD 9.2: Carotid Imaging (part2) VCD 9.3: Brain Case Review VCD 10.1: Anatomy and DJD Spine VCD 10.2: Extradural (Non-DJD) Spine Sinus CT VCD 11.1: I- Intradural Extramedullary Spine II- Spine Trauma VCD 11.2: I- Intradural Intramedullary Spine II- Spine Infection and Inflammation VCD 12.1: I- Spine Case Review VCD 12.2: New Techniques (Diffusion Tensor Imaging) VCD 12.3: Functional Imaging مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
327 VCD 13.1: Functional Imaging VCD 13.2: MR Spectroscopic Imaging VCD 13.3: An overview of 3.0 Tesla Imaging Understanding and Diagnosing Restless Legs Syndrome در اين CD كه توسط هيي ت علمي RLS Foundation طراحي و اجرا شده است. ا خرين اطلاعات و يافتهها در مورد بيماري سندرم پاهاي بيقرار و روشهاي درماني مختلف ان بحث شده و به صورت فايلهاي PDF در دسترس ميباشد. همچنين يك فيلم ا موزشي دربارة اين سندرم و تظاهرات باليني ا ن و تدابير درماني مختلف نيز در اين CD يافت ميشود. روانپزشكي-روانشناسي 101 DEFENSES (How the Mind Shields Ltself) (Taylor & Francis Books) توصيف كامل و كاربردي از انواع مكانيسمهاي دفاعي ناخودا گاه ذهن همراه با مثالها و شرح حالهاي نمونه جهت فهم بهتر دفاعها قابل استفاده براي روانپزشكان و روانشناسان باليني A Clinical Guide to PEDIATRIC SLEEP (Diagnosis & Management of Sleep Problems) (Jodi A. Mindell, Judith A. Owens) راهنماي باليني خواب كودكان جنبههاي عمومي خواب كودكان شامل خواب در نوزادان شيرخواران نوپاها سنين قبل از مدرسه سنين مدرسه و نوجوانان اختلالات خواب مرتبط با هر گروه سني در كودكان ارزيابي و درمان ا نها مروري بر موارد نمونه از شرح حالهاي روانپزشكي توصيههايي براي غلبه بر مشكلات تشخيص و باليني درمانهاي روانپزشكي و... تظاهرات باليني اختلالات خواب اختلالات اوليه خواب اختلالات خواب در بين ساير بيمارها Case Files Psychiatry (Toy, Klamen) قابل استفاده براي رزيدنتهاي روانپزشكي دانشجويان پزشكي و روانشناسي و... Clinical Sleep Disorders (Paul R. Carney, Richard B. Berry, James D. Geyer) Clinical Geriatric Psychopharmacology (Fourth Edition) (Cari Salzman) Comprehensive Handbook of Psychotropics (Florence W. Kaslow, Jeffrey J. Magnavita) (Volume 1-4) Comprehensive Textbook of Psychiatry (Kaplan & Sadock) (Eighth Edition) (Volume I, II) Concise textbook of CLINICAL PSYCHIATRY (KAPLAN & SADOCK) (Benjamin James Sadock, Virginia Alcott Sadock) DSM-IV-TR GuideBook the essential companion to the diagnostic & statistical manual of mental disorders (Fourth Edition) (Michael B. First, Allen Frances) راهنماي استفاده از معيارهاي اختلالات روانپزشكي متن تجديدنظرشدة نسخة چهارم كتابچة تشخيص و ا ماري اختلالات رواني (DSM-IV-TR). اين كتابچه نقشهاي كلي براي دستيابي به انواع تشخيصهاي روانپزشكي را فراهم ميكند و معيارهاي اشارهشده در DSM-IV-TR را براي استفاده و فهم بهتر كام لا توضيح ميدهد. Handbook of SLEEP MEDICINE (John M. Shneerson) كتاب كاربردي در خصوص ا شنايي با انواع اختلالات خواب خواب طبيعي و اختلالات ا ن فيزيولوژي خواب اثر داروها بر روي خواب ارزيابي درمان و مديريت اختلالات خواب قابل استفاده براي روانپزشكان متخصصين گوش و خلق و بيني متخصصين داخلي پزشكان عمومي و... Introducing Cognitive Analytic Therapy Principles & Practice (Antony Ryle & Lan B Kerr) رويكرد رواندرماني تلفيقي شناخت درماني- درمان تحليلي (CAT) چشمانداز مفاهيم و اصول CAT جنبههاي اساسي رواندرماني تحليلي- شناختي انتخاب بيماران قالب و روشهاي مورد استفاده در CAT Neurological and Neurosurgical Intensive Care (Allan H. Ropper, Daryl R. Gress, Michael N. Diringer) (Fourth Edition) Pocket Guide to the ICD-10 Classification of Mental & Behavioural Disorders (Compilation and editorial arrangements by JE Cooper) طبقهبندي و معيارهاي پذيرفتهشده در ا خرين نسخه طبقهبندي ICD پذيرفته شده توسط WHO براي اختلالات رواني به همراه معيارهاي باليني پيشنهادشده پژوهشي (DCR-10) راهنماي كاربردي روانپزشكي مشاوره- ارتباط. ا سيبديده و... ١٢٠٠ سو ال نمونه برگرفته از ا زمونهاي برد روانپزشكي Practical Guides in Psychiatry Consultation Liaison Psychiatry (Michael Blumenfield, Maria L.A. Tiamson) كتاب خلاصه و كاربردي استفاده و سريع در زمينه روانپزشكي مشاوره- ارتباط (C-L) با تا كيد بر ارتباط بين اختلالات روانپزشكي و اختلالات جسمي Psychonephrology, Psychocardiology مراقبتهاي روانپزشكي در بيماران Psychiatry: 1200 Questions To Help Youpass the Boatds (Salekan E-Book) Psychoanalytic Psychotherapy (A Practitioner's Guide) (Naney MeWilliams) راهنماي كاربردي رواندرماني روانپويايي مفاهيم و اصول رواندرماني روان تحليلي چهارچوب و فرا يند درمان تحليلي قابل استفاده براي روانپزشكان و روانشناسان باليني مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
328 Quick Reference to the Diagnostic Criteria from DSM-IV-TR Published by the American Psychiatric Association Washington, DC مرجع ا سان و سريع براي استفاده از ا خرين طبقهبندي و معيارهاي پذيرفتهشده اختلالات رواني طبق نظر انجمن روانپزشكي ا مريكا -(APA) متن تجديد نظرظده نسخة چهارم كتابچة تشخيصي و ا ماري اختلالات رواني (DSM-IV-TR) Social Skills Training for Schizophrenia A Step-by-Step Guide (Alan S. Bellack, Kim T. Mueser, Susan Gingerich, Julie Agresta) راهنماي مفيد جهت ا موزش مهارتهاي اجتماعي در بيماران مبتلا به اسكيزوفرنيا. شامل اصول اولي قالب و تكنيكهاي مورد استفاده در اين زمينه و اراي ه روشي گام به گام براي ا موزش مهارتهاي اجتماعي خاص بيماران و برنامهها و يادداشتهاي برنامهريزيشده براين اين منظور. قابل استفاده براي روانپزشكان روانشناسان روانپرستاران مددكاران اجتماعي كاردرمانگران و... Study Guide & Self-Examination Review in Psychiatry (Kkaplan & Sadock) (Seven Edition) نمونه سو الات استخراجشده از مراجع اصلي روانپزسكي comprehensive Synopsis بر طبق فصلبندي كتاب Synopsis SUBSTANCE ABUSE (A Comprehensive Texbook) (Fourth Edition) (Joyce H. Lowinson, Pedro Ruiz, Robert B. Millman, John G. Langrod) (CD I, II) كتاب مرجع كامل اختلالات مرتبط با مواد (ا مفتامينها كوكاي ين مواد توهمزا و...) با تا كيد جنبههاي اتيولوژيك و بيولوژيك اپيدميولوژيك تشخيصي و درماني. The American Psychiatric Publishing Textbook of Consultstion Liaison Psychiatry (Second Edition) (Michael G. Wise, James R. Rundell) كتاب جامع روانپزشكي مشاوره- ارتباط (C-L). اين كتاب مرجعي براي پزشكاني است كه بيماران مبتلا به اختلالات جسمي و روانپزشكي همراه را درمان ميكنند. اين كتاب ضمن اشاره به مفاهيم و اصول اوليه روانپزشكي مشاوره- ارتباط به اختلالات روانپزشكي در بين بيماران بيمارستانهاي عمومي (شامل افسردگي اختلالات اضطرابي اختلالات جنسي و...) و نيز ا رايه مشاورههاي باليني و نكات مهم در زمينه درمان اينگونه بيماريها ميپردازد The many Faces of Mental Disorders (Adult Case Histories According to ICD-10) شرح حالهاي نمونهاي از افراد مبتلا به انواع اختلالات رواني در سراسر جهان و بحث باليني و تشخيص بيماران نمونه بر پاية معيارهاي ICD-10. اين كتاب فهم سريعي به مطالعهكننده در امر تشخيص و مديريت بيماران مبتلا به اختلالات رواني با جلب توجه به جنبههاي فرهنگي و اجتماعي مختلف ميدهد ١٠- داخلي 1.10 عنوان CD (AGA Postgraduate Course) A Day and Night in the Life of a Gastroenterologist Esophagus and Stomach Liver Pancreas and Biliary Tract Nutrition GI Malignancy Small Bowel and Colon Clinical Challenge Sessions 3DClinic (Version 1.0) Seeing is Understanding سال انتشار جهت نصب اين نرمافزار بعد از شروع برنامه به صورت Autorun ابتدا QTS را كه درCD موجود است نصب نموده و سپس در قسمت دوم BI-B ) (SN: را بهمراه اسم خود وارد نماييد. سپس سيستم را Restart كنيد. 2D) Clinic) Icon بر روي Desktop شما ظاهر خواهد شد. كه با انتخاب و اجراي ا ن منوي اصلي ظاهر ميشود. بعد از نصب برنامه به طور كامل در كامپيوتر حفظ خواهد شد. اين نرمافزار با استفاده از عكسها و فيلمهاي سهبعدي جذاب مفاهيم مختلف مربوط به سيستمهاي مختلف بدن از جمله - -Cardiovascular Gastrointestinal -Musculoskeletal -Respiratory -Nervous -Urinary -Sensory -Endocrine -Lymphatic -Skin را در دو حالت Healthy و Disorder نشان ميدهد. فيلمهاي 3D كه به انتخاب شما نمايش داده ميشوند قسمتهاي بسيار جالب و ا موزندهاي از سيستمهاي مختلف بدن در حالت نرمال و بيماري اراي ه ميدهد كه به درك بهتر موضوع كمك شاياني مينمايد. قابليت نگهداشتن فيلم در لحظه دلخواه اضافهكردن نكات مهم با ماركر و نيز تايپ بر روي عكسها از قابليتهاي جالب اين نرمافزار ميباشد. شما در صورت تمايل ميتوانيد پرينت و اسلايد با كيفيت بالا از تصاوير تهيه فرماي يد. Adult Airway Management Principles & Techniques American Association (afael A. Ortega, M.D., Harold Arkoff, M.D.) Advanced Therapy of INFLAMMATORY BOWEL DISEASE (Theodore M. Bayless, MD, Stephen B. Hanauer, MD) 5.10 AGA Postgraduate Course CONTROVERSIES And CLINICAL CHALLENGES in Pancreatic Diseases (An Intensive Two-Day Course Covering A Diversity of Topics Related to the Pancreas) -Expanded Content -Includes Results of the Q&A -Section Challenge Sessions Atlas of GASTROINTESTINAL in Health and Disease (Marvin M. Schuster, Michael D. Crowell, Kenneth L. Koch) 6.10 Part 1: Physiologic Basis of Gastrointestinal Motility Part 2: Motility Test for the Gastrointestinal Tract 7.10 Atlas of GASTROINTESTINAL MOTILITY in Health and Disease (Second Edition) (Marvin M. Schuster, MD, FACP, FAPA, FACG, Michael D. Crowell, PhD, FACG, Kenneth L. Koch, MD) Part I: Physiologic Basic of Gastrointestinal Motility Part II: Motility Tests for The Gastrointestinal Tract 8.10 Atlas of Clinical Oncology Soft Tissue Sarcomas American Cancer Sosiety (Raphael E. Pollock, MD, Phd) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
329 Atlas of Clinical Oncology Cancer of the Lower Gastrointestinal Tract (Christopher G. Willett, MD) Atlas of Clinical Rheumatology (2 nd Edition) (David J. Nashel, Chief, Rheumatology Section Va Medical Center, Washington, Professor of Medicine Georgetown University) 1. Clinical Atlas of Rheumatic Diseases 3. Physical Examination 5. Physical Findings Instructional Module Radiography 2. Radiograph Intrerpretation Instructional Module 4. Procures 6. Aspiration/Injection Instructional Module Atlas of INTERNAL MEDICINE (Eugene Braunwald) CANCER Principles & Practice of Oncology (6 th Edition) (Vincent T. DeVita, Jr., Samuel Hellman, Steven A. Rosenberg) Case Studies in GASTROENTEROLOGY (Second Edition) (Ingram Roberts, MD) CD-ATLAS OF DIAGNOSTIC ONCOLOGY Clinical Endocarinology (G. Michael Besser MD, DSc, FRCP, Michael O. Thorner MB BS, DSc, FRCP) Adrenals Gonads Growth Hormone Assay Imaging Techniques Pancreas Ectopic Humoral Syndromes Gastrointestinal Tract Lipids and Lipoproteins Thyroid & Parathyroide Pituitary and Hypothalamus Clinical Immunology PRINCIPLES AND PRACTICE (Second Edition) (Robert R Rich, Thomas A Fleisher, William T Shearer, Brain L Kotzin, Harry W Schroeder) اين برنامه براساس كتاب Clinical Immunology نوشتة دكتر Rich اراي ه شده است. اين برنامه شامل ١١ بخش ميباشد: ١- اصول تشخيصي ايمني - ٢ مكانيسمهاي دفاعي ميزبان و التهاب ٣- عفونت و سيستم ايمني ٤- سيستم دفاعي ذاتي و اكتسابي ٥- بيماريهاي ا لرژيكي در هربخش اسلايدهاي متعددي همراه با توضيح اراي ه داده شده است. اين برنامه قابليت Search واژه و لغات را دارست و نيز تصاوير و اسلايدها را ميتوان چاپ نمود. نمود. همچنين ميتوان اسلايدهاي ديگري را به اين برنامه اضافه يا حذف كرد. اين برنامه بصورت Autorun اجرا ميشود و تحت Slide vision اجرا ميشود. ٦- بيماريهاي ايمونولوژيكي ٧- روشهاي تشخيصي در ايمونولوژي با روش drag & drop هر اسلايد را ميتوان در يك فايل (تحت برنامة ( Slide vision ذخيره و نگهداري CLINICAL ONCOLOGY (Raymond E. Lenhard, J. MD, Robert T. Osteen, MD, Ted Gansler, MD) Clinician's Guide to Laboratory Medicine (Saml, P. Desai, MD) Colonoscopy New Technology & Technique (CB Williams, JD Waye, Y Sakai) Color Atlas & Text of Pulmonary Pathology (Philip T. Cagle, MD) Comprehensive Clinical Endocrinology G. Michael Besser MD, DSc, FRCP, Michael O. Thorner Hypothalamus and Pituitary, Thyroid, Adrenal, Control of Blood glucose and its disturbance, gonad and growth, General conditions-basic, General conditionsclinical, Imaging, Patient Perspectives on endocrine Diseases COMPREHENSIVE MANAGEMENT OF Chronic Obstructive Pulmonary Disease (Jean Bourbeau, MD, MSc, FRCPC, Diane Nault, RN, MSc, Elizabet Borycki) Core Curriculum in Primary Care Metabolic Diseases Section CCC مجموعهاي از CDهايي ميباشد كه براي ا موزش مداوم دستياران و متخصصين هر رشته توسط اعضاء هيي ت علمي دانشگاه پزشكي Harvard بنا نهاده شده است. CD حاضر در مورد بيماري داخلي و قلب و عروق را گردا وري كرده است. هر كدام از اين سخنرانيها علاوه بر اسلايدهاي ا موزشي متن سخنراني نيز در دسترس كاربر ميباشد. در ا خر هر سخنراني و مبحثي سو الات مربوطه به صورت چهارگزينهاي براي ارزيابي كاربر ا ورده شده است. سپس خلاصه هر سخنراني به صورت يك مقاله چاپي در مجلات علمي و روزنامهها ا ورده شده است. مباحث زير در CD به صورت درسنامه ا موزشي موجود است. ١- Lipidها و بيماريهاي قلب و عروق ٢- ديابت مليتوس: نگرشي عملي (قسمت اول) ٣- ديابت مليتوس: نگرشي عملي (قسمت دوم) ٤- متابوليسم ا هن Critical Diagnostic Thinking in Respiratory Care A Case-Based Approach (James K. Storier, Eric D. badow, david L. longworth) Differential Diagnosis (Seventh Edition) (LC Gupta Abhitabh Gupta Abhishek Gupta) (Salekan E-Book) -Common Signs and Symptoms -Causes -Differentiating Tables -Essentials of Diagnosis -Staging of Diseases -Syndromes -Synonyms -Investigations Digestive Diseases Self-Education Program (A Core Curriculum and Self-Assessment in Gastroenterology and Hepatology) Diseases of the Liver (8 th Edition) (Lippincott Williams & Wilkins) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
330 General Considerations The Consequences of Liver Disease The Cholestasis Disorders Viral Hepatitis Immunology of Liver Autoimmune Liver Disease Alcohol and Drug-Luduced Disease Genetic and Metabolic Disease Vascular Disease and Trauma The Liver in Pregnancy and Childhood Infections and Granulomatous Disorders Transplantation Benign and Malignant Tumors ESAP (Endocrinology Self-Assessment Program) (Clark T. Sawin, MD, Kathryn A. Martin, MD) (The Endocrine Society) Evidence-Based Asthma Management PATHOPHYSIOLOGY/DIAGNOSIS/MANAGEMENT (7 TH edition) اين كتاب از سري كتابهاي Evidence-Based in medicin ميباشد كه به متخصصين كمك ميكند تا بهترين درمان را بر اساس دريافت شخصي خود از جديدترين درمانهاي موجود در مقالات و كتابها را انتخاب كرده و به كار برد. ا سم يك بيماري شايع پزشكي است كه شيوع رو به افزايش دارد. ا مارگيريها و مطالعات نشان داده شده كه افزايش شيوع ا سم واقعي بوده و با از كارافتادگي بيمار همراه بوده كه نشاندهنده درمان تا كامل اين بيماران است. اين كتاب با ا وردن مقالات بر اساس معتبربودن و درجهبندي اعتبار مقالات پزشك متخصص را كمك ميكند تا در درمان بيماري ا سم بهترين و كمعارضهترين درمان را براي هر بيمار جداگانه انتخاب نمايد. كتاب الكترونيكي حاضر شامل مباحث زير ميباشد: 1. Natural History and Epidemiology 9. Genetics of Asthma 17. Cellular and Pathologic Characteristics 2. Diagnosis 10. Role of the Outdoor Environment 18. Role of Indoor Aeroallergens 3. Role of Childhood Infection 11. Diagnosis and Management of Occupational Asthma 19. Principles of Asthma Management in Adults 4. Management of Persistent Asthma in Childhood 12. Mechanisms of Action of 2-Agonists and Short-Acting 2 Therapy 20. Role of Long-Acting 2-Adrenergic Agents 5. Use of Theophylline and Anticholinergic Therapy 13. Environmental Control and Immunotherapy 21. Role of Inhaled Corticosteroids 6. Leukotriene Modifiers 14. Alternative Anti-inflammatory Therapies 22. Exercise-Induced Bronchoconstriction 7. Acute Life-Threatening Asthma 15. Management of Asthma in the Intensive Care Unit 23. Severe Acute Asthma in Children 8. Role of Asthma Education 16. Asthma Unresponsive to Usual Therapy 24. Measures of Outcome EVIDENCE-BASED DIABETES CARE (Hertzel C. Gerstein, MD, R. Brain Haynes, MD,) 1- EVIDENCE 2- DEFINITION AND IMPORTANCE OF DIABETES MELLITUS 3- ETIOLOGIC CLASSIFICATION OF DIABETES 4- PREVENTION AND SCREENING FOR DIABETES MELLITUS 5- LONG-TERM CONSEQUENCES OF DIABETES 6- DELIVERY OF CARE EVIDENCE-BASED Diagnosis: A Handbook of Clinical Prediction Rules (Mark Ebell, MD, MS) (Springer-Verlag) -Cardiovascular Diseases -Endocrinology -Gastroenterology -Gynecology and Obstetrics -Hematology/Oncology -Infectious Disease -Musculoskeletal -Neurology -Pulmonary Diseas -Renal Disease -Surgery and Trauma First Principles of Gastroenterology The basis of disease & an approach to management (5 th edition) (A.B.R. Thomson, E.A. Shaffer) Gastric Cancer Diagnosis and Treatment (An interactive Training Program) (J.R. Siewert, D.Kelsen, K. Maruyama) (Springer) Gastroenterology Endoscopy (2 nd Edition) Gastrointestinal and Liver Disease Pathophysiology/Diagnosis/Management (7 th edition) (Sleisenger & Fordtran's) Esophagus Liver Nutrition in gastroenterology Topics involving multiple organs Biology of the Gastrointestinal Tract and Liver Stomach and duodenum Pancreas Biliary tract Approach to patients with symptoms and signs Small and Large Intestine Vasculature and Supporting Structures Psychosocial HARRISON'S 15 McGraw-Hill presents Linear ECHO ENDOSCOPY Tome I anatomy (Dr. Marc Giovannini) -Equipment -Environment -Echo-anatomy Management of Patients with Viral Hepatitis from the state of the Art to Real Life (Patrick Marcellin) Menopausal Osteoporosis (Neill Musselwhlte, M.D., Herman Rose, M.D.) Impact of osteobrosis -٤ ٥- استي وپروز ٦- سو الات جديد مطرحشده در اين زمينه MKSAP 12 (American College of Physiciance-American Sosiety Internal Medicine) 60 در اين CD مطالب جالبي در رابطه با منوپوز و استي وپروز اراي ه شده است كه عناوين ا ن به شرح زير ميباشد: ١- منوپوز و نحوة برخورد با ا ن ٢- روش جلوگيري از عوارض ا ن ٣- نگرانيهاي بيماريان -Gastroenterology and Hepatology - Endocrinology and Metabolism -Infectious Disease Medicine - Rheumatology - Oncology - Hematology - Cardiovascular Medicine - Pulmonary Medicine -Neurology - Dermatology - Nephrology -Hospital-Based Medicine and Critical Care - Ambulatory Medicine مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
331 Oxford Textbook of Medicine (OTM) (Weatherall, Ledingham, Weatherall) اين برنامه بصورت يك كتاب الكترونيكي مشتمل بر ٣٣ فصل در ٥٠٠ صفحه و ٢٥٠٠ تصوير اراي ه شده است. اين CD تمامي مباحث علوم پايه و مهارتهاي باليني مربوط به طب داخلي و تخصصهاي وابسته را دربر ميگيرد. اين برنامه يك منبع و مرجع قوي به منظور مشاوره در معاينات روزمره و پاسخ سو الاتي كه خارج تخصص پزشكان مطرح ميشود ميباشد. در نوشتن اين كتاب الكترونيكي از ٥٨٠ مقالهنويس و محقق معتبر در سرتاسر جهان استفاده شده است. از مزيتهاي اين برنامه ميتوان به موارد زير اشاره كرد: گردا وري غيرتكراري مباحث علوم پايه و علوم باليني. دامنة مباحث و موضوعات از قبل وسيعتر شده است. بيشتر مفاهيم بيماريهاي عفوني مربوط به درسنامه پزشكي را پوشش ميدهد. پزشكي ورزشي پزشكي قانوني پزشكي پيري معالجات دورهاي بيماريهاي مقاربتي. در اين CD بيماريهاي بارداري. بهداشت محيط و مشاغل تغذيه اختلالات و بيماريهاي اعتياد و روانپزشكي در معاينات عمومي مورد بحث دقيق و موشكافانه قرار نگرفته است. در پايان هر فصل كتاب منابع ا ن قيد شده است. هر فصل داراي تصاويري ميباشد كه ميتوان تمامي تصاوير CD را نيز جداگانه مشاهده نمود. قدرت تغيير اندازة قلمهاي متون و چاپگر و نيز قدرت چاپ متن و جستجوي كلمات و واژههاي تخصصي و دسترسي ا سان به جداول و تصاوير از ويژگيهاي اين برنامه است. سو الات چندگزينهاي (كه بصورت جداگانه اجرا ميشود) و فهرست تفصيلي از مندرجات كتاب نيز در اين CD طراحي شده است. Parenting Guide Pre-Colonoscopy Education Program (Dr. Michael Shaw, Dr. Oliver cass Dr. James Reynolds Patricia Tomshine, Rn) - Reason for Colonoscopy - The Colon and The Colonoscope - Preparations - Day of the Procedure - About the Procedure -After the Procedur - Minor Complicaions - Major Complications Reproductive Endocrinology Physilogy, Pathology & clinical management) (4 th edition) (Yen, Jaffe, Barbieri) Rheumatology (John H. Klippel.Paul A Dieppe) -Rheumatic Diseases -Signs and Symptoms -Rheumatoid Arthritis and Spondylopathy -Infection and Arthritis -Regional Pain Problems -Connective Tissue Disorders -Disorders of Bone, Cartilage -Management of Rheumatic Disease TEXTBOOK OF Gastroenterology (Third Edition) ATLAS OF Gastroenterology (Second Edition) (David H. Alpers, MD, Loren Laine, MD) Textbook of Rheumatology (Kelley's) (W.B. Saunders Company) Section I BIOLOGY OF THE NORMAL JOINT Section II IMMUNE AND INFLAMMATORY RESPONSES Section III EVALUATION OF THE PATIENT Section IV MUSCULOSKELETAL PAIN AND EVALUATION Section V DIAGNOSTIC TESTS AND PROCEDURES Section VI SPECIAL ISSUES Section VII CLINICAL PHARMACOLOGY Section VIII RHEUMATOID ARTHRITIS Section IX SPONDYLOARTHROPATHIES Section X SYSTEMIC LUPUS ERYTHEMATOSUS AND RELATED SYNDROMES Section XI VASCULITIC SYNDROMES Section XII SCLERODERMA AND MIXED CONNECTIVE TISSUE DISEASES Section XIII STRUCTURE, FUNCTION, AND DISEASE OF MUSCLE Section XIV RHEUMATIC DISEASES OF CHILDHOOD Section XV CRYSTAL-ASSOCIATED SYNOVITIS Section XVI OSTEOARTHRITIS, POLYCHONDRITIS, AND HERITABLE DISORDERS Section XVII ARTHRITIS RELATED TO INFECTION Section XVIII ARTHRITIS ACCOMPANYING SYSTEMIC DISORDERS Section XIX DISORDERS OF BONE AND STRUCTURAL PROTEIN Section XX TUMORS INVOLVING JOINTS Section XXI RECONSTRUCTIVE SURGERY FOR RHEUMATIC DISEASE Textbook of TRAVEL MEDICINE and HEALTH (Herbert L. Dupont, M.D., Robert Steffen, M.D.) (B.C.DECKER INC) اين برنامه بصورت يك كتاب الكترونيكي است كه شامل ٣٤ فصل در ٣٧٠ صفحه ميباشد. و توسط دكتر Dupont و دكتر Steffen نوشته شده است. در زمان مسافرت به مناطق مختلف امكان ابتلا به برخي بيماريها با توجه به شرايط اپيدميكي و اندميك بيشتر ميشود. بيماريهايي مثل مالاريا هپاتيت تيفوي يد ايدز وبا بيماريهاي مقاربتي از اين جمله هستند. بيماريهاي ناشي از حوادث شيوههاي درماني اثرات واكسيناسيون و ا مار مرگ و مير و... در مسافران مختلف در كشورهاي گوناگون مورد بحث و بررسي در اين CD قرار گرفته است. The Massachusetts General Hospital Handbook of Pain Management (Second Edition) (Jane Ballantyne, Scott M. Fishman, Salahadin Abdi) (SALEKAN-E-book) I. General Considerations II. Diagnosis of Pain III. Therapeutic Options: Pharmacologic Approaches IV. Therapeutic Options: Nonpharmacologic Approaches V. Acute Pain VI. Chronic Pain VII. Pain Due to Cancer VIII. Special Situations - Apendices - Subject Index UEGW Gastroenterology Week 10 th United European (Geneva, Switzerland) UEGW IBS: Management not myth 1. IBS: the clinician's view 2. IBS: care, cost and consequences 3. Diagnosis: identigy, Probe, eliminate 4. Tegaserod: a world of experience 5. Chairman's summary قسمتهاي مختلف اين CD شامل عناوين زير ميباشد: اين CD شامل عناوين زير ميباشد: Upper GI Endoscopy An Interactive Aducasional Program Video Segments of Common Pathologics of the Upper Gl tract (Iencludes Educational text) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
332 UpToDate CLINICAL REFERENCE LIBRARY 13.3 (CD I, II) (Burton D. Rose, MD, Joseph M. Rush, MD) Adult Primary Care Allwrgy and Immonology Cardiology Critical Care Drug Information Enodcrinoology Family Medicine Rheumatology Gastroenterology Gynecology Hematology Infections Disease Nephrology Oncology Pediatrics Pulmonology YEAR BOOK of RHEUMATOLOGY, ARTHRITI, AND MUSCULOSKELETAL DISEASE TM Health Sciences, Epidemiology, Economics, & Arthritis Care Rheumatoid Arthritis Systemic Selerosis and Related Disorders Regional Pain Syndromes, Non-Articular Musculoskeletal Disorders, and Fibromyalgia Critical Care Clinics Infections in Critical Care I & II (W.B. Saunders) Systemic Lupus Erythematosus and Related Disorders Women's Health (Richrd S. Panush, MD) (SALEKAN E-BOOK) Vasculitis and Systemic Rheumatic Diseases and Other Related Disorders عناوين اين CD شامل: Osteoarthritis, Crystal-Related Arthropathies, Osteoporosis, Infectious Arthritides, and Spondyloarthropathies Miscellaneous Topics عفوني Differential Diagnosis of Infectious Diseases (David Schlossberg, Jonas A. Shulman) Infectious Disease Pathology (Clinical Cases) (Gail l. Woods, Vicki, Schnadig, David H. Walker) Infectious Disease Secrets (Second Edition) Questions & Answers Reveal the Sectet to the Diagnosis & Management of Infectionus Diseases (Robert H. Gates) INFECTIOUS DISEASES (W Edmund Farrar, Martin J Wood, John A Innes, Hugh Tubbs) The Head and Neck Lower Respiratory Tract The Nervous System The Gastrointestinal Tract The liver and Biliary Tract The Urinary Tract The Genital Tract Bones and Joints The Cardiovascular System Bacterial Infections Vira, Fungal and Ectoparasitic Infections The Eye Systemic Infections HIV Infection and Aids Acknowledgements Infectious Diseases Handbook Diagnostic Medicine Series (Carlos M. Isada, Bernard L. Kasten, Morton P. Goldman) (5 th Edition) Manual of Clinical Problems in Infectious Disease (Nelson M. Gantz, Richard B. Brown) Principles & Practice of Infectious Diseases A Harcourt Health Sciences Company اين CD بصورت يك كتاب الكترونيكي همراه با بيش از ٨٠٠ جدول و ٨٠٠ تصوير ميباشد. و شامل تمامي مفاهيم اساسي و جاري در ميكروبيولوژي و درمان عوارض عفوني است. اين CD شامل سه بخش اصلي است: كه متن اصلي كتاب را شامل ميشود. s 1- Browse Mandell, Douglas & Bennett بر اساس حروف الفبا واژههاي تخصصي را پيدا نمود و به فصل و مباحث مربوط به ا ن در كتاب منتقل شد. Search: -2 Subject index طريقة استفاده از CD اراي ه شده است -3 Help ١) اصول اوليه در تشخيص و درمان بيماريهاي عفوني (عوامل ميكروبي مكانيزمهاي دفاعي ميزبان اپيدميولوژي روشهاي درماني) ٢) علاي م و نشانههاي كلينيكي (تب عفونتهاي فوقاني تنفسي عفونتهاي برونشيولها عفونتهاي دستگاه قلبي- عروقي عفونتهاي سيستم عصبي و...) ٣) بيماريهاي عفوني و عوامل و علل ا نها (بيماريهاي ويروسي بيماريهاي پريونها بيماريهاي ميوپلاسمها و...) ٤) problems Special (عفونتهاي بيمارستاني عفونتهاي ميزبانهاي خاص جراحي و عفونتهاي تروما و...) اين برنامه تحت internet explver و Java VM قابل اجرا ميباشد كه در هنگام نصب ا ن بر روي كامپيوتر شما (از طريق (CD قرار ميگيرند. The Washington Manual INFECTIOUS DISEASES Subspecialty consult (Richard Stalin) عنوان CD 1.11 A Major Contributor to Neonatal Infant Morbidity and Mortality (SURVANTA) (Part I, II) (Alan J. Gold, MD, J. Harry Gunkel, Arvin M. Overbach) 2.11 Atlas of Pediatric Gastrointestinal Disease 3.11 AVERY'S DISEASES OF THE NEWBORN (EIGHTH EDITION) (H. William Taeusch, M.D., Roberta A. Ballard, M.D., Christine A. Gleason, M.D.) (CD I, II) 4.11 Basic Mechanisms of Pediatric Respiratory Disease (Second Edition) (Gabriel G. Haddad,MD, Steven H. Abman, MD) ١١- اطفال سال انتشار مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
333 Genetic and Developmental Biology of the Respiratory System Structure-Function Relations of the Respiratory System During Development Developmental Physiology of the Respiratory System Inflammation and Pulmonary Defense Mechanisms Care of the Newborn: A Handbook for Primary Care (David E. Hertz, MD) Care of the Sick Neonate (A Ouick Reference for Health Care Providers) (Paulette S. Haws, MSN, RNC) Child Development, 9/e (John W. Santrock) Clinical Use of Pediatric Diagnostic Tests (Enid Gilbert-Barness, M.D, Lewis A. Barness, M.D., Philip M. Farrell, M.D.) CURRENT MANAGEMENT IN CHILD NEUROLOGY (SECOND EDITION) (Bernrd L. Maria, MD, MBA) Section 1: Clinical Practice Trends Section 2: The Office Visit Section 3: The Hospitalized Child EVIDENCE-BASED PEDIATRICS (William Feldmam, MD, FRCPC) (B.C. Decker Inc.) HANDBOOK A Manual for Pediatric House Officers (Jason Robertson, MD, Nicole Shilkofski, MD) Nelson TEXTBOOK OF PEDIATRICS (17 th Edition) (CD I, II, II) Neonatal and Pediatric Pharmacology Therapeutic Principles in Practice (Third Edition) (Sumner J. Yaffe, MD, Jacob V. Aranda, MD) Nutrition in Pediatrics (W. Allan Walker, John B. Watkins, Christopher Duggan) Oski's Essential Pediatrics (Michael Crocetti, M.D., Michael A. Barone, M.D.,) (Second Edition) PEDIATRIC GASTROINTESTINAL DISEASE Pathophysiology. Diagnosis. Management (Third Edition) TEXTBOOK OF NEONATAL RESUSCITATION (4 TH EDITION MULTIMEDIA CD-ROM) THE HARRIET LANE HANDBOOK (Seventeenth Edition) (Jason Robertson, MD Nicole Shilkofski, MD) A Manual for Pediatric House Officers عنوان CD 1. Review for USMLE NMS (Step 1) 2. Review for USMLE NMS (Step 2) 3. Review for USMLE NMS (Step 3) A.D.A.M. PracticePractical Review Anatomy Create New Test Open Existing Test هدف اين برنامه مرور مباحث ا ناتومي و محك زدن اطلاعات كاربر در اين زمينه است. اين برنامه شامل بيش از ٥٠٠ تصوير ا ناتوميكي (تصاوير واقعي طراحي شده و (X-ray ميباشد. داراي بيش از ١٥٠٠٠ سو ال امتحاني بوده كه بهمنظور يادا وري و مرور مطالب طراحي شده است. در پنجرة اصلي Review Anatomy در اين CD در ٢ قسمت مباحث اراي ه شدهاند: الف) مباحث مربوط به نواحي ا ناتوميكي ب) مباحث مربوط به دستگاههاي بدن هر قسمت را كه مشخص نماييد تصاوير و سو الات امتحاني ا ن بخش اراي ه خواهد شد. مباحث مطرح شده در بخش نواحي ا ناتوميكي شامل: ١- ا ناتومي سر و گردن ٢- ا ناتومي اندام فوقاني ٣- ا ناتومي تنه ٤- ا ناتومي قفسه سينه ٥- ا ناتومي شكم ٦- ا ناتومي لگن خاصره ٧- ا ناتومي اندام تحتاني. تصاوير وابسته به هر بحث از طريق دكمة Related images بطور جداگانه نشان داده ميشود. شما ميتوانيد نوع مقطع ا ناتوميكي را در هر قسمت مشخص انتخاب نماييد. قدرت بزرگنمايي تصاوير و نيز حذف و اضافه نمودن تصاوير مورد دلخواه و نمايش همزمان ٢ ١ و ٤ تصوير در اين برنامه وجود دارد. نحوة امتحانات بدين صورت است كه با فعال نمودن Start test در پنجرة text يك تصوير ا ناتوميكي به نمايش درميا يد و نام بخشي از ا ن مورد سو ال است با زدن كليد Show Results پاسخ سو الات به همراه نمرة نهايي اراي ه ميشود. قابليت اضافه نمودن يادداشتهاي شخصي به هر تصوير نيز وجود دارد. زمان پاسخ به هر سو ال در امتحانات اين CD را خود ميتوانيد به دلخواه تنظيم نماييد. در نوع ديگري از امتحانات اين برنامه ابتدا شما دستگاه يا ناحية ا ناتوميكي موردنظر را انتخاب مينماييد (و نيز زمان پاسخ هر سو ال را مشخص ميكنيد) با زدن كليد Start امتحان شروع ميشود. در هر سو ال نام بخشي از يك تصوير ا ناتوميكي موردنظر است. زمان باقيمانده براي هر سو ال در حين امتحان در حال نمايش است. اين CD نوشتة دكتر Pawlina و دكتر Olson ميباشد و بصورت Autorun اجرا ميشود. Atlas of Clinical Medicine (Version 2.0) (Forbes. Jackson) Infection Cardiovascular Renal Gastrointestinal Blood Joints and Bones Respiratory Endocrine, Metabolic and Nutritional Liver and Pancreas Nerve and Muscle CECIL TEXTBOOK of MEDICINE (21 st Edition) Part I MEDICINE AS A LEARNED AND HUMANE PROFESSION Part II SOCIAL AND ETHICAL ISSUES IN MEDICINE Part III AGING AND GERIATRIC MEDICINE Part IV PREVENTIVE HEALTH CARE Part V PRINCIPLES OF EVALUATION AND MANAGEMENT Part VI PRINCIPLES OF HUMAN GENETICS ١٢: عمومي سال انتشار 2001 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
334 Part VII CARDIOVASCULAR DISEASES Part VIII RESPIRATORY DISEASES Part IX CRITICAL CARE MEDICINE Part X RENAL AND GENITOURINARY DISEASES Part XI GASTROINTESTINAL DISEASES Part XII DISEASES OF THE LIVER, GALLBLADDER, AND BILE DUCTS Part XIII HEMATOLOGIC DISEASES Part XIV ONCOLOGY Part XV METABOLIC DISEASES Part XVI NUTRITIONAL DISEASES Part XVII ENDOCRINE DISEASES Part XVIII WOMEN'S HEALTH Part XIX DISEASES OF BONE AND BONE MINERAL METABOLISM Part XX DISEASES OF THE IMMUNE SYSTEM Part XXI MUSCULOSKELETAL AND CONNECTIVE TISSUE DISEASES Part XXII INFECTIOUS DISEASES Part XXIII HIV AND THE ACQUIRED IMMUNODEFICIENCY SYNDROME Part XXIV DISEASES OF PROTOZOA AND METAZOA Part XXV NEUROLOGY Part XXVI EYE, EAR, NOSE, AND THROAT DISEASES Part XXVII SKIN DISEASES Part XXVIII LABORATORY REFERENCE INTERVALS AND VALUES Common Medical Diagnoses: An Algorithmic Approach (Third Edition) (Patr. Ce M. Healey, Edwin J. Jacobson) 64 BEST MEDICAL COLLECTION اين برنامهها عبارتند از : اين CD داراي ٧ برنامة مختلف ميباشد كه هر يك را بايد بطور جداگانه از فايل مربوط انتخاب نصب و اجرا نمود. -٧ نرمافزار سلامت Health soft -٦ Reference medical Drug (مرجع پزشكي دارويي) -٥ داروهاي نسخهاي Drugs) (Prescription -٤ manger Health -٣ workout Multimedia -٢ طب سوزني -١ ديكشنري پزشكي نرمافزار ديكشنري پزشكي: مفاهيم واژهها و اصطلاعات پزشكي را ميتوان توسط اين برنامه جستجو نمود. همچنين دو فصل بصورت: الف) سلامت خانواده ب) سلامت كودكان در اين برنامه وجود دارد كه هر قسمت داراي عناوين و مطالبي بصورت text ميباشد. ١- طب سوزني : شامل ٩ فصل ميباشد كه روش كار با وسايل و نحوة درمان بيماريها بصورت توضيحات متني اراي ه شده است. يك فيلم راجع به طب سوزني نيز لحاظ شده است. اين برنامه محصول شركت ٢- Hopkins technology سال ١٩٩٧ ميباشد. برنامة workout نسخة ١: با وارد نمودن مشخصات فردي (سن قد وزن جنسيت ميزان انرژي پاية مورد نياز و...) اين برنامه رژيم غذايي مناسب نوع نرمش او موردنظر را به شما اراي ه ميدهد. اين برنامه محصول سال ١٩٩٤ است و داراي چندين فيلم ا موزشي از نحوة ٣- انجام نرمشها نيز ميباشد. manager :Health اين برنامه در حقيقت اطلاعات بيماري و سلامتي شغلي افراد را مديريت ميكند. برنامهاي است جهت ضبط و نگهداري وقايع پزشكي و درماني شخصي ليست داروهاي مورد استفادة فرد داروهاي ا لرژي و يك كتاب ا درس از مراكز مهم بهداشتي و درماني. ٤- زمان تجديد و تعويض نسخة پزشكي و مراجعه به دندانپزشك در جداولي مشخص ميشود. داروهاي نسخهاي: اين برنامه توضيحات مختصري راجع به داروها و اطلاعات فارماكولوژيكي مربوطه اراي ه ميدهد. محصول شركت Quanta Press سال ١٩٩٢ ميباشد. ٥- مرجع پزشكي دارويي نسخة ٢: از سه راه ميتوان وارد اين برنامه شد و از ا ن استفاده نمود: ٦- با استفاده از كليه Class گروههاي دارويي مختلف معرفي ميگردند. ج) ب) با استفاده از ميلة جستجو نام دارو را تايپ نموده و ا نرا بيابيد الف) ليست داروها: داروي موردنظر را انتخاب نماييد و اطلاعات لازم را دريافت كنيد. درمورد هر دارو مقدار مصرف روزانه اثرات جانبي اشكال مختلف دارو و هشدارهاي لازم درمورد اثرات سوء ا ن روشهاي نگهداري دارو و... اراي ه شده است. اين برنامه محصول شركت Parsons Technology سال ١٩٩٥ ميباشد. نرمافزار سلامت (Healthsoft) : اين نرمافزار شامل سهبخش (سه برنامه) مستقل ميباشد: ٧-... اين برنامه داراي تصاوير متعدد و نيز تلفظ صحيح اصطلاحات پزشكي ناا شنا نيز ميباشد با استفاده از فهرست الفبايي ميتوان اطلاعاتي راجع الف) اين برنامه شامل توضيحاتي راجع به اعمال جراحي مراقبتهاي پس از عمل اعمالي كه در زمان اورژانس بايد انجام داد و به هر واژه را پيدا نمود. در اين برنامه علت بيماريها علاي م و نشانههاي بيماريها پيشگيري مراقبتهاي بهداشتي روشهاي صحيح معالجه و نيز زمان لازم براي مراجعه به پزشك ا ورده شده است. ب) ج) در اين برنامه اطلاعاتي راجع به داروهاي ژنتيك اراي ه شده است. اثرات جانبي داروها واكنش ناسازگاري تداخل دارويي و... در اين CD اشاره شده است. البته اين اطلاعات تنها جنبة ا گاهي دادن به كاربر را داشته و نويسنده و شركت توليد كنندة CD هيچ توصيهاي در اين خصوص اراي ه نميدهند. در اين برنامه علاوه بر اراي ة نامهاي ژنتيك و تجاري گروههاي داروي ي و موارد كاربردي ا نها اراي ه شده است. مقدار مصرف دارو علاي م و نشانههاي Dverdose داروها موارد منع مصرف ا نها و تلفظ صحيح نام دارو ا ورده شده است. Clinical Examination Skin, nails & hair Respiratory system Heart & cardiovascular system Male genitalia Nervous system Ear, nose & throah Femal breast & genittalia Abdomen Bones, joints & muscle Infants & children CMDT CURREAT Medical Diagnosis & Treatment Endoscopic Assessment of Esophagitis According to the Los Angeles Classification System Definitions 1: Mucosal Break 2: Los Angeles Classification 3: Complicatins Viewing Area 1 :Slide Viewer 2: Slide Gallery 3:Video Gallery Quiz 1: International Working Group 2: On Endoscopic Assessment of Esophagitis GRIFFITH'S 5-MINUTE CLINICAL CONSULT به گفتة مو لفين اين CD براي پزشكان و متخصصين و دستي`اران براي مرور سريع ولي جامع در مورد بيماريهاي عمده داخلي زنان پوست جراحي چشم و ENT و... گردا وري شده است. بيش از هزار عنوان بيماري به ترتيب الفبا ترتيب يافته است كه در هر عنوان جزي يات كافي براي تشخيص و درمان و پيگيري بيماري وجود دارد. بيش از ٣٣٠ نفر متخصصين مجرب در گردا وري اين مجموعه همكاري داشتهاند. اين CD شامل توضيح بيماريها (در زير ا ورده شده است) و عكسهاي رنگي نمودار و جدول ميباشد. عنوان هر بيماري در ٦ قسمت اصلي و ٣٦ قسمت فرعي به تفضيل توضيح داده شده است. مشروح عناوين عبارتند از: 2002 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
335 6- MISCELLANEOUS Associated conditions Age-related factors Pregnancy Synonyms ICD-9-CM See also Other notes Abbreviations References 5- FOLLOW-UP Monitoring Prevention Complications Prognosis 4- MEDICATION Drugs of choice Contraindications Precautions Interactions Alternate drugs TREATMENT Genral measures Surgical measures Activity Diet Patient education HEALTH ASSESSMENT (Gaylene Bouska Altman, RN, Ph.D., Karrin Johnson, RN, Robert W. Wallach, MD) 2- DIAGNOSIS Differential Laboratory Pathological findings Special tests Imaging 1- BASICS Description Genetics Prevalence Age Signs and symptoms Causes Risk factors اين برنامه شامل ٤ بخش راجع به ارزيابي سلامت و ا زمايشات و معاينات فيزيكي ميباشد. بخش ١: مروري بر ا ناتومي و فيزيولوژي : شامل ١٧٥ قسمت همراه با ٥٩ تصوير طراحي شده از دستگاهها و اندامهاي بدن به همراه اطلاعات متني در اين بخش تمامي مطالب ا ناتومي و فيزيولوژي مرور شده است. بخش ٢: صداهاي قلب و ريه: در اين بخش صداهاي قلب و ريه (در حالت سلامتي و بيماري) در هنگام معاينة مريض اراي ه شده است. همچنين عملكرد و ساختارهاي قلب نيز بحث شده است. بخش ٣: مهارتهاي حياتي در ارزيابي سلامتي و معاينات فيزيكي: در اين بخش بصورت «بررسي و مطالعة موردي» اراي ه شده است. Case ٢٠ مختلف پس از اراي ه شرح حال وضعيت بيماري ا نها (بصورت سو ال و جواب) توسط كاربر مشخص ميشود. هدف از اين بخش افزايش قدرت و مهارت ارزيابي دانشجويان در تشخيص بيماريهاست. بخش ٤: ا شنايي بصري با معاينات فيزيكي كه داراي ٢C فصل ميباشد در اين بخش يك برنامة ا موزشي مصور همراه با اراي ه تعاريف و اصطلاحات مربوط به معاينات اراي ه شده است. در اين برنامه در هر چهار بخش امتحان بصورت سو الات چند گزينهاي نيز وجود دارد MCCQE Review Nots and Lecture Series (Marcus Law & Brain Rotengberg( Section Menu: Anesthesia, Cardiology, Color Atlas, Community Med, Dermatololgy, Diagnostic Imaging, Emergency, Endocrinology, Family Medicinne, Gastroenterology, General Surgery, Geriatrics, Gynecology, Hematology, Infectious Disease, Nephrology, Neurology, Neurosurgery, Obstetrics, Ophthalmology, Orthopedics, Otolaryngology, Pediatrics, Plastic Surgery, Psychiatry, Respirology, Rheumatology, Urology Medical Dictionary (Dorland's) (by W. B. Saunders) MEDICAL Encyclopedia For Health Consumers (With Atlas) MedStudy TM (The Best Internal Medicine Board Review) 1. The Most Board Specific 2. The Most Powerful 3. The Most Effective 4. The Most Talked About Natural Medicine Instructions for Patients (Lara U. Pizzorno, Joseph E. Pizzorno, Jr, Michael T. Murray) Patient Teaching Aids نرمافزار ا موزش جهت استفاده بيماران و پزشكان در رشتههاي مختلف طراحي شده است كه ا موزشهاي لازم را در بابت اقدامات حمايتي اقدامات تشخيص و درماني دربر دارد. مطالب بر اساس موضوع و بيماري دستهبندي شدهاند و هر مطلب حدود يك صفحه ميباشد. صفحات قابل Print و اراي ه به بيماران هستند. استفاده از اين نرمافزار نقش بيمار را در فرا يند درمان تقويت كرده و ديدگاه علمي و مناسبي به وي ميدهد كه به روند كلي سلامت و بهبود كمك بسزايي دارد. قابليت Search قوي و نيز اضافهكردن نوشته به متن از مزاياي اين نرمافزار محسوب ميگردد. حدود ٤٠٠ سرفصل كه هر كدام شامل چند Tapic عمده و شايع ميباشد را ميتوان براحتي در اين نرمافزار يافت Practical General Practice (Guidelines for effective clinical management) (Alex Khot, Andrew Polmear) (Third Edition) RAPID REVIEW FOR USMLE STEP 1 (Mosby) Sciences: Anatomy Behavioral Science Biochemistry Histology/Cell Biology Microbiology/Immunology Neuroscience Pathology Pharmocology Physiology Randomize All اين برنامه شامل ٦ فصل اصلي است: SPSS 12.0 for Windows Textbook of Physical Diagnosis HISTORY AND EXAMINATION (Fourth Edition) (Mark H. Swartz, M.D.) (W.B. SAUNDERS COMPANY) The Basics for Interns -١-٢ airway Management (ارزيابي مسير راههاي هوايي كنترل مسير راههاي هوايي در Apnea و hypoxia و... ابزارهاي مورد استفاده در مسيرهاي هوايي بيني و دهان روشهاي بيهوشي و نيتلاسيون ماسك كيسهاي لولهگذاري ناي تراكنوتومي) تفسير و ارزيابي اولية تصوير راديولوژي (شامل تصاوير Chest x-ray تصاوير Abdominal x-ray و (CT-scan مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
336 مديريت جراحي زخمها (شامل نخهاي جراحي معرفي ابزار و وسايل جراحي نمايش نحوة انواع بخيه زدنها روش پانسمان زخمها... ( دسترسي به شريانها (شامل شريان راديال شريان فمورال) دسترسي و بكارگيري سياهرگها (معرفي وسايل جهت دسترسي طولاني مدت به سياهرگها- ارزيابي پيش از عمل و تداركات لازم ا ناتومي و تكنيكهاي برشي سياهرگها و ايمپلنتهاي زيرپوستي و... ( در ناژ و تخليه پلورال : (موارد استعمال نحوة انجام عمل تكنيك توراسنتز تكنيك تيوب توراكوستومي ( تمامي مباحث عنوان شده در بالا بصورت فيلمغهاي ا موزشي و تصاوير متعدد همراه با توضيحات گوينده اراي ه شده است. اين فيلمغهاي ا موزشي يا بصورت واقعي است و نحوة انجام عمل برروي مريض دقيق ا نمايش داده شده است و يا بصورت انيميشن است. The MERCK MANUAL of Medical Information (Second Edition) (Mark H. Beers, MD) (CD I, II) (Salekan E-Book) Understanding Lung Sounds (Audio CD) UNDERSTANDING PATHOPHYSIOLOGY (Second Edition) (Sue E. Huether, Kathryn L. McCance) Virtual Medical Office CHALLENGE (to accompany Bonewit-West Clinical Procedures for Medical Assistants, 5 th Edition) (W.B. Saunders Company) اين نرمافزار با استفاده از CaseStudyهاي متعدد مطرحشده كاربر را به استفاده باليني از اطلاعات اراي هشده در كتب رفرانس عادت ميدهد. در عين حال شيوة حل مشكلات قدرت تصميمگيري به ضرافتهاي Critical و Triage كه از مهمترين مهارتها باليني پزشكان و كادر پزشكي محسوب ميگردد در طي مراحل متعدد و به صورت عملي و سمعي بصري ا موزش و تمرين ميگردند. اين CD شامل چهار سرفصل عمده به قرار زير است: - Case Study - Clinical Skills - Challenge Status -Help Contemporary Nutrition Food Wise (Food Wise, Weight Manager) Food Works (College Edition) تغذيه INTRODUCTION TO NUTRIOTION AND METABOLISM (Third Edition) (DAVID A Bender) Multimedia Workout (Jeffrey S. Smith, Joseph D. Cook) NUTRIENTS IN FOOD (Elizabet S. Hands) THE FOOD LOVER'S ENCYCLOPEDIA Culinary Techniques Recipes Nutrition Foods -٣-٤ -٥-٦ -٧ عنوان CD A Primer on Quality in the Analytical Laboratory (John Kenkel) American DRUG INDEX (FACTS AND COMPARISONS) Appleton and Lange's Quick Review PHARMACY (Twelfth Edition) (Joyce A. Generali, Christine A. Berger) -Parmaceutics/Pharmokinetics -Pharmacology -Microbiology and Public Health -Chemistry and Biochemistry -Physiology/Pathology -Clinical Pharmacy Basic Concepts in Biochemistry A Student's Survival Guid (Hiram F. Gilbert, Ph.D.) (Second Edition) Bioethics for Scientists (Professor John Bryant D. Linda Baggott La Velle, Revd Dr John Searle) British Pharmacopoeia (version 6.0) Vol 1: -Notices -Preface -British Pharmacopoeia Commision -Introduction -General Notices -Monographs: Meidicinal and Pharmaceutical Substances Vol 2: -Notices -General Notices -Monographs -Infrared Reference Spectra -Appendices -Supplementary Chapters British Pharmacopoeia (Veterinary): -Preface -British Pharmacopoeia Commission -Introduction -General Notices -Monographs -Infrared Reference Spectra -Appendics ١٣- داروي ي سال انتشار مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
337 Characterization of Nanophase Materials (Zhong Lin Wang) (Salekan E-Book) Chem Office (Renate Buergin Schaller) Chemometrics Data Analysis for the Laboratory and Chemical Plant Richard G. Brereton (University of Bristol, UK) Cleanroom Design (Second Edition) (Second Edition) CLINICAL DRUG THERAPY Rationnales for Nursing Practice (7 th Edition) (ANNE COLLINS ABRAMS) (Lippincott Williams & Wilkins) -Dosage Calc Challenge! -Animations -NCLEX Questions -Monographs of 100 Most Commonly Prescribed Drug -Preventing Medication Errors Video -Patient Teaching Sheets Common Fragrance and Flavor Materials (Kurt Bauer, Dorothea Garbe, Horst Surburg) DERIVATIZATION REACTIONS FOR HPLC (Georgelunn, Louise C. Hellwic) Dosages and Solutions CD Conpanion (Virginia Daugherty, RN, MSN, Diana Romans, RN, BSN) (Harcourt Health Sciences) -Mathematics Review -Introducing Drug Measures -How to Read a Drug Label -Calculatin Dosages -Comprehensive Posttest DRU ERUPTION REFERENCE MANUAL (The Parthenon Publishing Group) (Jerome Z. Litt, MD) Search by: - Drug Name -Reactions -Interactions -Categories -Company -Multiple Search -Printing -Common -Reaciton DRUG CONSULT (Mosby) Drug Identifier Find Products by: -Drug name -Imprint -NDC code -Manufacturer name Drug-Membrane Interactions Analysis, Drug Distribution, Modeling (Joachim K. Seydel, Michael Wiese) Encyclopedic Dictionary of Named Processes in Chemical Technology (Ed. Alan E. Comyns) European Pharmacopoeia (4 th Edition) FIRE AND EXPLOSION HAZARDS HANDBOOK OF INDUSTRIAL CHEMICALS (Tatyana A. Davletshina Nicholas P. Cheremisinoff, Ph.D.) Fluid Flow for Chemical Engineers (Second edition) (Professor F. A. Holland Dr R. Bragg) From Genome To Therapy: Integrating New Technologies with Drug Development GoodMan and Gilmans's CD-ROM Handbook of Solvents (George Wypych) HERBAL MEDICINE Expanded Commission E Monographs (INTEGRATIVMEDICINE) Herbal Remedy FINDER HPLC and CE METHODS for Pharmaceutical Analysis (Version 2.0) (George Lunn) (John Wiley and ons) Patient Education Guide to Oncology Drugs Name Search Categories Comparisons (Gail M. Wilkes, RNC, MS, AOCN, Terri B. Ades, RN, MS, AOCN) PDQ PHARMACOLOGY (GORDON E. JOHNSON, PHD) PDR Electronic Library PHYSICIANS DESK REFERENCE (Thomson Medical Economics) در مطب روي ميز كار هر پزشك صرفنظر از نوع تخصص وجود يك رفرانس جامع و معتبر اطلاعات داروي ي ضروري مينمايد. دو رفرانس PDQ) (PDR, فارماكولوژي كه به صورت CD اراي ه شدهاند از معتبرترين و جديدترين مراجع داروشناسي ميباشند كه با استفاده از ا نها ميتوان در كمترين زمان ممكن كلية اطلاعات لازم در مورد داروي مورد نظر منجمله دوزاژ انديكاسيونها كنتراانديكاسيونها عوارض جانبي و... را به دست ا ورد مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
338 PDR for Herbal Medicines (Third Edition) (David Heber, MD. Phd, Facp, FACN) PHARMACOLOGY (Thomas L. Pazderink, Laszlo Kerecsen, Mrugshkumar K. Shah) (Mosby) PHYSICANAS' CANCER CHEMOTHERAPHY DRUG MANUAL (Jones & Bartlett) - Principles of Cancer Chemotheraphy - Physician's Cancer Chemotherapy Drug Manual Guidelines for Chemotherapy and Dosing Modifications - Common Chemotherapy Regimens in Clinical Practice - Antimetic Agents for the Treatment of Chemotherapy-Induced Nausea and Vomiting The Analysis of Controlled Substances (Michael D. Cole) (Wiley) The Aqueous Cleaning Handbook A Guide to Critical-cleaning Procedures, Techniques, and Validation) The Constituents of Medicinal Plant (2 nd Edition) (An introduction to the chemistry and therapeutics of herbal medicine) The Herbalist (David L. Hoffman) THE MERCK INDEX on CD-ROM (Version 12:3) USP 27-NF 22 Through Supplement Two (U.S. PHARMACOPEIA) (The standard of Quality) (The United States Phamocopeial Convention, Inc) Workplace Safety Volume 4 of the Savety at Work Series (John Ridley, John Channing) عنوان CD BUILDING A MEDICAL VOCABULARY (FIFTH EDITION) (FEGGY C. LEONARD) (W.B. Saunders Company) ELECTRONIC MEDICAL DICTIONARY (STEDMAN'S) (LIPPINCOTT WILLIAMS & WILKINS) English Family (Merriam-Webster) Entertainment Collection How to Prepare for TOEFL Mad About English Spelling (Interactive Learning) Medical Information on the Internet (A Guide for Health Professionals) (Second Edition) (Robert Kiley) ١٤: زبان سال انتشار Why use the Internet? Getting Wired Finding what you want The top ten medical resources Internetive Learning , discussion lists and newsgroups The quality issue Consumer health information The future Appendix A: Finding more information information Appendix B: Netscape Navigator and Internet Appendix C: Optimising your computer Appendix D: Configuring TCP/IP Appendix E: Glossary Preparation For the TOEFL (Dictionary Crossword Puzzle Matching Game) Preparing for the GRE Writing Assessment What does the GRE General Test measure? The GRE General Test is designed to measuregeneral knowledge and reasoning skills in three areas that are important for a academic achievement: Verbal Ability Quantitative Ability Analytical Ability Speak Fluent Series Studying a Study Texting a Test (Fourth Edition) (Richard K. Riegelman) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
339 Designation Statement Target Audience Test-CME Needs Assessment Glossary Learning Objectives The AMERICAN HERITAGE TALKING DICTIONARY (Daniel Finkel) TriplePlayPlus! ENGLISH (Syracuse Languag Systems) Users' Guides To The Medical Literature (A manual for Evidence-Based Clinical Practice) (Gordon Guyatt, MD, Drummond Rennie, MD, Robert Hayward, MD) Learn To Speak English Dictionary & Grammer (CD1-4) THE LANGUAGE OF MEDICINE (6 TH EDITION) (W.B. Saunders Company) 1. Word Ports (Chapters 1-4) 2.Body Systems (Chapter 5-18) 3. Specialties (Chapter 19-22) عنوان CD 1. Reflux Disease and Nissen Fundoplication (Philip E. Donahue, MD) (VCD) 2. Supraceliac Aortic-Celiac Axix-Superior Mesenteric Artery Bypass (Gregorio A. Sicard, Charles B. Anderson) Advanced Therapy in THORACIC SURGERY (Kenneth L. Franco, MD, Joe B. Putnam Jr., MD) Aesthetic Department ARTECOLL: Injectable micro-implant, for long lasting levelling of facial wrinkles and folds American Collage of Surgeons ACS Surgery Principles & Practice (CDI, II) Anesthesia for the Cardiac Patient (Christopher A. Troianos) Aspects of Electrosurgery (Dr. Anthony C. Easty, PhD PEng CCE) Department Medical Engineering Atlas of RENAL TRANSPLANTATION (Prof. Legndre, Martin, Helenon, Lebranchu, Halloran, Nochy) Basic Surgical Skills (David A. Sherris. M.D., Eugene B. Kern, M.D.) (Mayo Clinic) Cholecystectomy by Laparoscopy (Department of Surgery Hospitalor Saint-Avold France) (VCD) Clinical Surgery (Second Edition) (Michael M. Henry, Jeremy N. Thompson) (Salekan E-Book) Core Curriculum in Primary Care Gynecology (Michael, Isaac Schiff, Keith, Thomas, Annekathryn) Core Curriculum in Primary Care Gynecology (Michael, Isaac Schiff, Keith, Thomas, Annekathryn) Core Curriculum in Primary Care Patient Evaluation for Non-Cardiac Surgery and Gynecology and Urology (Michael K. Rees, MD, MPH) ١٥- جراحي سال انتشار 2005 CCC مجموعهاي از CDهايي ميباشد كه براي ا موزش مداوم دستياران و متخصصين هر رشته توسط اعضاء هيي ت علمي دانشگاه پزشكي Harvard بنا نهاده شده است. CD حاضر در مورد جراحي زنان و اوروژي را گردا وري كرده است. هر كدام از اين سخنرانيها علاوه بر اسلايدهاي ا موزشي متن سخنراني نيز در دسترس كاربر ميباشد. در ا خر هر سخنراني و مبحثي سو الات مربوطه به صورت چهارگزينهاي براي ارزيابي كاربر ا ورده شده است. سپس خلاصه هر سخنراني به صورت يك مقاله چاپي در مجلات علمي و روزنامهها ا ورده شده است. شامل مباحث زير ميباشد: Male impotence ١- چگونه يك بيمار را براي اعمال جراحي (بجز جراحي قلب) ارزيابي و ا ماده كنيم در ا خر هر سخنراني سو الات شنوندگان و جواب سخنران نيز به صورت text ا ورده شده است. ٢- ارزيابي خونريزيهاي ابنرمال رحم.(AUB) ٣- عقيمي مردان LAPAROTOMY (Royal Society of Medicine in association with Royal College of Surgeons of England) (VCD) Lipostructure (Sydncy Coleman, M.D.) (byron) (VCD) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
340 LONG-TERM MECHANICAL VENTILATION (Nicholas S. Hill) Lower Body Lift (Abdominoplasty) (Lockwood, M. d., Kansas Gity) (VCD) (CD I, II) MALAR AUGMINTATION (CLINICAL MIRASIERRA MADRID) (Ulrich T. Hinderer Dr. Juan L. Del Rio) (VCD) Mammary augmention by High-Cohesive Silicon Gel Implant (Igar Nicchajev, Goran Jurell) Mastery of Endoscopic & Laparoscopic Surgery (Second Edition) Nail Surgery A text & Atlas (Edward A. Krull, Elvin G. Zook, Robert Earan, Eckart Haneke) NMS Surgery Tutor (Dereck Mooney, T. Mack Brown, Cristian Jansenson, Denise Riedlinger) Open Repair of Abdominal Wall Hernias Using Prosthetic materials (Arthur I. Gilbert, M.D.) Small Bowel Obstrution Immediately Following Laparoscopic Herniorraphy (Karl A. Zucher, MD) -VJGS Case Study: Laparoscopic Loop Ilestomy for Temporary Fecal Diversion (Steven D. Wexner, Petachia Reissman) -VJGS Consultants Corner: Managed Care Update, Pt, III (Michael A. Wood) Plug Repair for Inguinal Hernias 1- First Case: Inguinal Hernia type "Direct" 2- Second Case: Injuinal Hernia type "Indirect" 25.6 Practical MINOR SURGERY Principles of Surgery (Eight Edition) (Schwartz's) (E-Book) (CD I, II) Part1: Basic Considerations Part II: Specific Considerations SCHWARTZ'S PRINCIPLES OF SURGERY (8 th Single Puncture Laparoscopic Technique (Marco Pelosi, MD) (VCD) Edition) (F. Charles Brunicardi, Dana K. Andersen, Timothy R. Billiar) (Salekan e-book) (CD I, II) Submitted Subject: Transvaginal Sonographic Assessment of Pelvic Pathology: Preoperative Evaluation (Frances R. Batzer, MD) Surgical Decision Marking (Mcintyre, Stiegmann, Eiseman) SURGERY (John D Corson, Robin CN Willimson) (Launching Slide Vision) (Mosby) -Surgical Principles and Critical Care -Trauma -Gastrointestinal surgery -Vascular Surgery -Brast and Endoceine Surgery -Transplantation Surgery -Allied Surgical Specialties Surgery of the Liver & Biliary Tract 3e: Selected Operative Procedures (L.H. BLUMGART, Y. FONG) (W.B. Saunders) -Hepatic Procedures -Biliary Procedures -Special Procedures The Distal Splenorenal Shunt: Effective or Obsolete? (VIDEO JOURNAL OF GENERAL SURGERY) (Layton Fredrick Rikkers, M.D.) (VCD) - Options for Treating Portal Hypertension -Ideal Candidates for Distal Splenorenal Shunt -Components of Distal Splenorenal Shunt Procedure -HIPS Advantages -HIPS Disadvantages -Distal Splenorenal Shunt Patency The Ileana Pull-through Operative Prpcedure of Ulcerative Colitis: Eliminating the Permanent Ileostomy (Eric W. Fonkalseud, M.D.) (VCD) The Massachusetts General Hospital Handbook of Pain Management (Second Edition) (Jane Ballantyne, Scott M. Fishman, Salahadin Abdi) (SALEKAN-E-book) - General Considerations - Diagnosis of Pain - Therapeutic Options: Pharmacologic Approaches - Therapeutic Options: Nonpharmacologic Approaches - Acute Pain - Chronic Pain - Pain Due to Cancer - Special Situations - Apendices - Subject Index TISSUE ADHESIVES In Wound Care (James V. Quinn, M.D., FACEP) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
341 Tolaryngology Surgery for Fronatal Sinus Disease (Professor & Chairman, Bobby R. Alford, M.D.) (VCD) Video Journal General Surgery (VCD) Reflux Disease and Nissen Fundoplication (Philip E. Donahue, MD) 2. Supraceliac Aortic-Celiac Axis-Superior Mesenteric Artery Bypass (Gregorio, Leonardo, Brent, Charles) Video Journal General Surgery (VCD) 1. Open Repair of Abdominal Wall Hernias Using Prosthetic materials (Arthur I. Gilbert, M.D.) 2. Small Bowel Obstrution Immediately Following Lapatoscopic Herniorraphy (Karl A. Zucker, MD) 3. Laparoscopic Loop Ileostomy For Temporary Fecal Diversion (Steven D. Wxner, MD, Petachia Reissman, MD) 4. Consultants Corner: Managed Care Update, Pt, III (Michael A. Wood) Aesthetic Plastic Surgery (Thomas D. Rees) Atlas of Liposuction (Tolbert s. Wilkinson, MD) (Salekan E-Book) Breast-Augmentation with Novagold TM The PVP-Hydrogel Filled Implant Case Presentations In Plastic Surgery (Christopher Stone, Consultant Plastic Surgeon) COMPREHENSIVE FACIAL REJUVENATION (A practical and systematic guide to surgical management of the aging face) جراحي پلاستيك VCD 1: Rhinophyma (9:52) - Alloderm Lip Augmentation (14:04) - Collagen Injection Sequence VCD 2: Full-Face Jessner s/35% Trichloroacetic Acid Pell (31:21) VCD 3: Combined Resurfacing Technique for Aone Scarring (10:18) Botox Reconstitution and Injection Sequence (20:53) - Carbon Dioxide Laser Resurfacing (8:10) VCD 4: Postoperative Care of the Chemical Peel Patient (31:21) VCD 5: Transconjunctival Lower-Lid Blepharoplasty (9:05) Skin-Muscle Flap Lower-Lid Blepharoplasty with Midface Extension (16:20) VCD 6: Follicular Transfer Hair Transplantation Session (30:20) VCD 7: Upper-Lid Blepharoplasty (11:25) - Chin Augmentation with Gore-Tex Alloplast (13:21) VCD 8: Minimal Incision Brow and Midface Lift (31:02) VCD 9: Primary Facelift (37:17) VCD 10: Secondary Facelift with Gore-Tex Sling (30:21) VCD 11: Scalp Reduction Sessions (31:47) Facial Rejuvenation Greams, Toxins, Lasers & Surgery (Thomas C Spoor MD, Ronald L Moy MD) FACIAL SURGERY Plastic and Reconstructive Fundamental Techniques of Plastic Surgery and their Surgical Applications (10 th Edition) (Alan D McGrergo, Ian A. McGregor) Plastic and Reconstructive Breast Surgery (Second Edition) (Volume 1, 2) Plastic Surgery (Indications, Operations & Outcomes) (Volume five) (Bahman Gayuran, MD FACS) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
342 چگونگي تشخيص و Mangeكردن بيماران - Textbook دندانپزشكي و پريودونتولوژي -اختلالات تمپورومندمبولار و Manage ا نها - بررسي انواع لثه نرما Structural Fat Grafting (Sydney R. Caleman) (E-book & Film) Techniques of Cosmetic Eyelid Surgery A Case Study Approach (Joseph A. Mauriello, Jr) Tissue Glues in Cosmetic Surgery (RENATO SALTZ, M.D., DEAN M. TORIUMI, M.D.) (Salekan E-Book) - طبقهبندي بيماري لثه و PPL و... Transaxillary Augmentation عنوان CD Burkect's Oral Medicine Diagnosis and Treatment 72 - ملاحظات دندانپزشكي در بيمارات داراي بيماري سيستميك Caratera's Clinical PERIODONTOLOGY 9 th Edition نحوه درمان بيماريهاي لثه و PDL COLOR ATLAS OF Dental Medicine Aesthetic Dentistry (Josef Schnidsedes) اطلس رنگي درمانهاي دنداني- دندانپزشكي زيبايي- بررسي انواع متال كراونها و روشهاي كراونكردن- بررسي انواع سراميك كراونها- درمانهاي قبل از ترميم- كامپازيت افيله (مزايا و معايب)- (PFM) بررسي انواع ونيرو روشها و اصول ونيركراون - روشهاي تشخيص - ارتودونسي نوين - سينوسهاي پارانازال - بررسيهاي پريودونتال Color Atlas of Endodontics (William T. Johnson DDS.MS) درمان مجدد (Retreatment) - روشهاي Acsess - Textbook ارتودونسي در دندانپزشكي - تشخيص و اندازهگيري طول كانال ريشه - مشكلات ارتودونسي - ا مادهكردن كانال و... - نحوه تكامل ايرادات ارتودونسي - تشخيص و طرح درمان Contemporary Orthodontics PROFFIT - مكانيسمها و بيومكانيسمها - اختلالات TMJ و.. Craniofacial Development Critical Decisious in Periodoutology (Walte R.B.HALL) - درمانهاي جراحي مورد نياز در پريودونتيكس و زيبايي - منديبول و... - سابقه بيمار - نحوه شناسايي ضايعات - طرح درمانهاي مورد نياز - ا موزش به صورت تصويري - كليه روشهاي كنترل عفونت در مطب - روشهاي فلورايدتراپي - روشهاي معاينه و Position بيمار و دندانپزشك - روشهاي صحيح راديوگرافي گرفتن و نحوه ظهور ا نها و كنترل عفونت تاريكخانه - پريودونتال Dessing و نحوه برداشتن ا ن - روش صحيح استفاده از Instroment (قلمها) Dental Assisting - روش نصب رابردم و استفاده صحيح از ا ن Dental Implant System - اينترومنت - ا ناليز و بررسي روش كار - اعمال جراحي - ترميم و ا موزش بيمار Dental Implant System Fixed Implant Restorations (ITI Dental Implant System) (VCD) Endodontics - اينتدومنتهاي جديد Cleaning بررسي بيماريهاي سيستميك و تظاهرات دهاني ا نها اصول و تكنيكهاي: ١ -ترميمهاي كامپازيت - Shaping و ا داپتهكردن روتكانال و... ٢- سراميك- متال - نكات ضروري فارماكومورعي ٣- چيني فولكراون Endodontics 5 th Edition (John I. Ingle, DDS, MSD, Leif K. Bakland, DDS) ESSENTIAL OF ORAL MEDICINE (Silverman, Roy Eversole, Truelove) - بررسي در دهان سر و صورت همراه با تصاوير ا موزشي همراه با Caseهاي مختلف و پرسش و پاسخ ESTHETIC DENTISTRY 2th Edition (Dennet W. Aschheim, Barry G. Dale) ٥- رزينتهاي چسبنده ٦- بليچينگ (سفيدكردن دندانها) ٧- ايمپلنت و جراحي دهان و صورت Esthetic Implant Dentistry (Daniel Buser, Hans Peter Hirt) (VCD) -٤ وينير (PFM) ١٦- دندانپزشكي سال انتشار مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
343 ESTHETIC IMPLANT DENTISTRY (Daniel A. Bases, Urs.E.Belses) ١- جايگزيني تكدنداني با ايمپلنت ٢- ITI ايمپلنت دنداني تيتانيوم با پوشش TPS در اين نرمافزار توضيحات كامل و نحوة جايگذاري ايمپلنت مزايا و معايب انواع ايمپلنتها- بررسي بافت نرم قبل از انجام ايمپلنت و بررسي درصد موفقيت نشان داده شده است. Esthetic in Dentistry (Vol 1- Vol 2) ESTHETICS IN DENTISTRY (Second Edition) PRINCIPLES COMMUNICATIONS TREATMENT METHODS Glossary of Orthodontic Terms (John Daskalogiannakis) Guide to Physical Examination (Mosby) - مشكلات زيبايي تكدنداني - از دستدادن دندان - مال اكلوژي اين نرمافزار بررسي بهداشت دهاني و بررسي چندين Case همراه با عكسها و راديوگرافيهاي دهاني را توضيح ميدهد. Implant Medpor Mandibular A method to Restore Skeletal Support to the Lower Face (Oscar M. Ramirez M.D., F.A.C.S.) (POREX) (VCD) ITI Dental Implant (CD I, II, III) ITI TE Solution ITI TE Implant (DENTAL IMPLANT SYSTEM) (Daniel Buser) (Disk 1-3) Journal of Esthetic & Restorative Dentistry ٦- بررسي روشها ٧- انديكاسيونها ٨- بليچينگ - كليه مراحل ا مادهسازي - وسايل مورد نياز - نحوه جراحي لثه و فك و ا مادهسازي محل ١- بررسي كامل انواع انواع تريسها ٢- ژورنال دندانپزشكي ترميمي و زيبايي ٩- عكسهاي كامل از مراحل ترميم همراه با توضيحات ٣- سراميك اينله و انله Post -١٠ ٤- كامپازيت رزين ٥- كامپازيت رزين Packable ١١- Crown تمام سراميك LINGUAL ORTHODONTICS (Rafi Romano) (TO EXPLORE THE CD-ROM) Local Anesthesia in Dentistry (VCD) - خطرات موجود و ايرادات - روشهاي مختلف تزريق با اهداف متفاوت براي بيحسي نواحي مختلف دندانها و لثه و بافت نرم - بررسي روشهاي صحيح همراه با تصاويري گويا به صورت عملي Local Anesthesia in Dentistry (Dr. Markus D. W. Lipp Wolfgang Kelm) (VCD) My Orthodontics -بررسي مراحل معاينه - قبل از درمان طي درمان بعد از درمان - نتايج حاصله از درمان مراقبتهاي حين درمان - داراي لينكهاي متعدد و ا درسهاي جالب سايتهاي ارتودونسي Oral & Management Surgery Trauma (Raymond J. Fonseca, Robert, Barry H. Hendler) Oral Disease Diagnosis & Treatment Oral Pathology 4 th edition - بررسي انواع ضايعات دهان - بررسي بيش از Case ٥٠ متفاوت - ضايعات سفيد ا بي قرمز - بيماريهاي وزيكولوبولوز - بررسي به صورت ا زمون همراه با جواب صحيح - شرايط زخمها - اختلالات رنگدانهاي - ضايعات بافت همبند - مطالعة جزي يات و ملاحظات و مشخصات بيمار همراه با تصوير - كيستها و تومورها Orthodontics Current Principles and Techniques (Third Edition) (Thomas M. Graber, Robert L. Vanaradall, Jr.) Orthodontics & Paediatric Dentistry Orthodontics Priociples & Techniques 3th Edition - مال اكلوژن dentition- Mixed - تشخيص و طرح درمان در ارتودونسي و تكنيكهاي درمان - مال اكلوژن و اختلالات TMJ - واكنشهاي بافتها - فيزيولوژي استخوان - اختلالات TMJ و بيومكانيسمها Pathways of the PMP (8 th Edition) Part I: The Art of Endodoutics Part II: The Science of Endodoutics Part III: Related Clinical Topics PDQ ORAL DISEASE Diagnosis and Treatment (James J. Sciubba, DMD, PhD, Joseph A. Regezi, DDS, MS, Roy S. Rogers III, MD) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
344 PERIODONTAL MEDICINE (L.F. Rose, R.J.Genco, B.L. Mealey, D.W. Cohen) Periodontal Surgery Periodontal Surgery Clinical Atlas Removal Orthodontics Apliances جراحي پريودونتال - حذف پاكت پريودونتال - بررسي تحليل لثه در بيماريهاي پريودونتال كورتاژ - بررسي انواع بيماريهاي پريودونشيم بررسي دهها Case مختلف اعم از كلاس I و II و III همراه با مراحل لابراتواري و توضيحات كامل و تصويرهاي كامل از تمام مراحل. - درمانها و ا موزش بهداشت پس از درمان Saunders Dental Assisting (Multimedia Resource) (Second Edition) (Doni L. Bird, Debbie S. Robinson) Strauman Dental Implant System (VCD) نحوه ا مادهسازي نسج نرم و سخت براي استقرار ايمپلنت - پينگذاري در استخوان الوي ل - ايمپلنت چند دنداني ماگزيلد The Center of Education, Teaching and Research for Oral Implant Reconstruction (Prof. Dr. Hns L. Grafelmann) (CD I, II) -Pitt-Easy BIO OSS -Phase TPS Cylinder Implant - Vertical Load The Entegra Dental Implant System Entegra Surgical Videos (Robert Schroering) The IMZ Implant System (VCD) (Dr. Karl-Ludwing Ackermann, Dr. Axel Kirsch) (CD I, II) Toothcolored Restoratives - بررسي مواد مختلف در ترميم همرنگ مزايا و معايب - اصول و تكنيكها - نحوه تشخيص و انتخاب Case و دندان نيازمند به ترميم TOOTH-COLORED RESTORATIVES Ninth Edition (Principles and Techniques) (Harry F. Albers, DDS) Treatment Planning in Dentistry Treatment Planning in Dentistry (Stephen Stefanac, D.D.S., M.S. Sam Nesbit, D.D.S., M.S.) UCD Implant عنوان CD ANATOMY & PHYSIOLOGY (5 th Edition) (Gary A. Thibodeau, Kevin T. Patton) بررسي Caseهاي مختلف همراه با پروندههاي كامل - روشهاي بيحسي - داراي ا زمونهاي جالب و كامل - ا مادهسازي نسج نرم و نحوه ايجاد فلپ و نحوه ا مادهسازي نسج استخوان - نحوه جايگذاري پينها و... BODY WORKS 6.0 A 3D Journey Through The Human Anatomy Interactive Physilogy MUSCULAR SYSTEM (A. D. A. M. Benjamin/Cummings) (Marvin J. Branstrom, Ph.D.) -Anatomy Review: Skeletal Muscle Tissue -The Neuromuscular Junction -Sliding Filament Theory -Muscle Metabolism -Contraction of Motor Units -Contraction of Whole Musle InterActive PHYSIOLOGY Cardiovascular System The Heart Blood Vessels Anatomy Review: The Heart Intrinsic Conduction System Anatomy Review: Blood Blood Pressure Regulation Cardiac Action Potential Vessel Structure and Function Autoregulation and Capillary Dynamics Cardiac Cycle Measuring Blood Pressure Cardiac Output Factors that Affect Blood Pressure Interactive PHYSIOLOGY for Windows Urinary System Version 1.0 ١٧: فيزيولوژي سال انتشار اين برنامه داراي دو مبحث مجزا ميباشد و اهداف ا موزشي در ابتداي هر فصل اراي ه شده است. الف) قلب ب) عروق خوني مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
345 الف) قلب شامل مباحث: ا ناتومي قلب سيستم هدايتي قلب پتانسيل عمل قلبي چرخة قلبي و برونده قلبي. ب) عروق خوني شامل مباحث: ساختار و عملكرد عروق خوني اندازهگيري فشار خون فاكتورهاي مو ثر برروي فشار خون تنظيم فشار خون خودتنظيمي و ديناميك مويرگها. در هر قسمت از اين برنامه ري وس مطالب اراي ه شده است و گوينده ا نها را بيان ميكند. اين CD داراي يك فهرستي از اصطلاحات است و هر واژه را مختصر ا توضيح ميدهد. در بخش امتحان (Quiz) در هر يك از مباحث فوق سو الات چند گزينهاي اراي ه شده است و پاسخهاي ناصحيح با رنگ قرمز مشخص ميشوند. Interactive Physiology RESPIRATORY SYSTEM (A. D. A. M. Benjamin/Cummings) (Andrea K. Salmi) -Anatomy Reviw: Respiratory Structures -Pulmonary Ventilation -Gas Exchange -Gas Transport -Control of Respiration MedWorks Anatomy & Physilogy Anatomy Y Physiology: Overview The Endocrine System The Sensory Organs Cells and Tissues The Integumentary System Body Chemistry The Skeletal System The Muscula System Cardiovascular System: The Blood Somatic and Autonomic Systems Cardiovascular System, The Heart The Peripheral Nervous Systems Lymphatic and Immune System Inheritance The Respiratory System The Digestive System The central Nervous System The Reproductive System The Nervous System Organization The Urinary System براي اجرا فايل Setup.exe را از مسير دايركتوري Medwork انتخاب و اجرا كنيد. Panorama of Anatomy & Physiology Structure & Function of the Body (Eleven Edition) (Gary A. Thibodeau, Kevin T. Patton) Range of Motion-AO Neutral-0 Method Measurement and Documentation (Thime) The Interactive Skeleton Tutorial (Dr. peter Abrahams of cambridger University, UK.) 1. Head 2. Spine 3. Ribs 4. Upper Limb 5. Lower Limb World of SPORT examined Interactive Guide to Human Neuroanatomy (Mark F. Bear, Barry W. Connors, Michael A. Paradiso) Atlas: -Surface Anatomy of Brain -Cross-Sectional Anatomy of Brain -The Spinal Cord -The Anatomy Nervous System -The Cranial Nerves -The Blood Supply to the Brain Exam:I -Surface Anatomy of the Brain -Cross-Sectional Anatomy of the Brain -Comprehensive Exam Sobotta (Atlas of Human Anatomy) (Urban & Schwarzenbery) 1. General Anatomy 2. Head and neck 3. Upper Limb 4. Brain and Spine Cord 5. Eye 6. Ear 7. Thoracic and Abdominal Wall 8. Thoracic Oegans 9. Lower Limb طريقة نصب: جهت نصب اين نرمافزار ابتدا از دايركتوري Setup English ا بيرنگ را اجرا ميكنيم. پس از اتمام وارد دايركتوري Crack و سپس ميكنيم. حال نرمافزار فوق قابل خواندن و اجراست. Past اجرا شده) Setup مسيري كه (همان C:\Urban را كپي كرده و در Sobotta 1.5Crack Student Companion CD-ROM for Principles of Anatomy & Physiology (Tenth Edition) (John Willey & Sons, INC.) Gray's Anatomy The Anatomical Basis of Clinical Practice (Thirty-Ninth Edition) (Susan Standring) (CD I, II) (Salekan E-Book) عنوان CD The Oncology Nursing Society presents THE ADVANCED PRACTICE ONCOLOGY NURSING REVIEW Textbook of MEDICAL SURGUCAL NURSING (Ninth Edition) (Katherine H. Dimmock) Student Self Study Disk to Accompany BRUNNER & SUDDARTH'S Focus on Nursing Pharmacology (Lippincott Williams & Wilkins) Wongs ESSENTIALS OF Pediatric Nursing (Mosby) A Harcoun Health Sciences Company Maternal, Neonatal and Women's Health Nursing By Delmar, a division of Thomson Learning Nursing Care of Infants and Children (Seven Edition) اين CD شامل عناوين زير ميباشد: ١٨: پرستاري سال انتشار مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
346 Childre, Their Families, and the Nurse - Assessment of the Child and Family - Family-Centered Care of the Newborn - Family-Centered Care of the Infant - Family-Centered Care of the Young Child - Family-Centered Care of the School-Age Child - Family-Centered Care of the Adolescent - Family-Centered Care of the Child with Special Needs - The Child who is Hospitalized - The Child with Disturbance of Fluid and Electrolytes - The Child with Problems Related to Transfer of Oxygen and Nutrients - The Child with Problems Related to Production & Circulation of Blood - The Child with Disturbance of Regulatory Mechanisms - The Child With a Problem that Interfers with Physical Mobility McMinn's Interactive Clinical Anatomy INRERACTIVE ATLAS OF CLINICAL ANATOMY (Illustrations by Frank H. Netter, M.D.) عنوان CD A Manual of ACUPUNCTURE (Peter Deadman & Mazin Al-Khafaji with Kevin baker) BACK STABILITY Christopher M. Norris, MSc, MCSP, Director, Norris Associates, Manchester, UK) (Salekan E-Book) Chiropractic Pediatrics A Clinical Handbook (Neil J. Davies, Jennifer R. Jamison) Chiropractic Peripheral Joint Technique (Raymond T. Broome) Chronic Pain Management for Physical Therapists (Second Edition) (Harriet Wittink, Theresa Hoskins Michel) Clinical Tests for the Musculoskeletal System (Klaus Buckup, KlinikumDortmund Orthopaedic Hospital Dortmund Germany) (Salekan E-Book) Daniels and Worthingham's MUSCLE TESTING Techniques of Manual Examination DIET & FITNESS DIGITAL SHIATSU اين برنامه داراي ٦ قسمت مي باشد كه به شرح زير است: ١٩- فيزيوتراپي سال انتشار راهنما - جستجو - خود ماساژ درماني shiatsu) (self- - ماساژ درماني تمامي بدن body) (total - موارد كاربرد ماساژ درماني (therapies) - اساس و مباني ماساژ درماني در اين قسمت روش ماساژ صحيح و عملي تمامي بدن همراه با نمايش فيلم و توضيحات گوينده و متن چاپي اراي ه مي شود. در تصاوير طرحوارهاي نقاط حساس كه در ماساژ درماني مورد توجه قرار ميگيرد نمايش داده شده است. ١- همراه با نمايش فيلم و توضيحات گوينده در دو قسمت روش ماساژ درماني اراي ه شده است. ٢- موارد كاربرد ماساژ درماني در ٢٢ مورد توضيح داده شده است. ) شامل : ا رتريواسكلروز درد قفسه سينه فلج صورت سينوزيت خون دماغ بيماريهاي كبدي بيماريهاي كليوي ياي سگي اسهال قاعدگي گرفتگي و كرامپ پا و...) ٣- اصول ماساژ درماني و روشهاي كلاسيك ا ن و نيز تاريخچه متد Namikoshi توضيح داده شده است ٤- بر اساس حروف الفبايي مي توان واژههاي تخصصي مورد نظر خود را پيدا نمود و با كليك نمودن بر روي ا ن به ا ن مباحث منتقل شد. ٥- اين برنامه به صورت Autorun اجرا مي شود. طريقة نصب: جهت نصب اين برنامه لازم است بر روي ا يكون Setup.exe دو بار كليك نماي يد و مراحل نصب را پيگيري كنيد در نهايت اين برنامه به نام Lifestyle softuare Group در گزينه program نصب مي شود. در اين CD يك برنامه جانبي به نام Jurassic Park Entertainment نيز وجود دارد كه براي سفارشي نمودن صفحه Desktop كامپيوتر شما به كار مي رود. براي نصب ا يكون install.exe كليك نماي يد EXERCISE THERAPY PREVENTION AND TREATMENT OF DISEASE ((John Gormley and Juliette Hussey) Fibromyalgia Syndrome Bodywork Management Strategies در اين CD ابتدا تعدادي از كتب Leon Chitow كه در زمينة تكنيكهاي دستي است معرفي شده است. سپس ارزيابي و درمان فيبروميالژيا بر اساس پروسه درماني پيشنهاد شده ا موزش داده ميشود بدينصورت كه در مراحل مختلف ارزيابي كه شامل ٥ بخش ميباشد با تا كيد بر مهارتهاي لمس نشان داده شده است. Assessment Methodes - Manual Thermal Diagnosis - Skin on Fascia Adherence - Hyperalgesic Skin Zones reduced Skin elasticity - Drag palpation for increased hydrosis - Neuro muscular Technique Evaluation (NMT) 2005 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
347 12.19 Fundamentale of Sensation ad Perception (3 rd Edition) (M.W. Levine) 77 محتواي اين CD شامل ١٦ عنوان زير ميباشد: Introduction and instructions Threshold experiment or Signal Detection Specializations of the Vertebrate eye Retinal Cells responding to light Afterimages Brain anatomy, Blink Suppression, or Cortical Demonstratuins of Fourier Cortical columns or Equiluminant demos Cell responses components Depth from motion of random dots Optical IIIusions and Constancies Motion demonstrations Color mixing or Opponent cells Traveling waves on the basilar membrane Pitch and Loudness of tones Speech sounds of Mystery phrase Muscle spindle feedback Gnglion Cells responding to light Motions from form of Impossible figures Mechanics of the middle and inner ear Taste-influenced by vision Health & Fitness (DataSel Software, Inc) 1. Getting Started 2. The Exercise Demonstration Screen 3. Strength 4. Stretch 5. Equipment 6. Muscles 7. Workouts 8. Setup 9. Technical Support Hysical Agents in Rehabiliation from Research to practice (Michelle H. Cameron) Interactive Atlas of Human Anatomy Introduction to Massage Therapy (Mary Beth Braum, Steplianic Simonsoon) (Salekan E-Book) Kinesiology of the Musculoskeletal Foundations for Physical Rehabilitation (Donald A. Neumann.PT.PHD) Maintaining Body Balance Flexibility and Stability A Practical Guide to the Prevention and Treatment of Musculoskeletal Pain and Dysfunction (Leon Chaitow ND DO, Douglas C. Lewis ND) MANIPULATION OF THE SPINE, THORAX AND PELVIS An Osteopatic Perspective (Peter Gibbons, Philip Tehan) اين CD بصورت نمايش ٣٤ قطعه فيلم ا موزشي كوتاه در خصوص تكنيكها و نحوة معاينة فيزيكي و manipulation بيماريهاي استخواني ستون فقرات فقسة سينه و لگن خاصره ميباشد. اين فيلمها در دو بخش كلي به شرح ذيل اراي ه شده است: : HVLA thrust techniques-spine and thorax - Cervical and cervicothoracie spine -Thoracic spine and rib cage -Lumbar and thora Columbar spine بخش اول : بخش دوم HVLA thrust techniques-pelvis Massage Therapy Review (interactive Edition) (Mosby) Medical Acupuncture (A Western scientific approach) (Jacqueline Filshie) Men's Health GET RID OF THAT GUT STAGE 1: BEGINNERS LEVEL STAGE 2: INTERMEDIATE LEVEL STAGE 3: ADVANCED LEVEL Modern Neuromuscular Techniques (Leon Chaitow) در هر قطعه فيلم پزشك متخصص نحوة انجام معاينه و manipulafion را بر روي بيمار نمايش ميدهد. اين CD به صورت Autorun اجرا ميشود MUSCLE ENERGY TECHNIQUES ADVANCED SOFT TISSUE TECHNIQUES (Second Edition) در اين CD متن كامل كتاب Muscle Energy Techniques لي ون چيتو مشتمل بر ٨ فصل به همراه ٣٠ تصوير ويدي وي ي وجود دارد. Post يكي از روشهاي درمان دستي است كه در ا ن از انقباض ارادي عضله در يك جهت كنترل شده و دقيق با شدتهاي مختلف و در برابر نيروي درمانگر استفاده ميشود. در اين تكنيك بيمار نقش فعالي در اصلاح اختلالات عملكردي بر عهده دارد و تراپيست با استفاده از MET isometric Relaxation يا Reciprocal inhibtion باعث كاهش تون يا مهار عضلات كوتاهشده و تقويت عضلات ضعيف ميشود. اين تكنيك كاربرد باليني زيادي دارد كه ميتوان به موارد زير اشاره كرد: كشش عضلات كوتاه و اسپاستيك تقويت عضلات ضعيف رفع احتقانهاي وريدي از بينبردن چسبندگي متعاقب احتقان وريدي كاهش ادم موضعي اصلاح موانع مكانيكي داخل مفصل مثل ا رتريت گيرافتادگي منيسك و عدم تطابق كامل سطوح مفصلي و همچنين متحركنمودن مفاصل محدود Muscles (Testing and Function with Posture and Pain) Myofascial Release Techniques (John F. Barnes, PT) (VCD I, II) Occupational Therapy for Physical Dysfunction (Fifth Edition) (Catherine A. Trombly, Mary Vining Radomski) Orthopaedics for Nurses (John Ebnezar) (Salekan E-Book) Orthopedic Massage Theory and Technique (Whitney Lowe Leon Chaitow) مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
348 Palpation Skill in Assessment and Tr eatment Fibromyalgia Syndrome (Leon Chaitow) Physical Education and the Study of Sport (Bob Davis, Ros Bull, Jan Roscoe, Dennis Roscoe) (Mosby) Physical Education and the Study of Sport 2- Synoptic Questions Harcourt Health Sciences 3- The Project Personal Performance Profile Physical Rehabilitatioon of the Injured Athlete 3 rd Edition (James R. Andrews, Gary I., Harrison, Kevin) (Salekan E-Book) Physiotherapy for Respiratory & Cardiac Problems Adults & Paediatrics (Jennifer A. Pryor, S. Ammani Prasad) Physiotherapy in Obstetrics & Gynaecology (Second Edition) (Jill Mantle, Jeanette Haslamk Sue Barton) (Second Edition) Positional Release Techniques ADVANCED SOFT TISSUE TECHNIQUES (Leon Chaitow) (Harcourt) (Second Edition) در اين CD متن كامل كتاب Positional Release لي ون چيتو مشتمل بر ١٢ فصل همراه با ٣١ تصوير ويدي وي ي از تكنيكهاي اعمالشده وجود دارد. Positional Release به عنوان يكي از تكنيكهاي مو ثر در درمان بافت همبند مناطقي كه در لمس هايپرتون يا كوتاه شدهاند بكبار ميرود و چون اساس ا ن قراردادن بافت همبند يا عضله در راحتترن وضعيت ميباشد بهكاربردن ا ن در موارديكه به علت اسپاسم يا التهاب بافت همبند بسيار دردناك است براي بيمار قابل تحمل ميباشد. لذا در درمان بيماران مبتلا به مشكلات ماسكلواسكلتال بسيار مو ثر است. Spontaneous Positional relese variations The evolution of dysfunction Unloading and Proprioceptive taping Modified strain/counterstrain technique Learning SCS SCS for muscle pain (plus INTT and self-treatment) Goodheart and Morrison's Positional release variations and lift techniques SCS (and SCS variations) in hospital settings The Mulligan concept: NAGs, SNAGs, MWMs, etc. Functional technique Facilitated Positional release (FPR) Cranial and TMJ Positional release methods Power Touch Principles & Pracice of Sport Management (Second Edition) (Lisa Pike Masteralexis, Carol A. Barr, BS, Mary A. Hums) Principles of Manual Therapy (A Manual Therapy Approach to Musculoskeletal Dyslimction) (Salekan E-Book) Rehabilitation for the Postsurgical orthopedic patient Running Biomechanics & Exercise Physiology Applied in Practice (Frans Bosch & Ronald Klomp) Surface and Living Anatomy (Gordon Joslin SOtJ) در اين CD متن كامل ا ناتومي سطحي قسمتهاي مختلف بدن وجود دارد و پيداكردن ٢٢٦ منطقه ا ناتوميكي را مرحله به مرحله توضيح ميدهد. در كنار هر يك از متنهاي مربوطه عكسهاي رنگي وجود دارد كه به وسيلة ماركرهايي مناطق مربوطه را نشان ميدهند The Back Pain Revolution (Gordon Waddell) The Complete Acupuncture The Principles of Harmonic Techniques (Eyal Lederman) (VCD) هارمونيك تكنيك به عنوان يك تكنيك درماني مو ثر در زمينه تكنيكهاي مانوال (دستي) به وسيلة Eyal Lederman معرفي شد. بر اين اساس كه هر سيستمي يك فركانس نوسان طبيعي دارد چنانچه اين تكنيكهاي درماني در محدودة فركانس بافتها و تودههاي بدن اعمال شوند باعث ايجاد رزونانس شده با صرف انرژي كمتر توسط درمانگر دامنه حركتي مناسب در بيمار ايجاد ميشود. در اين CD اصول و روش استفاده از اين تكنيك در مفاصل مختلف در ٤ بخش نشان داده شده است: 1- The Principles of Harmonic Technique 3- The Principles of Harmonic Technique Using Pelvic Mass Oscillations 2- The Principles of Harmonic Technique Using Thoracic Mass Oscillations 4- The Principles of harmonic Technique Using Appendicular Oscillations Therapeutic Exercise (Foundations and Techniques) (4 th Edition) (Carolyn Kisner, MS, PT, Lynn Allen Colby, MS, PT) Therapeutic Exercise for Lumbopelvic Stabilization A motor Control Approach for the Treatment and Prevention of low back pain (Second Edition) (Carolyn Richardson, Paul W. Hodges, Julie Hides) (Salekan E-Book) Tidy's Physiotherapy (Stuart B.Porter) (13 th edition) YOGA for YOU (Anatomy) ٢٠: اورژانس و بيهوشي مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
349 عنوان CD A manual of Acupuncture (Peter Deadman& Mazin Al-Khafaji, With Kevin Baker) Advanced Pediatric Life Support: The Critical First Hour CPR and ACLS Review (David G. Nichols, MD) 79 سال انتشار اين CD در مورد احياء قلبي- ريوي پيشرفته در كودكان و بالغين شرح ميدهد: 1: Initial Evaluation, 2: Airway Management, 3: Epiglottitis and Gidup, 4: Respiratory Failure, 5: Advanced Pediatric CPR, 6: Resuscitative Drugs American College of Surgons ACS Surgery Principles & Pracitce (CD I, II) (E-Book) ANESTHESIA (Ronald D. Miller, MD) (Fifth Edition) Anesthesiology (The Journal of the American Society of Anesthesiologists, Inc) Abstracts of Scientific Papers Anesthesiology (The Journal of the American Society of Anesthesiologists, Inc) Abstracts of Scientific Papers Anesthesiologist's manual of Surgical Procedures شامل كلية مراحل ا مادهسازي بيماران و Preob (ويزيت) قبل از عمل جراحي و همچنين مراحل بيهوشي و تكنيكهاي بيهوشي متناسب با هر عمل جراحي و بيماري و همچنين مراقبتهاي بعد از عمل جراحي ذكر شده است. Atlas of Interventional Pain Managemetn (Steven D. Waldman) Bonica's Management of Pain (John D. Loser, M.D.) (3th Edition) CHINA ZHENJIUOLOGY (VCD) (VCD 1 30) اين مجموته شامل كلي مباحث علمي و كاربردي در تمامي زمينههاي طب سوزني و مباحث جنبي همچون داروهاي گياهي حجامت مباحث تكنيكال (مسيرهاي انرژي نقشههاي نقاط طب سوزني و...) و شناخت ابزارها و... ميباشد Clinical Procedures in EMERGENCY MEDICINE (4 th Edition) (James R. Roberts, MD, Jerris R. Hedges, MD, MS) (E-Book) (CD I, II) Critical Care Handbook of the Massachusetts general hospital (3th edition) (William E. Hurford) Critical Care Secrets (Third Edition) (Pollye, parsons, jeantne p. wiener-kronish) Decision Making in ANESTHESIOLOGY An Algorithmic Approach (Lois L. Bready, Rhonda M. Mullins) Emergency Medical Training (MedEMT) Victory Technology, Inc. Presents (DISC ONE, TWO) MedEMT Overview Emergency Medical Services (EMS) The Well-Being of the EMT-Basic Anatomy and Physiology-Part 1 Anatomy and Physology-Part 2 Medical Terminology Vital Signs and SAMPLE History Lifting and Moving Patients Airway Management Patient Assessment Medical and Behaval Care I Medical and Behavioral Care II Obstetric and Gynecological Care Trauma Infants and Children Operations Appendix A: Video/Animation List Appendix B: Victory Products EMERGENCY MEDICINE A COMPREHENSIVE STUDY GUIDE (Rosen's ) (Volume 1-3) (Sixth Edition) (Judith E. Tintinall, MD, MS) EMT-Basic Slide Set Slide Program Guide (John A. Stouffer, EMT-P, Richard S. Bennett, RN, EMT-P, BSN) (Mosby) Halperin & Goldstein Fluid, Electrolyte, & Acid-Base Physiology (A Problem-Based Approack) (Mitchell L. Hlperin, Marc B. goldstein) فيزيولوژي اسيد و باز ا ب و الكتروليتها كليه اختلالات اسيد و باز و الكتروليتي را به صورت مرحله به مرحله و با مشخصكردن نكات مهم و بصورت جداول و الگوريتم توضيح داده است. Intensive Care Medicine (Irwin & Rippe) (Vol A,B) Interactive Regional Anesthesia Medical Acupuncture A western scientific approach (Jacqueline Filshie, Adrian White) Miller's Anesthesia (Vol I & II) (Salekan E-book) SECTION I: INTRODUCTION SECTION II: SCIENTIFIC PRINCIPLES SECTION III: ANESTHESIA VOLUME 2 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
350 48.9 SECTION IV: SUB SPECIAL TV SECTION V: CRITICAL CARE MEDICINE SECTION VI: ANCILLARY RESPONSIBILITIES AND PROBLEMS COMPANION VIDEO CD-ROM Video 1 Patient Positioning in Anesthesia Video 2 Code Blue Simulation New Analgesic Options: Overcoming Obstacles to Pain Relief - MD, NP, PA, RN Answer Sheet -Pharmacist Answer Sheet -Back Pain -Fibromyalgia -OA Pain -Post Op Pain -Trauma -References NEW YORK SCHOOL OF REGIONAL ANESTHESIA PERIPHERAL NERVE BLOCKS PRINCIPLES AND PRACTICE -TRAINING IN PERIPHERAL NERVE BLOCKS - ESSENTIAL REGIONAL ANESTHESIA ANATOMY -EQUIPMENT AND PATIENT MONITORING IN REGIONAL ANESTHESIA -PERIPHERAL NERVE STIMULATORS AND NERVE STIMULATION -CLINICAL PHARMACOLOGY OF LOCAL ANESTHETICS -NEUROLOGIC COMPLICATIONS OF PERIPHERAL NERVE BLOCKS -KEYS TO SUCCESS WITH PERIPHERAL NERVE BLOCKS -CERVICAL PLEXUS BLOCK -INTERSCALENE BRACHIAL PLEXUS BLOCK -INFRACLAVICULAR BRACHIAL PLEXUS BLOCK -AXILLARY BRACHIAL PLEXUS BLOCK -INTRAVENOUS REGIONAL BLOCK OF THE UPPER EXTREMITY -CUTANEOUS NERVE BLOCKS OF THE UPPER EXTREMITY -THORACIC PARAVERTEBRAL BLOCK -THORACOLUMBAR PARAVERTEBRAL BLOCK -LUMBAR PLEXUS BLOCK - SCIATIC BLOCK: POSTERIOR APPROACH 234 -SCIATIC BLOCK: ANTERIOR APPROACH 252 -FEMORAL NERVE BLOCK -POPLITEAL BLOCK: INTERTENDINOUS APPROACH -POPLITEAL BLOCK: LATERAL APPROACH -ANKLE BLOCK - WRIST BLOCK -CUTANEOUS NERVE BLOCKS OF THE LOWER EXTERMITY -DIGITAL BLOCK PERIPHERAL NERVE BLOCKS Principles & Practice (Admir Hadzic, Jerry D. Vloka) Peripheral Regional Anaesthesia Tutorial in the Ulm Rehabilitation hospital (Prof. Dr. Med. H. Mehrkens) (VCD) (CD I, II) 1. Anatomical Fundamentals 2. Peripheral Neve Stimulation 3. Regional Anaesthesia 4. Upper, Lower Extremity 5. Peripheral Neve Blocks 6. Peripheral Neve Blocks Textbook of CRITICAL CARE (Salekan E-book) SECTION I RESUSCITATION AND MEDICAL EMERGENCIES SECTION II TRAUMA SECTION III IMAGING SECTION IV CELL INJURY AND CELL DEATH SECTION V INFECTIONS DISEASE SECTION VI ENDOCTINOLOGY, METABOLISM, NUTRITION, PHARMACOLOGY SECTION VII CARDIOVASCULAR SECTION VIII PULMONARY The American Academy of Pediatric (David G. Nichols, MD Associate Professor of Anesthesiology and Clinical Care Medicine) Intitial Steps in Resuscitation -Ventilating the Infant -Chest Compressions -Endotracheal Intubaion The ICU Book (Second Edition) (Paul L. Marino) The Lipponcott-Raven Interactive Anesthesia Library on CD-ROM (Version 2.0) (Paul G. Barash, MD) The Massachusetts General Hospital Handbook of Pain Management (Salekan E-Book) اين CD ديدگاه كامل و مفيدي از اطلاعاتي كه در درمان مو ثر درد مورد نياز ميباشند و در بيماران Mass.Gen اجرا ميگردند در اختيار كاربر قرار ميدهد. اين Edition از Poacet guide به علت دستيابي راحت پزشكاني كه با بيماران دردمند سروكار دارند مشهور ميباشد. با مرور مباحث عمدة درد اين CD مواليتهاي درماني مختلف را مورد بحث قرار ميدهد و جنبههاي مختلف درد اعم از حاد مزمن و درد كانسر را پوشش ميدهد. شامل: - مداخلات جراحي و جراحي اعصاب - مداخلات راديوتراپي و راديوفارماسي براي دردهاي كانسر -درد صورت - اطلاعات دارويي كامل ميباشد ٢١ اورولوژي 1.21 عنوان CD Adult and Pediatric Urology (Jay Y. Gillenwater, john T. Grayhack, Stuart S. Howards, Michael E. Mitchell) Adult Urology Adult Urology Continued Pediatric Urology Video Library سال انتشار 2002 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
351 Advanced Therapy of Prostate Disease (Martin I. Resnick, MD, Ian M. Thompson, MD) اين كتاب ٦٤٨ صفحهاي در محيط Acrobat reader بوده و يكي از بهترين رفرانسها در مورد چگونگي تشخيص و درمان بيماريهاي پروستات ميباشد. رفرانسها در مورد چگونگي تشخيص و درمان بيماريهاي پروستات ميباشد. اين كتاب الكترونيكي شامل ٧١ فصل ميباشد. فصول ١-٦ اپيدميولوژي كانسر پروستات شرح داده شده است. فصل ٧- الگوريتم ارزيابي خطر پروستات كانسر شرح داده شده است. فصل ٨- فاكتورهاي ملكولي در ارزيابي كانسر پروستات. فصول ١٢ و ١١ و ٩- غربالگري كانسر پروستات فصل ١٠- ابزارهاي تشخيصي. فصول ١٦-١٣- تاريخچة فيزيولوژي پروستات و تاريخچة پاتوبيولوژي كانسر پروستات بيان شده است. فصل ١٨-١٧- تشخيص و staging كانسر پروستات فصل ١٩ -ا مادگي بيمار براي: راديكال پروستاتكتومي. ٢٠ و ٢١ و ٢٢- Stageهاي مختلف در روشهاي جراحي ا نها. ٢٣- Prostatectomy.Radical Perianal ٢٤-٢٩- راديوتراپي Brachy therapy و هورمونالتراپي و كرايرتراپي كانسرهاي مختلف پروستات ٣٠-٣٩- در هر فصل (TNM) Staging جداگانه شرح و روش درمان ا ن نيز توضيح داده شده است ٤٣-٤٠- چگونگي ارزيابي بيماران بعد از عمل پروستاتكتومي با PSA و هورمونتراپي و... ٤٤- اسفنكتر genitourinary ا رتيفيشتال ٤٥- كلاژنتراپي براي بياختياري بعد از عمل جراحي پروستات ٤٧-٤٦- تدابير درماني براي عوارض erction و انوركتال ٤٨-٥٠- جلوگيري از عود كانسر با شيميدرماني و راديوتراپي ٥١- نگرش سلولي و هورموني به. BPH ٥٣-٥٢- نسبت اوروديناميك و ابنرماليهاي ديگر. ٥٤- پاتوفيزيولوژي انسداد مجراي خروجي مثانه و اختلال در ٥٥- Voding جلوگيري از پيشرفت و عوارض بلندمدت ٥٦- BPH :BPH كي بايد مداخله كرد ٥٨-٥٧- روشهاي ارزيابي/ ا مادگي و انتخاب درمان مناسب براي ٥٩- BPH مهاركنندههاي 5α ردوكتاز ٦٦-٦٠- روشهاي مختلف جراحي در BPH شامل (ترانس اورترال needle Ablation ليزتراپي TUIP TUFP و فيتوتراپي و open پروستاتكتومي). ٧١-٦٧- پروستات: پاتوفيزيولوژي تشخيص افتراقي فاكتورهاي مو ثر در پروگنوز و جديدترين درمانها در پروستات. ANDROLOGY (Male Reproductive Health and Dysfunction) (2 nd Edition) Atlas of Clinical Andrology (ESE Hafez and SD Hafez) AUA Vide Digest The American Urogical association (AUA) Impotence and Infertility اين CD شامل يكي از سري فيلمهاي ا موزشي انجمن اورولوژيستهاي ا مريكا digest) (AUA video ميباشد. كه شامل مباحث Impotence و Infertilitey ميباشد. قسمت اول :Impotence الف) ابتدا در مورد روشهاي تشخيصي و سپس انتخاب درمان مناسب ا ن بيان شده و سپس در حين نشاندادن فيلم ا موزش توسط اساتيد مربوطه داده شده است. option) (Diagnosis8 treatment ب) :Penile Venous Ligation در اين قسمت چگونگي انجام عمل جراحي با توضيح حين عمل با فيلم نشان داده شده است. قسمت دوم :Rectal Probe Electroejaculation :Infertiliry در اين قسمت پاتوفيزيولوژي ejaculation مورد بحث قرار گرفته و سپس تجهيزات و دستگاههاي مورد نياز و طرز كار ا نها با فيلم نشان داده شده و سپس طريقه انجام پروبگذاري و ايجاد ejaculation به نمايش درا مده است. BLADDER BIOPSY INTERPRETATIONS (Jonathan I. Epstein, M.D., Mahul B. Amin, M.D., Victor E. Reuter, M.D.) (SALEKAN E-BOOK) اين كتاب كه در مركز خدمات فرهنگي سالكان تبديل به كتاب الكترونيكي گرديده است شامل مباحث زير ميباشد: Normal Blodder Anatomy and Variants of Normal histology Flat Urothelial Lesions Papillary Urothelial Neoplasms with Inverted Growth Patterns Invasive Urothelial Carcinoma Conventional Morphologic, Prognostic, and Predictive Factors and Reporting of Bladder Cancer Glandular Lesions Squamous Lesions Cystitis Mesenchymal Tumors and Tumor-Like Lesions Miscellaneous Nontumors and Tumors Second ary Tumors of the Bladder Bristol Urological Institute (Computer Aided Learning Program) به گفتة مو لفين اين CD براي افزايش معلومات حفظي نيست بلكه هدف اين CD ارزيابي دانش اورولوژي هر شخص و چگونگي فهم مطالب و كم به بهترفهميدن و تصميم گرفتن در مورد مباحث اورولوژي است. اين CD شامل تستهاي ٤ گزينهاي است و شامل مباحث: ١- معاينه بيماران اورولوژي ٢- impotence ٣- تروماي كليه ٤- علاي م دستگاه ادراري تحتاني ٥- هماتوري ٦- عقيمي مردان ٧- سنگهاي كليوي ٨- بياختياري ادرار ٩- اختلالات اسكروتوم ١٠- كانسر پروستات ١- در هر عنوان ابتدا مقدمهاي در مورد بيماري و اختلالات مربوطه ا ورده شده است. ٢- سپس اهدافي كه با مطالعه اين قسمت از بيماري بايد به دست ا ورد بيان شده است. ٣- در قسمت سوم ابتدا شرح حال بيماري و سپس تصاوير رنگي راديوگرافي سونوگرافي پاتولوژي هر اختلال در صفحهاي جداگانه ا ورده شده و سو الات ٤ جوابي بر ا ن فراهم گرديده است. در ا خر نيز به معلومات شخص Score داده ميشود. CAMPBELL'S UROLOGY Urologic Examination and Diagnostic Physiology, Pathology, and Management of Upper Infections and Inflammations of the Voiding Function & Anatomy Techniques Urinary Tract Diseases Genitourinary Tract Dysfunction Benign Prostatic Reproductive Function and Sexual Function and Dysfunction Pediatric Urology Oncology مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
352 Hyperplasia Dysfunction Carcinoma of the Prostate Urinary Lithiasis and Endourology Urologic Surgery Pathology Atlas Radiology Atlas Study Guide Additional Media Case Studies in Genes & Disease A Primer for Clinicians (Bryan Bergeron) Core Curriculum in Primary Care Patient Evaluation for Non-Cardiac Surgery and Gynecology and Urology (Michael K. Rees, MD, MPH) CCC مجموعهاي از CDهايي ميباشد كه براي ا موزش مداوم دستياران و متخصصين هر رشته توسط اعضاء هيي ت علمي دانشگاه پزشكي Harvard بنا نهاده شده است. CD حاضر در مورد جراحي زنان و اوروژي را گردا وري كرده است. هر كدام از اين سخنرانيها علاوه بر اسلايدهاي ا موزشي متن سخنراني نيز در دسترس كاربر ميباشد. در ا خر هر سخنراني و مبحثي سو الات مربوطه به صورت چهارگزينهاي براي ارزيابي كاربر ا ورده شده است. سپس خلاصه هر سخنراني به صورت يك مقاله چاپي در مجلات علمي و روزنامهها ا ورده شده است. شامل مباحث زير ميباشد: -٣ عقيمي مردان Male impotence ١- چگونه يك بيمار را براي اعمال جراحي (بجز جراحي قلب) ارزيابي و ا ماده كنيم ٢- ارزيابي خونريزيهاي ابنرمال رحم.(AUB) Core Curriculum in Primary Care Gynecology (Michael, Isaac Schiff, Keith, Thomas, Annekathryn) Cystectomy and Construction an Ileocecal Neobladder for Urethral Voiding (John A. Libertino MD, FACS) Erectile Dysfunciton Current Investigation and Management (lan Eardley, Drishna Sethia) Glenn's Urologic Surgery (Sixth Edition) (Sam D. Graham, James F. Glenn,) (Salekan E-Book) Hot Topics in UROLOGY (Roger S Kirby, Michael P O'Leary) (SALEKAN E-BOOK) Premature ejaculation Michael P O'Leary New developments for the treatment of erectile dysfunction: Present and Future Erectile dysfunction and cardiovascular disease Angiogenesis as a diagnostic and therapeutic tool in urological malignancy Chemoprevention of prostate cancer Apoptosis in the prostate Robotic surgery and nanotechnology Marginally worse? Positive resection limits after radical prostatectomy Adjuvant therapy for prostate cancer Bisphosphonates: a potential new treatment strategy in prostate cancer I mmunotherapy for prostate What,s hot and whats not - the medical management of BPH Three-dimensional imaging of the upper urinary tract Future prospects for.. nephron conservation in renalcel I carcinoma Urethral stricture surgery: the state of the art Reducing medical errors in urology Management of female sexual dysfunction Laparoscopic radical prostatectomy Antisense therapy in oncology: current The overactive bladder Organ preserving therapies for penile carcinomas HOW the Human Genome Works (Edwin H. McConkey.Ph.D) Male and Famale Sexual Dysfunction (Allen D. Seftel) (Salkan E-Book) جنبههاي ارگانيك و سايكولوژيك عملكرد سكسوا ل. توصيف باليني انواع اختلالات عملكرد حنسي و تشخيص و درمان ا نها Male Hypogonadism (Feiedpich Jockeahovel) Mind Maps in pathology (Michele Harrison, Peter Dervan) Pelvic Floor Exercises for Erectile Dysfunction (Grace Dorey phd MSCP) كتابي جامع در خصوص اختلال عملكرد سكسوا ل در افراد مذكر و مو نث. ا ناتومي و فيزيولوژي عملكرد سكسوا ل. Smith's General Urology (Sixteenth edition) (Emil A. Tanagho, Jack W. Mcaninch) (Salekan E-Book) The Journal of UROLOGY (Spring & Summer) (CD I, II) (Official Journal of the American Urological Association) CD I: - Clinical Urology -Pediatric Urology -Investigative Urology -Urological Survey CD II: - Clinical Urology -Pediatric Urology -Investigative Urology -Urological Survey -CME Participant Assessment Test and Course Evaluation مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
353 Urogynecology: Evaluation and Treatment of Urinary Incontinence (Bruce Rosenzweig, MD, Jeffrey S. Levy, MD, Donald R. Ostergard, MD) اين CD كه به صورت تصاوير كام لا رنگي بوده و توضيحات به صورت نوشتاري و فايل صوتي كه بر روي هر قسمت از اين CD وجود دارد. ٤ Urogynechology قسمت مجزا دارد شامل: Consideration for the OB/GYN Generalist -٤ won surgical & surgical Management -٣ Evaluation -٢ Introduction Definigg Incontinence -١ :Introduction & Defining Incontince (١ اين قسمت خود شامل مباحث: Patient misconceptions Cystoscopy uroflowmetry affected women Postvoid residual تشخيص incontince Types of incontinernce incontinence awareness ٢) ارزيابي بيماران با :incontinency Cystometrogram Pad test تاريخچه معاينات باليني Voiding diary un, u/s Pessary test Multi-Channel urodynamics ٣) تدابير درماني جراحي و غير جراحي در : Stress urinary incontinence اين قسمت شامل الگوريتم تصميمگيري در مورد روش درماني ميباشد و سپس روش درماني غيرجراحي modification)) biofeedback, Beharioral و درمانهاي داروي ي funetional electrieal Stimalation و...) بحث شده است. روشهاي جراحي: ابتدا در مورد روشهاي انجام جراحي بحث شده و سپس Procedure اعمال جراحي شرح داده شده است. در قسمتهاي بعدي مقايسه درصد موفقيت روشها ذكر شده و در ا خر Complication اين روشها توضيح داده شده است. Staff Allied مورد بحث قرار گرفته است. eystometry incontinrence management to private patients Non surgical therapy equipment cost Set-up requirement Urodynamics : Consideration for the OB/Gyn Generalist (٤ در اين فصل: subdiscipline urogynechology as a professional consideration WHO Manual for the standardized investigation & diagnosis of the infertile couple (Patrick J, Rowe, Frank H. Conhaire, Timothy B. Hargreave) WHO Manul for the standardized investigation, diagnosis and management of the infertile male (Patrick J. Rowe, Frank H. Comhaire) نفرولولوژی Atlas of RENAL TRANSPLANTATION (Prof. Legndre, Martin, Helenon, Lebranchu, Halloran, Nochy) -Histopathology -surgery -clinical section -imaging -immunology -immunosupperssive Core Curriculum in Primary Care Nephrology (Michael K. Rees, MD, MPH) CCC مجموعهاي از CDهايي ميباشد كه براي ا موزش مداوم دستياران و متخصصين هر رشته توسط اعضاء هيي ت علمي دانشگاه پزشكي Harvard بنا نهاده شده است. CD حاضر مطالبي از نورولوژي به صورت اسلايد سخنراني نمودار و الگوريتمهاي تشخيصي را گردا وري كرده است. هر كدام از اين سخنرانيها علاوه بر اسلايدهاي ا موزشي متن سخنراني نيز در دسترس كاربر ميباشد. در ا خر هر سخنراني و مبحثي سو الات مربوطه به صورت چهارگزينهاي براي ارزيابي كاربر ا ورده شده است. سپس خلاصه هر سخنراني به صورت يك مقاله چاپي در مجلات علمي و روزنامهها ا ورده شده است. مباحث زير در اورولوژي در اين CD موجود است. 1- How to erahcate Renal mass/tumor 2- Drugs vs Diet in Modifying Renal failure 3- Treatment of Mypertension-Special Case 4-Clinical Application of Renal Physiology PRIMER ON KIDNEY DISEASES (Second Edition) (NATINAL KINDEY FOUNDATION SCIENTIFIC ADVISORY BOARD) اين كتاب الكترونيك در محيط اكروبات اجرا شده است. شامل ١١ فصل و مشتمل بر ٥١٧ صفحه ميباشد. فصل ١- ساختمان وفانكشن كليه و ارزيابي باليني كليه شامل: ا ناتومي فيزيولوژي ارزيابي فانكشن كليه U/A هماتوري پروتي ين ادراري تكنيك تصويربرداري از كليه ميباشد. فصل ٢- اختلالات اسيد و باز و الكترونيك شامل: هيپووهيبرناتومي اسيدوز الكالوزمتابوليك اختلالات متابوليسم پتاسيم و كليسيم منيزيوم و ديورتيك ميباشد. فصل ٣- Diseuse Glomerular شامل: ايمونوپاتوژنز بيماري اي گلومروي MGN FSGN MPGN MCD و سندروم گودپاسچر و IGA نفروپاتا ميباشد. فصل ٤- كليه و بيماريهاي سيستميك ميباشد شامل: كليه در CHF و بيماريهاي كبدي PSGN و اسكوليتها و كليه SLE و بيماريهاي روماتيسمي و كليه ديابتيك نفروپاتي و HIV و بيماريهاي كليه و... ميباشد. فصل ٥- نارساي ي حاد كليه شامل: پاتوفيزيولوژي علل approach و درمان ميباشد. فصل ٦- داروهاي و كليه: شامل NSAID و كليه و موارد داروي درماني در نارساي ي كليه فصل ٧- اختلالات ارثي كليه: نفروپاتي Sickle cell بيماريهاي Cystic كليه سندروم Alport و بيماريهاي كسيتيك كليه فصل ٨- نفروپاتي توبولواينترستيشيل و اختلالات مجاري اداري شامل: بيماري كليه و ليتيوم سرب اگزالات سنگهاي كليوي عفونتهاي كليوي عفونتهاي كليوي انسداد مجاري و سرطانهاي كليه و مجاري ا ن. فصل ٩- كليه و موارد خاص شامل كليه در نوزادان و كودكان كليه در حاملگي كليه در پيري. فصل ١٠- نارساي ي مزمن كليه و درمان شامل: سندروم اورمي همودياليز و هموفيلتراسيون دياليز صفاتي پيشا گهي و تغذيه CRF تظاهرات قلبي عصبي هماتولوژي غددي CRF و پيوند كليه و چگونگي دارودماني در ا نها. فصل ١١- فشار خون شامل: پانوژنز فشار خون اساسي فشار خون Renovascular و درمان فشار خون. مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
354 The Kidney (Volume 1-2) Seven Edition (Barry M. Brenner) (E-Book) اين كتاب الكترونيكي شامل دو جلد است. در انتهاي هر بخش كتاب تصاوير مربوطه با وضوح بالا ا ورده شده است. كيفيت بالاي تصاوير اين امكان را فراهمي ميسازد تا استفاده از ا نها در سمينارها و همينطور جهت ا موزش مناسب باشد. اين جلد داراي دو بخش است: ١- قسمتهاي مختلف كليه طبيعي و عملكرد هر يك از اين بخشها در اين بخش مباحثي همچون ا ناتومي كليه رشد و بلوغ كليه اصول متابوليك انتقال يون جريان خون كليه انتقال كليوي گلوكز اسيد ا مينه سديم... كنترل ترشح كليوي پتاسيم و... دهها عنوان ديگر مطرح شدهاند. ٢- اختلال در كنترل حجم مايع بدن: كنترل حجم خارج سلولي و پاتوفيزيولوژي ادم عوامل مو ثر بر هموستاز مايع فاكتورهاي مو ثر بر توبرل كليه AVP پروستاگلاندينها ادم در سيروز ادم در CHF ديابت بيمزه و انواع ا ن هيپوناترمي و ايتولوژيهاي مختلف ا ن اختلالات اسيد و باز اختلالات توازن پتاسيم برخورد با بيمار مبتلا به هيپووهيپركاسمي اختلالات كلسيم و فسفر و... دهها مطلب ديگر در اين بخش در دسترس ميباشند. جلد ٢ كتاب شامل ٣ قسمت است: الف) پاتوفيزيولوژي بيماريهاي كليه: مباحثي چون: ارزيابي باليني در بيماريهاي كليه بيماريهاي گلومرولي اوليه و ثانويه عفونتهاي ادراري نفروپاتي توكسيك و ب) پاتوژنز بيماريهاي كليه: ني وپلازي كليه هيپرتانسيون (اوليه (renovascular اوري استي ودسيتروفي رنال و... از جمله مباحث مطرح شده ميباشند. ج) برخورد با بيمار مبتلا به نارسايي كليوي: انواع دياليز ايمونولوژي پيوند انواع داروهاي ديورتيك و... در اين بخش بحث شدهاند.... دهها مطلب ديگر عنوان CD Adult and Pediatric Urology (Jay Y. Gillenwater, john T. Grayhack, Stuart S. Howards, Michael E. Mitchell) Adult Urology Adult Urology Continued Pediatric Urology Video Library American Cancer Society Atlas of Clinical Oncology (Cancer of the Female Lowe Genital Tract) (Patricia J. Eifel, M.D. Charles Levenback, M.D.) (SALEKAN E-BOOK) اين كتاب الكترونيكي به گفتة مو لفين به منظور فراهمكردن مرور و ا ناليز بيولوژي تشخيص ارزيابي و درمان كانسرها دستگاه تناسلي تحتاني زنان ميباشد. در همه مباحث ا ورده شده شده است. ا خرين تغييرات در درمانهاي پذيرفتهشده براي كانسر مهاجم Cervix و يك بازنگري كلي 2.22 Chemotherapy in Curative Management Post-treatment Surveillance Palliative Care Surgery for Vulvar Cancer Radiation Therapy for Vulvar Cancer Acute Effects of Radiation Therapy Late Complications of Pelvic Radiation Therapy Surgical Treatment of Invasive Cervical Cancer Radiation Therapy for Invasive Cervical Cancer Radical Management of Recurrent Cervical Cancer Management of Vaginal Cancer Diagnostic Imaging Screening for Neoplasms Treatment of Squamous Intraepithelial Lesions Invasive Carcinoma of the Cervix Epidemiology Pathology Molecular Biology Anatomy and Natural History American Cancer Society Atlas of Clinical Oncology Skin Cancer (Arthur J. Sober, MD, Frank G. Haluka, MD, phd) (Bc Decker Inc) همچنانكه وارد قرن ٢١ ميشويم شايعترين شكل سرطانها كانسرهاي پوستي ميباشد و به علت اينكه بر خلاف كانسرهاي ديگر كانسرهاي پوست در معرض ديد ميباشد سريعتر و راحتتر قابل تشخيص است. در نتيجه دانش تشخيص و درمان و جلوگيري از سرطانهاي پوستي موجب نگارش اين كتاب گرديده است. مشخصة اين كتاب تا كيد بر نماهاي باليني Skin cancer ميباشد چون علم درماتولوژي بر پاية مشاهده بنا شده است بنابراين كتاب داراي تصاوير زياد با كيفيت بسيار بالاست و هر جا كه عكسها در اراي ه مطلب كمككننده نبوده text اضافه شده است. و علاوه بر اين نكات تشخيصي اپيدميولوژي درماني و پيشگيري در كتاب گنجانده شده است. اين كتاب به ٤ قسمت تقسيم شده است: بخش ١: Concept Basic شامل اپيدميولوژي ژنتيك كانسرهاي پوستي و عوامل خطرزا ميباشد. بخش ٢ : تظاهرات باليني: در هر فصل جداگانه نماي باليني ملانوم (فصل ٤ و) BCE (فصل ٥ و) Scc (فصل ٦ ) لمفومهاي پوستي (فصل ٧ و) مالينگنانسيهاي پوستي ناشايع (فصل ٨:١ ) Merckle cell Carcinoma (فصل ٨:٢ ( و كاپوسي ساركوم (فصل ٨:٣ ) اشاره شده است. بخش : ٣ Management كه شامل: تكنيك بيوپسي از ملانوم (فصل ٩) تدابير جراحي ملانوم پوستي (فصل ١١) ارزيابي لمفنودها و بيوپسي از لمفنود در ملانوم (فصل ١١) therapy adjuvant در ملانوم (فصل ١٢) ايمونوتراپي در ملانوم (فصل ١٣) و كموتراپي سيتوكين تراپي و بيوكموتراپي در ملانوم (فصل ١٤) ميباشد. همچنين درمان لمفوم پوستي اوليه [MF] (فصل ١٧) ميباشد. بخش : ٤ در مورد پيشگيري از كانسرهاي پوستي بحث كرده است Atlas of Clinical oncology Breast Cancer (American Cancer Society ) (David J Winchester, MD, David P Winchester, MD) Genetics, Natural History, and DNA-Based Genetic Counseling in Hereditary Brast Cancer Breast Cancer Risk and Management: Chemoprevention, Surgery, and Surveillance Screening and Diagnostic Imaging Imaging-Directed Breast Biopsy Histophathology of Malignant Breast Disease Unusual Breast Pathology Prognostic and Predictive Markers in Breast Cancer Surgical Management of Ductal Carcinoma In Situ Evaluation and Surgical Management of Stage I and II Breast Cancer Locally Advanced Breast Cancer Breast Reconstruction Atlas of Clinical Oncology Cancer of the Lower Gastrointestinal Tract (Christopher G. Willett, MD) Atlas of DIAGNOSTIC ONCOLOGY CANCER Principles & Practice of Oncology (7 th Edition) (Vincent T. Devita, Jr., Samuel Hellman, Steven A. Rosenberg) Color atlas of Cancer Cytology (Third Edition) (Masayoshi Takahashi) : ٢٢ کانسر سال انتشار مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
355 Gastric Cancer Diagnosis and Treatment (An interactive Training Program) (J.R. Siewert, D.Kelsen, K. Maruyama) (Springer) Handbook of Cancer Combination Chemotherapy Holland.frei CANCER 6 MEDICINE (volume 2) (Danald W. Kufe, MD, Raphael E. Pollock, Md, PHD) Human Brain Cancer: Diagnostic Decisions (Lauren A. Langford, MD, Dr. med,) American Medical Association PHYSICANAS' CANCER CHEMOTHERAPHY DRUG MANUAL (Jones & Bartlett) - Principles of Cancer Chemotheraphy - Physician's Cancer Chemotherapy Drug Manual Guidelines for Chemotherapy and Dosing Modifications - Common Chemotherapy Regimens in Clinical Practice - Antimetic Agents for the Treatment of Chemotherapy-Induced Nausea and Vomiting Thyroid Cancer 4 & Asso Schilddruse (Werner Langsteger, Paul Sungler, Peter Lind, Bruno Niederle) اسامي كتاب/نويسنده قيمت (ريال) تعداد مجلدات RADIOLOGY 200,000 تك جلدي Blickman) 1. Pediatric Radiology (The Requestions) (Hans 240,000 تك جلدي Konnano) 2. Differential Diagnosis in Conventioanl Gastrointestinal Readiology (Francis A. Burgener, Marti 500,000 تك جلدي Verla) 3. Dynamic Radiology of the Abdomen: Normal and Pathologic Anatomy (Morton A. Meyers, 5 th Edition Springer 250,000 تك جلدي URBINA) 4. Primary Care Radiology (Mettker, Guibert EAU. VO.SS', 400,000 تك جلدي MD) 5. Textbook of Uroradiology (N. Reed Dunnick, MD, Carl M. Sandler, Md, Jeffrey H. Newhouse, MD, Estephen Amis', JR., 400,000 تك جلدي Wilkins) 6. Head and Neck Radiology a Teaching File (Anthony a Mancusd, Hiroya Ojiri, Ronald G. Quisling)(Lippincottt Williams & 700,000 دو جلدي Rowe) 7. Essentials of Skeletal Radiology (Terry R. Yochum; Lindsay J. 8. (2003) Stutton) Textbook of Radiology & Imaging (David دو جلدي (اورژينال) 1,400, ,000 تك جلدي (2003) Dahnert) 9. Radiology Reviw Manual (Fourth Edition) (Wolfgang 300,000 تك جلدي MD) 10. Forensic Radiology (B. G. Brogdon 400,000 تك جلدي Wilkins) 11. The Core Curriculum Neuroradiology (Mauricio Castillo) (Lippincott Williams & 500,000 تك جلدي (Mosby) 12. Diagnostic Neuroradiology (Anne G. Osborn) 300,000 تك جلدي Kormano) 13. Bone and Joint Disorders (Conventional Radiologic Differentioal Diagnosis) (Francis A. Burgener Marti 14. Atlas of Radiologic Measurement (Theodore E. Keats, Christopher Sistrom) (Mosby) در این کتاب قسمت اعظم جداول و نمودارهای معم کاربردی مرتبط با اندازهگیریهای رادیولوژی و تصویربرداری در 14 مبحث و در 630 صفحه گردآوری گردیده و میتواند به عنوان یک ابزار بسیار مهم در تفسیر نواحیهای 400,000 تك جلدي مختلف مورد استفاده قرار گیرد. فصول این کتاب به قرار ذیل میباشند: - محتویات اینتراکرانیال - بلوغ اسکلتی - جمجمه حفره ادربیت و سینوسهای پارانامال - محتیات ادربیت صورت و گردن - ستون فقرات و محتویات آن - اندام فوقانی - لگن و مفاصل - Hip اندام تحتانی - قلب و عروق بزرگ - توراکس ریهها مدیاستن و جنب - دستگاه گوارش - دستگاه ادراری- تناسلی - بیومتری و پلوسیتری در جریان حاملگی - سیستم عروقی و لنفاوی مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
356 86 400,000 تك جلدي Edition) 15. Radiobiology for the Radiologist (Fifthe 470,000 تك جلدي Hayes) 16. Anatomy Positioning & Procedures Workbook (Steven G. 700,000 تك جلدي (Mosby) 17. Atlas of Normal Roentgen Variants That May Simulate disease (Seven Edition) (Theodere E. Keats & Mark W. Anderson) مباني اساسي در سونوگرافي داپلر و تجهيزات ا ن (ترجمه و گردا وري: دكتر پروين عليپور (.18 50,000 تك جلدي اصول تشخيصي و درماني بيماريهاي پستان (دكتر معصومه گيتي دكتر الهام رحيميان دكتر علي عرب خردمند ( ,000 تك جلدي شايعترينها نادرترينها تشخيصهاي افتراقي بهترين روش تشخيص بيماريها (تا ليف: دكتر احمد عليزاده (.20 50,000 تك جلدي 380,000 دو جلدي Sr.) 21. Radiographic Anatomy Positioning and Procedures Workbook (Second Edition) (volume I, II) (Steven G. Hayes, 600,000 تك جلدي 22. Gastrointestinal Radiology A Pattern Approach (4 th Edition) (Ronald L. Eisenberg) (Lippincott Williams & Wilkins) (2003) این کتاب مجموعە کاملی از مباحث مختلف مرتبط با تصویربرداری دستگاه گوارش میباشد. مطالب این کتاب در 80 مبحث 10 فصل تدوین گردیده و حدود 1200 صفحه حجم دارد روش اراي ه مطالب در این کتاب به صورت Pattern Approach بوده و خواننده را قادر میسازد تا الگوهای تصویربرداری مختلف دستگاه گوارش را دستهبندی نموده و تشخیصهای افتراقی هر کدام را به خوبی از دیگر الگوها تمیز دهد. 250,000 تك جلدي (2003) Abrahams) 23. Imaging Atlas of Human Anatomy (Third Edition) (Jamie Weir, Peter H. 600,000 تك جلدي (2004) Meyers) 24. Pediatric Sonography (Third Edition) (Thieme) (Francis A. Burgener, Steven P. 500,000 تك جلدي (2002) Berquist) 25. Musculoskeletal Imaging Companion (Thomas H. 550,000 جلد اول (2004) Edition) 26. Surgical Neuroangiography 2.1 (A. Berenstein, P. Lasjaunias, K.G. TER Brugge) (Springer) (Second 600,000 جلد دوم (2004) Edition) 27. Surgical Neuroangiography 2.2 (A. Berenstein, P. Lasjaunias, K.G. TER Brugge) (Springer) (Second 500,000 تك جلدي (2005) Campbell) 28. The Neurologic Examination (Dejong's) (William W. 800,000 تك جلدي (2006) Pentecost) 29. Abrams' Angiography Interventional Radiology (Stanley Baum, Michael J. 350,000 تك جلدي (Thieme) 30. The Practice of Ultrasound A Step-by-Step Guide to Abdominal Scanning (Berthold Block) 1,200,000 دوجلدي (2005) Kochanek) 31. Textbook of CRITICAL CARE (FIFTH EDITION) (Mitchell P. fink, Edward Abraham, Jean-Louis Vincent, Patrick M. SONOGRAPHY 350,000 تك جلدي H.) 32. Ultrasonography in Urology A Practical Approach to Clinical Problems (Edward I. Bluth-Peter 70,000 تك جلدي 33. Seminars in Ultrasound CT and MR 1,800,000 دو جلدي 34. Diagnostic Ultrasound (Rumack, Wilson, Charboneau) (2005) چاپ اول این کتاب که در سال 1991 به پایان رسید و به عنوان رایجترین مرجع سونوگرافی در جهان میباشد. از آنجا که دانش سونوگرافی در طول 6 سال گذشته پیشرفتهای بسیاری داشته است نیاز به بازنگری در این کتاب احساس میشد. در این کتاب بیش از یکصد نویسنده متخصص درسونوگرافی تلاش کردهاند تا آخرین دستاوردهای دانش سونوگرافی در زمینه تصویربرداری تشخیص و کاربرد آنها را به رشته تحریر درآوردهاند. فصول کتاب شامل هیستروسونوگرافی لاپاروسکوپیک سونوگرافی و تکنیکهای بیوپی تحت هدایت سونوگرافی نیز میباشد. در کلی %25 به حجم کلی کتاب افزوده شده است بحث عمده افزایش حجم مربوط به سونوگرافی زنان و زایمان میباشد. تعداد زیادی از تصاویر جایگزین شدهاند و بیش از 450 تصویر تمام رنگی در ویرایش جدید وجود دارد. تغییرات جدیدی برای سهولت خواندن و درک مطلب در ساختار ویرایش انجام شده است. کدبندیهای رنگی مطالب و جداول highlight شده برای نکات کلیدی تشخیصی انجام شده است. مطالب مهمتر درشتتر نوشته شدهاند و مراجع استفاده شده به صورت دقیقتری بازنویسی شدهاند. این کتاب در دو جلد نوشته شده است. جلد اول شامل پنج فصل میباشد فصل اول شامل فیزیک و اثرات بیولوژیک سونوگرافی و مواد حاجب در سونوگرافی میباشد. فصل دوم شامل سونوگرافی سونوگرافی شکم و لگن توراکس و روشهای مداخلهای (interrcntional) میباشد. فصل سوم سونوگرافی Intraoperative و لاپاراسکوپیک را شرح میدهد فصل چهارم تصویربرداری اعضاء کوچک part) (small را اراي ه میکند. که شامل کاروتید شریانها و وریدهای محیطی است. جلد دوم کتاب شامل فصل پنجم که بحث مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
357 87 کامل سونوگرافی زنان و مامایی است و نهایتا فصل ششم سونوگرافی اطفال است. بخش جدید در مورد سونوگرافی داپلر اطفال و سونوگرافی مداخلهای در اطفال به این فصل افزوده شده است. خواندن این کتاب متخصصین و دستیاران رادیولوژی دانشجویان پزشکی و سونوگرافها توصیه میگردد. (2005) MD) 35. Diagnostic Ultrasound (John P. McBany Gorgon, B. Gorgon, تك جلدي 800,000 (Thieme) 36. Ultrasound A Practical Approach to Clinical Problems (Edward Bluth, Peter H. Arger Carol B. Benson, Philip W. Rails, Marilyan) تك جلدي 500,000 (2004) FACR) 37. Breast Ultrasound (A. Thomas Stavros, MD, تك جلدي 800,000 Fenster) 38. Musculosceletal Ultrasound (Thomas R. Nelson, Donal B. downey, Dolores H. Pretorius, A aron تك جلدي 500,000 Wilkins) 39. The Core Curriculum Ultrasound (William E. Brant) (Lippincott Williams & تك جلدي 400, Ultrasound in Obstetrics and Gynecology (Eberhard Merz) (Thieme) (Vol.1: Obstetrics 2005 تك جلدي 800,000 (2004) (Thieme) 41. Color Atlas of Ultrasound Anatomy (B. Block) تك جلدي 450,000 CT Helms) 42. Fundamentals of Body CT (Second Edition) (Webb & Brant & تك جلدي 250,000 (2006) Major) 43. Fundamentals of Body CT (Third Edition) (W. Richard Webb, William E. Brant, Nancy M. تك جلدي 500, Body CT A Practical Approach تك جلدي 240,000 Webb) 45. High Resolution CT of the Lung (W. Richard تك جلدي 280,000 Williams&Wilkins) 46. High Resolution CT of the Chest Comprehensive Atlas (Second Edition) (Eric J. ster, Stephen J. Swensen)(Lippincott تك جلدي 320,000 Siegel) 47. Pediatric Body CT (Marilyn J. تك جلدي 320,000 (2000) (Thieme) 48. CT Teaching Manual (Marthias Hofer) تك جلدي 250,000 (2005) (Thieme) 49. CT Teaching Manual (A Systematic Approach to CT Reading) (Second Edition) تك جلدي 550,000 Jeffrey) 50. Spiral CT (Eliot K Fishman & R. Brocke تك جلدي 400,000 Silverman) 51. Helical (Spiral) computed Tomography (A Practical Approach to Clinical Protocols) (Paul M. تك جلدي 250,000 (Thieme) 52. Norma findings in CT and MRI (Torsten B. Moeller, EmilReif) تك جلدي 300,000 (2003) MD) 53. CT and MR Imaging of the Whole Body (John R. Haaga, دو جلدي 1,000,000 JR.) 54. Multidetector CT (Principles, Techniques, & Clinical Applications) (Elliot K. Fissman, R. Brooke Jeffrey, تك جلدي 550,000 (2003) (Thieme) 55. Spiral and Multislice Computed Tomography of the Body (Aart J. Van der Molen Cornelia M. Schaefer-Prokop) تك جلدي 800,000 MRI Berquist) 56. MRI of the Musculoskeletal System (2006) (Thomas H. تك جلدي 600,000 Pathria) 57. MRI of the Musculoskeletal System MRI Teaching file Series (Karence K Cahn, Mini تك جلدي 240,000 Ross) 58. MRI of the Head and Neck MRI Teaching file Series (Jrffrey S. تك جلدي 240,000 مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
358 88 240,000 تك جلدي Ross) 59. MRI of the Spine MRI Teaching file Series (Jeffrey S. 480,000 دو جلدي and ) 60. MRI of the Brain I & II MRI Teaching file Series (Michel Brant, Zawadzki 35,000 تك جلدي Wilkins) 61. MRI the basics fray h. Hashemi and William g. bradley, Jr.) (Williams & 190,000 تك جلدي MD) 62. MRI Principles (Donald G. Mitcell, 300,000 تك جلدي MD) 63. Clinical Pelvic Imaging CT, Ultrasound, and MRI (Arnold C. Friedman, 700,000 تك جلدي (2006) Ross) 64. MRI and CT of the Cardiovascular System (Second Edition) (Charles B. Higgins, Albert de 105,000 تك جلدي Rinck) 65. Magnetic Resonance in Medicine The Basic Textbook of the European Magnetic Resonance Forum (Peter A. 450,000 تك جلدي (Thieme) 66. Magnetic Resonance in diagnosis of C.N.S. disorders (vaso antunavic, gradimir dragutinovic, zvonimir lec) 450,000 تك جلدي (Thieme) 67. Section and MRI anatomy of the human body (slobodan marinkovic, milan milisavljevic, dieter sehellinger, vaso antunovic) 450,000 تك جلدي BROWN) 68. PRACTICAL GUIDE TO ABDOMINAL & PELVIC MRI (JOHN R. LEYENDECHER, JEFFERY J. Doppler 600,000 تك جلدي Neuerburg-Heusler)(Thieme) 69. Vascular diagnosis with Ultrasound Clinical References With Case Studies (Hennerici, 70. Introduction to Vascular Ultrasonography (Fourth Edition) (Zwiebel) (James Saunders) (2005) پيشرفتهاي اخير در عرصه راديولوژي تصويربرداري و سونوگرافي داپلر را از نظر دور نداشته و اين روش را به عنوان يك شيوه ا لترناتيو غيرتهاجمي كارا مد مورد بررسي عروق بدن در كنار ا نژيوگرافي قرار داده است. اين كتاب در ٥ بخش اصلي (مشتمل بر ٣١ مبحث جزي يتر) به بحث و بررسي ا خرين دستاوردهاي سونوگرافي داپلر در تشخيص پاتولوژي و ارگانهاي بدن ميپردازد. و شامل سرفصلهاي ذيل ميباشد: تك جلدي 850,000 ٢. فيزيك داپلر و سونوگرافي B-mode و تجهيزات لازم ١. نكات قابل توجه هموديناميك مربوط به بيماريهاي عروق محيطي الف- اصول سونوگرافي داپلر: ٥. مواد حاجب سونوگرافيك ٤. نقش داپلر رنگي در تشخيص بيماريهاي عروقي ٣. ا ناليز طيف (موج) فركانس داپلر ٩. ارزيابي سونوگرافيك پلاك كاروتيد ٨. شراي ين كاروتيد نرمال و تكنيكهاي ارزيابي داپلر كاروتيد ٧. ا ناتومي نرمال عروق مغزي ٦. مقياس در سونوگرافي داپلر عروق مغزي ب- عروق مغزي: ١٣. سونوگرافي داپلر ترانس كرانيال (TCD) ١١. موضوعات متفرقه با كاروتيد (شامل اسداد- ديسكنسيون ( ١٢. ارزيابي اولتراسونيك عروق و رتبرال ١٠. ارزيابي داپلر تنگي كاروتيد ١٦. نقشهاي فيزيولوژيك جهت ارزيابي بيماريهاي شرياني اندام تحتاني ١٥. ا ناتومي شرياني اندامها ج- شريانهاي اندامها: ١٤. نقش روشهاي غيرتهاجمي در پيگيري بيماريهاي شرياني اندامها ١٨. سونوگرافي داپلر شريانهاي اندام تحتاني ١٧. ارزيابي شريانهاي اندام فوقاني ٢٢. ارزيابي وريدهاي اندامها (جنبههاي تكنيكي) ٢١. ترمينولوژي و كاراكترهاي نرمال ٢٠. ا ناتومي وريدي اندامها د- وريدهاي اندامها: ١٩. مقياس سونوگرافي داپلر در ارزيابي وريدهاي اندامها ٢٤. فيستول شرياني وريدي (AVF) و پامولوژي غيروريدي اندام ٢٣. ترومبوز وريدي ٢٩. اختلالات عروقي كبد ٢٨. ارزيابي اولتراسونيك شريانهاي احشاي ي ٢٧. ا ي ورت شريانهاي ايلياك ه- عروق شكمي: ٢٦. ا ناتومي و نماهاي نرمال سونوگرافيك داپلر عروق شكمي ٣١. سونوگرافي معمولي و داپلر Penis ٣٠. ارزيابي داپلر عروق كليوي (مربوط به كلية Native و كلية پيوندي) (2005) (Thieme) 71. Teaching Manual of Color Duplex Sonography A Wokbook in color duplex ultrasound and echocardiographer (Matthias Hofer) تك جلدي 550, ,000 تك جلدي Wilkins) 72. Vascular Ultrasound of the Neck an Interpretive atlas (Antonio Alayon)(Lippincott Williams & 600,000 تك جلدي Jr.) 73. Duplex Scanning in Vascular Disorders (Third Edition) (D. Eugene Strandness, 500,000 تك جلدي (2004) Vetter) 74. Doppler Ultrasound in Gynecology and Obstetrics (Christof Sohn, Hans-Joachim Voigt, Klaus Imaging 500,000 تك جلدي MD) 75. Skeletal Imaging Atlas of the Spine and Extremities (John A. M. Donald Resnick, مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
359 89 90,000 تك جلدي 76. Imaging for Surgeons 600,000 تك جلدي (2004) Swischuk) 77. Imaging of the Newborn, Infant and Young Child (Fourth Edition) (Leonard E. 250,000 تك جلدي Gutier) 78. Thoracic Imaging A Practical Approach (Richard H. slone Fernando R. 250,000 تك جلدي Halperi) 79. Gastrointestinal Imaging, Case Review (Peter J. Feczko, Obert d. 500,000 تك جلدي Ariyama) 80. Imaging in Hepatobiliary and Pancreatic Disease A Practical Clinical Approach (Dirk Van Leeuwen, Jacques Reeders, Joe 420,000 تك جلدي Mathieson) 81. Aids Imaging A Practical Clinical Approach (J WA J. Reeders, J. R. 350,000 تك جلدي Moore) 82. Special Procedures in diagnostic Imaging (C'lark's)(A. Stewart Whitley, Chrissie W. Alsop Adrin D. 500,000 تك جلدي Kopans) 83. Breast Imaging (Second Edition) (David B. 4 00,000 تك جلدي Cardenosa) 84. The Core curriculum Breast Imaging (Gilda 900,000 دو جلدي jr) 85. Neuroimaging I & II (William It. On'ison, 360,000 تك جلدي Woodruff.M.D.) 86. Fundamentals of Neuroimaging (William w. 420,000 تك جلدي Loehr)(Thieme) 87. Atlas of Musculoskeletal Imaging (Thomas Lee Pope, Jr. Stephen 500,000 تك جلدي chong) 88. Atlas of Head and Neck Imaging (The Extracranial Head and Neck) (Suresh K. Mukherji, Vincent 250,000 تك جلدي Wilkins) 89. Magnetic Resonance Imaging of Orthopeadic Trauma (Stephen J. Eustace)(Lippincott Williams & 500,000 تك جلدي MDCM) 90. Pediatric Gastrointestinal Imaging and Intervention (David A. Stringer-Paul S. Babyn 260,000 تك جلدي castelijins)(springer) 91. Modern Head and Neck Imaging Medical Radiology, Diolopy, Nostic Imaging (S. K. Mukhetji, J. A. 500,000 تك جلدي Wilkin's) 92. Variants and Pitfalls in Body Imaging (Ali Shirkhoda)(Lippincot Williams & 580,000 تك جلدي 93. Clinical Imaging 94. Diagnostic Imaging Brain (Osborn) (2004) مدت طولاني بود كه نورولوژيستها نوروراديولوژيستها نوروپاتولوژيستها و جراحان اعصاب منتظر كتاب جديدي از دكتر Osborn" "Ann بودند. اين كار جديد نمايانگري از كتب مرجع در قرن ٢١ ميباشد كه ديگر مانند كتابهاي قديميتر اطلاعات بسيار زياد را به صورت فشرده و با تصاوير اندك اراي ه نميدهد بلكه با format مدرن و پيشرفته خود دو برابر اطلاعات و چهار برابر تصاوير بيشتري براي هر تشخيص دارد. كيفيت تصاوير و گرافيكها واقع ا عاليست و جهت بهترنشاندادن تصاوير ا ناتوميك و پاتولوژيك استفادة زيادي از رنگها شده است. ابتكار ديگر در اين كتاب اين است كه موارد و تصاوير مشابه و تشخيصهاي افتراق را در همان فصل جهت بررسي بيشتر اراي ه نموده است. شايد بتوان گفت كه اين كتاب يكجلدي "اينترنت" نورولوژي و بيماريهاي CNS ميباشد: كامل موجر و بروز بطوريكه حتي كلمهاي را نميتوان يافت كه اضافي نگاشته شده باشد. PART I (Pathology-based diagnoses): Congenital malformations-trauma Sulianachnoid hemorrhage and Aneurisms-Stroke-Vascular Malformations Neoplasm's and Tumor in lesions-primary Non-neoplastic cysts- Infection and Demyelinating Disease-Metabolic/Degenerative Disorders, Inhenited-Toxic/Metabolic/Degenesative Disorders, Acquired PART II (Anatomy-based Diagnoses): Ventricles and Cysterns-Sella and Pitutary-CPA-IAC-Skull, Scalp and Meninges توضيحات اراي هشده در مورد هر بيماري شامل عناوين زير ميباشد: Terminology-Imaging Findings-Differentioal Diagnosis-Pathology Clinical Issues-Selected references-imaging Gallery-Key Facts هر جايي كه لازم بوده است توضيحات ضروري از ا ناتومي جنينشناسي و پاتولوژي ا ورده شده تا به خواننده درك تشخيص و موقعيت كمك نمايد. قسمت Key Facts خلاصهاي جامع براي مرور سريع و ا سان ميباشد. 1, , تك جلدي مركز خدمات فرهنگي سالكان : اراي ه كنندة كتاب و سيديهاي تخصصي پزشكي نشاني: تهران م انقلاب خ كارگر جنوبي خ لبافينژاد بين كارگر و جمالزاده بنبست سيمين پلاك ٢٣٩ تلفن: ٦٦٩٣٦٦٩٦-٠٩١٢١٣٧٢٣٦١
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