Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old woman is evaluated for a 3-month history of gradually progressive abdominal distention. Her medical history is notable for a 20-year history of obesity, type 2 diabetes mellitus, hyperlipidemia, and hypertension. She also has had a 10-year history of elevation of serum aminotransferase levels, which was attributed to nonalcoholic fatty ...

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The most exciting and difficult part of my job is keeping up with all the rapid changes occurring in the field of cancer treatments.  It is amazing how each day there seems to be a breakthrough treatment coming along, shifting old cancer paradigms.  Although this is a good problem to have, finding time to stay current is easier said than done.  Even more difficult is making sure we can explain these ...

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On November 18, the World Health Organization (WHO) declared that Zika will no longer be classified as a public health emergency, while maintaining that the epidemic remains “a highly significant and long-term problem,” and emphasizing that this change in designation did not represent a downgrade, but rather an escalation in its long-term importance. Most major news outlets rushed to report the news, with headlines focusing on the end of the emergency ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old man is evaluated for a 2-year history of fatigue, low libido, and infertility. His family history is notable for a brother with infertility. His medical history is unremarkable, and he takes no medications. On physical examination, vital signs are normal. His height is 195.6 cm (77 in), and his weight ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. The possibility of anesthetic neurotoxicity in infants and children -- the supposition that anesthesia may alter normal activity in the nervous system - was first suggested more than 15 years ago with findings of increased neuronal cell death in the developing brains of rodents ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old woman is evaluated at a well-patient visit. Both her parents have a history of nonmelanoma skin cancer within the past year, and she is seeking counseling regarding skin cancer prevention. She has a history of remote sunburns and had previously tanned as a teenager. She requests advice on how ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 47-year-old man is evaluated during a routine examination. He has no symptoms. Medical history is significant for a bicuspid aortic valve. He is not taking any medications. On physical examination, he is afebrile, blood pressure is 130/70 mm Hg, pulse rate is 56/min, and respiration rate is 15/min. Cardiac examination reveals ...

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A popular meme is that the U.S. spends more on health care than other developed nations but has nothing to show for that spending. This is different from saying that the U.S. spends more, but achieves something, but the something it achieves is so little that it isn’t worth the public purse. The latter is difficult to assert because the asserter must then say how little is too little in ...

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I’m just coming out of two years of sleep deprivation. Due to some sleep apnea issues (hopefully finally resolved), my now two-year-old daughter slept like a newborn until this summer. Which means, like the mom of a newborn, I was up every three hours at night for the last two years. This has given me more experience in living with sleep deprivation than I ever wanted and plenty of time to think ...

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We fought. And we fought hard. We were smarter and quicker and we could multi-task, and critically think beyond any MD or NP or PA or beyond any cardiovascular ICU (CVICU) nurse. We always thought we had the higher acuities. We had the critical patients. The multi-system failure patients. The hemodynamically unstable patients. We had to figure out the lungs, the heart, the kidneys, the brain, the pancreas, the gallbladder, the liver. And ...

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