Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 26-year-old man is evaluated for a 3-month history of depressed mood, poor concentration, decreased energy, increased sleep, and weight gain. He reports missing many days at work and that his work performance has lagged. He has no suicidal ideation. He states that his current symptoms differ markedly from his usual state ...

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Anyone who knows me, knows I have long been skeptical of the safety of pubic hair removal. We evolved to have pubic hair, and we have no data to say that we have outgrown that need as we have wisdom teeth. The current thinking is that pubic hair plays a role in protecting the more delicate/sensitive tissues of the labia and the vaginal opening. Basically, pubic hair is a mechanical ...

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New Year’s resolutions have the potential to make our lives new and different and better than ever. But they also can do more harm than good. That’s because we put all our energy into setting the goal and don’t do the homework necessary to meet that goal. By the time February arrives, we’ve relapsed to our old habits and, what’s worse, we’ve given up hope of ever losing that weight ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 29-year-old man is evaluated during a routine examination. His medical history is significant for ulcerative colitis involving the entire colon, which was diagnosed 4 years ago. His symptoms responded to therapy with mesalamine and have remained in remission on this medication. His family history is significant for a maternal uncle ...

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We chat about the day, as I use a sharp knife to cut into her. We joke about my kids, as the blood is spurting. We reminisce about our friendship, as I rip open her tissue. For most surgeons, their patients are asleep as they perform their surgery. In obstetrics, however, we want our patients awake, not only to witness their baby's arrival, but also because it is safer. When I ...

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Megan, like all parents, hates the whining and nagging: "It’s driving me crazy. My children whine and complain until they get what they want. I try not to give in, but sometimes it’s just impossible. What can I do?" (That’s an excerpt from a much longer message. You get the idea.) Let’s look at whining from a classic behavioral approach. Stay with me, here -- behavioral theory is a big part of ...

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Once upon a time, I worked for a large hospital in the surgical-trauma ICU. It was just a six-month gig, and I had to travel from home further than I wanted. But my son would be starting college soon, and the $10,000 bonus was too irresistible. Diane was the manager. The most kind, skilled, and helpful person I have ever met as an ICU manager. She had every possible attribute as a ...

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asco-logo Many of the couples that I see in my practice grow closer after the diagnosis and treatment of cancer. I describe it as being forged by the searing flames of this dreaded disease. First, comes the terror of the diagnosis and the fear of losing one’s love. I see it in the eyes of the women and men as they sit ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man with type 1 diabetes mellitus presents to the office. He seeks advice on his diabetes management as he intensifies his exercise routine in preparation for participation in a 10-K race. He reports prolonged hypoglycemia during intense exercise, despite eating a meal prior to the activity. His insulin regimen ...

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Parents are sometimes surprised to find out that migraines are the most common cause of recurrent headaches in children. Yes, kids get migraines -- and many adults who get them started getting them as children, even if they weren’t diagnosed correctly. (And many adults who get migraines are still not being diagnosed correctly. Do you get “sinus” headaches? They’re almost certainly migraines. Yes, I know you feel congested with them. Yes, ...

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