Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman comes for a preconception evaluation. She has a history of hypertension that is well controlled with lisinopril. Medical history is otherwise unremarkable. On physical examination, blood pressure is 134/86 mm Hg in both upper extremities; other vital signs are normal. Results of the cardiovascular examination are unremarkable. There is no ...

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medpagetodayFrom MedPage Today:

  1. Eating Fish While Pregnant -- Worth a New Look? In babies of women who consumed a lot of fish while pregnant, the benefits of n-3 polyunsaturated fatty acids in the fish outweighed the potential adverse effects of mercury exposure.
  2. With RA Remission, Try Cutting TNF Dose. A substantial proportion ...

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I arrived at my designated gate at Chicago’s O’Hare Airport.  After handing over my crumpled boarding pass for scanning, I made my way down the jetway and onto what appeared to be a small but fairly packed little jet. Passengers on each side of the aisle eyed me as I walked past, a few noticed that my jeans were soaked from the knees down. Some caught the odor that trailed ...

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As part of a plan to improve our practice's quality of care for patients with high blood pressure, my office's nurse announces at every morning huddle which patients on that day's schedule had a blood pressure measurement of greater than 140/90 at their last visit. Most of these patients have measurements consistent with mild hypertension (systolic blood pressure less than 160 mm Hg and/or diastolic blood pressure less than 100 ...

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medpagetodayFrom MedPage Today:

  1. Carotid Stenting Linked to High Real-World Mortality. Carotid stenting was associated with much higher than expected 2-year mortality in the Medicare population.
  2. 'Generic' Colchicine to Hit Market. A so-called authorized generic version of the colchicine formulation sold as Colcrys for acute gout flares and for treating familial Mediterranean fever ...

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medpagetodayFrom MedPage Today:

  1. Statins and RA: No Joint Benefit. The use of statins does not reduce onset of new joint pain or stiffness in middle-age or older women but their use is associated with poor physical functioning and poor self-rated health.
  2. Expert Groups Clarify HPV Testing Recommendations. Primary cervical cancer screening with ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 46-year-old woman is evaluated before undergoing a dental cleaning procedure involving deep scaling. She has a history of mitral valve prolapse without regurgitation and also had methicillin-resistant Staphylococcus aureus(MRSA) aortic valve endocarditis 10 years ago treated successfully with antibiotics. The patient notes an allergy to penicillin characterized by hypotension, hives, and wheezing. ...

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medpagetodayFrom MedPage Today:

  1. Whole Grains Reduce CVD, Total Death Risk. Eating a diet rich in whole grains was found to be associated with lower total mortality and deaths from cardiovascular disease (CVD), but not cancer.
  2. Tight Control Lowers Death in Type 1 Diabetes. Tight glucose control has a legacy effect of reduced ...

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medpagetodayFrom MedPage Today:

  1. Patients with peripheral spondyloarthritis responded to anti-TNF treatment. Patients with non-psoriatic peripheral spondyloarthritis (SpA) derived significant benefit from treatment with tumor necrosis factor (TNF) inhibition.
  2. Does Creatinine Say More About Muscle Quality than Mass? Urinary creatinine may be revealing more about muscle quality than muscle mass.
  3. 'Fat ...

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There are plenty of good reasons why thoughtful physicians are often unhappy with the current approach to measuring the quality of care they provide. Some, of course, object to the whole notion of quality measurement, but I believe they are in a shrinking minority clinging to an anachronistic mental model in which each physician defines for himself what constitutes high quality care. I have addressed this previously. But even those, ...

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