A tired but beaming mom greeted me as I entered the room. In her lap was a content appearing, slightly chubby, cherubic faced baby. “This is Caleb … isn’t he beautiful” mom gushed. “He is named after his dad …” but then added in a softer voice, “but I’m not sure how much he plans to be involved.” Mom’s smile waned for a moment but quickly came back. “Looking forward to ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for a 2-year history of cough and a 1-year history of increasing dyspnea. He describes the cough as nonproductive, and his shortness of breath is worse with exertion. He does not have chest pain, orthopnea, paroxysmal nocturnal dyspnea, or any other symptoms. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a 6-month history of worsening exertional dyspnea. He has a history of severe COPD diagnosed 4 years ago and previously had minimal exertional symptoms. However, he now notes shortness of breath when walking short distances that is limiting his activity level. He does not have ...

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My brother-in-law, Ron, was a curmudgeon; grumpy, sullen, even downright mean at times. By blood, he and my husband Bill were cousins. In the 1950s, when Bill was just a child, his mother died unexpectedly, and Ron's mother took Bill in to live with her and her four children. They were an African-American family living in the midst of a middle-class, predominantly white Connecticut township. Their home, located on a wealthy ...

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Many Americans have never visited a predominantly Muslim country and may know relatively little about the faith of Islam. This is relevant in light of the Trump administration’s recent executive order attempting to reduce terrorist threats to the U.S. by halting the issuance of visas to travelers from seven predominantly Muslim countries. Having returned this month from Sudan, one of the countries affected by the ban, I wish to ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is evaluated in follow-up for a right-sided pleural effusion. He initially presented with increasing dyspnea and a constant dull ache on his right side. He also has lost 9.1 kg (20.0 lb) over the last 6 months. Medical history is otherwise unremarkable, and he takes no medications. He ...

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Asthma is a complex, chronic lung problem that now affects nearly 10 percent of all children. Both the incidence of new cases and the prevalence of ongoing cases in the pediatric population have been rising steadily for years, although there are hints these increases may have leveled off. A wealth of research suggests a huge part of asthma causation comes from the environment the child lives in, things like air quality and exposure to various ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old man is evaluated for declining exercise capacity over the past year. He was diagnosed with moderate COPD 3 years ago. His symptoms had previously been well controlled with tiotropium and as-needed albuterol. He has not had any hospitalizations. He is adherent to his medication regimen, and his inhaler technique ...

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77-year-old Edward Tripp had been to the emergency room with chest pain last Friday night. It was relentless, aching, and involved the upper part of his left chest. He had no cough, fever or shortness of breath. He was not sweaty or nauseous, and his blood work, EKG and chest x-ray were normal. He was distinctly tender over the part of his rib cage where bone and cartilage join each other ...

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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 a 3-year history of dyspnea on exertion. He experiences no headaches or blurred vision. Medical history is notable for a stroke 2 years ago. He is a smoker with an 80-pack-year smoking history. Medications are hydrochlorothiazide, lisinopril, aspirin, and simvastatin. On physical examination temperature is 36.7 °C ...

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