Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 71-year-old man is evaluated in the emergency department for new dyspnea on exertion. He has a 15-year history of type 2 diabetes mellitus and has had a number of changes in his medications over the past 12 weeks to improve glycemic control. His dosage of metformin has been increased to 1000 mg/d, glyburide ...

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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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This series is brought to you by MedPage Today. 1. Painful Speed Bumps? Could Be Appendicitis. Diagnostic uncertainty surrounding appendicitis could turn into a small bump in the road, according to a study showing a high correlation between appendicitis and pain on driving over speed bumps on the way to the hospital. 2. Family Dinners Promote Healthier Eating. Having the family sit down together ...

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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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This series is brought to you by MedPage Today. 1. Newer Gene Tests Spot More Fetal Problems. Genetic microarray testing may be a better means of prenatal screening for abnormalities than karyotyping, the current standard of care. 2. Diabetes-Statin Link Hinges on Risk Factors. Higher-dose atorvastatin (Lipitor) increased the risk of new-onset diabetes compared with lower statin doses, but only among patients who already ...

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This series is brought to you by MedPage Today. 1. Weight-Loss Surgery May Not 'Cure' Diabetes. Although bariatric surgery is increasingly touted as a cure for type 2 diabetes, its remission was only temporary in about one-third of patients. 2. Grapefruit-Drug Interaction Seen With More Drugs. The number of drugs that react adversely with grapefruit is higher than previously recognized, and the interactions occur ...

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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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This series is brought to you by MedPage Today. 1. No Healthcare Savings with ACOs. Accountable care organizations (ACOs) that improved diabetes outcomes by as much as 10% achieved minimal or no cost savings. 2. Aspirin: Protects Brain as Well as Heart. Low-dose aspirin may help forestall cognitive decline in elderly women at high cardiovascular risk. 3. Weight-Loss Drug May Work in Diabetes. ...

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This series is brought to you by MedPage Today. 1. More People Had Health Insurance Last Year. The percentage of Americans without health insurance fell from 16.3% in 2010 to 15.7% in 2011. 2. Pertussis Vax Loses Power Over Time. Protection from the five-dose childhood series of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine fades within 5 years of the last dose. 3.
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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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