Category: Neurology

MKSAP: 56-year-old woman with a 1-year history of tremor

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old woman is evaluated for a 1-year history of tremor. The tremor is more prominent on the right side. She also reports increasing problems with balance and numerous falls, especially when arising from a chair or turning. The patient does […]

MKSAP: 56-year-old woman with a 1-year history of tremor

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old woman is evaluated for a 1-year history of tremor. The tremor is more prominent on the right side. She also reports increasing problems with balance and numerous falls, especially when arising from a chair or turning. The patient does […]

What can physicians do to combat confirmation bias?

The day begins at 6 a.m. I am rounding on my nine patients, quickly examining them and providing a brief update about the plan. Like the other harried residents, I am speeding from one room to the next, trying to get everything done on time. And then, inevitably my beeper goes off — “Patient in […]

Delirium is a serious and common outcome of treatment in hospital intensive care

Since intensive care units (ICU) were created in hospitals more than a half a century ago, there has been a steady decline in death rates for individuals who are critically ill and require life support. That’s significant and meaningful progress, and it’s thanks to the pioneering work of many doctors, nurses and researchers who have discovered better […]

The fine line between dementia, sex, driving, and money

How do we balance freedom and safety for those with dementia, particularly in the risky domains of sex, driving and money? In 2014, Henry Rayhons, a 78-year-old Iowan, was arrested because he allegedly had sex with his wife. Wait. What? The Rayhonses, both previously widowed, met while singing in a church choir. Over time, Mrs. Rayhons […]

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% […]

MKSAP: 70-year-old man with a transient ischemic attack

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 70-year-old man is admitted to the hospital with a 1-hour episode of left arm and left leg weakness. He is diagnosed with a transient ischemic attack. The patient has a history of hypertension and type 2 diabetes mellitus and a […]

The art of medicine is needed to prevent migraine headaches

He spoke with an aura of superiority, in a slightly nasal voice, and his topic was migraines. It was in the late 70s, a time when there were few options to treat migraines. “Most people who claim to have migraines just have simple tension headaches,” he scoffed. And in a move that seemed unorthodox at […]