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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I sit at my desk in a cubicle with high ceilings and an open entryway.  It is dark except for the somewhat eerie glow of light emitted by CRT monitors.  With concentration and some sense of urgency, I methodically plow through the queue of studies to be interpreted.  Some are marked STAT, some not.  I address the former first. Our ER is a busy one.  Many cases come from that department.  ...

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“This is our sickest patient,” my co-intern began as she told me about one of her patients I would care for overnight. It was my first week of intern year, and I was assigned the overnight cross-cover shift for a busy cardiology service. Introducing myself as “Dr. Tredway” still rolled awkwardly off my tongue, but I had grown more comfortable throughout the week in my new role as a physician. ...

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shutterstock_248807428 Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated during a routine examination. She has very severe COPD with multiple exacerbations. She has dyspnea at all times with decreased exercise capacity. She does not have cough or any change in baseline sputum production. She is adherent to ...

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shutterstock_110076689 Smoking is a major cause of heart attacks, strokes, emphysema, and lung cancer. Smoking rates have steadily declined in the U.S. in the last 50 years, but about a fifth of U.S. adults still smoke. Helping them quit would make a major contribution to their health. A study in the New England Journal of Medicine (NEJM) studied the effectiveness ...

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ZDoggMD with a Katy Perry-inspired take on sleep apnea.  CPAP users rejoice! For those without sleep apnea, watch and you'll something too.

medpagetodayFrom MedPage Today:

  1. Time to Retire Lithotripsy for Kidney Stones? More than 30 years ago, extracorporeal shock wave lithotripsy (ESWL) had a highly anticipated, much-ballyhooed introduction as a nonsurgical therapy for kidney stones. Obviating the need to cut the skin or insert a device into the body, ESWL would use acoustic shock waves to ...

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medpagetodayFrom MedPage Today:

  1. Sleep Apnea Linked to Depression in Men. Obstructive sleep apnea (OSA) is associated with an increased risk of depression in men.
  2. Tapering Asthma Meds Saves Money in Stable Patients. Reducing asthma medications in stable patients led to cost savings without increasing utilization of other asthma resources.
  3. Poor ...

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I see some odd things in my clinic. One recent diagnostic dilemma was a man in his late fifties with shortness of breath. He had been born with a ventricular septal defect and had undergone surgery for this in his infancy. During his lifetime, he had seldom gone to doctors and always thought he was in fairly good health, maybe just of a weak constitution. A smoker since age 13, he ...

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medpagetodayFrom MedPage Today:

  1. Is This 'Meaningful Use'? Docs Say Yes, Patients Unsure. Proposed changes to patient engagement requirements under the federal government's Meaningful Use program are drawing praise from physician groups but are disappointing patient advocates.
  2. Point: Does the Risk of E-Cigarettes Exceed Potential Benefits? Yes. The use of e-cigarettes continues to ...

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