Category: Conditions

MKSAP: 56-year-old man with painless intermittent bloody urine

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old man is evaluated for painless intermittent bloody urine of 6 weeks’ duration. History is significant for granulomatosis with polyangiitis (formerly known as Wegener granulomatosis) diagnosed 10 years ago, which is now in remission; he was treated with prednisone for […]

MKSAP: 56-year-old man with painless intermittent bloody urine

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old man is evaluated for painless intermittent bloody urine of 6 weeks’ duration. History is significant for granulomatosis with polyangiitis (formerly known as Wegener granulomatosis) diagnosed 10 years ago, which is now in remission; he was treated with prednisone for […]

Children of war: inherited bereavement

The children of survivors are important to the Holocaust story.  The children are the future of the past.  For a time, it seemed that no one would be left to create a future.  That history has been so carefully, lovingly chronicled.  It must be preserved.  If it is preserved and told, the possibility exists that […]

A breakdown of your pathology report

I’m a pathologist and the main way I communicate to the outside world — to your doctor and ultimately to you, the patient is via the pathology report. But the short missives I send from behind the microscope lack any excitement and can fall short of full communication. Here’s the usual story: Skin left scapula, […]

A case of instant gratification in primary care

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 […]

MKSAP: 25-year-old woman with type 1 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman with type 1 diabetes mellitus is evaluated for recent-onset glycemic fluctuations without symptomatic hypoglycemia. She was diagnosed with diabetes 7 years ago. Her HbA1c levels since diagnosis have ranged from 6.4% to 7.3%, with the most recent value […]

A physician with congenital heart disease

Everyone always jokes with doctors, “What happens if you get sick?” Some of us laugh off the question. The busy schedule of health care often means our own health comes last. However, what happens when it’s a chronic disease that requires treatment? Then the answer to this question is a little different. I am a […]

Looking for the silver lining at supervised injection facilities

The Hippocratic Oath, as presumably most of us know, is the oath taken by physicians promising to uphold ethical standards in treating their patients. The four pillars of medical ethics primarily stem for this oath: autonomy, beneficence, non-maleficence, and justice. The world we see now is socially different compared to what it was when Hippocrates […]

Opioid cheating is a billion-dollar industry

If you search for “how to pass a urine drug test” on the internet, you will get several million results. As physicians, we see and manage the national opioid crisis every day. We see the impacts of this in our practices and our lives. The crisis frankly shows no signs of abating or becoming a […]

Words can hurt those on benzodiazepines

There exists a large, mostly-underground, a growing community consisting of those iatrogenically harmed by benzodiazepines. Guilty only of following doctors orders, these patients are marginalized and misunderstood. This has been enabled, at least in part, by poor terminology. Recently on Twitter, Michael P. Hengartner and Marnie Wedlake both posted critical questions in response to a […]