Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 21-year-old male student is evaluated for a murmur heard during an athletic preparticipation physical examination. He is asymptomatic. His medical and family history is unremarkable and he takes no medications. On physical examination, the patient is afebrile, blood pressure is 118/76 mm Hg, pulse rate is 68/min, and respiration rate is 14/min. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old man is evaluated as a new patient. He was diagnosed with type 2 diabetes mellitus during a health insurance evaluation 6 months ago. At that time, metformin was initiated. Medical history is otherwise unremarkable. On physical examination, blood pressure is 145/94 mm Hg; other vital signs are normal. BMI is 29. ...

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My last patient, Joyce, a 45-year-old single mother of four with high blood pressure and diabetes, is late. She was in the emergency department last week with dizziness and blurred vision, a blood sugar of 345 and a blood pressure of 190/110. Her last office visit was a month ago, when weighing in at 222, she joked that she wished she could pull those numbers at the casino’s slot machines. She ...

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The medical condition provocatively called exploding head syndrome, or EHS, brings back the disturbingly graphic images of the 1981 sci-fi horror flick Scanners where the main character blew up people’s heads with the power of telekinesis. Fortunately, as ominous as exploding head syndrome sounds, no skulls have actually exploded, and the condition is reassuringly non-life threatening. For the people who experience the symptoms of EHS, however, the ordeal can be ...

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I read with interest the recent article written by Dr. Rourke Stay, "What ESPN doesn’t tell you about MRI in professional athletes,” and couldn't agree more.  The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries.  Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair ...

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Over 100 million Americans suffer from chronic pain such as spinal disorders (lower back pain, disc disease, pinched nerves and neck pain), complex regional pain syndrome, fibromyalgia and headaches. The cost of chronic pain in human suffering, lost worker productivity and in health care dollars is counted in the billions. Yet despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve  "burning" and ...

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My father’s sister Mary died from measles when she was six years old. Her death haunted my grandparents for the rest of their lives. She was one of the thousands who died each year from measles before there was a vaccine to prevent this life-threatening disease. Her story has always stayed with me -- from my days as a child to my years in medical school. And once again I’m reminded of ...

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There’s been a lot written about the measles outbreak and antivaccine parents. Fact is, the current situation is a direct and predictable result of many social/political trends that have emerged in America over the last generation. I am sharing five easy steps to take if you want to create an epidemic just like this. 1. Raise a generation ignorant about science. The majority of Americans are 
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shutterstock_122870008 On Valentine’s Day weekend last year I found myself at Paddles, the local dungeon in New York City’s Chelsea neighborhood, for the first time. I was perched at the alcohol-free bar when a man politely introduced himself as a human carpet. He asked that I tread on him and lay on the floor to demonstrate. A professional dominatrix-in-training stepped onto his ...

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March is colon cancer awareness month.  We have made tremendous strides in the fight against cancer especially colon cancer. Between 1991 and 2011, U.S. cancer death rate decreased by 22 percent (1.5 million lives saved), and colon cancer death rate decreased by almost 50 percent. This decrease coincides with widespread adoption of colorectal cancer screening particularly colonoscopy. Despite this progress, colon cancer is still the 2nd leading cause of cancer death in ...

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