toronto notes - baixardoc

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COMPREHENSIVE MEDICAL REFERENCE

& REVIEW FOR MCCQE AND USMLE II

Editors-in-Chief: Zamir Merali & Jason D. WoodfineProduction Managers: Jieun Kim & Ilya Mukovozov

TORONTO NOTES

2 16

http://medsouls4you.blogspot.com


Toronto NotesComprehensive medical reference and review for the

Medical Council of Canada Qualifying Exam Part I and the

United States Medical Licensing Exam Step 2

32nd Edition

Editors-in-Chief:

Zamir Merali and Jason D. Woodfine

Wherever the art of medicine is loved,

there is also a love of humanity.

– Hippocrates

Toronto Notes for Medical Students, Inc.Toronto, Ontario, Canada

2016



2 Toronto Notes 2016

Thirty-second Edition

Copyright © 2016 – Toronto Notes for Medical Students, Inc.

Toronto, Ontario, Canada.

Typeset and production by Type & Graphics Inc.

ISBN 978-1-927363-26-3 (32nd ed.)

All rights reserved. Printed in Toronto, Ontario, Canada. Toronto Notes 2016 is provided for the sole use of

the purchaser. It is made available on the condition that the information contained herein will not be sold or

photocopied. No part of this publication may be used or reproduced in any form or by any means without prior

written permission from the publisher. Every effort has been made to obtain permission for all copyrighted

material contained herein. Previous editions copyright © 1985 to 2016.

Cover design: Ashley Hui

Illustrations: Biomedical Communications, University of Toronto

Notice:

THIS PUBLICATION HAS NOT BEEN AUTHORED, REVIEWED, OR OTHERWISE SUPPORTED BY

THE MEDICAL COUNCIL OF CANADA NOR DOES IT RECEIVE ENDORSEMENT BY THE MEDICAL

COUNCIL AS REVIEW MATERIAL FOR THE MCCQE PART I. THIS PUBLICATION HAS NOT BEEN

AUTHORED, REVIEWED, OR OTHERWISE SUPPORTED BY THE NATIONAL BOARD OF MEDICAL

EXAMINERS U.S.A. NOR DOES IT RECEIVE ENDORSEMENT BY THE NATIONAL BOARD AS REVIEW

MATERIAL FOR THE USMLE.

The editors of this edition have taken every effort to ensure that the information contained herein is accurate and

conforms to the standards accepted at the time of publication. However, due to the constantly changing nature of

the medical sciences and the possibility of human error, the reader is encouraged to exercise individual clinical

judgement and consult with other sources of information that may become available with continuing research.

The authors, editors, and publisher are not responsible for errors or omissions or for any consequences from

application of the information in this textbook, atlas, or software and make no warranty, expressed or implied,

with respect to the currency, completeness, or accuracy of the contents of the publication. In particular, the

reader is advised to check the manufacturer’s insert of all pharmacologic products before administration.

Library of Congress Cataloging-in-Publication Data is available upon request

FEEDBACK AND ERRATA

We are constantly trying to improve the Toronto Notes and welcome your feedback. If you have found an error in this edition please do not hesitate to contact us. As well, we look forward to receiving any comments regarding any component of the Toronto Notes package and website.

Please send your feedback to: [email protected]

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Dedicated to all

past and present contributors

and

supporters of Toronto Notes

who have made the production of the 2016 edition possible!

Note:

Many of you have wondered about the Toronto Notes logo, which is based on the rod of Asclepius, the Greek god of medicine. The rod of Asclepius consists of a single serpent entwined around a staff. This icon symbolizes both rebirth, by way of a snake shedding its skin, and also authority, by way of the staff.

In ancient Greek mythology, Asclepius was the son of Apollo and a skilled practitioner of medicine who learned the medical arts from the centaur Chiron. Asclepius’ healing abilities were so great that he was said to be able to bring back people from the dead. These powers displeased the gods, who punished Asclepius by placing him in the sky as the constellation Orphiuchus. The rod of Asclepius is at times confused with the caduceus, or wand, of Hermes, a staff entwined with two serpents

and often depicted with wings. The caduceus is often used as a symbol of medicine or medical professionals, but there is little historical basis for this symbolism.

As you may have guessed, our logo uses the rod of Asclepius that is modified to also resemble the CN Tower – our way of recognizing the university and community in which we have been privileged to learn the art and science of medicine.

Thomas O’Brien, MDClass of 2009M.D. Program, University of Toronto

The Toronto Notes is dedicated to helping fund many charitable endeavours and medical student initiatives at the University of Toronto’s Faculty of Medicine. Programs that have received Toronto Notes funding include:

Community Affairs Projects

• Saturday Program for Inner City High School and Grade 8 students• St. Felix Mentorship Program for Inner City children• Parkdale Mentorship Program for Grade 10-12 students• WoodGreen Community Centre• Let’s Talk Science• Growing Up Healthy

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• Bruce Tovee Lecture Series• Daffydil, in support of the Canadian Cancer Society• Earthtones Benefit Concert • Convocation and Ceremonies

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• Books with Wings• Women in Medicine• University of Toronto International Health Program• Complementary and Alternative Medicine• Peer Support for Students• History of Medicine Society• Faculty of Medicine Yearbook

Scholarships and Bursaries

• Nishant Fozdar Memorial Award• Graduating Medical Class Scholarships and Bursaries




Preface – From the Editors

Dear Readers,

As the Editors-in-Chief of Toronto Notes 2016 we are

proud to present this updated edition.

Toronto Notes began humbly in 1985 from a set of

student notes circulated among medical students at

the University of Toronto. Over time, Toronto Notes

has grown into one of the premier study resources for

generations of Canadian medical school graduates.

This rich history has led to our firm commitment to

publish a comprehensive study resource for medical

students engaged in clinical rotations and studying

for both the USMLE Step 2 and Canadian MCCQE

Part 1.

For over 30 years we have remained committed to

our original vision. The 2016 edition of Toronto Notes

contains significant improvements including:

1. A new emphasis on ‘Approaches to Common

Clinical Presentations’ in addition to traditional

content organized by disease.

2. A completely revised Psychiatry chapter

incorporating the DSM-V in a quick-to-reference

and readable format.

3. The Toronto Notes Quiz App, which is available

for free on iTunes and Google Play. This app

contains hundreds of questions allowing users to

test themselves on the content contained within

Toronto Notes.

4. A significantly improved interactive eBook with

many new high-quality colour images.

5. A brand-new Clinical Handbook that is more

concise, has numerous new figures, and features

approaches to hundreds of common clinical

situations.

Toronto Notes 2016 is produced by Toronto Notes

for Medical Students Inc., which is a non-for-profit

organization supporting various charity organizations

in the city of Toronto. This year Toronto Notes

for Medical Students has supported organizations

including medical school clubs, community outreach

groups, student bursaries and scholarships, and the

Canadian Cancer Society. Your purchase of Toronto

Notes 2016 is much appreciated by these well-

deserving groups.

We would like to highlight the exceptional work of

our team, composed of over 150 medical students,

medical illustrators/artists, and faculty members

at the University of Toronto Faculty of Medicine.

Without the tireless effort expended by these

individuals the production of Toronto Notes 2016

would not have been possible. In particular, we would

like to highlight the work of the executive team, all of

whom made personal sacrifices in balancing clinical

work with the responsibilities asked of them. We also

want to highlight the work of Jesse Lu and Kota Talla,

without whom the production of the Toronto Notes

Quiz App would not have been possible. Lastly, we

would like to thank our partners at Type & Graphics

Inc., particularly Enrica Aguilera, for their guidance

during the production of Toronto Notes 2016.

We hope you find Toronto Notes 2016 enhances your

medical knowledge and allows you to perform better

on both your clinical rotations and licencing exams.

We continue to encourage feedback – this year, we

have read and incorporated every piece of feedback

we received about the previous edition of Toronto

Notes. On behalf of the Toronto Notes 2016 team, we

wish you success in your studies.

Sincerely,

Zamir Merali, BSc. and Jason D. Woodfine, BSc.

Editors-in-Chief, Toronto Notes 2016

MD Program, University of Toronto




Acknowledgements

We would like to acknowledge the exceptional work of all previous Toronto Notes (formerly MCCQE Notes)

Editors-in-Chief and their editorial teams. The 32nd edition of this text was made possible with their contributions.

2015 (31th ed.): Justin Hall and Azra Premji

2014 (30th ed.): Miliana Vojvodic and Ann Young

2013 (29th ed.): Curtis Woodford and Christopher Yao

2012 (28th ed.): Jesse M. Klostranec and David L. Kolin

2011 (27th ed.): Yingming Amy Chen and Christopher Tran

2010 (26th ed.): Simon Baxter and Gordon McSheffrey

2009 (25th ed.): Sagar Dugani and Danica Lam

2008 (24th ed.): Rebecca Colman and Ron Somogyi

2007 (23rd ed.): Marilyn Heng and Joseph Ari Greenwald

2006 (22nd ed.): Carolyn Jane Shiau and Andrew Jonathan Toren

2005 (21st ed.): Blair John Normand Leonard and Jonathan Chi-Wai Yeung

2004 (20th ed.): Andrea Molckovsky and Kashif S. Pirzada

2003 (19th ed.): Prateek Lala and Andrea Waddell

2002 (18th ed.): Neety Panu and Sunny Wong

2001 (17th ed.): Jason Yue and Gagan Ahuja

2000 (16th ed.): Marcus Law and Brian Rotenberg

1999 (15th ed.): Sofia Ahmed and Matthew Cheung

1998 (14th ed.): Marilyn Abraham and M Appleby

1997 (13th ed.): William Harris and Paul Kurdyak

1996 (12th ed.): Michael B. Chang and Laura J. Macnow

1995 (11th ed.): Ann L. Mai and Brian J. Murray

1994 (10th ed.): Kenneth Pace and Peter Ferguson

1993 (9th ed.): Joan Cheng and Russell Goldman

1992 (8th ed.): Gideon Cohen-Nehemia and Shanthi Vasudevan

All former Chief Editors from 1991 (7th ed.) to 1985 (1st ed.)




Student Contributors

Editors-in-Chief Zamir MeraliJustin D. Woodfine

Production Managers Jieun Kim Ilya Mukovozov

Clinical Handbook Editors Caleigh CampbellSabah KhanSharon Lee

Electronic Content EditorsJesse LuKota Talla

Chief Copy Editor Tu Nguyen

Copy EditorsCatherine BrownHenry ChenLeema DookhooDaniel GlattJacqui HayworthLindsay HerzogRichard HoangAndrea HuntSandra Huynh

Priyanka KapilStephanie LapinskyOlivia LiAnthony MakZamir MeraliJanet NguyenChris NoelJonathan ParkMohini Patel

Christina Reppas

Nikki SchneiderMelissa SheehanDavid SmithWilliam StuartJason D. WoodfineIssac YangErik Yao

BMC Production EditorsAshley HuiSusan Le

PRIMARY AND OTHER SPECIALTIES MEDICINE SURGERY

Associate Editors Lindsey ChapmanMeghna Rajaprakash

EBM Editors Shany Gertzbein

Associate Editors Hart StadnickKevin Yau

EBM Editors Alex Cressman

Associate Editors Hasaan ChaudhryNardin Samuel

EBM Editors Alex CressmanShany Gertzbein

Chapter Editors Chapter Editors Chapter Editors

Ethical, Legal, and Organizational Medicine Yang Lei

Anesthesia and Perioperative MedicineEileen Heo

Clinical PharmacologyFarah Jazuli

DermatologyMengzhu JiangEmily Stewart

Emergency MedicinePrateek SehgalKelvin WongMichael Wong

Family MedicineMark BambergerSaurabh KalraSarah Whynot

Medical ImagingSidharth SainiDavid Wang

PediatricsAhmed FaressLucy LiFahad MasudLeah Smith

Population Health and EpidemiologyCatherine Brown

PsychiatryJordan BawksRaman Srivastava

Cardiology and Cardiac SurgeryDavid ArmstrongMena GewargesSagar Rohailla

EndocrinologyTara JusticeIlia Makedonov

GastroenterologyKevin PivavarovMelanie Wong

Geriatric MedicineAyan Dey

HematologyBrahim RedouaneHart GoldharHiten Naik

Infectious DiseasesVanda McNivenKimberly Stewart Marie Yan

NephrologyEric CoomesTamara Gimon

NeurologyAdi KartoloYi (Emma) QuanJeremy Zung

RespirologyAlex KumachevNavjot Rai

RheumatologySusan ArmstrongAmy Miles

General SurgeryMing Hao (Dennis) Guo Kelsey RaganElizabeth Shin

GynecologyDalia BibrKatie BiesChristine EdwardsJames Wang

NeurosurgeryOliver AylingHolly Lee

ObstetricsDalia BibrKatie BiesChristine EdwardsJames Wang

OphthalmologyThomas Andrew BerkCarl Shen

OrthopedicsAmedeo FalsettoScott Kim

OtolaryngologyAnna GouldingSoroush LarjaniMario Moscovici

Plastic SurgeryScott TurcotteOren Zarnett

UrologyMatthew LenardisKai Yang

Vascular SurgeryKeith Gunaratne

BMC ILLUSTRATORSMeriem Benlamri

Kristen Browne

Cassandra Cetlin

Natalie Cormier

Naveen Devasagayam

Wendy Gu

Erina He

Sam Holmes

Ashley Hui

Susan Le

Derek Ng

Melissa Phachanhla

Kateryna Procunier

Sonia Seto

Madeline Spacher

Kelly Speck

Caitlyn Swanberg

Sara Vukson

Emilie Wiens




Faculty Contributors, University of Toronto

All contributing professors have been appointed at the University of Toronto.

David Adam, MD, FRCPC

Division of Dermatology

Department of Medicine

St. Michael’s Hospital

Anne M. R. Agur, BSc, MSc, PhD

Division of Anatomy

Department of Surgery

University of Toronto

Iqbal Ahmed, MD, FRCSC

Department of Ophthalmology

and Vision Science


Ruby Alvi, MD, CCFP, MHSc

Department of Family

and Community Medicine


Meyer Balter, MD, FRCPC

Division of Respiratory Medicine


Mount Sinai Hospital

Nirit Bernhard, MSc, MD, FRCPC

Department of Pediatrics

Hospital for Sick Children

Kate Bingham, MD, MPH, CCFP-EM

Faculty of Medicine


Matthew Binnie, MD

Division of Respirology

University Health Network


Ari Bitnun, MD, MSc, FRCPC

Division of Infectious Diseases

The Hospital for Sick Children

Andrea Boggild, MSc, MD, FRCPC

Tropical Disease Unit and

Division of Infectious Diseases


Toronto General Hospital

Arthur Bookman, MD, FRCPC

Division of Rheumatology



Toronto Western Hospital

Mark Boulos, MD, MSc, CSCN(EEG), FRCPC

Division of Neurology and Sleep Medicine


Sunnybrook Health Sciences Centre

Simon Carette, MD, FRCPC




Alice Cheung, MD, FRCPC

Division of Endocrinology and Metabolism



Chi-Ming Chow, MDCM, MSc, FRCPC

Division of Cardiology



Allison Chris, MD, MSc, FRCPC

Division of Clinical Public Health

Dalla Lana School of Public Health

Maria Cino, HonBSc, MSc, MD, FRCPC

Division of Gastroenterology



Isabella Devito, MD, FRCPC

Department of Anesthesia and

Pain Management

University Health Network and


Alfonso Fasano, MD, PhD, FRCPC

Division of Neurology



Mark Freedman, MD, FRCPC

Department of Emergency Medicine


Natasha Gakhal, MD, FRCPC



Women’s College Hospital

Barry J. Goldlist, MD, FRCPC

Division of Geriatric Medicine



Jeremy Hall, MD, FRCSC

Division of Orthopedic Surgery



Philip C. Hébert, MA, PhD, MD, FCFPC

Department of Family and

Community Medicine

Joint Centre for Bioethics


Sender Herschorn, MDCM, FRCSC

Division of Urology


Sunnybrook Health Sciences Centre and


Jonathan C. Irish, MD, MSc, FRCSC

Department of Otolaryngology -

Head and Neck Surgery


Nasir Jaffer, MD, FRCPC

Division of Abdominal Imaging

Department of Medical Imaging

Joint Department of Medical Imaging


David Juurlink, BPhm, MD, PhD, FRCPC

Division of Clinical Pharmacology

and Toxicology

Departments of Medicine and Pediatrics


Lorraine Kalia, MD, PhD, FRCPC




Gabor Kandel, MD, FRCPC

Division of Gastroenterology, Department of

Medicine


Sari L. Kives, MD, FRCSC

Department of Obstetrics and Gynecology

St. Michael’s Hospital and


Wai-Ching Lam, MD, FRCSC

Department of Ophthalmology and

Vision Science



Chloe Leon, MD, FRCPC

Division of Brain and Therapeutics

Department of Psychiatry

Centre for Addiction and Mental Health

Armando Lorenzo, MD, FRCSC

Division of Urology



Todd Mainprize, MD, FRCSC

Department of Neurosurgery


Eric Massicotte, MD, MSc, FRCSC

Department of Neurosurgery



Michael McDonald, MD, FRCPC

Division of Cardiology and

The Multi-Organ Transplant Program







Adam C. Millar, MD, MScCH

Division of Endocrinology and Metabolism



Yvette Miller-Monthrope, MD, FRCPC




Azadeh Moaveni, MD, CCFP

Department of Family and

Community Medicine



Eva Mocarski, MD, FRCSC



Ally Murji, MD, MPH, FRCS(C)



Melinda Musgrave, MD, PhD, FRCSC

Division of Plastic and Reconstructive Surgery



Sharon Naymark, MD, FRCPC


St. Joseph’s Health Centre

George Oreopoulos, MD, MSc, FRCSC

Division of Vascular Surgery



Susan Poutanen, MD, MPH, FRCPC

Department of Microbiology

University Health Network and


Ramesh Prasad, MBBS, MSc, FRCPC

Division of Nephrology



Mary Preisman, MD, FRCPC



Evan Propst, MD, MSc, FRCSC

Division of Head and Neck Surgery

Department of Otolaryngology


Angela Punnett, MD, FRCPC



Graham Roche-Nagle,

MD, MBA, FRCSI, EBSQ-VASC

Division of Vascular Surgery



Amanda Selk, MD, FRCSC



Rajiv Shah, MD, MSc, FRCSC



Marisa Sit, MD, FRCSC

Department of Ophthalmology

and Vision Science



Kevin Skarratt, MD, FRCPC



Peter Tai, MD, FRCPC




Diana Tamir, MD, FRCPC

Department of Anesthesia and

Pain Management


Gemini Tanna, MD, FRCPC

Division of Nephrology



Piero Tartaro, MD, FRCPC

Division of Gastroenterology



Fernando Teixeira, MD, FRCPC



Martina Trinkaus, MD, FRCPC

Division of Hematology



Herbert P. von Schroeder, MD, MSc, FRCSC

Divisions of Orthopedic Surgery and

Plastic Surgery



Oshrit Wanono, MD, FRCPC

Division of Child and Adolescent Psychiatry


Centre for Addiction and Mental Health

Kyle R. Wanzel, MD, MEd, FRCSC

Division of Plastic Surgery

St Joseph’s Health Centre

Richard Ward, MBBS, MRCP, FRCPath

Division of Hematology



Jeffrey Wassermann, MD, FRCPC

Department of Anesthesia


Alice Wei, MD CM, MSc, FRCSC

Division of General Surgery



Fay Weisberg, MD, FRCSC

Division of Reproductive Endocrinology

and Infertility



Michael Wiley, BSc, MSc, PhD

Division of Anatomy



Anna Woo, MD CM, SM, DABIM, FRCPC

Division of Cardiology




Jensen Yeung, MD, FRCPC




Eugene Yu, MD, FRCPC

Division of Neuroradiology

Department of Medical Imaging


Faculty Contributors, University of Toronto




Table of Contents

Index Abbreviations

1. Common Unit Conversions

2. Commonly Measured Laboratory Values

3. Ethical, Legal, and Organizational Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ELOAM

4. Anesthesia and Perioperative Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A

5. Cardiology and Cardiac Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C

6. Clinical Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CP

7. Dermatology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D

8. Emergency Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ER

9. Endocrinology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E

10. Family Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FM

11. Gastroenterology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G

12. General Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GS

13. Geriatric Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GM

14. Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GY

15. Hematology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H

16. Infectious Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ID

17. Medical Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MI

18. Nephrology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NP

19. Neurology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N

20. Neurosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NS

21. Obstetrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OB

22. Ophthalmology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OP

23. Orthopedics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OR

24. Otolaryngology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OT

25. Pediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P

26. Plastic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PL

27. Population Health and Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PH

28. Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PS

29. Respirology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R

30. Rheumatology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RH

31. Urology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . U

32. Vascular Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VS

33. Index



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