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Блог петербургского врача
USMLE OASys for IMGs
An Open Access, Systematic approach
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[USMLE study for IMGs: an Open Access, Systematic approach]
In Development
Pavel Zhelnov, MD
@drzhelnov
Dear Colleagues,
An excerpt from the original publication (accessed on July 7, 2021):
This outline provides a common organization of content across all USMLE examinations. Each Step exam will emphasize certain parts of the outline, and no single examination will include questions on all topics in the outline. The examples listed within the outline are just examples. Questions may include diseases, symptoms, etc., that are not included in the outline.
Note that Step component specifications next to the content topics are not from the original document but from the official Step 1 Content Description (PDF) as well as the Step 2 CK Content Description (PDF) (accessed on July 29, 2021), so please take these accordingly. Also, Step 3 was not considered.
Interactive features are under development. I presume this outline as well as the USMLE Physician Tasks/Competencies could be nicely aligned with my amalgam USMLE prep schedule made of U.S. med schools syllabi so that each task/competency linked to specific study resources per each content topic. This would effectively create a self-study roadmap with tasks/competencies as its tracks and content topics as the milestones. Naturally, to navigate the roadmap, the prospective Step-taker would need to clear specific resources such as textbook chapters, journal articles, videos, or their glternatives. QBanks would still be required to test one’s competencies and topic knowledge once there is something to test.
For the time being, I am creating glternatives for each topic block (note the [glternative] links next to the topic titles). An glternative, a portmanteau of legal, Google, and alternative, is an open access community-written list of web searches that, in combination, cover all information from a given resource—in this instance, basically the topic content but as clickable Google links. Check these and other glternatives for free at the website I created, glternative.com (no registration required).
I do not own any outline content, just reproduce it for self-learning purposes and in good faith:
Copyright © 2021 by the Federation of State Medical Boards of the United States, Inc. (FSMB), and National Board of Medical Examiners® (NBME®). All rights reserved. The United States Medical Licensing Examination (USMLE®) is a joint program of the FSMB and NBME.
⚠ Disclaimer: This is an unofficial publication not affiliated with nor endorsed by the FSMB, NBME®, or USMLE® program. For official information please visit usmle.org or other relevant resources.
View this page on GitHub to create a custom copy (also to track versions). Feedback is always welcome via GitHub or Twitter. Enjoy!
Gene expression: DNA structure, replication, exchange, and epigenetics (eg, imprinting, X-activation, DNA methylation)
Gene expression: transcription
Gene expression: translation, post-translational processing, modifications, and disposition of proteins (degradation), including protein/glycoprotein synthesis, intra-extracellular sorting, and processes/functions related to Golgi complex and rough endoplasmic reticulum
Structure and function of proteins and enzymes (eg, enzyme kinetics and structural/regulatory proteins)
Energy metabolism (eg, ATP generation, transport chain)
Adaptive cell responses and cellular homeostasis (eg, hypertrophy)
Mechanisms of injury and necrosis, including pathologic processes (eg, liquefactive necrosis, free radical formation)
Apoptosis
Cell cycle and cell cycle regulation (eg, mitosis)
Mechanisms of dysregulation
Cell/tissue structure, regulation, and function, including cytoskeleton, organelles, glycolipids, channels, gap junctions, extracellular matrix, and receptors
Principles of pedigree analysis
Population genetics: Hardy-Weinberg law, founder effects, mutation-selection equilibrium
Principles of gene therapy
Genetic testing and counseling
Genetic mechanisms (eg, penetrance, genetic heterogeneity)
Acute inflammatory responses (patterns of response)
Chronic inflammatory responses (eg, tumor necrosis factor)
Reparative processes
Pharmacokinetics: absorption, distribution, metabolism, excretion, dosage intervals
Mechanisms of drug action, structure-activity relationships (eg, anticancer drugs)
Concentration and dose-effect relationships (eg, efficacy, potency), types of agonists (eg, full, partial, inverse) and antagonists and their actions
Individual factors altering pharmacokinetics and pharmacodynamics (eg, age, gender, disease, tolerance, compliance, body weight, metabolic proficiency, pharmacogenetics)
Mechanisms of drug adverse effects, overdosage, toxicology
Mechanisms of drug interactions
Signal transduction, including structure/function of all components of signal transduction pathways such as receptors, ligands (eg, general principles of nitric oxide, autocrine and paracrine signaling)
Microbial identification and classification, including principles, microorganism identification, and non-immunologic laboratory diagnosis
Bacteria
Viruses
Fungi
Parasites
Prions
Infancy and childhood (0-12 years) [glternative]
Normal physical changes: linear growth, variations in linear growth, including constitutional delay; weight; head circumference; micturition, defecation, primary incontinence/bedwetting; normal physical examination; screening; sleep; teething syndrome
Developmental stages: motor; speech; cognitive; psychosocial; anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of exercise); preventive/travel medicine; risk factors and prevention (eg, guns, swimming, motor vehicles, car seats); routine vaccinations
Adolescence (13-17 years) [glternative]
Normal physical changes: linear growth, variations in linear growth including constitutional delay; weight; puberty; normal physical examination; gynecomastia; autonomy/self-identity; sleep
Developmental stages: cognitive (eg, abstract thought); psychosocial (eg, autonomy, role confusion, sexual identity); anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of exercise); preventive/travel medicine; risk factors and prevention (eg, risk-taking behavior, helmets, safe sex, motor vehicles, seat belts, distractions); routine vaccinations
Adulthood (18-64 years) [glternative]
Normal physical changes: weight; normal physical examination; screening; sleep
Developmental stages: cognitive; intimacy vs isolation; anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of exercise); preventive/travel medicine; risk factors and prevention; routine vaccinations
Older Adulthood (65 years and older) [glternative]
Normal physical changes, including normal physical exam for age: weight, height (spinal compression), skin, bruising; normal physical examination; response to temperature; micturition, defecation; sleep
Developmental stages: motor; cognitive (eg, psychomotor slowing); psychosocial; integrity vs despair; retrospection; anticipatory guidance
Lifestyle and routine preventive health care: nutrition; exercise (eg, benefits of exercise); preventive/travel medicine; risk factors and prevention (eg, falls, general medical condition; polypharmacy, driving, caregiver stress); routine vaccinations
Development of cells of the adaptive immune response, including positive and negative selection during immune development
Structure, production, and function
Cellular basis of the immune response and immunologic mediators
Basis of immunologic diagnostics (eg, antigen-antibody reactions used for diagnostic purposes, ELISA, immunoblotting, antigen-antibody changes over time, ABO typing)
Principles of immunologic protection
Effect of age on the function of components of the immune system
Disorders associated with immunodeficiency
HIV/AIDS: HIV1 and HIV2; AIDS; AIDS complications (eg, neuropathy, dementia, renal insufficiency); immunology of AIDS; immune reconstitution syndrome (IRS); secondary infections; noninfectious complications
Immunologically mediated disorders
Adverse effects of drugs on the immune system: Jarisch-Herxheimer reaction; drugs affecting the immune system (eg, prednisone, azathioprine, cyclosporine, methotrexate, monoclonal antibody drugs [eg, abciximab, adalimumab; bevacizumab, infliximab, omalizumab, rituximab]); vaccine adverse effects
Embryonic development, fetal maturation, and perinatal changes
Organ structure and function
Cell/tissue structure and function
Repair, regeneration, and changes associated with stage of life
Infectious and immunologic
Neoplasms: leukemia, acute (ALL, AML); leukemia, chronic (CLL, CML); lymphomas, Hodgkin disease, non-Hodgkin lymphoma, Burkitt lymphoma, T-cell lymphoma; multiple myeloma, dysproteinemias, monoclonal gammopathy of unknown significance (MGUS); myelofibrosis; myelodysplastic syndrome, myelodysplasias; other immunoproliferative neoplasms (eg, Waldenstrom macroglobulinemia)
Anemia, cytopenias, and polycythemia anemias
Coagulation disorders (hypocoagulable and hypercoagulable conditions)
Traumatic, mechanical, and vascular disorders: mechanical injury to erythrocytes (eg, cardiac valve hemolysis); disorders of the spleen; splenic rupture/laceration; splenic infarct; splenic abscess; effects/complications of splenectomy (eg, sepsis due to encapsulated bacteria); hypersplenism
Adverse effects of drugs on the hematologic and lymphoreticular systems: antiplatelet drugs, antithrombin drugs (eg, dabigatran); chemotherapeutic agents; inhibitors of coagulation factors; methemoglobinemia, acquired; propylthiouracil; tumor lysis syndrome; warfarin
Psychodynamic and behavioral factors, related past experience (eg, transference, personality traits)
Adaptive behavioral responses to stress and illness (eg, coping mechanisms)
Maladaptive behavioral responses to stress and illness (eg, drug-seeking behavior, sleep deprivation)
Patient adherence: general adherence; adolescent adherence
Psychotic disorders: brief psychotic disorder; delusional disorder; psychotic disorder due to another medical condition; schizophrenia; schizoaffective disorder; substance-induced psychotic disorder
Anxiety disorders: acute stress disorder; anxiety disorders (generalized anxiety disorder, anxiety due to another medical condition, social phobia); hyperventilation syndrome; obsessive-compulsive disorder; panic disorder with and without agoraphobia; phobic disorders; post-traumatic stress disorder; separation anxiety disorder; substance-induced anxiety disorder, trichotillomania
Mood disorders: major depressive disorder with and without psychotic features, with and without seasonal pattern; major depressive disorder, postpartum, with and without psychotic features, including screening; cyclothymic disorder; persistent depressive disorder (dysthymia); bipolar disorder, manic/depressed/mixed; premenstrual dysphoric disorder; bipolar and related disorder or depressive disorder due to another medical condition; substance/medication-induced bipolar and related disorder or depressive disorder (illegal or prescribed); suicidal ideation/attempt
Somatoform disorders: body dysmorphic disorder; conversion disorder, including psychogenic seizures; dissociative disorders; illness anxiety disorder (hypochondriasis); malingering; pain disorder; somatic symptom disorder
Factitious disorders: factitious disorder imposed on self
Eating disorders and impulse control disorders: anorexia nervosa; binge-eating disorder; bulimia nervosa; eating disorder; disruptive, impulse-control, and conduct disorders (eg, gambling, kleptomania, pyromania)
Disorders originating in infancy/childhood: reactive attachment disorder; attention-deficit/hyperactivity disorder; speech sound disorder or language disorder; learning disorder/dyslexia; intellectual developmental disorder and developmental delay, undefined, including school problems, fetal alcohol syndrome; oppositional defiant disorder, conduct disorder; autism spectrum disorder, Rett syndrome; psychoses with origin specific to childhood; elimination disorders (incontinence, encopresis); tic disorders/Tourette disorder
Personality disorders: antisocial personality disorder; avoidant personality disorder; borderline personality disorder; dependent personality disorder; histrionic personality disorder; narcissistic personality disorder; obsessive-compulsive personality disorder; paranoid personality disorder; schizoid personality disorder
Psychosocial disorders/behaviors: adjustment disorder; grief response/bereavement, normal and persistent complex; parent-child relational problems other than physical or emotional abuse; other psychosocial stress
Sexual and gender identity disorders: gender dysphoria; psychosexual dysfunction
Substance use disorders: alcohol use disorder/intoxication/dependence/withdrawal; tobacco/nicotine use disorder/dependence/withdrawal; varenicline use; cannabis use disorder/intoxication/dependence; hallucinogen use disorder/intoxication/dependence/withdrawal; inhalant use disorder/intoxication/dependence/withdrawal; opioid, heroin, including prescription drug, use disorder/intoxication/dependence/withdrawal; sedative, hypnotic, including benzodiazepine and barbiturate use disorder/intoxication/dependence/withdrawal; stimulant, cocaine, methamphetamine use disorder/intoxication/dependence/withdrawal; other drugs of use disorders (eg, ecstasy, PCP, bath salts)/intoxication/dependence/withdrawal; polysubstance use disorder/intoxication/dependence/withdrawal
Embryonic development, fetal maturation, and perinatal changes, including neural tube derivatives, cerebral ventricles, and neural crest derivatives
Organ structure and function
Cell/tissue structure and function, including neuronal cellular and molecular biology
Repair, regeneration, and changes associated with stage of life
Infectious, immunologic, and inflammatory disorders
Neoplasms (cerebral, spinal, and peripheral): benign (meningioma, neurofibromatosis); malignant (glioblastoma multiforme, astrocytoma, medulloblastoma, primary CNS lymphoma); metastatic (eg, breast, lung, pancreatic, testicular, melanoma)
Cerebrovascular disease: arteriovenous malformations, ectatic cerebral vessels; transient ischemic attack; stroke, thrombotic: cerebral artery occlusion/cerebral infarction; stroke, embolic: cerebral embolism; stroke: intracerebral hemorrhage, including subarachnoid hemorrhage, traumatic intracranial hemorrhage; cerebral artery aneurysm; carotid artery stenosis/atherosclerosis/occlusion/dissection; vertebral artery deficiency/dissection; subclavian steal syndrome; vascular dementia; hypertensive encephalopathy; posterior reversible encephalopathy syndrome; venous sinus thrombosis
Disorders relating to the spine, spinal cord, and spinal nerve roots: cauda equina syndrome; spinal artery thrombosis/embolus/infarct; spinal cord compression; spinal cord transection, paraplegia and quadriplegia, acute and chronic effects (eg, autonomic dysreflexia); spinal stenosis (cervical, lumbar); syringomyelia
Cranial and peripheral nerve disorders
Neurologic pain syndromes: complex regional pain syndrome (reflex sympathetic dystrophy, causalgia); fibromyalgia; postherpetic neuralgia; phantom limb pain/syndrome; thalamic pain syndrome; trigeminal neuralgia
Degenerative disorders/amnestic syndromes: Alzheimer disease; frontotemporal dementia, including progressive supranuclear palsy, Lewy body disease; mild neurocognitive disorder, mild cognitive impairment
Global cerebral dysfunction: altered states of consciousness; delirium; coma/brain death
Neuromuscular disorders: amyotrophic lateral sclerosis/spinal muscular atrophy; muscular dystrophy (eg, Duchenne, myotonic); muscle channelopathies (eg, hypokalemic period paralysis)
Movement disorders: acute dystonia; adult tic disease; essential tremor; Huntington disease; Parkinson disease, including Parkinson dementia
Metabolic disorders: adrenoleukodystrophy; metabolic encephalopathy
Paroxysmal disorders: headache, including migraine, mixed, tension, ice-pick, cluster, medication withdrawal, caffeine withdrawal; seizure disorders, including generalized tonic-clonic, partial, absence, febrile
Sleep disorders: cataplexy and narcolepsy; circadian rhythm sleep-wake disorder; insomnia, primary; sleep terror disorder and sleepwalking; REM sleep behavior disorder; restless legs syndrome
Traumatic and mechanical disorders and disorders of increased intracranial pressure: anoxic brain damage, cerebral hypoxia; epidural, subdural hematoma (cerebral and spinal); intraparenchymal hemorrhage, traumatic subarachnoid hemorrhage; cerebral edema; pseudotumor cerebri (idiopathic intracranial hypertension); torticollis/cervical dystonia; hydrocephalus, including normal-pressure; traumatic brain injury (concussion)/postconcussion syndrome (dementia pugilistica); traumatic brain syndrome
Congenital disorders: Friedreich ataxia; neural tube defects (eg, spina bifida, holoprosencephaly, anencephaly); microcephaly; Sturge-Weber syndrome; tuberous sclerosis, von Hippel-Lindau disease; hydrocephalus, obstructive (Arnold-Chiari)
Adverse effects of drugs on the nervous system: acute dystonic reaction; drug-induced meningitis (eg, NSAIDs, sulfa drugs); drug-induced neuropathy (eg, vincristine, isoniazid, metronidazole); extrapyramidal adverse effects (eg, akathisia, dystonia, drug-induced parkinsonism); neuroleptic malignant syndrome; poisoning by psychotropic agents, including antidepressants; serotonin syndrome; tardive dyskinesia
Disorders of the eye and eyelid
Disorders of the ear
Embryonic development, fetal maturation, and neonatal changes
Organ structure and function, including barrier function, thermal regulation
Cell/tissue structure and function, eccrine function
Repair, regeneration, and changes associated with stage of life (eg, senile purpura, male pattern baldness, postmenopausal hair changes)
Skin defense mechanisms and normal flora
Infectious, immunologic, and inflammatory disorders
Neoplasms
Integumentary disorders (hair and hair follicles, nails, sweat glands, sebaceous glands, oral mucous membranes)
Oral disease: aphthous ulcers (stomatitis, canker sores); leukoplakia
Disorders of pigmentation: albinism; lentigo
Traumatic and mechanical disorders: animal bites (dogs, cats, etc); burns or wounds affecting the skin or subcutaneous tissue (eg, sunburn, other including blast injuries and burns); cauliflower ear; effects of ultraviolet light; keloids; tattoo; thermal injury, perniosis, frostbite; ulcers, decubitus
Congenital disorders: xeroderma pigmentosum; benign lesions in neonates, infants, children (eg, congenital nevi)
Adverse effects of drugs on skin and subcutaneous tissue: drug reactions, eruptions, including local reaction to vaccine
Embryonic development, fetal maturation, and perinatal changes
Organ structure and function
Cell/tissue structure and function
Repair, regeneration, and changes associated with stage of life
Infectious, inflammatory, and immunologic disorders
Neoplasms: benign neoplasms (e.g., ganglion cyst); malignant neoplasms of bone (eg, osteosarcoma, sarcoma, leiomyosarcoma, rhabdosarcoma); metastases to bone, secondary malignant neoplasm of bone
Degenerative and metabolic disorders [glternative]
Traumatic and mechanical disorders: amputation and care of amputees; backache, including low back pain; blast injuries; compartment syndrome; contractures, hospital-acquired; contusions; dislocations; fractures; sprains, strains; kyphoscoliosis, scoliosis; rotator cuff syndrome; slipped capital femoral epiphysis; dislocation of hip
Congenital disorders: achondroplasia/dwarfism; disorders of limb development (HOX gene mutation, phocomelia); developmental dysplasia of the hip; dislocation of hip in infantile spinal muscular atrophy; genu valgum or varum; foot deformities (flat foot, valgus/varus deformities); osteogenesis imperfecta; McArdle disease; mitochondrial myopathies
Adverse effects of drugs on the musculoskeletal system: drug-induced myopathy (eg, steroids, statins, cocaine, AZT); malignant hyperthermia
Embryonic development, fetal maturation, and perinatal transitional changes
Organ structure and function
Cell/tissue structure and function
Repair, regeneration, and changes associated with stage of life
Infectious, immunologic, and inflammatory disorders
Neoplasms: myxoma, metastases
Dysrhythmias: premature beats (PACs, PVCs); atrial flutter/fibrillation; multifocal atrial tachycardia; paroxysmal tachycardias; ventricular tachycardia/fibrillation; wide complex tachycardia; torsades de pointes; bradycardias; atrioventricular block (first-, second-, third-degree); conduction disorder (LBBB, RBBB); cardiac arrest; sick sinus syndrome; prolonged QT syndrome; Wolff-Parkinson-White syndrome; carotid sinus hypersensitivity; pacemaker dysfunction, including failure to sense, capture
Heart failure: chordae tendineae rupture; congestive heart failure; cor pulmonale; diastolic dysfunction; systolic dysfunction; mitral valve dysfunction; heart failure secondary to myocardial infarction; high-output heart failure, including thyrotoxicosis-induced, anemia-induced; tachycardia-induced; cardiogenic pulmonary edema
Ischemic heart disease: acute coronary syndrome, acute myocardial infarction; angina pectoris, stable and unstable/coronary artery disease/coronary insufficiency; coronary artery spasm
Diseases of the myocardium: cardiomyopathy, dilated, including alcoholic, viral, takotsubo; cardiomyopathy, obstructive hypertrophic; cardiomyopathy, familial dilated; cardiomyopathy, restrictive; hypertensive heart disease, left ventricular hypertrophy, right ventricular hypertrophy; complications of myocardial infarction; nontraumatic tamponade post-myocardial infarction; papillary muscle rupture/dysfunction; ventricular free wall rupture; myocarditis
Diseases of the pericardium: chronic constrictive pericarditis; pericardial effusion; pericardial tamponade; acute pericarditis; pericarditis, following myocardial infarction, surgery, trauma
Valvular heart disease: valve disorders, mitral/aortic/tricuspid, pulmonic (eg, regurgitation, stenosis, prolapse, insufficiency, vegetation); functional murmurs; rheumatic heart disease; complications of artificial valves
Hypotension: orthostatic hypotension
Hypertension: elevated blood pressure reading without diagnosis of hypertension; essential hypertension; malignant hypertension; secondary hypertension
Dyslipidemia: hypercholesterolemia; hyperlipidemia; hypertriglyceridemia; lipoproteins/lipoprotein lipase deficiency
Vascular disorders
Traumatic and mechanical disorders: ventricular puncture; myocardial contusion; myocardial rupture; traumatic aortic dissection; traumatic tamponade
Congenital disorders, including disease in adults: anomalous left coronary artery; atrial septal defect; coarctation of the aorta; endocardial cushion defect; patent foramen ovale; patent ductus arteriosus; tetralogy of Fallot; transposition of the great vessels; ventricular septal defect
Adverse effects of drugs on the cardiovascular system: adriamycin; cocaine, amphetamine, PCP; ACE inhibitors, calcium channel blockers, alpha blockers, minoxidil
Embryonic development, fetal maturation, and perinatal changes
Organ structure and function
Cell/tissue structure and function, including surfactant formation, and alveolar structure
Repair, regeneration, and changes associated with stage of life
Pulmonary defense mechanisms and normal flora
Infectious, immunologic, and inflammatory disorders
Neoplasms
Obstructive airway disease: asthma, reactive airway disease; bronchiectasis; chronic airway obstruction; chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema
Pneumoconiosis/fibrosing/restrictive pulmonary disorders/interstitial lung disease: pneumoconiosis; asbestosis; silicosis; silo-filler’s lung, byssinosis, bagassosis, berylliosis; hypersensitivity pneumonitis; hypereosinophilic syndromes, Loeffler syndrome; interstitial pneumonia, usual (UIP), desquamative (DIP), nonspecific
Respiratory failure/respiratory arrest and pulmonary vascular disorders: acute respiratory distress syndrome (ARDS); pulmonary hypertension; pulmonary vascular disorders, arteriovenous fistula; pulmonary edema, pulmonary cause and unspecified; pulmonary embolism; air and fat embolism; respiratory failure due to enteral feeding
Metabolic, regulatory, and structural disorders: disorders of gas exchange; hypoventilation; hypoxia; pulmonary alveolar proteinosis; ventilation-perfusion imbalance
Disorders of the pleura, mediastinum, and chest wall: chylothorax; costochondritis; empyema; hemothorax; mediastinitis; pleural effusion; pleuritis; pneumomediastinum; pneumothorax
Traumatic and mechanical disorders
Congenital disorders: bronchogenic cysts; congenital cysts; congenital diaphragmatic hernia; pulmonary sequestration; immotile cilia syndrome
Adverse effects of drugs on the respiratory system: bleomycin, amiodarone; adverse effects of 100% oxygen; acute effects of tobacco/nicotine, inhalants, cocaine
Embryonic development, fetal maturation, and perinatal changes
Organ structure and function
Cell/tissue structure and function
Repair, regeneration, and changes associated with stage of life
Gastrointestinal defense mechanisms and normal flora
Infectious, immunologic, and inflammatory disorders
Neoplasms
Signs, symptoms, and ill-defined disorders: upper gastrointestinal bleeding; lower gastrointestinal bleeding; constipation; diarrhea; hematochezia; bright red rectal bleeding; melena; nausea, vomiting, rumination
Disorders of the oral cavity, salivary glands, and esophagus
Disorders of the stomach, small intestine, colon, rectum, anus
Disorders of the liver and biliary system, noninfectious
Disorders of the pancreas: pancreatitis, acute; pancreatitis, chronic; pancreatitis, hereditary; pancreatic cyst/pseudocyst; pancreatic duct obstruction; pancreatic insufficiency
Disorders of the peritoneal cavity: ascites
Traumatic and mechanical disorders: abdominal wall defects; adhesions, postsurgical; digestive system complications of surgery; post-gastric surgery syndromes (eg, blind loop syndrome, adhesions); duodenal tear; foreign body in digestive system; inguinal, femoral, and abdominal wall hernias; open wound, abdominal; perforation of hollow viscus and blunt trauma; perforation/rupture of esophagus (Boerhaave syndrome); umbilical hernia
Congenital disorders: annular pancreas, biliary atresia, cleft lip and palate, esophageal atresia, malrotation without volvulus, Meckel diverticulum, pyloric stenosis, tracheoesophageal fistula
Adverse effects of drugs on the gastrointestinal system: drug-induced changes in motility (chronic laxative abuse, opioids); drug-induced gastritis, duodenitis, peptic ulcer disease (NSAIDs); drug-induced hepatitis (eg, acetaminophen, isoniazid); drug-induced pancreatitis (eg, thiazide diuretics)
Embryonic development, fetal maturation, and perinatal changes
Organ structure and function
Cell/tissue structure and function
Repair, regeneration, and changes associated with stage of life
Infectious, immunologic, and inflammatory disorders
Neoplasms
Signs, symptoms, and ill-defined disorders: dysuria; hematuria; oliguria, anuria; proteinuria
Metabolic and regulatory disorders: acute kidney injury; renal insufficiency; azotemia, uremic syndrome; chronic kidney disease, including end-stage renal disease; cystinuria; Fanconi syndrome; hypertensive renal disease (renal complications of hypertension); renal calculi, ureteral calculi, nephrolithiasis; renal tubular acidosis
Vascular disorders: renal artery stenosis (atherosclerosis, fibromuscular dysplasia, nephrosclerosis); renal vein thrombosis; renal infarction
Traumatic and mechanical disorders: bladder rupture; neurogenic bladder; obstructive uropathy; posterior urethral valves; renal laceration; renal vascular injury; ureteral laceration/avulsion/disruption; urethral diverticulum; obstruction/stricture/prolapse, urethral/ureteral, vaginal walls, uterine, uterovaginal; urinary incontinence, including secondary enuresis; vesicoureteral reflux
Congenital disorders: double ureters/ureteral duplication/double collecting system; horseshoe kidney; hydronephrosis/reflux; renal agenesis, renal hypoplasia, renal dysplasia; single kidney
Adverse effects of drugs on the renal and urinary system: ACE inhibitors; aminoglycosides; amphotericin B; cisplatin; furosemide; gadolinium (nephrogenic systemic fibrosis); heroin; iodinated contrast dye; lithium; NSAIDs; penicillins; sulfa drugs; tenofovir; drug-induced urinary retention
Organ structure and function: pregnancy, including fertilization, implantation, development of embryo, labor and delivery, the puerperium, lactation, gestational uterus, placenta
Prenatal care
Obstetric complications: abortion, induced, septic, missed, spontaneous, threatened; acute fatty liver of pregnancy; anemia of pregnancy, sickle cell disease, thalassemia in pregnancy; antepartum hemorrhage, including third-trimester bleeding; cardiomyopathy of pregnancy; cervical insufficiency, cervical shortening; cholestasis of pregnancy, intrahepatic; congenital abnormalities, maternal (eg, bicornuate uterus); ectopic pregnancy; fetal abnormality affecting management of mother (eg, hydrocephalus, spina bifida); fetal growth restriction; gestational diabetes; maternal mortality; multiple gestation; placental abnormalities (abruptio placentae, placenta previa, premature separation of placenta); polyhydramnios, oligohydramnios; preeclampsia, eclampsia, HELLP syndrome, gestational hypertension; prolonged pregnancy; Rh isoimmunization affecting management of mother; vomiting in pregnancy (morning sickness, hyperemesis gravidarum); trauma in pregnancy; infections complicating pregnancy
Labor and delivery: labor and delivery, uncomplicated; labor and delivery, complicated, including shoulder dystocia; cesarean delivery, including complications; cord compression, cord prolapse; fetal malpresentations (eg, breech/external cephalic); intrapartum fetal evaluation, including fetal heart tones; intrapartum prophylaxis (eg, HIV, Chlamydia, gonococcal prophylaxis); premature rupture of membranes; preterm (before 37 weeks’ gestation) and postdates labor and delivery; threatened preterm labor
Puerperium, including complications: lactation problems; breast-feeding problems; lochia; postpartum cardiomyopathy; postpartum blues; postpartum hemorrhage; postpartum sepsis; retained placenta, products of conception (eg, placenta accreta); uterine atony
Newborn (birth to 4 weeks of age)
Congenital disorders, neonatal: congenital malformations and anomalies; neonatal hydrocele
Adverse effects of drugs on pregnancy, childbirth, and the puerperium: alcohol, tobacco, and other drugs (ATOD); prenatal radiation exposure; teratology (eg, ACE inhibitors, SSRIs, warfarin, infections, toxins)
Systemic disorders affecting pregnancy, labor and delivery, and puerperium: appendicitis; asthma; carpal tunnel syndrome in pregnancy; cirrhosis; deep venous thrombosis (DVT); diabetes mellitus; heart failure, valvular heart disease; hypertension; myasthenia gravis; obesity; pancreatitis; psychiatric disorders; renal calculus/calculi; renal failure/renal disease, including SLE; seizure disorders; thyroid disorders, hypothyroidism, hyperthyroidism
Embryonic development, fetal maturation, and perinatal changes, gametogenesis
Organ structure and function
Cell/tissue structure and function: hypothalamic-pituitary-gonadal axis, sex steroids, and gestational hormones
Reproductive system defense mechanisms and normal flora
Repair, regeneration, and changes associated with stage of life
Breast
Female reproductive system
Neoplasms of the cervix, ovary, uterus, vagina, and vulva
Fertility and infertility: assisted reproductive techniques (ART); contraception (eg, oral contraceptives, IUD, vaginal cap, cervical sponge, diaphragm, implant, morning-after pill, male and female condoms); female infertility; gonadal dysgenesis 45,X (Turner syndrome); sterilization; tubal factors; infertility
Menopause: ovarian failure, premature menopause; perimenopause; premenopausal menorrhagia; postmenopausal atrophic vaginitis (vaginal atrophy); postmenopausal bleeding; vasomotor symptoms
Menstrual and endocrine disorders: abnormal uterine bleeding, including perimenopausal; absence of menstruation (primary amenorrhea, secondary amenorrhea including undiagnosed pregnancy); anovulation; dysmenorrhea; endometriosis; hirsutism, virilization; mittelschmerz; pelvic pain; polycystic ovarian syndrome; postcoital bleeding; premenstrual syndrome
Sexual dysfunction: dyspareunia; orgasmic dysfunction; sexual desire/arousal syndrome; vaginismus
Traumatic and mechanical disorders: Asherman syndrome; chronic inversion of uterus; chronic pelvic pain syndrome; cystocele; imperforate hymen; injuries, wounds, and burns affecting the female reproductive system and injuries, wounds, burns, and blast injuries; ovarian torsion; pelvic relaxation; rectocele; urethrocele
Congenital disorders: müllerian agenesis; uterus didelphys, bicornuate uterus; short cervix
Adverse effects of drugs on the female reproductive system and breast: antihistamines, H2-receptor blockers; benzodiazepines; beta-adrenergic blockers; hormone replacement; opioids; spironolactone; selective serotonin reuptake inhibitors; tricyclic antidepressants
Embryonic development, fetal maturation, and neonatal changes, gametogenesis
Organ structure and function
Cell/tissue structure and function, including hypothalamic-pituitary-gonadal axis, sex steroids, and gestational hormones
Reproductive system defense mechanisms and normal flora
Repair, regeneration, and changes associated with stage of life
Infectious, immunologic, and inflammatory disorders
Neoplasms: malignant neoplasms, penile, prostate, testicular, breast
Metabolic and regulatory disorders, including sexual dysfunction: erectile dysfunction, impotence; infertility, male factor; male sexual dysfunction; premature ejaculation
Traumatic and mechanical disorders: benign prostatic hyperplasia/hypertrophy; circumcision, including complications; epididymal cyst; hydrocele; injuries, wounds, and burns to male genitalia, including blast injuries; penile laceration, penile fracture, Peyronie disease; phimosis; scrotal laceration; spermatocele; testicular rupture/avulsion/laceration; torsion of testis; urethral laceration/disruption; varicocele
Congenital disorders of the male reproductive system: hypospadias; Klinefelter syndrome; undescended testicle
Adverse effects of drugs on the male reproductive system: alcohol; androgens, testosterone; antipsychotics, antidepressants including selective serotonin reuptake inhibitors; beta-adrenergic blockers; diuretic including thiazides; drug-induced priapism (eg, trazodone); finasteride, dutasteride; sildenafil, tadalafil, vardenafil; marijuana; nitric oxide reductase inhibitors
Embryonic development, fetal maturation, and perinatal changes
Organ structure and function
Cell/tissue/structure and function, including hormone synthesis, secretion, action, metabolism
Repair, regeneration, and changes associated with stage of life
Diabetes mellitus and other disorders of the endocrine pancreas
Thyroid disorders: cyst, nodule; euthyroid sick syndrome; goiter (euthyroid-normal thyroid function with goiter); hypothyroidism; hyperthyroidism, including thyrotoxicosis and thyroid storm; thyroiditis, including Hashimoto; Graves disease; neoplasms (benign cysts and nodules, thyroid cancer including papillary, follicular, medullary, and anaplastic); thyroid deficiency from pituitary disorder; infertility due to thyroid disease; secondary hypothyroidism and hyperthyroidism
Parathyroid disorders: hyperparathyroidism; hypoparathyroidism; metabolic bone disease
Adrenal disorders: corticoadrenal insufficiency (Addison disease); adrenal insufficiency, secondary; hypocortisolism; Cushing syndrome; hyperaldosteronism; neoplasms, benign and malignant (adrenal neuroblastoma, pheochromocytoma, adrenal carcinoma, adrenal adenoma, aldosteronoma, adrenal incidentaloma); delayed and precocious puberty; hypertensive endocrine disease
Pituitary disorders: acromegaly/gigantism; diabetes insipidus; galactorrhea not associated with childbirth; panhypopituitarism from any cause; pituitary apoplexy (eg, Sheehan syndrome); growth hormone deficiency; short stature; SIADH (inappropriate secretion of ADH [vasopressin]); neoplasm, benign and malignant (pituitary adenomas, craniopharyngioma, metastatic disease); prolactinoma and hyperprolactinemia, including infertility due to these disorders; hypogonadism, primary and secondary
Hypothalamic endocrine disorders
Multiple endocrine neoplasia (MEN1, MEN2)
Congenital disorders: disorders of sexual differentiation; congenital adrenal hyperplasia; androgen insensitivity/resistance syndrome; congenital hypothyroidism
Adverse effects of drugs on the endocrine system: drug, medicinal, and biologic substance effects; exogenous steroid suppression of adrenal glands, anabolic steroids
Principles of nutrition
Electrolyte and water metabolism
Intracellular accumulations (eg, pigments, fats, proteins, carbohydrates, minerals, inclusions, vacuoles, lysosomal/glycogen storage disease and structures related to storage diseases, glycogen phosphorylase deficiency, Zellweger syndrome)
Infectious, immunologic, and inflammatory disorders
Neoplasms and related disorders
Signs, symptoms, and ill-defined disorders: arthralgias; abdominal pain; chest pain; cough; dizziness, light-headedness, syncope, including breath-holding spells with syncope; dyspnea, shortness of breath; edema, anasarca; fatigue; fever of unknown origin; hemoptysis; pain management (in a nonaddiction, nonpalliative-care setting); joint pain; lymphedema; palpitations; pruritus; unexpected weight gain/weight loss
Nutrition
Toxins and environmental extremes
Venomous bites and stings: hymenoptera bites and stings; scorpion bites; snake bites; spider bites; jellyfish stings
Fluid, electrolyte, and acid-base balance disorders
Abuse
Multiple trauma (eg, prioritization, blast injury involving more than one organ system)
Shock, cardiogenic, hypovolemic, neurogenic, septic, sepsis, bacteremia, systemic inflammatory response syndrome (SIRS), refractory, multiorgan dysfunction syndrome: meningococcemia
Genetic metabolic and developmental disorders
Adverse effects of drugs on multisystem disorders: drug-induced electrolyte abnormalities and acid base-disorders (eg, albuterol; prednisone; diuretics; alcohol; drugs inducing polydipsia, SIADH, or diabetes insipidus)
Epidemiology/population health
Study design, types and selection of studies (includes dependent/independent variables)
Measures of association
Distributions of data: measures of central tendency; measures of variability; regression to mean; normal distribution; nominal measurement
Correlation and regression, uses and interpretation: correlation coefficients; multiple regression
Principles of testing and screening
Study interpretation, drawing conclusions from data
Clinical decision making, interpretation and use of evidence-based data and recommendations: application of study results to patient care and practice, including patient preferences and individualization of risk profiles; risk/benefit analysis; synthesis of concepts with real data
Research ethics
Communication and interpersonal skills, including health literacy and numeracy, cultural competence - STEP 1 ONLY
Medical ethics and jurisprudence, include issues related to death and dying and palliative care - STEP 2 CK ONLY
Systems-based practice (including health systems, public health, community, schools) and patient safety (including basic concepts and terminology) - STEP 2 CK ONLY