;)
CPX는 모의환자와 떠나는 일종의 여행이다. 우리는 서로 성향이나 말투가 각자 다른데 CPX는 정답도 정해진 기준(route)도 없다. 이제까지의 CPX 대비서는 관공서에비치된 딱딱한 지도 수준이었다. 방대한 정보의 나열만 있을 뿐, 정보를 어떻게 조직하고 배열할지는 순전히 우리의 몫이었다. 그런 의미에서 본 책은 의학서적이라기보다 여행서적을 지향한다.
저자: 퍼시픽 학술국
1 문진-7
-Quick-View EZ CPX ··························· 8
-순환기
가슴통증·············································· 22
실신····················································· 22
두근거림·············································· 24
고혈압·················································· 24
이상지질혈증······································· 26
-호흡기
기침····················································· 28
콧물, 코막힘········································ 28
객혈····················································· 30
호흡곤란·············································· 30
-상담
음주····················································· 32
-소화기
복통····················································· 36
소화불량·············································· 36
토혈····················································· 38
혈변····················································· 38
구토····················································· 40
변비····················································· 40
설사····················································· 42
황달····················································· 42
-상담
금연····················································· 44
약물····················································· 46
-전신
발열····················································· 50
멍························································· 50
피로····················································· 52
체중감소·············································· 52
체중증가·············································· 54
-정형/피부
관절통증·············································· 56
허리통증·············································· 56
목통증·················································· 58
피부발진·············································· 58
-상담
가정폭력·············································· 60
-정신
기분변화·············································· 64
불안····················································· 64
수면장애·············································· 66
기억력저하··········································· 66
-신경
어지럼증·············································· 68
두통····················································· 68
경련····················································· 70
5
팔다리 근력약화·································· 70
의식장애·············································· 72
손떨림증·············································· 72
-비뇨기
다뇨증·················································· 76
핍뇨····················································· 76
혈뇨····················································· 78
배뇨이상·············································· 78
소변찔끔증··········································· 80
-여성
유방····················································· 82
질분비물·············································· 82
월경이상·············································· 84
산전진찰·············································· 84
-상담
성폭력·················································· 86
나쁜소식전하기···································· 90
자살····················································· 92
예방접종·············································· 94
성장발달지연······································· 96
2 신체진찰-103
-Quick-View EZ CPX ······················· 104
1- 본격적인 Physical examination에
들어가기 앞서·································· 105
2- General physical examination ·········· 107
3- 순환기·············································· 112
4- 호흡기·············································· 117
5- 소화기·············································· 121
6- 정형·················································· 129
7- 신경·················································· 139
8- 비뇨/여성·········································· 158
3 증례집-163
-순환기
1- 가슴통증········································ 167
2- 실신··············································· 170
3- 두근거림········································ 172
4- 고혈압··········································· 174
5- 이상지혈증···································· 177
-호흡기
6- 기침··············································· 179
7- 콧물/코막힘··································· 181
8- 객혈··············································· 183
9- 호흡곤란········································ 185
-상담
10- 음주············································· 188
-소화기
11- 급성복통······································ 193
12- 소화불량/만성복통······················ 195
6
13- 토혈············································· 197
14- 혈변············································· 200
15- 구토············································· 203
16- 변비············································· 205
17- 설사············································· 207
18- 황달············································· 210
-상담
19- 금연············································· 213
20- 약물오남용·································· 215
-전신
21- 발열············································· 219
22- 쉽게 멍이 듦······························ 221
23- 피로············································· 223
24- 체중감소······································ 225
25- 체중증가······································ 228
-정형/피부
26- 관절통증······································ 231
27- 허리통증······································ 234
28- 목통증········································· 236
29- 피부발진······································ 238
-상담
30- 가정폭력······································ 240
-정신
31- 기분변화······································ 245
32- 불안············································· 248
33- 수면장애······································ 250
34- 기억력저하·································· 252
-신경
35- 어지러움······································ 255
36- 두통············································· 257
37- 경련············································· 259
38- 팔다리 근력약화························· 261
39- 의식장애······································ 264
40- 손떨림증······································ 266
-비뇨기
41- 다뇨증········································· 271
42- 핍뇨············································· 273
43- 혈뇨············································· 275
44- 배뇨이상······································ 277
45- 소변찔끔증·································· 280
-여성
46- 유방통········································· 282
47- 질분비물······································ 285
48- 월경이상······································ 287
49- 산전진찰······································ 289
-상담
50- 성폭력········································· 292
51- 나쁜소식 전하기························· 297
52- 자살············································· 299
53- 예방접종······································ 301
54- 성장발달지연······························· 304
-Quick-View EZ CPX ··························· 8
-순환기
가슴통증·············································· 22
실신····················································· 22
두근거림·············································· 24
고혈압·················································· 24
이상지질혈증······································· 26
-호흡기
기침····················································· 28
콧물, 코막힘········································ 28
객혈····················································· 30
호흡곤란·············································· 30
-상담
음주····················································· 32
-소화기
복통····················································· 36
소화불량·············································· 36
토혈····················································· 38
혈변····················································· 38
구토····················································· 40
변비····················································· 40
설사····················································· 42
황달····················································· 42
-상담
금연····················································· 44
약물····················································· 46
-전신
발열····················································· 50
멍························································· 50
피로····················································· 52
체중감소·············································· 52
체중증가·············································· 54
-정형/피부
관절통증·············································· 56
허리통증·············································· 56
목통증·················································· 58
피부발진·············································· 58
-상담
가정폭력·············································· 60
-정신
기분변화·············································· 64
불안····················································· 64
수면장애·············································· 66
기억력저하··········································· 66
-신경
어지럼증·············································· 68
두통····················································· 68
경련····················································· 70
5
팔다리 근력약화·································· 70
의식장애·············································· 72
손떨림증·············································· 72
-비뇨기
다뇨증·················································· 76
핍뇨····················································· 76
혈뇨····················································· 78
배뇨이상·············································· 78
소변찔끔증··········································· 80
-여성
유방····················································· 82
질분비물·············································· 82
월경이상·············································· 84
산전진찰·············································· 84
-상담
성폭력·················································· 86
나쁜소식전하기···································· 90
자살····················································· 92
예방접종·············································· 94
성장발달지연······································· 96
2 신체진찰-103
-Quick-View EZ CPX ······················· 104
1- 본격적인 Physical examination에
들어가기 앞서·································· 105
2- General physical examination ·········· 107
3- 순환기·············································· 112
4- 호흡기·············································· 117
5- 소화기·············································· 121
6- 정형·················································· 129
7- 신경·················································· 139
8- 비뇨/여성·········································· 158
3 증례집-163
-순환기
1- 가슴통증········································ 167
2- 실신··············································· 170
3- 두근거림········································ 172
4- 고혈압··········································· 174
5- 이상지혈증···································· 177
-호흡기
6- 기침··············································· 179
7- 콧물/코막힘··································· 181
8- 객혈··············································· 183
9- 호흡곤란········································ 185
-상담
10- 음주············································· 188
-소화기
11- 급성복통······································ 193
12- 소화불량/만성복통······················ 195
6
13- 토혈············································· 197
14- 혈변············································· 200
15- 구토············································· 203
16- 변비············································· 205
17- 설사············································· 207
18- 황달············································· 210
-상담
19- 금연············································· 213
20- 약물오남용·································· 215
-전신
21- 발열············································· 219
22- 쉽게 멍이 듦······························ 221
23- 피로············································· 223
24- 체중감소······································ 225
25- 체중증가······································ 228
-정형/피부
26- 관절통증······································ 231
27- 허리통증······································ 234
28- 목통증········································· 236
29- 피부발진······································ 238
-상담
30- 가정폭력······································ 240
-정신
31- 기분변화······································ 245
32- 불안············································· 248
33- 수면장애······································ 250
34- 기억력저하·································· 252
-신경
35- 어지러움······································ 255
36- 두통············································· 257
37- 경련············································· 259
38- 팔다리 근력약화························· 261
39- 의식장애······································ 264
40- 손떨림증······································ 266
-비뇨기
41- 다뇨증········································· 271
42- 핍뇨············································· 273
43- 혈뇨············································· 275
44- 배뇨이상······································ 277
45- 소변찔끔증·································· 280
-여성
46- 유방통········································· 282
47- 질분비물······································ 285
48- 월경이상······································ 287
49- 산전진찰······································ 289
-상담
50- 성폭력········································· 292
51- 나쁜소식 전하기························· 297
52- 자살············································· 299
53- 예방접종······································ 301
54- 성장발달지연······························· 304
의대생이라면 누구나 교내 CPX, 사설 CPX를 치르며 좌절해 본 적이 있을 것입니다. 질문에만 급급
하여 PPI를 쌓지 못하거나 시간에쫓겨 해야 할 환자 교육을 하지 못한 경험들 말이죠. 이는 CPX 시험
에대한 오해에서 기인합니다.
CPX를 준비하기 위해서는 우선 CPX라는 시험에대한 진짜 이해가 필요합니다. CPX는 10분 동안
의 history taking과 physical examination으로 진단명을 맞히고 치료를 읊는 시험이 아닙니다. 자신 앞의 모의 환자는 교수님이 아닙니다. 의학용어의 나열보다 환자의 걱정을 이해하고 공감해주는 것이 더 중
요합니다. 다음 중 말라리아로 설정된 환자에게 교육 시 해야 할 말은 무엇일까요? 다음 중 말라리아로
설정된 환자에게 교육 시 해야 할 말은 무엇일까요?
“10분간 진찰하고 면담한 바로는 삼일열 말라리아일 가능성이 높습니다. 확진을 위해서는 혈액 도말
검사에서 말라리아 원충을 확인해야 합니다. 말라리아의 치료는 클로로퀸이나 프리마퀸 등의 항말라리
아제입니다.”
“열이 나서 많이 걱정되시죠? 열이 나는 원인이 될 수 있는 것은 많기 때문에우선은 혈액검사와 가
슴 엑스레이 촬영을 하고 나서 더 이야기를 나눠볼까 합니다. 일단은 열이 나서 불편하실 테니 해열제
를 좀 처방해드릴게요.”
CPX는 PBL 시험이 아닙니다. 환자의 걱정에대한 공감과 이해가 있다면 impression과 약물 이름이
떠오르지 않더라도 우리는 환자 교육을 적절히 수행할 수 있습니다. 10분간 면담, 신체진찰, 환자 교육
이 세 가지의 적절한 시간 분배와 화기애애한 분위기라면 어떤 방이든 pass 할 수 있습니다.
CPX는 모의환자와 떠나는 일종의 여행입니다. 우리는 서로 성향이나 말투가 각자 다른데 CPX는 정
답도 정해진 기준(route)도 없죠. 이제까지의 CPX 대비서는 관공서에비치된 딱딱한 지도 수준이었습
니다. 한 마디로 불친절했습니다. 방대한 정보의 나열만 있을 뿐, 정보를 어떻게 조직하고 배열할지는
순전히 우리의 몫이었죠. 그런 의미에서 본 책은 의학서적이라기보다 여행서적을 지향합니다. 여러분
의 CPX가 성공적인 여행이 될 수 있도록 EZ CPX가 돕겠습니다.
본 책만의 장점
1. 본 책은 감별진단, 문진, 신체진찰, 교육을 한 페이지에모두 넣어 한눈에들어 오도록 하였습니다.
감별진단표를 보고 나서 한 두장을 넘겼을 때 신체진찰표가 있다면, 감별진단과 신체진찰 사이의
연결성을 한 눈에유 추하기 매우 힘들게 됩니다. 이것이 수십차례 반복될 경우 펼쳤던 책을 접게
만들도록 하죠. 그러나, 한 페이지에모든 정보가 있다면 감별진단과 문진, 신체진찰이 서로 줄로
연결되어 있지 않더라도 본과 4학년 학생이라면 충분히 ‘이 신체진찰은, 아 문진의 이 질문은 이
감별진단 때문이구나!’하고 떠올리실 수 있습니다.
Tip 노트 정리 시에는 무작정 외우기보다는 감별진단 옆에 관련된 질문과 신체진찰을 써가며 암기하는 것이 도움이 됩니다.
2. TMI(too much information), 교과서적 말투를 최대한 지양하였습니다. 기존의 수험서들은 권당 300
∼600페이지를 상회하는 압도적인 페이지 수를 자랑하였습니다. 마치 페이지수가 책의 가치인 것
처럼요. 하지만 CPX에서 페이지 수는 책의 질과 반비례합니다. 54개나 되는 CPX 증례를 다 공부
하기에도 벅찬데, 시험에 도움이 안 되는 쓸모없는 정보는 오히려 공부 의지를 꺾기 때문이죠. 그
간의 CPX 수험서들이 책상 위가 아닌 책장에만, 그것도 쓸데없이 큰 공간을 차지하며 꽂혀 있던
이유라고 생각합니다.
3. 누구나 어렸을 때 아나바다라는 말을 들어봤던 적이 있을 것입니다. 처음 봤을 때는 규칙도 의미
도 없는 음절들이 어느 순간 뇌리에 박히는 경험은 CPX에도 적용될 수 있습니다. 본 책에서는 계
통별로 ‘발오감체피부야’, ‘어두호’ 등의 음절을 사용합니다. 어떤 계통인지 impression만 잡으면
머리에서 술술 꺼내는 경험을 해볼 수 있을 것입니다.
출간하는 데 있어 큰 도움을 주신 엄민영, 이원선, 김현지 그리고 차봉은 님께 감사드립니다.
2019.8.
퍼시픽 학술국
하여 PPI를 쌓지 못하거나 시간에쫓겨 해야 할 환자 교육을 하지 못한 경험들 말이죠. 이는 CPX 시험
에대한 오해에서 기인합니다.
CPX를 준비하기 위해서는 우선 CPX라는 시험에대한 진짜 이해가 필요합니다. CPX는 10분 동안
의 history taking과 physical examination으로 진단명을 맞히고 치료를 읊는 시험이 아닙니다. 자신 앞의 모의 환자는 교수님이 아닙니다. 의학용어의 나열보다 환자의 걱정을 이해하고 공감해주는 것이 더 중
요합니다. 다음 중 말라리아로 설정된 환자에게 교육 시 해야 할 말은 무엇일까요? 다음 중 말라리아로
설정된 환자에게 교육 시 해야 할 말은 무엇일까요?
“10분간 진찰하고 면담한 바로는 삼일열 말라리아일 가능성이 높습니다. 확진을 위해서는 혈액 도말
검사에서 말라리아 원충을 확인해야 합니다. 말라리아의 치료는 클로로퀸이나 프리마퀸 등의 항말라리
아제입니다.”
“열이 나서 많이 걱정되시죠? 열이 나는 원인이 될 수 있는 것은 많기 때문에우선은 혈액검사와 가
슴 엑스레이 촬영을 하고 나서 더 이야기를 나눠볼까 합니다. 일단은 열이 나서 불편하실 테니 해열제
를 좀 처방해드릴게요.”
CPX는 PBL 시험이 아닙니다. 환자의 걱정에대한 공감과 이해가 있다면 impression과 약물 이름이
떠오르지 않더라도 우리는 환자 교육을 적절히 수행할 수 있습니다. 10분간 면담, 신체진찰, 환자 교육
이 세 가지의 적절한 시간 분배와 화기애애한 분위기라면 어떤 방이든 pass 할 수 있습니다.
CPX는 모의환자와 떠나는 일종의 여행입니다. 우리는 서로 성향이나 말투가 각자 다른데 CPX는 정
답도 정해진 기준(route)도 없죠. 이제까지의 CPX 대비서는 관공서에비치된 딱딱한 지도 수준이었습
니다. 한 마디로 불친절했습니다. 방대한 정보의 나열만 있을 뿐, 정보를 어떻게 조직하고 배열할지는
순전히 우리의 몫이었죠. 그런 의미에서 본 책은 의학서적이라기보다 여행서적을 지향합니다. 여러분
의 CPX가 성공적인 여행이 될 수 있도록 EZ CPX가 돕겠습니다.
본 책만의 장점
1. 본 책은 감별진단, 문진, 신체진찰, 교육을 한 페이지에모두 넣어 한눈에들어 오도록 하였습니다.
감별진단표를 보고 나서 한 두장을 넘겼을 때 신체진찰표가 있다면, 감별진단과 신체진찰 사이의
연결성을 한 눈에유 추하기 매우 힘들게 됩니다. 이것이 수십차례 반복될 경우 펼쳤던 책을 접게
만들도록 하죠. 그러나, 한 페이지에모든 정보가 있다면 감별진단과 문진, 신체진찰이 서로 줄로
연결되어 있지 않더라도 본과 4학년 학생이라면 충분히 ‘이 신체진찰은, 아 문진의 이 질문은 이
감별진단 때문이구나!’하고 떠올리실 수 있습니다.
Tip 노트 정리 시에는 무작정 외우기보다는 감별진단 옆에 관련된 질문과 신체진찰을 써가며 암기하는 것이 도움이 됩니다.
2. TMI(too much information), 교과서적 말투를 최대한 지양하였습니다. 기존의 수험서들은 권당 300
∼600페이지를 상회하는 압도적인 페이지 수를 자랑하였습니다. 마치 페이지수가 책의 가치인 것
처럼요. 하지만 CPX에서 페이지 수는 책의 질과 반비례합니다. 54개나 되는 CPX 증례를 다 공부
하기에도 벅찬데, 시험에 도움이 안 되는 쓸모없는 정보는 오히려 공부 의지를 꺾기 때문이죠. 그
간의 CPX 수험서들이 책상 위가 아닌 책장에만, 그것도 쓸데없이 큰 공간을 차지하며 꽂혀 있던
이유라고 생각합니다.
3. 누구나 어렸을 때 아나바다라는 말을 들어봤던 적이 있을 것입니다. 처음 봤을 때는 규칙도 의미
도 없는 음절들이 어느 순간 뇌리에 박히는 경험은 CPX에도 적용될 수 있습니다. 본 책에서는 계
통별로 ‘발오감체피부야’, ‘어두호’ 등의 음절을 사용합니다. 어떤 계통인지 impression만 잡으면
머리에서 술술 꺼내는 경험을 해볼 수 있을 것입니다.
출간하는 데 있어 큰 도움을 주신 엄민영, 이원선, 김현지 그리고 차봉은 님께 감사드립니다.
2019.8.
퍼시픽 학술국
