Category: Conditions

MKSAP: 77-year-old woman with frequently fluctuating INRs

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 77-year-old woman is evaluated for frequently fluctuating INRs (<1.8 to >3.5) while taking warfarin therapy. She has undergone INR testing every 1 to 2 weeks and frequent warfarin dose adjustments. She reports a consistent dietary intake. Medical history is notable […]

How clinicians can impede clinical trial recruitment

In the second week of April, I headed to San Francisco where I took part in the SWOG Semi-Annual Meeting. To those who might be unfamiliar with us, SWOG is a member organization of the National Clinical Trials Network (NCTN) and is tasked in running clinical trials across disease sites and scenarios, from prevention to […]

My story isn’t Serena Williams’ story, but some things sound the same

I’m not much of a tennis fan, but I am a fan of Serena Williams. Who wouldn’t be after hearing her story? Her rise to the upper echelon of athletics was remarkable, and her longevity is incomparable. All the while, she has challenged the sporting world’s notions about who and what an elite tennis player […]

The many ways to describe chest pain

There are at least 50 words in the Eskimo languages for snow, 25 in mainstream Swedish, and supposedly 180 or so in the Sami language of the nomadic inhabitants of the northernmost parts of Norway, Sweden, and Finland. But there are even more words than that for “chest pain” among my patients, many of whom […]

Think you have an iodine allergy? You may want to reconsider.

Let’s begin with a quiz question: Patients may be allergic to: A. oxygen B. carbon C. iodine D. none of the above If you answered anything but “D,” better keep reading. Consider this scenario: If a patient is allergic to penicillin, you would document “penicillin” in the medical records. It would never occur to you […]

Parents vs. Fortnite: tips from a child psychiatrist

Fortnite Season 5 has officially arrived — bringing new features, a new maps, and new skins. Parents can anticipate battles over the amount of time spent playing the game to “level up” with your teens. If you are not familiar with this game, then it likely means that you are not the parent of a […]

MKSAP: 57-year-old man with type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% […]

MKSAP: 57-year-old man with type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% […]

How to improve the care of in-flight emergencies

“If there is a physician on the plane, please press your call light!” The vast majority of doctors who have flown on airplanes have heard this, and most of us are willing, if not entirely eager, to respond. What follows is usually a far from ideal encounter with inadequate information, too much noise, a cramped […]

Rallying at the end of life

Let’s say your loved one is at the end of life. She’s 84, with advanced cancer that is no longer treatable. A decision has been made to put her in hospice — which is a level of care more than an actual location. (Most hospice actually occurs at home.) The patient waxes in and out […]