Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 49-year-old-man is evaluated 1 day after having an episode of right arm weakness without pain that lasted 5 minutes. He is now asymptomatic. The patient has type 2 diabetes mellitus and dyslipidemia. Medications are aspirin, metformin, and atorvastatin. On physical examination, blood pressure is 126/68 mm Hg, pulse rate ...

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As a doctor that specifically deals with brain and spine surgeries, I have adopted a No Room for Error mentality in the operating room. I believe this same mentality can be helpful in making the best possible life decisions. What do I mean by No Room for Error? It is natural to visualize the successful achievement of a goal. For instance, prior to performing the most common surgery I perform, resection of ...

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Everyone knows someone today who's dealing with dementia. And as a geriatrician — that means a lot of questions come my way. Questions about parents who recently had cognitive testing, about the role of assisted living, about prevention — you name it. Dementia is out there in a way it never was before. People have questions, and they need answers. Dementia is not a normal part of aging This is where I ...

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Since childhood, I have suffered from severe stabbing headaches. Then in my first year of medical school in anatomy, as we peeled back the scalp of our cadaver, I saw a nerve poking out of a muscle on the back of the skull. With a flash, I knew that I was seeing the source of my pain. But despite identifying it, it would be another five years before I ...

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When I was on staff at a large medical center, the CEO established four core values for the institution which he arranged in a diamond pattern: safety at the apex — think of yourself as a patient expectedly at the bottom. While it seems hard to assess how seriously this widely displayed mission statement was taken, or if anyone really remembered which value went in which corner, the institution expanded. Thinking ...

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The other day, I happened across a YouTube video called the “Try Not to Look Away Challenge.” There were some obvious video clips, such as a person vomiting, a spider, and a spooky video game. What struck me was a clip from a movie in which a middle-aged woman forgets where the restroom in her house is located. After letting her husband know that she was headed to the restroom, ...

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On several occasions, most recently during a press conference in March 2019, Speaker of the House Nancy Pelosi has advocated changing the voting age to 16. Pelosi told reporters that lowering the voting age would increase engagement in politics among younger Americans and would help drive a higher level of voter awareness and turnout. Speaker Pelosi is not the only prominent lawmaker to advocate for a lowered voting age. Also in ...

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A call came about noon a few years ago that a patient I'll call Stella was being admitted once again. She had come into the ER from her nursing home to receive transfusions. These were now needed every two weeks to keep her alive. The problem was that every time Stella was moved she decompensated. Her Alzheimer's was severe. She no longer recognized her family. She was now 83 and slowly ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old man is evaluated for a 1-year history of progressive weakness that began as right foot drop and bilateral tingling in the feet. Within the past 2 months, the patient has developed progressive weakness, which makes walking difficult; he also notes weakness in the hands and burning below ...

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The incidence of brain trauma has been rising in recent years. According to the Centers for Disease Control and Prevention (CDC), emergency department visits related to traumatic brain injury (TBI) increased by 53 percent in the U.S. from 2006 to 2014. For 2014 alone, the CDC reported about 2.87 million TBI-related visits, hospitalizations, and deaths. Reports of concussions in high school athletes have also increased in recent ...

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