At 3 1/2 years old, my son was the picture of health. I have an actual picture. He is in jammies, wearing my sunglasses, laughing and chalk coloring the driveway while the sun is shining on his blond hair. That picture frequently flashes in my mind. I posted it on Facebook, my happy, healthy boy. There was no warning and nothing to prepare me for the months ahead. First, it was ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is evaluated for a 4-month history of intermittent, nonprogressive solid-food dysphagia. He has a long-standing history of heartburn that has been well controlled with once-daily proton-pump inhibitor (PPI) therapy for the past 5 years. Results of a screening colonoscopy 4 years ago were normal. ...

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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 evaluated during a routine examination. She has a history of hip and knee pain related to degenerative joint disease. The joint pain is now well controlled with diclofenac, which was started 3 months ago. A previous trial of high-dose acetaminophen was not effective. ...

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An excerpt from Looking Out for Number Two: A Slightly Irreverent Guide to Poo, Gas, and Other Things That Come Out of Your Baby. Early bowel patterns | What's normal As we learned, the poo patterns of new babies don’t settle in until a week or two after birth. And ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old woman is evaluated after a recent screening colonoscopy. The colonoscopy disclosed a 12-mm polyp in the ascending colon, which was removed. No other lesions were noted. On pathology, the lesion was found to be a sessile serrated polyp. Physical examination findings are unremarkable. Which of the following ...

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I was covering for my partner over the weekend and saw his patient with end-stage liver disease, a consequence of decades of alcohol abuse.| He was one of the most deeply jaundiced individuals I have ever seen. His mental status was still preserved. He could converse and responded appropriately to my routine inquiries, although he was somewhat sluggish in his thinking. It’s amazing that even after the majority of a liver ...

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What should a medical consultant do when the referring physician wants a procedure that the consultant does not favor? Of course, this sounds like a layup. The consultant, readers would surmise, should have a conversation with the referring colleague to explain why the procedure is not in the patient’s interest. The colleague then thanks the consultant for his thoughtful input, and for sparing the patient from the risks and expense of ...

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Physicians spend a lot of time counseling patients on the phone. Often, these conversations occur at night with patients we have never met before. When I am on-call in the evenings or on the weekends, these are some typical phone calls I receive from patients I have never met.

  • I have a very bad stomach ache for the last hour.
  • I started having rectal bleeding an hour ago.
  • My wife tells ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated for new-onset ascites with lower-extremity edema. Symptoms have increased gradually over the past 4 weeks. He has consumed three alcoholic beverages per day for many years. His medical history is notable for coronary artery bypass graft surgery 8 months ago and dyslipidemia. His medications are low-dose ...

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Are you a baby boomer? Have you been tested for hepatitis C virus (HCV)? Do you know why you should be tested for hepatitis C? Do you even know what hepatitis C is? According to research published by my colleagues from the American Cancer Society in the American Journal of Preventive Medicine, the odds are overwhelming that if you are in the boomer generation you ...

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