Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 82-year-old woman is seen for follow-up evaluation of Alzheimer disease. Since her last visit 12 weeks ago, she has been taking rivastigmine, with a progressively titrated dosage. The patient's only new symptoms are increasing insomnia, loss of appetite, and occasional diarrhea; she has had no feelings of hopelessness, ...

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You’ve probably seen it on the news – a rare, polio-like illness is causing cases of paralysis in children. Here’s the latest info, based on our best current knowledge from the CDC. Acute flaccid myelitis (AFM) is a sudden illness that causes weakness in one or more extremities – one arm or (less likely) a leg, or any combination of arms and legs. The words in the name express the key ...

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When I finished my training, I was taught that the vast majority of dementia was Alzheimer's disease, with occasional cases of multi-infarct dementia as well as odd syndromes such as Kreutzfeld-Jacob disease and genetic, traumatic, toxic and tumor-related syndromes. Parkinson's disease, we were taught, caused a tremor and freezing up of a person's movements and only very rarely was associated with any kind of memory loss. These teachings helped us modern ...

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“He’s having a senior moment.” That dismissive phrase seems harmless, but, in reality, it leads to devastating, debilitating disease. I firmly believe that a generation from now, people will not know the pain of watching a loved one slip into oblivion. But the only way we will get there is we stop dismissing memory loss and other behaviors as “normal aging.” The recent news that former Supreme Court Justice Sandra Day O’Connor ...

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There is a man. He is in my house. I don’t know where he came from. But he just came into my house. And now he is living there. And I am afraid of him. I do not know who he is. There is a man in my house. I am so scared. I don’t know why he came. But he is there. And he tells people he is my ...

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Teleneurology is the new and vastly expanding practice of neurology involving the use of technology and/or video chat to improve access to services. With an ever-increasing aging population there is and will continue to be a shortage of neurologists in the United States. Teleneurology has increased patient access to neurologists especially in rural areas but also in urban and suburban areas. Practicing as a teleneurologist for the last two years I ...

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A excerpt from A Mind Unraveled: A Memoir. Copyright © 2018 by Kurt Eichenwald. Published by Ballantine Books, an imprint of Random House, a division of Penguin Random House LLC. All rights reserved. I awoke in pain. Sometime during a seizure, I had fallen down the stairs outside of ...

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Computed tomography, or CT scanning, is one of the most powerful diagnostic tools to emerge during my medical career. Just look at the detail in the brain images above, taken at 90-degree angles through the brain. And I was there at the beginning. I remember well when I was a medical student taking neurology, and the first CT scanner arrived at the Mayo Clinic. By today’s standards, it was incredibly ...

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“Do your parents realize that he could die?” I had been summoned to the workspace of the ED physician who was trying to save my brother’s life. I remember noticing that he was short with thick brown hair and a crisp white coat which were both too tidy and incongruent with the message he was delivering. He struck me as someone who was earnestly playing the role of a physician instead ...

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Few things in primary care give patient and doctor mutual and instant gratification. It’s been a while since I reduced a “nursemaid's elbow” or a spontaneous shoulder dislocation other than my own, or a finger dislocation, but those all count. I once wrote about curing deafness in a man with a movement disorder by flushing ear wax more or less on the run as he bobbed around the exam room. That ...

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