how to create the perfect study calendar

5
Use Techniques From StudyWise to Create a Plan That Helps You StudySTRONG Even the most successful test-takers need a study structure to keep them on track with their review. If you have a 6-month meline (e.g., you’re taking your board exam in the next 6 months), read how to prepare for the boards in 6 months. If you have 7 months to 1 year (or longer), use this guide to structure your study calendar. It will let you focus on the current sprint without being distracted by the whole project, and connually reassess what is working and what isn’t while you study. We’ll show you how to be in control of your study calendar, and how frequent adjustments can help you leave every session with confidence. Soon, you’ll be able to see the light at the end of the tunnel long enough to get a burst of achievement from the amount of work done! Let’s jump in. DECIDE HOW MUCH TIME YOU’LL SPEND STUDYING Determine how much me you can dedicate to studying: Write out what you’ll be doing during each hour of a typical day. Once you fill in all the necessies, add in me blocks for studying. This may differ by days of the week or weekday versus weekend. SELECT THE STUDY TOOLS YOU WANT TO USE You’ll want to ensure that you go through all the Core content as efficiently and effecvely as possible. No cram sessions or crash courses! Be sure and read StudyWise for a deeper explanaon of the evidence-based MedStudy Method. We’ll show you how to combine the MedStudy Method with this structured approach to make the best use of your study me. The MedStudy Core is the foundaonal source for all MedStudy’s other products. It is the perfect study tool for a really comprehensive review. DETERMINE WHERE TO START Ensuring a solid review of all the Core content is a big management project. How do you parcel out what to study, when to study it, and when to review it? We’ve borrowed key project management elements from successful soſtware companies who are churning out projects with the snap of their fingers—and we’re breaking down how to create the perfect study calendar using these elements. Using this to structure your review will feel like an easy and even invigorang process. How to Create the Perfect Study Calendar

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Use Techniques From StudyWise to Create a Plan That Helps You StudySTRONGEven the most successful test-takers need a study structure to keep them on track with their review. If you have a 6-month timeline (e.g., you’re taking your board exam in the next 6 months), read how to prepare for the boards in 6 months.

If you have 7 months to 1 year (or longer), use this guide to structure your study calendar. It will let you focus on the current sprint without being distracted by the whole project, and continually reassess what is working and what isn’t while you study. We’ll show you how to be in control of your study calendar, and how frequent adjustments can help you leave every session with confidence. Soon, you’ll be able to see the light at the end of the tunnel long enough to get a burst of achievement from the amount of work done! Let’s jump in.

DECIDE HOW MUCH TIME YOU’LL SPEND STUDYINGDetermine how much time you can dedicate to studying: Write out what you’ll be doing during each hour of a typical day. Once you fill in all the necessities, add in time blocks for studying. This may differ by days of the week or weekday versus weekend.

SELECT THE STUDY TOOLS YOU WANT TO USE You’ll want to ensure that you go through all the Core content as efficiently and effectively as possible. No cram sessions or crash courses! Be sure and read StudyWise for a deeper explanation of the evidence-based MedStudy Method.

We’ll show you how to combine the MedStudy Method with this structured approach to make the best use of your study time.

The MedStudy Core is the foundational source for all MedStudy’s other products. It is the perfect study tool for a really comprehensive review.

DETERMINE WHERE TO START Ensuring a solid review of all the Core content is a big management project. How do you parcel out what to study, when to study it, and when to review it? We’ve borrowed key project management elements from successful software companies who are churning out projects with the snap of their fingers—and we’re breaking down how to create the perfect study calendar using these elements. Using this to structure your review will feel like an easy and even invigorating process.

How to Create the Perfect Study Calendar

1455 Quail Lake Loop

Colorado Springs, CO 80906

800-841-0547

medstudy.com

BRAIN HACKING TECHNIQUES

TO STUDY STRONGStudyWISE

StudyWise

StudyWISE

StudyWISE

Study

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2019_StudyWise_print_COVER_9_dh.indd 1

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2/28/20 11:12 AM

CHOOSE YOUR ORDER OF STUDYFirst you should decide in what sequence you want to go through the sections (Cardio, Pulm, etc.). You may want to do it in the same order as the Core is printed. Or you may want to go from most difficult to easiest. You pick—any way will work equally well. If you plan to do it in a sequence different from the printed one, you can put the sequence number on the cover of the Core book beside the sections.

Label the topics on the cover of the Core.

SET UP YOUR FIRST STUDY SPRINTGo to the Table of Contents (TOC) pages of the first section you plan to study. Here’s an example using the IM Cardio section.

Use the Cardiology section to set up your first study sprint.

A “study unit” is a focused presentation of interrelated concepts. In the Core, the main topics make ideal study units, and these topic headings are the only bold text on the TOC page.

See main topics of the Core highlighted in yellow.

GUIDELINES AND REVIEW ARTICLES AVAILABLE ON THE MEDSTUDY HUB AT: medstudy.com/hub

VALVULAR HEART DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-37SPECIFIC VALVE LESIONS � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-37

Note � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-38Aortic Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-39Chronic Aortic Regurgitation � � � � � � � � � � � � � � � � � � � � � 13-40Acute Aortic Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � 13-41Mitral Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-41Chronic Mitral Regurgitation � � � � � � � � � � � � � � � � � � � � � � 13-41Mitral Valve Prolapse � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-42Acute Mitral Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � 13-42Tricuspid Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-42Tricuspid Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-42Pulmonic Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Pulmonic Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Ebstein Anomaly � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43

INFECTIVE ENDOCARDITIS � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Antibiotic Prophylaxis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-44

RHEUMATIC FEVER � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-44VALVE SURGERY � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-45FINAL PEARLS ABOUT MURMURS � � � � � � � � � � � � � � � � 13-45

ARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46MECHANISMS OF ARRHYTHMIAS � � � � � � � � � � � � � � � � 13-46BRADYARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46SICK SINUS SYNDROME � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46HEART BLOCK � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46TACHYARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46

Note � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-47Atrial Flutter � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-47Atrial Fibrillation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-47MAT � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-50SVT � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-50WPW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-50

VENTRICULAR ARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � 13-51PVCs � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-51Ventricular Tachycardia � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-51Nonsustained Ventricular Tachycardia � � � � � � � � � � 13-52

PACEMAKERS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-52ANTIARRHYTHMIC THERAPY � � � � � � � � � � � � � � � � � � � � � � 13-53

Drugs � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-53Electrophysiologic Testing � � � � � � � � � � � � � � � � � � � � � � � � � 13-54Radiofrequency Ablation � � � � � � � � � � � � � � � � � � � � � � � � � � 13-54

SYNCOPE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-55

CARDIOMYOPATHIES � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-56NOTE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-56DILATED CARDIOMYOPATHY � � � � � � � � � � � � � � � � � � � � � � 13-56HYPERTROPHIC CARDIOMYOPATHY � � � � � � � � � � � � 13-56RESTRICTIVE CARDIOMYOPATHY � � � � � � � � � � � � � � � � 13-57ARRHYTHMOGENIC RIGHT

VENTRICULAR CARDIOMYOPATHY � � � � � � � � � � � � 13-57UNCLASSIFIED CARDIOMYOPATHIES � � � � � � � � � � � 13-57

HEART FAILURE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-58OVERVIEW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-58LOW-OUTPUT HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-58

NYHA Classification � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-59ACC / AHA Staging and Management� � � � � � � � � � � 13-59Determining Prognosis in HF� � � � � � � � � � � � � � � � � � � � � � 13-60Mechanism of HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-60Treatment for HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-60Emergency Treatment for Severe HF � � � � � � � � � � � � 13-63

HIGH-OUTPUT HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-63RIGHT VENTRICULAR FAILURE � � � � � � � � � � � � � � � � � � � � 13-64PULMONARY EDEMA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-64

PERICARDIAL DISEASES � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-64NONCONSTRICTIVE PERICARDITIS � � � � � � � � � � � � � � 13-64CONSTRICTIVE PERICARDITIS � � � � � � � � � � � � � � � � � � � � � 13-65RECURRENT PERICARDITIS � � � � � � � � � � � � � � � � � � � � � � � � � 13-66PERICARDIAL EFFUSION � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66TAMPONADE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66

CONGENITAL HEART DISEASES � � � � � � � � � � � � � � � � � � � � � � 13-66NOTE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66ASD� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66

Ostium Secundum ASD � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66Ostium Primum ASD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67Sinus Venosus ASD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67

PDA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67PULMONARY STENOSIS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67VSD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67COARCTATION OF THE AORTA � � � � � � � � � � � � � � � � � � � � 13-67ANOMALOUS CORONARY ARTERY � � � � � � � � � � � � � � 13-67TETRALOGY OF FALLOT � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68SUDDEN DEATH IN EXERCISING

YOUNG PEOPLE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68OTHER � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68

PULMONARY HEART DISEASE � � � � � � � � � � � � � � � � � � � � � � � 13-68COPD AND SLEEP APNEA � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68EISENMENGER SYNDROME � � � � � � � � � � � � � � � � � � � � � � � � 13-68CHRONIC THROMBOEMBOLIC

OBSTRUCTION � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68PULMONARY HYPERTENSION � � � � � � � � � � � � � � � � � � � � � 13-68

PREGNANCY AND THE HEART � � � � � � � � � � � � � � � � � � � � � � � 13-69

The ElectrocardiogramTHE 12-LEAD ECG � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-70

AXIS DEVIATIONS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-70

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WITH CAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-31REVASCULARIZATION � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32

Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32CABG vs� PCI � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32Stents � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32Other PCI Techniques � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-33

PERIPHERAL ARTERIAL DISEASE� � � � � � � � � � � � � � � � � � � � � 13-33CAUSES OF PAD AND

INTERMITTENT CLAUDICATION � � � � � � � � � � � � � � � � 13-33DIAGNOSIS OF PAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34TREATMENT OF PAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34ACUTE LIMB ISCHEMIA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34RENAL ARTERY STENOSIS � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-35

CAROTID ARTERY DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-35CAROTID ARTERY ATHEROSCLEROSIS � � � � � � � � � � 13-35INTERNAL CAROTID ARTERY DISSECTION � � � � � 13-35

CEREBRAL EMBOLIC DISEASE � � � � � � � � � � � � � � � � � � � � � � � � 13-35OVERVIEW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36TRANSIENT ISCHEMIC ATTACK � � � � � � � � � � � � � � � � � � � � 13-36

AORTIC DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36AORTIC ANEURYSMS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36

Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36Thoracic Aortic Aneurysms � � � � � � � � � � � � � � � � � � � � � � � 13-36Abdominal Aortic Aneurysm � � � � � � � � � � � � � � � � � � � � � � 13-37

COARCTATION OF THE AORTA � � � � � � � � � � � � � � � � � � � � 13-37

Let’s zoom in on the 1st column of the Cardiology TOC and see how to set up your first “study sprint”!

A study sprint should be 1 to 2 weeks. Let’s start with 1 week. Decide on how many pages you think you can review per hour and multiply by the number of hours you have available to study that week. For example, you think you can review (i.e., your study velocity) is 4 pages per hour and you have 6 hours available during your first week or “sprint.”. This gives you 24 pages to go over this sprint. Draw a bracket to the left of these topics on the TOC page and … start!

The first column of the Cardiology TOC after you’ve set up your first study sprint.

HOW TO STUDYGo over the Preview | Review Questions for the study units (main topics) the day before you study them. Try to recall all you can about each topic before you study it. Even if you can’t remember anything, try. This effort will prime your brain for the study session tomorrow.

The next day—your scheduled study day—read the material the next day solely for understanding. At this point, you are not trying to memorize anything.

GUIDELINES AND REVIEW ARTICLES AVAILABLE ON THE MEDSTUDY HUB AT: medstudy.com/hub

CARDIOLOGYTable of ContentsPHYSICAL EXAM� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-1

PULSES � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-1MURMURS AND HEART SOUNDS � � � � � � � � � � � � � � � � � � 13-1

Note � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-1Murmurs � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-1Heart Sounds � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-2

JUGULAR VENOUS WAVEFORMS � � � � � � � � � � � � � � � � � � � 13-3

CHEST X-RAYS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �13-4

PROCEDURES AND LABS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �13-6ECHOCARDIOGRAM � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-6CARDIAC STRESS TESTS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-7

Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-7Exercise Tolerance Test � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-7Stress Imaging Tests � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-8Picking the Correct Cardiac Stress Test � � � � � � � � � � � 13-9

CARDIOPULMONARY EXERCISE TESTING � � � � � � � � 13-9CARDIAC CATHETERIZATION AND OTHER

CARDIAC IMAGING TESTS � � � � � � � � � � � � � � � � � � � � � � � � � � 13-9Contrast Cardiac Catheterization � � � � � � � � � � � � � � � � � � 13-9Cardiac CT � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-9Cardiac MRI � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-10

PULMONARY ARTERY CATHETERIZATION � � � � � 13-10CARDIAC BIOPSY � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-11

HYPERTENSION � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-11

CARDIAC MEDICATIONS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-11

ANGINA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-12OVERVIEW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-12ANTIANGINAL DRUGS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-13EVALUATION OF CHRONIC STABLE ANGINA

(STABLE ISCHEMIC HEART DISEASE) � � � � � � � � � � � 13-14Note � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-14History and Physical Exam —

Determine Probability of CAD � � � � � � � � � � � � � � � � � � 13-14Noninvasive Tests for Chronic Stable Angina —

Diagnosis and Risk Stratification � � � � � � � � � � � � � � � 13-14Determination of Further Workup in Chronic

Stable Angina � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-15TREATMENT OF CHRONIC STABLE ANGINA � � � 13-15CARDIOVASCULAR DISEASE PREVENTION

IN WOMEN � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-15

ACUTE CORONARY SYNDROME � � � � � � � � � � � � � � � � � � � � � 13-16CLASSIFICATION OF ACS � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-16NOTES � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-16MARKERS FOR AMI � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-16TREATMENT OF ACS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-17

Prehospital Management � � � � � � � � � � � � � � � � � � � � � � � � � � 13-17Evaluation of Patients with Symptoms

Suggestive of ACS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-17ACS — GENERAL MEASURES � � � � � � � � � � � � � � � � � � � � � 13-19

ECG, NTG, Morphine, Beta-Blockers, ACEIs, and Atropine � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-19

Anticoagulant / Antiplatelet Therapy in ACS � � 13-19Fibrinolytic Therapy in ACS � � � � � � � � � � � � � � � � � � � � � � � 13-20

ACS — MANAGEMENT OF NSTE-ACS — THE ACUTE ISCHEMIA PATHWAY � � � � � � � � � � � � � � � 13-20Early Invasive vs. Ischemia-Guided Therapy � � � 13-20Early Invasive Therapy in NSTE-ACS � � � � � � � � � � � � 13-20Ischemia-Guided Therapy in NSTE-ACS � � � � � � � � 13-21Long-Term Antiplatelet Therapy

after NSTE-ACS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-21

ACS — MANAGEMENT WITH STEMI OR NEW LEFT BUNDLE BRANCH BLOCK � � � � � � � � � � 13-21Note � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-21Immediate Reperfusion Therapies � � � � � � � � � � � � � � � 13-22Cocaine and Methamphetamine Users with

ST Elevation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-23Additional Treatment Recommendations from

the 2013 ACC / AHA STEMI Guidelines � � � � � � 13-23Complications of Myocardial Infarction� � � � � � � � � 13-23Implantable Cardioverter-Defibrillators � � � � � � � � � 13-24

CORONARY ARTERY DISEASE � � � � � � � � � � � � � � � � � � � � � � � � 13-24NOTE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-24RISK FACTORS FOR CAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-25HYPERLIPIDEMIA SCREENING � � � � � � � � � � � � � � � � � � � � � 13-25

Evaluation of Hyperlipidemia � � � � � � � � � � � � � � � � � � � � � 13-25Review of Lipoproteins � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-25Hereditary Dyslipidemias � � � � � � � � � � � � � � � � � � � � � � � � � � 13-27

TREATMENT OF HYPERLIPIDEMIA � � � � � � � � � � � � � � � 13-28Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-28General Concepts of Primary Prevention � � � � � � 13-282013 ACC / AHA Clinical Practice Guidelines

on Blood Cholesterol to Reduce ASCVD Risk in Adults � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-29

Dietary Therapy � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-29Drugs for Dyslipidemias � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-29

LIPIDS IN ACUTE CORONARY SYNDROME � � � � � 13-31GOAL LEVELS OF LDL IN PATIENTS

WITH CAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-31REVASCULARIZATION � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32

Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32CABG vs� PCI � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32Stents � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32Other PCI Techniques � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-33

PERIPHERAL ARTERIAL DISEASE� � � � � � � � � � � � � � � � � � � � � 13-33CAUSES OF PAD AND

INTERMITTENT CLAUDICATION � � � � � � � � � � � � � � � � 13-33DIAGNOSIS OF PAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34TREATMENT OF PAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34ACUTE LIMB ISCHEMIA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34RENAL ARTERY STENOSIS � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-35

CAROTID ARTERY DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-35CAROTID ARTERY ATHEROSCLEROSIS � � � � � � � � � � 13-35INTERNAL CAROTID ARTERY DISSECTION � � � � � 13-35

CEREBRAL EMBOLIC DISEASE � � � � � � � � � � � � � � � � � � � � � � � � 13-35OVERVIEW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36TRANSIENT ISCHEMIC ATTACK � � � � � � � � � � � � � � � � � � � � 13-36

AORTIC DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36AORTIC ANEURYSMS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36

Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36Thoracic Aortic Aneurysms � � � � � � � � � � � � � � � � � � � � � � � 13-36Abdominal Aortic Aneurysm � � � � � � � � � � � � � � � � � � � � � � 13-37

COARCTATION OF THE AORTA � � � � � � � � � � � � � � � � � � � � 13-37

SV = 4

The Medstudy Method

As you go through each section, just as in a trip to a destination, it is always incredibly important to always know where you are! You do this by starting at the TOC with each study session and looking at what you will be studying and at the surrounding topics. During each study period, you read for understanding and as you do this, keep in mind the surrounding subtopics and how they fit together. Building these mental connections helps stabilize the concepts and processes you’ll be learning in your memory. You are building a foundational framework that allows you to more easily recall knowledge; it acts as a ready-made context-correct home for current and future learning.

Remember that the most board- and clinically relevant information in the Core is highlighted in yellow. If you are pressed for time, focus on this material, only reading surrounding material as needed to supply context and understanding.

Also remember that the answers to the Preview | Review Questions are contained in the highlighted text but more text is highlighted that just these P|R answers.

Don’t dawdle. When your study period starts, jump right in and maintain your focus and pace. Remember that any lollygagging will be reflected in a decrease of your study velocity. Do all the topics you picked out for the sprint, no matter how long (or short) it takes, before going to the next step.

ASSESSING YOUR STUDY VELOCITY At the end of each sprint (which, again, is defined by the topics you chose to review, not the hours you thought it would require), you assess how things went. How many pages per hour did you do? 2? 6? Write the study velocity (SV) next to the bracket you drew on the TOC page.

Consider what factors helped or hindered your studying efforts. Decide on how you are going to do the next sprint. Pick a new study velocity (in pages per hour; pph) based on what you now know and pick the next set of topics depending on how much time you have available. And with clear eyes and renewed vigor, start again!

When you are done with a section, add up the sprint velocities you wrote on the TOC page and divide by the number of sprints you did in that section. Put this number on the top of the TOC page. This is your average study velocity for that section.

Any time during this period you can determine, given your overall study velocity, how long it will take to finish the Core.

GUIDELINES AND REVIEW ARTICLES AVAILABLE ON THE MEDSTUDY HUB AT: medstudy.com/hub

VALVULAR HEART DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-37SPECIFIC VALVE LESIONS � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-37

Note � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-38Aortic Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-39Chronic Aortic Regurgitation � � � � � � � � � � � � � � � � � � � � � 13-40Acute Aortic Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � 13-41Mitral Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-41Chronic Mitral Regurgitation � � � � � � � � � � � � � � � � � � � � � � 13-41Mitral Valve Prolapse � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-42Acute Mitral Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � 13-42Tricuspid Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-42Tricuspid Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-42Pulmonic Stenosis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Pulmonic Regurgitation � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Ebstein Anomaly � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43

INFECTIVE ENDOCARDITIS � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-43Antibiotic Prophylaxis � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-44

RHEUMATIC FEVER � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-44VALVE SURGERY � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-45FINAL PEARLS ABOUT MURMURS � � � � � � � � � � � � � � � � 13-45

ARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46MECHANISMS OF ARRHYTHMIAS � � � � � � � � � � � � � � � � 13-46BRADYARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46SICK SINUS SYNDROME � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46HEART BLOCK � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46TACHYARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-46

Note � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-47Atrial Flutter � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-47Atrial Fibrillation � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-47MAT � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-50SVT � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-50WPW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-50

VENTRICULAR ARRHYTHMIAS � � � � � � � � � � � � � � � � � � � � 13-51PVCs � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-51Ventricular Tachycardia � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-51Nonsustained Ventricular Tachycardia � � � � � � � � � � 13-52

PACEMAKERS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-52ANTIARRHYTHMIC THERAPY � � � � � � � � � � � � � � � � � � � � � � 13-53

Drugs � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-53Electrophysiologic Testing � � � � � � � � � � � � � � � � � � � � � � � � � 13-54Radiofrequency Ablation � � � � � � � � � � � � � � � � � � � � � � � � � � 13-54

SYNCOPE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-55

CARDIOMYOPATHIES � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-56NOTE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-56DILATED CARDIOMYOPATHY � � � � � � � � � � � � � � � � � � � � � � 13-56HYPERTROPHIC CARDIOMYOPATHY � � � � � � � � � � � � 13-56RESTRICTIVE CARDIOMYOPATHY � � � � � � � � � � � � � � � � 13-57ARRHYTHMOGENIC RIGHT

VENTRICULAR CARDIOMYOPATHY � � � � � � � � � � � � 13-57UNCLASSIFIED CARDIOMYOPATHIES � � � � � � � � � � � 13-57

HEART FAILURE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-58OVERVIEW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-58LOW-OUTPUT HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-58

NYHA Classification � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-59ACC / AHA Staging and Management� � � � � � � � � � � 13-59Determining Prognosis in HF� � � � � � � � � � � � � � � � � � � � � � 13-60Mechanism of HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-60Treatment for HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-60Emergency Treatment for Severe HF � � � � � � � � � � � � 13-63

HIGH-OUTPUT HF � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-63RIGHT VENTRICULAR FAILURE � � � � � � � � � � � � � � � � � � � � 13-64PULMONARY EDEMA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-64

PERICARDIAL DISEASES � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-64NONCONSTRICTIVE PERICARDITIS � � � � � � � � � � � � � � 13-64CONSTRICTIVE PERICARDITIS � � � � � � � � � � � � � � � � � � � � � 13-65RECURRENT PERICARDITIS � � � � � � � � � � � � � � � � � � � � � � � � � 13-66PERICARDIAL EFFUSION � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66TAMPONADE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66

CONGENITAL HEART DISEASES � � � � � � � � � � � � � � � � � � � � � � 13-66NOTE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66ASD� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66

Ostium Secundum ASD � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-66Ostium Primum ASD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67Sinus Venosus ASD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67

PDA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67PULMONARY STENOSIS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67VSD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-67COARCTATION OF THE AORTA � � � � � � � � � � � � � � � � � � � � 13-67ANOMALOUS CORONARY ARTERY � � � � � � � � � � � � � � 13-67TETRALOGY OF FALLOT � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68SUDDEN DEATH IN EXERCISING

YOUNG PEOPLE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68OTHER � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68

PULMONARY HEART DISEASE � � � � � � � � � � � � � � � � � � � � � � � 13-68COPD AND SLEEP APNEA � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68EISENMENGER SYNDROME � � � � � � � � � � � � � � � � � � � � � � � � 13-68CHRONIC THROMBOEMBOLIC

OBSTRUCTION � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-68PULMONARY HYPERTENSION � � � � � � � � � � � � � � � � � � � � � 13-68

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GUIDELINES AND REVIEW ARTICLES AVAILABLE ON THE MEDSTUDY HUB AT: medstudy.com/hub

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the 2013 ACC / AHA STEMI Guidelines � � � � � � 13-23Complications of Myocardial Infarction� � � � � � � � � 13-23Implantable Cardioverter-Defibrillators � � � � � � � � � 13-24

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LIPIDS IN ACUTE CORONARY SYNDROME � � � � � 13-31GOAL LEVELS OF LDL IN PATIENTS

WITH CAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-31REVASCULARIZATION � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32

Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32CABG vs� PCI � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32Stents � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-32Other PCI Techniques � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-33

PERIPHERAL ARTERIAL DISEASE� � � � � � � � � � � � � � � � � � � � � 13-33CAUSES OF PAD AND

INTERMITTENT CLAUDICATION � � � � � � � � � � � � � � � � 13-33DIAGNOSIS OF PAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34TREATMENT OF PAD � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34ACUTE LIMB ISCHEMIA � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-34RENAL ARTERY STENOSIS � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-35

CAROTID ARTERY DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-35CAROTID ARTERY ATHEROSCLEROSIS � � � � � � � � � � 13-35INTERNAL CAROTID ARTERY DISSECTION � � � � � 13-35

CEREBRAL EMBOLIC DISEASE � � � � � � � � � � � � � � � � � � � � � � � � 13-35OVERVIEW � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36TRANSIENT ISCHEMIC ATTACK � � � � � � � � � � � � � � � � � � � � 13-36

AORTIC DISEASE � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36AORTIC ANEURYSMS � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36

Overview � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 13-36Thoracic Aortic Aneurysms � � � � � � � � � � � � � � � � � � � � � � � 13-36Abdominal Aortic Aneurysm � � � � � � � � � � � � � � � � � � � � � � 13-37

COARCTATION OF THE AORTA � � � � � � � � � � � � � � � � � � � � 13-37

SV = 4 SV = 4

AVG SV = 4

SV = 5SV = 3

There are 935 content pages in the IM core—let’s say you are studying 5pph and average 10 hours per week. This gives you 50 pages per week. Total content pages divided by pages per week give you the number of weeks it will take to get through the entire core. For example, if you’re doing the Peds Core at 50 pages per week, it will take 954/50 = 19 weeks. Is this too long? If so, increase the number of study hours per week. Or increase your study velocity by applying a little more focus.

Using a different tactic, you can determine how many pages per week must be done to meet a predetermined finish date. Say you want to finish in 3 months. 3 months is 12 weeks. 935/12 = 78 pages per week.

What study velocity do you need to do given the hours a week you have available? Say you can set aside 12 hours per week for studying. 78/12 = 6.5 pages per hour. Do you want to try and start with this study velocity? Or make more time to study? You’ll always be able to reassess and reset SV at the end of the sprint based on actual time spent.

If you are taking the boards, you should plan to finish your Core review 3–6 months out from the exam.

KEEP ON STUDYING!When you’re done with the comprehensive review, continue spaced retrieval of the Core content. You should also jump in and start on the Board-Style Q&As. You will want to saturate the last few months before your exam with board-focused questions. From each question & explanation, learn why the correct answer is right and why the incorrect answer is wrong.

And, per the StudyWise, practice “recall” with all you do.

StudySTRONG.