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Editor-in-Chief, NEJM Group
Jeffrey M. Drazen, MDro

Vice President for Publishing, NEJM Group
Christopher R. Lynch

Senior Consulting Education Editor, NEJM Knowledge+
Ole-Petter Riksfjord Hamnvik, MB BCh BAO, MMSc

Founding Editor
Graham T. McMahon, MD, MMSc

Internal Medicine Board Review Editors

Deputy Reviewers
Allan S. Brett, MD
Patricia A. Kritek, MD, EdM
C. Christopher Smith, MD

Associate Reviewers
Daniel P. Hunt, MD
Stephen Joseph Huot, MD, PhD
Sylvia Cheney McKean, MD
Stuart B. Mushlin, MD
Daniel Randall, MD, MPH

Pediatrics Board Review Editors

Senior Reviewers
Deborah Lehman, MD
Shannon E. Scott-Vernaglia, MD

Family Medicine Board Review Editors

Senior Reviewer
Mark T. Nadeau, MD, MBA, FAAFP

Deputy Reviewer
Paul Gordon, MD

Associate Reviewers
Frank J. Domino, MD
Alan Ehrlich, MD
Caroline R. Richardson, MD

Section Editors

Cardiology
Michael D. White, MD
Hematology & Oncology
Dan L. Longo, MD
Pulmonology
Patricia A. Kritek, MD, EdM
Infectious Disease
Rajesh T. Gandhi, MD
Gastroenterology
Alan C. Moss, MD
Endocrinology
Melissa Cavaghan, MD
Rheumatology
Derrick J. Todd, MD, PhD
Nephrology/Urology
Melanie P. Hoenig, MD
Andrew A. Wagner, MD
Neurology
Manu Hegde, MD, PhD
Psychiatry
Michael Craig Miller, MD
Dermatology
Kelly M. Cordoro, MD
Allergy/Immunology
Rebecca Gruchalla, MD, PhD
Otolaryngology
David M. Vernick, MD
OB/GYN
Megan J. Bray, MD
Ophthalmology
Bradford J. Shingleton, MD
General Pediatrics
Brett W. Robbins, MD
John I. Takayama, MD, MPH
Lori J. Wan, MD
Pediatric Mental and Behavioral Health
Steven Schlozman, MD
Pediatric Infectious Disease
Deborah Lehman, MD
Pediatric Ophthalmology
Mitchell Strominger, MD
Pediatric Dermatology
Kelly M. Cordoro, MD
Pediatric Emergency and Critical Care
Vincent W. Chiang, MD
Neonatal Medicine
Katherine A. Sparger, MD
Pediatric Metabolic Disorders and Genetics
Amel Karaa, MD
Pediatric Nephrology/Urology
Melanie P. Hoenig, MD
Pediatric Pulmonology
Benjamin A. Nelson, MD
Pediatric Ethics, Research, Safety, and Quality
Brian M. Cummings, MD
Pediatric Gastroenterology
Christopher J. Moran, MD
Pediatric Neurology
Jason T. Lerner, MD
Pediatric Endocrinology
Srinath Sanda, MD
Pediatric Hematology/Oncology
Lindsay Frazier, MD, ScM
Pediatric Cardiology
Leigh C. Reardon, MD
Sports Medicine
Mark D. Price, MD, PhD
Patient Safety
Kaveh G. Shojania, MD

Past Editors

Alexander M. Djuricich, MD (Education Editor, 2016)
Thomas M. Best, MD, PhD (Sports Medicine, 2014–2016)
John Betjemann, MD (Neurology, 2015–2016)
Joanne E. Cox, MD (Pediatrics, 2014)
Michael Furman Greene, MD (OB/GYN, 2013–2014)
James V. Hennessey, MD (Endocrinology, 2013–2016)
L. David Hillis, MD (Cardiology, 2013–2014)
Donald M. Hilty, MD (Psychiatry, 2013)
S. Andrew Josephson, MD (Neurology, 2013–2015)
Richard A. Lange, MD, MBA (Cardiology, 2013–2014)
Paul A. Monach, MD (Rheumatology, 2013–2015)
Anju Nohria, MD (Cardiology, 2015)
Timothy T. Nostrant, MD (Gastroenterology, 2013–2015)
Judith S. Palfrey, MD (Pediatrics, 2014)
Arturo P. Saavedra, MD, PhD, MBA (Dermatology, 2013–2015)
Paul E. Sax, MD (Infectious Diseases, 2013)

Content Programs

Cardiology »
Cleveland Clinic
University of Texas Southwestern Medical Center
Pulmonology »
University of Colorado School of Medicine
Infectious Disease »
Emory University
Gastroenterology »
Massachusetts General Hospital
Brigham and Women’s Hospital
Endocrinology »
Brigham and Women’s Hospital
Rheumatology »
Brigham and Women’s Hospital
Hematology »
Stanford University Medical Center
Oncology »
The University of Texas MD Anderson Cancer Center
Nephrology/Urology »
Mayo Clinic
Neurology »
Johns Hopkins University School of Medicine
Psychiatry »
McLean Hospital
Dermatology »
The Hospital of the University of Pennsylvania
Allergy/Immunology »
University of Wisconsin Hospital and Clinics
Otolaryngology »
Massachusetts Eye and Ear Infirmary
OB/GYN »
University of Maryland Medical Center
University of Washington, Department of Family Medicine
Ophthalmology »
Wills Eye Institute
Pediatrics »
Children’s Hospital of Philadelphia
Cincinnati Children’s Hospital Medical Center
Massachusetts General Hospital
University of Michigan Hospital and Health Systems
Vanderbilt University
Washington University
Sports Medicine »
University of Arizona, Department of Family and Community Medicine

NEJM Knowledge+ Publishers

Strategic Oversight
Lisa Rawding

General Manager
Matthew O’Rourke

Managing Editor
Catherine Tomeo Ryan

Production Editor
Josette Akresh-Gonzales

Digital Program Operations Manager
Melissa Elmore

Product Operations Manager
Leokadia Marchwinski

Production Operations Specialist
Karen O’Brien

Director, Sales and Business Development
David Robbins

Regional Sales Manager
David Tavares

Marketing Manager
Ellen McCullough

Customer Relationship Marketing Manager
Kristin Burati

Manager, Education Compliance Office
Anan Nathif, EdM

Massachusetts Medical Society Leadership

Henry L. Dorkin, MD, President

Lois Dehls Cornell, Executive Vice President

Committee on Publications
Lynda M. Young, MD, Chair
Stuart B. Mushlin, MD, Vice Chair

Edward W. Boyer, MD
Paul M. Copeland, MD
James A. Feldman
Subramanyan Jaysankar, MD
Paul M. Ridker, MD
John B. Wong, MD
Beverly Woo, MD

Complete List of Contributors by Specialty

Conflict of Interest Disclosures

NEJM Knowledge+ Internal Medicine Board Review
NEJM Knowledge+ Pediatrics Board Review
NEJM Knowledge+ Family Medicine Board Review

Cardiology

Cleveland Clinic

Site Director
Benico Barzilai, MD

Contributors
Kia Afshar, MD
Justin M. Dunn, MD, MPH
Andrew L. Goodman, MD
James E. Lai, MD
Junyang Lou, MD, PhD
Michael D. McCulloch, MD
Parag R. Patel, MD
Marwa A. Sabe, MD
Todd Senn, MD
Brian Stegman, MD
Amanda Vest, MD

University of Texas Southwestern Medical Center

Site Director
Amit Khera, MD, MSc

Contributors
Anish B. Bhatt, MD
Sonia Garg, MD
Hurst M. Hall, MD
Elizabeth A. Hardin, MD
Houman Khalili, MD
David Lofthus, MD
Phuong-Khanh J. Nguyen-Trong, MD
Andre Paixao, MD
Vishal Patel, MD
Vijay Raja, MD
Christopher Regan, MD
Monika Sanghavi, MD
Jainy Savla, MD

Pulmonology

University of Colorado School of Medicine
Site Director
Mark W. Geraci, MD

Contributors

Walter D. Conwell, MD
Silpa Dhoma, MD
Gregory A. Hickey, MD
Christine M. Lin, MD
Derek Linderman, MD
Madison Macht, MD
Susan K. Mathai, MD
Michael Mohning, MD
Steven Pugliese, MD
Jeffrey C. Robinson, MD
Marvin I. Schwarz, MD
Alexandra Smart, MD
George M. Solomon, MD
Peter Sottile, MD
Amanda Stream, MD
Andrew Waas, MD

Infectious Disease

Emory University
Site Director
Wendy S. Armstrong, MD

Contributors
Sol Aldrete, MD
Valeria Cantos, MD
Emily J. Cartwright, MD
Jonathan Colsanti, MD, MSPH
Cecile Delille, MD, MSc
Jessica Fairley, MD
Mary Foote, MD, MPH
Rachel Friedman-Moraco, MD
Emily P. Hyle, MD
Jesse T. Jacob, MD
Sheetal Kandiah, MD, MPH
Colleen F. Kelley, MD, MPH
Colleen S. Kraft, MD, MSc
Aneesh K. Mehta, MD
Andre Melendez, MD
Varun K. Phadke, MD
Paulina Rebolledo, MD, MSc
Marcos Schechter, MD
Jay B. Varkey, MD
Brian R. Wood, MD

Gastroenterology

Massachusetts General Hospital

Site Directors
Andrew T. Chan, MD
Daniel S. Pratt, MD

Contributors
Nitin K. Gupta, MD
Lindsay Y. King, MD
Gauree Gupta Konijeti, MD, MPH
Jay Luther, MD
Joanna M. Peloquin, MD
Ying Wu, MD

Brigham and Women’s Hospital

Site Director
Molly Perencevich, MD

Contributors
Jennifer A. Inra, MD
Navin Kumar, MD
Andrew Storm, MD

Endocrinology

Brigham and Women’s Hospital
Site Director
Robert G. Dluhy, MD

Contributors
Tobin M. Abraham, MD
Adi Barlev-Ehrenberg, MD, MS
Anna L. Goldman, MD
Norra Kwong, MD
Eva S. Liu, MD
Chevon M. Rariy, MD
Amir Tirosh, MD, PhD

Rheumatology

Brigham and Women’s Hospital
Site Director
Simon M. Helfgott, MD

Contributors
Fadi Badlissi, MD
Medha Barbhaiya, MD
Mollie Nicole Carruthers, MD
Candace H. Feldman, MD, MPH
Lydia Gedmintas, MD, MPH
Eli Miloslavsky, MD
Jennifer Meara Nashel, MD
Monica P. Ramirez, MD, MPH
Deepak A. Rao, MD, PhD
Naina Rastalsky, MD
Jeffrey A. Sparks, MD

Hematology

Stanford University Medical Center
Site Director
Jason Robert Gotlib, MD

Contributors
Oyebimpe Adesina, MD
Anosheh Afghahi, MD
Caroline Berube, MD
Rondeep S. Brar, MD
Steven Chan, MD
Shira Dinner, MD
Magali Fontaine, MD, PhD
Wan-Jen Hong, MD
David J. Iberri, MD
Brian A. Jonas, MD, PhD
Michael Khodadoust, MD, PhD
David Kurtz, MD
Lawrence Leung, MD
Lauren Maeda, MD
Beth A. Martin, MD
Everett Meyer, MD
Siddhartha Mitra, MD, PhD
Rupa Narayan, MD
David Nguyen, MD
Mary-Elizabeth Muchmore Percival, MD
Elie Richa, MD
Gabriel Rivera, MD
Stanley Schrier, MD
Alexander Ungewickell, MD, PhD
James L. Zehnder, MD

Oncology

The University of Texas MD Anderson Cancer Center
Site Director
Ahmed Eid, MD, MEd

Contributors
Carlos H. Barcenas, MD, MSc
Isabella C. Glitza, MD, PhD
Marc S. Hoffmann, MD
Sylvia Jaramillo, MD
Meghan S. Karuturi, MD
Syed Mohamman Ali Kazmi, MD
John Linford, MD
Marc Matrana, MD
Van Morris, MD
Sarah Mougalian, MD
Krina Patel, MD
Kanwal P. Raghav, MD
Ishwaria Subbiah, MD
Nizar M. Tannir, MD
Jennifer Wang, MD
Jeff Yorio, MD
Alex Zarzour, MD

Nephrology/Urology

Mayo Clinic

Site Director
Suzanne M. Norby, MD

Contributors
Hatem Amer, MD
Bhavna Chopra, MD
Mireille El Ters, MD
Ziad M. El-Zoghby, MD
Sandra M. Herrmann, MD
Musab S. Hommos, MD
Kianoush B. Kashani, MD
Mira T. Keddis, MD
Angela K. Muriithi, MD
Carlos R. Franco Palacios, MD
Qi Qian, MD
Michael Selby, MD
Ladan Zand, MD

Neurology

Johns Hopkins University School of Medicine

Site Director
Peter W. Kaplan, MD

Contributors
Charlene E. Gamaldo, MD
Lindsey Hayes, MD, PhD
Rafael H. Llinás, MD
Thomas E. Lloyd, MD, PhD
Zoltan Mari, MD
Elisabeth B. Marsh, MD
Abhay R. Moghekar, MD
Payam Mohassel, MD
Aruna Rao, MD
Jack Ratchford, MD, MSc
Jason Rosenberg, MD

Psychiatry

McLean Hospital

Site Director
Felicia Anne Smith, MD

Contributors
Gaston Baslet, MD
Eugene Victor Beresin, MD
Christina Brezing, MD
Stephanie Cincotta, MD
Jennifer Gatchel, MD, PhD
Alex S. Keuroghlian, MD, MSc
Rachel Ross, MD, PhD
Kathy Sanders, MD
Theodore Allan Stern, MD
John Taylor, MD, MBA
Oriana Vesga Lopez, MD
Joji Suzuki, MD
Heather Vestal, MD, MHS
Ying Wang, MD
Lazaro Zayas Jr., MD

Dermatology

Hospital of the University of Pennsylvania

Site Director
Misha A. Rosenbach, MD

Contributors
Robert G. Micheletti, MD
Lisa K. Pappas-Taffer, MD
Evan W. Piette, MD
James R. Treat, MD
Kanade Shinkai, MD, PhD
Karolyn A. Wanat, MD

Allergy/Immunology

University of Wisconsin Hospital and Clinics

Site Director
James E. Gern, MD

Contributors
William Busse, MD
Daniel J. Jackson, MD
Sujani Kakumanu, MD
Robert F. Lemanske Jr., MD
Sameer K. Mathur, MD, PhD
Mark H. Moss, MD
Christine M. Seroogy, MD

Otolaryngology

Massachusetts Eye and Ear Infirmary

Site Director
Stacey Tutt Gray, MD

Contributors
Megan M. Abbott, MD, MPH
Dunia Abdul-Aziz, MD
Margaret S. Carter, MD
Gillian Diercks, MD
Rebecca J. Hammon, MD
Elliott Kozin, MD
Aaron Remenschneider, MD, MPH
Daniel Roberts, MD, PhD

OB/GYN

University of Maryland Medical Center

Site Director
May Hsieh Blanchard, MD

Contributors
Kiranpreet K. Chawla, MD
Katrina S. Mark, MD
Vadim M. Morozov, MD

University of Washington, Department of Family Medicine

Site Director
Amanda Kost, MD

Contributors
Jeanne Cawse-Lucas, MD
David V. Evans, MD
Emily M. Godfrey, MD, MPH
Misbah Keen, MD
Pamela Pentin, MD
Jaqueline Raetz, MD
Richard Waters, MD
Ying Zhang, MD

Ophthalmology

Wills Eye Institute

Site Directors
Brad H. Feldman, MD
Sagun Pendse, MD

Contributors
David R. Lally, MD
Jared D. Peterson, MD
David A. Salz, MD
Adiel G. Smith, MD

Pediatrics

Children’s Hospital of Philadelphia

Site Directors
Jeanine C. Ronan, MD
Rebecca Tenney-Soeiro, MD

Contributors
Adelaide E. Barnes, MD
Maya Lynn Dewan, MD, MPH
Caitlin W. Elgarten, MD
Nina A. Fainberg, MD
Rebecca D. Ganetzky, MD
Dylan Graetz, MD, MPH
Nicole Hames, MD
Joelle B. Karlik, MD
Chén C. Kenyon, MD, MSHP
Marissa J. Kilberg, MD
Emilie R. Korn, MD
Pamela Mazzeo, MD
Christina McClam, MD
Susan E. McClory, MD, PhD
Erika J. Mejia, MD
Elana B. Mitchel, MD
Evan William Orenstein, MD
Erin Pete Devon, MD
Stacey R. Rose, MD
Jennifer Salant, MD
Eloise Salmon, MD
Margarita Sergonis, MD
Levon H. Utidjian, MD
Nicole R. Washington, MD
Anna K. Weiss, MD, MSc

Cincinnati Children’s Hospital Medical Center

Site Director
Jennifer Lynn Huggins, MD

Contributors
Khalid Abulaban, MD
Armand Antommaria, MD, PhD
Stefanie Woolridge Benoit, MD
Kate E. Berz, DO
Michal Feldon, MD
Barbara E. Hallinan, MD, PhD
Sophia Hufnagel, MD
Melissa Jimenez, MD
Jordan Jones, DO
Oriaku A. Kas-Osoka, MD
Kelsey Logan, MD, MPH
Ernest Pedapati, MD
Kirsten Simonton, MD
Rachel M. Thienprayoon, MD
Denise Warrick, MD

Massachusetts General Hospital

Site Director
Benjamin A. Nelson, MD

Contributors
Brian M. Cummings, MD
Chadi M. El Saleeby, MD, MS
Nina L. Gluchowski, MD
Ann Y. Kao, MD, MPH
Thomas B. Kinane, MD
Christopher J. Moran, MD
Stephanie Ruest, MD
Takara Stanley, MD
Avram Z. Traum, MD

University of Michigan Hospital and Health Systems

Site Directors
Heather L. Burrows, MD, PhD
Namita Sachdev, MD

Contributors
Mark N. Hakim, MD
Amy E. Hepper, MD
Sharon Kileny, MD
Debra M. Langlois, MD
John Schmidt, MD
Maria S. Skoczylas, MD

Vanderbilt University

Site Director
Sandra A. Moutsios, MD

Contributors
Cassandra C. Brady, MD
Whitney L. Browning, MD
Alaina M. Davis, MD
Maie El-Sourady, MD, MS
Cristina M. Estrada, MD
Geoffrey M. Fleming, MD
Maria Gillam-Krakauer, MD
Jennifer K. Green, MD, MPH
Tiffany Hines, MD
Ashley Rowatt Karpinos, MD, MPH
Jaime Kaye Otillio, MD
Devang J. Pastakia, MD
Mary E. Romano, MD, MPH
Cosby A. Stone, Jr., MD, MPH

Washington University

Site Director
Andrew J. White, MD

Contributors
Tara C. Copper, MD, MS
Michele M. Estabrook, MD
Sarah K. Garwood, MD
Elizabeth Harrison, MD
Carrie A. Nalisnick, MD
Erin Marie O’Brien, MD
Cassandra Pruitt, MD
Patrick J. Reich, MD

Sports Medicine

University of Arizona, Department of Family and Community Medicine

Site Director
Holly Good McNulty, MD

Contributors
Sagir G. Bera, DO, MPH, MS
Allison Lane, MD
Daphne A. Scott, MD
Krista A. Sunderman, MD
Matthew A. Tennison, MD
Brett Toresdahl, MD
Anna Waterbrook, MD

Patient Safety

Site Director
James Song-Jeng Yeh, MD (Brigham and Women’s Hospital)

Contributors
Kate E. Humphrey, MD (Boston Children’s Hospital)
Jeffrey Bruckel, MD (Massachusetts General Hospital)
Julie Fu, MD, MA (Boston Medical Center)
Kiran Gupta, MD (Brigham and Women’s Hospital)
Michelle P. Lin, MD, MPH (Brigham and Women’s Hospital)
Sonali Saluja, MD (Cambridge Health Alliance)

General Medicine

Indiana University School of Medicine

Site Director
Curtis A. Wright, MD

Contributors
James M. Hotz, MD
Archana M. Mahankali, MD
Joshua D. Pinner, MD
Allyson Thomas, MD