Studying for licensure examinations is like eating a twelve course meal: if you try and do it in five minutes, it will make you sick. As you prepare, pace yourself, don't memorize but review, and, most importantly, a few days before the examina tion, try and get some rest. I don't think I've ever heard of a soul who looked forward to this examination, and I can assure you no one has ever walked out saying "What a wonderful experi ence." Think of this ordeal as a rite of passage and try to remember that most of you will make it through. I'd like to thank Dr. Ron Krug for his continued support and guidance, not only in the preparation of this text, but through the years. Additional thanks to Dr. Rita Claudet for continued suggestions and editing of this text. Good luck in your studies and remember what Winston Churchill said, "Never, never, never, give up " Jeffrey G. Hirsch, M.D."

Dear Young Doctor, You are nearing the end of your formalized test-taking after so many years of education. We want to help you pass your boards and these books were written for that end. This review of internal medicine is not an exhaustive treatise, but serves as an example of learning points considered important throughout the years. You will run into the same patients on this examination, the internal medi cine specialty boards, and the medicine sub-specialty boards should you choose to take them. Our US healthcare delivery system is undergoing major transformation, which has become frenetic since the first edition of this series was published three years ago. This creates anxiety in physicians and physicians-to-be, as we are unsure of the very foundations which have supported medicine as we knew it. The chal lenge is to carryon the duties of our noble profession while adapting to and helping to shape the marketplace. Medical information is too expansive to be mastered by the individual alone, and we must learn to rely on automated inform atics systems to access current data. Yet with all the changes, traditions of medical education are remembered, honored, and still practiced. You will see evidence of this history contained herein."

Updated, revised and organized, the new Second Editions in the Clinical Sciences Series reflect the format of the USMLE Step 2. Each volume systematically presents the core information of a single segment of the medical curriculum, from Family Medicine to Psychiatry. You will also learn time-honored tricks of the trade,as well as the latest advances in clinical medicine: new diagnostic tools, new therapeutic interventions, and new pharmacologic options.

The United States Congress has designated the 1990s as the "Decade of the Brain" in recognition of the major importance of neurology and the other neurosciences in the health and well-being of Americans. It has been suggested that as many as 20% of all patients seeking medical treatment have neurologic problems, either as the presenting complaint or as an associated condition complicating the primary illness. Thus, it is fitting that Springer-Verlag should acknowledge the prominence of this medical specialty area by devoting an entire volume of the Oklahoma Notes series to neurology and clinical neuroscience. Of course, this text is an outline overview and does not attempt to provide ency clopedic coverage of neurology (the student desiring a comprehensive review of the field may wish to seek in the library the 60 + volumes in the series Handbook of Clinical Neurology edited by Pierre J. Vinken and George W. Bruyn). However, the information selected for inclusion in this volume of the Oklahoma Notes series remains true to the goal of the whole series-only materials vital in both the general clinical practice of medicine and to answer questions on the all-important United States Medical Licensing Examination have been incorporated in the text. Roger A. Brumback, M.D.

Each Oklahoma Notes book presents the core information of one segment of the medical school curriculum. Written by some of the most effective medical educators in the U.S., and now thoroughly updated and revised, the Oklahoma Notes feature: Concise text presented in outline format for rapid review; contents oriented to promote success; self-assessment questions; and more tables and figures designed to facilitate self-assessment and review.

One learns medicine, including pediatrics, by first learning a set of rules and then spending the rest of his/her productive career discovering exceptions to those rules. This book is intended to serve as a study guide for organizing the acquisition of an initial foundation of information about pediatric topics. Without an initial set of rules all new information is simply another new rule, and not an interpretive frame of reference for the deeper level of understanding that occurs with the recognition that one is dealing with a change in his previously held belief. As such, we have attempted to include what we think most would agree are com monly held operational "facts" of pediatrics, and have not tried to justify or sub stantiate the facts with references or lengthy background information as to why these facts are currently thought to be true. Our primary intent in writing this book is to provide an adequate core of pediatric information to enable one to pass the pediatric portion of the national boards. We hope it will also provide a foundation for those who wish to spend more time discovering why children are different. If this study guide fulfills whichever of these needs is yours, it will have been successful. Jane E. PuIs, M. D. A. Eugene Osburn, D. O. vii Acknowledgments No effort of this magnitude can be accomplished without a good deal of support."

We have arranged this review text in an order that makes clinical sense. We have assumed that the student has had considerable experience with the field of psychiatry via didactic courses, clinical rotations or both. The first chapter is an introduction to psychiatry, noting significant persons and events in the growth of the field. Chapter two focuses on general diagnostic categories and the major intervention strategies that are used in the field. Chapter three presents patient management in detail so that in the later chapters, as disorders are being pre sented, the student can have the management strategies clearly in mind. Chapters four through twelve review each of the major psychiatric disorders in detail and provide suggestions regarding the etiology and appropriate treatment of the disorder. Chapter thirteen focuses on the special problems of children. That is, while children can have most of the same disorders as adults, there are disor ders that are diagnosed in childhood that are different from those of adults. Chapter fourteen focuses on special issues in the practice of psychiatry such as sleep issues, forensic psychiatry, AIDS, etc. Chapter fifteen is devoted to psychiat ric emergencies in both adults and children. This is a review text and should not be substituted for more complete texts. The authors do not recommend that this book be used as a course text except in those academic offerings that are specifically directed to an overview of psychiatry."