Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 37-year-old woman undergoes preoperative evaluation prior to a hysterectomy for worsening menstrual bleeding of several years' duration caused by uterine fibroids. She has a recent history of recurrent epistaxis and bleeding after recent dental work but denies thromboembolism and a family history of unusual bleeding. The patient is otherwise healthy. Her only medication ...

Read more...

Full disclosure. I have 4 board certifications and dutifully do all of the required reading, continuing medical education (CME) and recertification exams to maintain my status (I am board certified in OB/GYN in both the US and Canada as well as board certified in pain medicine by both the American Board of Pain Medicine, ABPM, and the American Board of Physical Medicine and Rehabilitation). I would never go to a non-board ...

Read more...

This weekend I tried to buy Plan B over the counter at a Rite Aid and was denied. Let me explain. It wasn’t for me, I have a Paraguard and my boyfriend had a vasectomy. Basically, the chance of me getting pregnant is so astronomically impossible that we’d be pimping the story out to every tabloid and we would aim for a reality show, which we would call The Second Coming. What ...

Read more...

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. As an obstetric anesthesiologist, it is my responsibility to make sure expectant mothers are comfortable during labor and delivery. It is important women understand their pain management options during childbirth by having discussions with their anesthesiologist and obstetrician. However, as an obstetric anesthesiologist, my role often extends ...

Read more...

I was skeptical when a doctor casually mentioned that 2% of all pregnancies are ectopic pregnancies (in which the fertilized egg is implanted somewhere other than the uterus, usually the fallopian tube). Without treatment, a common outcome is fallopian tube rupture, which jeopardizes the life of the mother. It is a serious medical concern. I shot a confused look at a fellow first-year medical student. Two percent? It seemed way ...

Read more...

At no other time in my medical training was I as confident that, with hard work and dedication, I could master the field of internal medicine as when I was a newly minted third year medical student. Fresh from having taken the USMLE step 1, I interpreted my ability to recite the mechanism of penicillin resistance or the role of histamine in the immune response, and describe in great detail the ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated in the office for a history of migraine, with and without aura, since age 16 years. She has an average of three attacks each month and consistently experiences an attack 2 days prior to menstruation; this headache is more difficult ...

Read more...

Where is the physician outrage? Right. Here. I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics. I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins. I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as "rape." If I insert any ...

Read more...

As an OB/GYN resident, I tried to reconcile quality and cost of care every day. This is the story of one patient who cost the system a lot of money, but I don’t know to this day if it was too much. Cheryl (name changed) had HIV, a history of cervical cancer, and 3 kids. At age 35, she had been cured from cervical cancer after surgery and radiation therapy. However, ...

Read more...

I cradled my son's miniature body in my hands. Only moments old, he looked up with large glassy eyes. He was so alert, so perfect. I carried him over to the bedside. The obstetrician worked on the afterbirth as my wife waited patiently to hold her child. At the time, it hadn't sunken in yet how much our solitary lives were changing. The nurses swept the baby away for routine testing ...

Read more...

Join 147,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 148,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.
close-image