Category: Conditions

MKSAP: 50-year-old man with a left lower extremity ulcer

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 50-year-old man is evaluated for a left lower extremity ulcer. He has a 15-year history of worsening arthritis for which he has never been …

The problem of overdiagnosis: What can patients do?

An interesting article in the journal Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students about; it is sobering because it describes the potential harm that can come…

Explaining Peter Fonda’s lung cancer

Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda …

What is patient autonomy?

I yelled for the nurse as I wrapped my arms around Mr. John. He was suffering from a violent acute dystonic reaction from a dose of Haldol the night before. Severe muscle spasms overtook his entire body. I saw the whites of his eyes as his gaze shot to…

The patient with a pocketful of IDs

All of us nurses and physicians in the ED and ICU knew him well. He was a young, 21-year-old. A smart, articulate guy who kept going from one hospital to the next. He had a system down … almost. This young man was a drug seeker. He knew all about…

MKSAP: 64-year-old woman with severe COPD

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old woman is evaluated during a posthospital visit for severe COPD with an FEV1 of 30% of predicted. She has been admitted three ti…

What to consider before undergoing stem cell treatment or banking stem cells

It can be difficult to tease out the evidence-based science amidst the claims of successful adult stem cell-based treatments for a range of health problems from joint pain to Parkinson’s disease, macular degeneration, and spinal cord injury. Even a num…

The costly decision of delaying surgery

It was a common enough reason for someone to have a CT scan. The order read, “Abdominal pain, colon cancer resected in January.” It was now March, only two months post-surgery. Yet the patient’s CT scan showed a number of large masses in the liver, con…

What does evidence-based psychotherapy really mean?

When a mental health clinic, online referral service, or private practice offers “evidence-based” psychotherapy, that certainly sounds like a selling point.  It suggests solid science supports the therapy offered — and that competing services lac…

No, phones don’t cause horns to grow on skulls

The Washington Post ran this headline: “’Horns’ are growing on young people’s skulls. Phone use is to blame, research suggests.” The headline is entirely correct except for a few minor points: They’re not horns, which point up from the forehead. They’r…