Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is transferred to the cardiothoracic intensive care unit (ICU) after undergoing repair of an abdominal aortic aneurysm. She has a 12-year history of type 2 diabetes mellitus. Her blood glucose level on arrival at the ICU is 289 mg/dL (16.0 mmol/L). Although no longer on a cardiopulmonary bypass pump, she remains intubated ...

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MKSAP: 68 year old woman with type 2 diabetes mellitus Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old woman comes to the office for a follow-up evaluation. She has had type 2 diabetes mellitus for the past 13 years and has experienced two early-morning hypoglycemic episodes in the past 3 months. Although her self-monitoring of fasting blood glucose levels over the past ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 78-year-old man is evaluated in the hospital for poor glycemic control before undergoing femoral-popliteal bypass surgery. He has been on the vascular surgery ward for 3 weeks with a nonhealing foot ulcer. The patient has an extensive history of arteriosclerotic cardiovascular disease, including peripheral vascular disease, and a 20-year history of type 2 diabetes ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old woman is seen for routine follow-up. She has type 2 diabetes mellitus, diagnosed 5 years ago; initial treatment included metformin and glimepiride. A daily injection of insulin glargine was added to her regimen 1 year ago. At present, her hemoglobin A1c value is 8.1%. Mean blood glucose values derived from the past 4 ...

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New York City’s Mayor Bloomberg has proposed a ban on the selling of sugar-containing drinks in containers larger than 16 ounces in all types of eating establishments including street vendors, movie theaters, delicatessens and even stadiums. The purpose is to limit sugar intake and theoretically help people lose weight by saving them from themselves. The plan has received mixed reviews with some calling it a “nanny state” action. Also since a ...

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Now more than ever, the growing consensus among many is that doctors should avoid seeing pharmaceutical sales representatives, otherwise known as drug reps. A position statement from the AAMC, the head organization of all US medical schools and residency programs, recommends that all academic health centers avoid having drug reps on their campuses, hospital and clinics. Many medical institutions including the VA and Kaiser have also enacted similar policies banning ...

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Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to a way to save billions of dollars in healthcare costs.  There may be a future for mobile apps but a lot of work is yet to be done. Last year I led some market research into mobile apps across all demographic segments and several disease conditions.  While we did ...

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MKSAP: 22 year old man with type 1 diabetes mellitusTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 22-year-old man comes for a routine evaluation. He has a history of type 1 diabetes mellitus and began taking insulin glargine and insulin lispro 8 years ago. Two days ago, he participated in a marathon race. On physical examination, temperature is 36.4 °C (97.5 °F), ...

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Year: 1979 Setting: George Washington University Hospital Position: Intern In sharing my global health background, I would be remiss if I did not talk about some of my American experience. After all, Washington, D.C., is remote from Palo Alto and Paris! I am in my late 20s and an intern at George Washington University as an exchange student from Brazil. My mentor, Stanley Talpers, MD, has organized a rotating program for the interns, ...

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Physicians and other healthcare professionals often tell their patients with type 2 diabetes to avoid eating too much starch and sugar in order to keep their blood sugar from going too high. But if the patients follow that advice, they'll end up eating more fat and more protein, which could increase their risk of cardiovascular and renal complications. Worse yet, a high fat intake may actually keep the patients diabetic. It ...

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