I met Mr. B during my week on the endocrine service of my internal medicine rotation. My attending told me we were being consulted for this patient’s high sugars and a foot ulcer, and asked me to take the history. I walked into Mr. B’s room and was immediately struck by its stench. Mr. B had undergone a resection of his bladder tumor the day before and as a result was ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is evaluated for a new skin rash of 10 days' duration. The rash appeared abruptly and is not tender or pruritic. The patient has poorly controlled type 2 diabetes mellitus. His current medications include metformin and glyburide. Family history is unremarkable. On physical examination, vital signs are ...

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“We pass through the present with our eyes blindfolded … Only later when the cloth is untied can we glance at the past and find out what we have experienced and what meaning it has.” – Milan Kundera Two days ago, during a clinical skills session on lymph node examination, my classmates insisted that I get what appeared to be an enlarged lymph node in my neck checked by the physician ...

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Last summer, I published a post called "Alternative Medicine is Kicking Our Ass." In it, I focused on one particularly slick alt-thyroid site that has done a masterful job of sowing doubt regarding the advice mainstream physicians give to our patients about the thyroid. Not only that, but the site has called into question our competency as doctors, citing "evidence" that supposedly proves (it doesn't) we ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old man variable 2-hour postprandial blood glucose is evaluated during a routine follow-up examination. He has type 2 diabetes mellitus. Review of his blood glucose log demonstrates fasting blood glucose values ranging from 120 to 160 mg/dL (6.7-8.9 mmol/L) and variable 2-hour postprandial blood glucose values ranging from ...

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I just had a conversation with a physician and faculty member at my school. He started the conversation like this: “It’s alright if you disagree with me, and I can disagree with you too. Good academic discourse should allow people to disagree with each other.” He then allowed me to question him and explain my perspectives for over an hour as he explained his answers, helped clarify some points, and gave ...

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Medical crises come in many forms: from illnesses to sudden injuries. Most often the victims are unsuspecting. They may be gradual in onset or happen in seconds. There are many causes, from faulty drivers to electrolyte disturbances. Mine was caused by a squirrel, a routine yard rodent. In less than three seconds, I went from a practicing physician with a heavy patient load to temporarily disabled. Returning home from a busy ...

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I'm excited to announce that I'll be keynoting AACE 2019, the annual meeting of the American Association of Clinical Endocrinologists, April 27, 2019 in Los Angeles, CA. Health professionals often hear about social media from a perspective of risk and negativity, especially with the headlines in the past year. But there's another side: One where we can use social ...

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There is a wealth of information about your health circulating in your blood. For people with diabetes, accessing that information can be a matter of life or death. For nearly 30 years, the prevailing technology for checking the blood sugars of someone with diabetes has been the fingerstick. People with diabetes are often asked to stick their fingers and check their blood multiple times a day to assess whether their blood ...

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It was a slow day in the emergency department. I was sitting across the bedside from my patient who came in for a left forearm infection checkup. She was a 73-year-old female with a history of diabetes. She was elegant and soft-spoken. Prior to examining her wound, which had been worsening, I asked her what her A1c number is. She wondered what an A1c number was, and I explained that ...

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