ZDoggMD has done it again.  I Can't Feel My Face is a musical parody that teaches us the warning signs of stroke.  Watch it, so you don't forget it.

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 61-year-old man is evaluated for a 10-month history of generalized weakness. He reports no pain or myalgia. History is significant for hypercholesterolemia treated with a stable dose of simvastatin for the past 3 years. On physical examination, temperature is normal, blood pressure is 138/74 mm Hg, pulse rate is 70/min, and respiration ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 53-year-old man is evaluated for persistent right-sided facial weakness. Three months ago, he first noticed "droopiness" of the right side of his lower face, difficulty closing the right eye and wrinkling the forehead, increased sensitivity to loud noises, and occasional slurred speech. Bell palsy was diagnosed, and he began a 10-day ...

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Curiosity and apprehension. I experience this tension as a young man ushers me through large daunting doors with “Authorized Personnel Only” posted in bold red letters. Inside, a massive machine dominates the room, and yet my focus turns to the patient lying on the table, face covered in a white mask holding his head still while the technician targets the malignant brain tumor. “All right in there?” the specialist asks, and ...

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My patient was an elderly farmer with severe vascular disease. He had advanced leg artery narrowing, had survived multiple heart attacks, and was admitted to the hospital after a large stroke. He was incredibly cheerful, vibrant, and optimistic. He had a very large, loving family who took turns attending to him, and encouraging him with each small improvement in his leg and arm strength. They knew his neurological exam better ...

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Today, I talked at length with that lady whose husband has Creutzfeldt–Jakob disease (CJD). That patient -- the one with arbitrary myoclonic jerks, always naked and uncovered by blankets due to uncontrolled flailing, his penis and Foley catheter exposed. That one with overgrown mycotic toenails and eyes that are always only half-open, his gaze drifting everywhere. He was until now just a patient for me -- the CJD patient. Yet today ...

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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 seen for follow-up evaluation of a tremor in his upper extremities that has been present since age 20 years. The tremor was mild for many years and did not interfere with his work but has become more prominent in recent years. He has difficulty writing and using utensils ...

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As the awareness and recognition of concussion in sports continue to increase and the frightening long-term outcomes for frequently and severely concussed athletes are realized, as a physician I cannot help but advocate drastic changes in football.  Of the major sports, it sees the highest rates of concussion, and for every highly publicized Greek tragedy of a broken NFL star (Jim McMahonJunior SeauDave ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman had a burning sensation involving the right side of her forehead and the tip of her nose for 2 days, followed by increased redness and the development of lesions involving the tip of her nose. Medical history is significant for hypertension, and her only medication is ramipril. On physical examination, ...

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"I have always depended on the kindness of strangers." - Blanche DuBois, A Streetcar Named Desire, Tennessee Williams It was near the end of 2008 that I developed symptoms that I recognized as sciatica.  The Internet is a wonderful source of information (and some misinformation).  I decided to educate myself.  In my reading, I encountered one study that indicated that patients who underwent surgery were better at one year, but about the ...

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