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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In her new book In This Together: My Story, the former First Lady of Massachusetts, Ann Romney, describes receiving in her mid-40s a diagnosis of multiple sclerosis (MS). She offers vignettes of a “life upended”: her abandonment of therapeutic swimming because it made her hair “look bad” and the need to revise plans for her Park City home to include an elevator. In her case, MS is invisible, characterized by fatigue, ...

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Tackling: in so many ways, it's what football is all about. Now, of course running, passing and scoring (and strategy) are important parts of football too. But it's tackling that stops the opponent. Without tackling, you can't play football. Or can you? A policy statement just released by the American Academy of Pediatrics (AAP) suggests that we need to do some thinking about tackling and its impact -- literally -- on ...

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In May 2003, during my second year of pediatric residency, I had a right temporal lobectomy to remove a seizure focus in my right hippocampus.  Although the surgery proceeded without complications, I was unable to walk unsupported for several weeks after the operation.  My experiences taught me what makes an exceptional physician. An ...

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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 for a 1-year history of increasing forgetfulness. She reports greater difficulty keeping track of upcoming appointments, recalling details of recent telephone conversations, and remembering names of new acquaintances. She has completed 16 years of formal education, currently works as a teacher's assistant, and has noticed no change ...

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Evan Murray was a 17-year-old high school senior, honor student, and three-sport athlete who died recently as a direct result of injuries sustained playing quarterback for his school football team.  On the last play of his life, he got drilled by a defender with a clean hit to the midsection.  He gathered himself, rose, and walked off the field on his own.  Shortly thereafter, however, he collapsed on the sideline ...

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shutterstock_172354895 Compassion.  Once upon a time, I had a lot of it. I guess I still do, or I wouldn't be at this desk. I think most medical students start out that way. We want to help the sick, heal the wounded, decrease suffering. All that stuff we once wrote in the "personal statement" section of the universal med school application. And believed. A friend ...

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