Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 46-year-old man is evaluated for intermittent rectal bleeding of 3 months’ duration. He is otherwise well and takes no medications. His father had a few polyps removed from the colon when he was 71 years old, but no other details […]
Category: Conditions
MKSAP: 55-year-old woman with an eating disorder
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old woman is evaluated for a new-patient visit. Medical history is significant for an eating disorder. Although she has maintained a normal weight for the past 20 years, she notes that prior to that time her weight would fluctuate in […]
Never underestimate the power of a smile
He was a young patient with AIDS and Pneumocystis jiroveci pneumonia (PJP). Maybe that should have scared me from the start, but it didn’t. In hindsight, I keep wondering when the fear really set in. But downstairs under the glaring lights and the swooshing bustle in the ER, I only remember that he looked slightly […]
Who named our bones? And what were they thinking?
All of our 200+ bones have names, which facilitates describing them when we cannot actually hold them or point directly at them. It might be easier to remember the names if they were familiar ones like Robert, Sally, and Kevin, but no such luck. Latin was the original language of science, so the bones received […]
MKSAP: 70-year-old man with heartburn
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 70-year-old man is evaluated in follow-up for heartburn of 7 years’ duration. He has frequent nocturnal reflux but has not had odynophagia or dysphagia, and his weight has been stable. He was recently started on once-daily omeprazole with good control […]
Not all depression is alike. Here are the differences.
Adapted from Understanding Antidepressants. In his often-quoted beginning of Anna Karenina, Tolstoy wrote, “All happy families are alike; each unhappy family is unhappy in its own way.” If we stretch this notion a little — going from families to individuals, and from unhappiness to depression — we come up with an interesting question, which is […]
Tips to manage chronic pain on summer vacation
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. It’s officially that time of year. Summer is in full-swing, and all of America is getting ready to take a much-needed holiday. However, some Americans, particularly those who suffer from chronic pain, often dread getting away. They are afraid their chronic pain might prevent them […]
Why do so few doctors treat people with opioid addictions?
Dear Doctor, Please help me understand why so few of you have chosen to treat people with opioid addictions. I’ve been following the topic of opioid addiction for years. It is one of the most common themes for First Opinion submissions. Authors routinely point to the importance of medication-assisted therapy, the standard of care for individuals with opioid […]