Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 41-year-old woman is evaluated in follow-up after presenting to the emergency department 1 week ago for burning epigastric and chest pain. In the emergency department, a complete blood count and liver chemistry studies were normal, but a radiograph of the chest and upper abdomen demonstrated calcified gallstones. The ...

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The last few years have been marked by public outcry over the costs of novel prescription drugs, such as the hepatitis C medication sofosbuvir (brand name Sovaldi), which are highly efficacious but extremely expensive. On the one hand, sofosbuvir produces cure rates of  >90%, a figure that seemed unthinkable a few decades ago. On the other, it is priced at approximately $1000 per pill ($60,000–$90,000 for a treatment course), making it ...

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A patient comes to you asking, "Doc, my seizures are getting worse, I really hate the side effects of my medications, I want to go a different route. What do you think about medical marijuana?" You start sweating profusely, fidgeting in your seat, thinking of every single reason why not to recommend it and come up with the standard response, "Uh, well, I'm not qualified to recommend it, and it's ...

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When you go to your physician's office, or the laboratory for blood work or radiology for X-ray's, do you feel like you're an imposition? Like you're an inconvenience to the clinician or health care staff — as if you being there is interrupting the personal conversation they are holding with others in their workplace? You are not alone. Although many who enter the health care field do so out of a desire ...

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Jenna had it all: She was smart, pretty, inquisitive and popular, with just one more year until she graduated from high school. She was at the top of her class and couldn't wait until high school was over, and she could become a pediatrician just like her dad. One day, Jenna would be an MD. "One day at a time," her parents always told her, even though she wanted to rush 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 during a routine examination. His medical history is notable for chronic hepatitis C infection with cirrhosis, which was diagnosed 3 years ago. He undergoes surveillance ultrasound for hepatocellular carcinoma every 6 months. On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 110/82 ...

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asco-logo As the patient talked, I found myself nodding my head. In so many ways, she was just like me. Highly educated, a professional, a woman who had worked hard and long to get where she was. And then cancer took it all away, or at least that’s the way she described it. She was diagnosed with metastatic cancer one year ...

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A recent news story in the Journal of the American Medical Association (JAMA) reminds me that lots of things in our lives are changing these days, not the least of which is the shape of our bodies. Oh, my. This aging thing isn’t so easy, and that is really the message behind Rita Rubin’s timely piece about shifting body mass and muscle as we age and its implications. Although focused ...

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Our health care system in the United States is notorious for providing a lot of unnecessary medical care — something we’ve written about extensively. Doctors may provide that unnecessary care because they perceive that patients are expecting or requesting it. If health care professionals don’t provide the aggressive care that patients believe they require, the thinking goes, patients won’t be satisfied, and the doctor-patient relationship will suffer. Plus, the patient ...

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STAT_Logo Home delivery for everything from fresh produce to custom-selected clothing has become a way of life for many Americans. While most home-delivery conveniences are generally changing our lives for the better — giving us more time and choices — at-home genetics kits that reveal information about the risk of developing certain cancers represent a risky step in ...

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