We’ve heard it before: Antibiotics just don’t work for viral infections. Docs know this, and I think most patients know this, but it’s an addiction we’ve had a hard time shaking. Docs overprescribe because it’s fast, it’s easy, and it (might) increase patient satisfaction and return visits. That’s led to a cycle of reinforcing expectations from patients -- who, after all, keep feeling better after the antibiotics. Of course, they do. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated after being informed his roommate at a homeless shelter was diagnosed with pulmonary tuberculosis. He reports no fever, cough, night sweats, or weight loss. Medical history is significant for injection drug use, most recently 2 weeks ago, although he reports no known infectious complications in the past. ...

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In the wake of the horrific Orlando shootings, there has been renewed attention given to the U.S. Food and Drug Administration's (FDA) so-called ban on blood donations from gay men.  A congressman called the ban discriminatory, and demanded it's repeal -- a call joined by the American Medical Student Association. I can understand how many gay men feel.  I often donated blood at various American ...

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Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world. I have a proposal to make: over-the-counter antibiotics. (Insert tongue-in-cheek here.) Will this help us deal with the falsely popular notion that antibiotics are a cure-all? I don’t know, but here’s something I do. I've had patients storm out because I've said no, and I ...

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It’s difficult to turn to any major media outlet without being confronted with the latest breaking information on Zika virus infection. The images of newborns from Brazil with excessively small heads are searing. To most of the U.S. population, the Zika virus epidemic in South and Central America is mainly a travel concern. But to the millions of people living in areas from the Caribbean to Central and South America, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 30-year-old woman is evaluated for a 2-day history of increasing pain in the right antecubital fossa and biceps. She reports daily injection drug use. Medical history is otherwise unremarkable, and she takes no prescription medications. On physical examination, temperature is 39.7 °C (103.5 °F), blood pressure is 90/56 mm Hg, pulse rate ...

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An excerpt from Seductive Delusions: How Everyday People Catch STIs. Dear Ashley, Your blood count and mono test did not show any signs of mononucleosis infection. Unfortunately, however, your throat swab was positive for gonorrhea. Please schedule an appointment today in urgent care so you can be treated with the appropriate shot ...

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It’s still flu season, although the flu gods have shown a bit more mercy than in years past.  So many variables determine whether each winter brings a relatively mild flu season, a “flunami,” or something in between.  I’m a country boy doing primary care in the city, and I have only a modest understanding of which influenza strain is circulating, the concepts of antigenic drift and shift, and how the ...

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The Zika virus in the news these days reminds us of another microcephaly-causing virus which scourged our world in the not-so-distant past. In the years right before we were born (the late 1960s), the virus rubella routinely swept through the United States and the rest of the world. The airborne germ rubella, just like the Zika virus, caused most people just a mild illness that they usually never even knew that they ...

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I recently told you of my admiration for Dr. Mona Hanna-Attisha, the Michigan pediatrician and epidemiologist whose strong research and advocacy was able to finally bring a shining light to the problem of lead in the water supply of Flint. Continuing with a theme, I now bring you the story of Dr. Adriana Melo of Campina Grande, Brazil. Dr. Melo is an OB-GYN who subspecializes in maternal-fetal medicine (MFM), the branch ...

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