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Arterial and Venous Thrombosis From a Patent Foramen Ovale (With Video)A 59-year-old man presented with painful paraparesis of acute onset, severe low back pain, and shortness of breath. On initial examination, he had 0/5 strength and numbness in his lower extremities. The skin from below his umbilicus to his lower legs was pale.
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New Orleans Now -- Few Doctors in the HouseA Multimedia Special ReportThis special report from Zach Wise, a MedPageToday contributing photographer, presents the sights and sounds of New Orleans medicine a year after Hurricane Katrina.
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Case In Point: Peripheral nerve sheath tumor mimicking pulmonary embolismWe describe a case in which a patient received thrombolytic therapy after he presented with a clinical picture consistent with submassive pulmonary embolism (PE). Two months later, a malignant peripheral nerve sheath tumor was diagnosed, and the patient died with metastatic disease. The filling defect in the left main pulmonary artery originally interpreted as PE was in fact a tumor. This case describes an unusual presentation of a rare disease (malignant peripheral nerve sheath tumor) mimicking a submassive PE.
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Wellens SyndromeA 72-year-old obese man with chronic atrial fibrillation, hypertension, hyperlipidemia, and a history of tobacco use presented for a routine office visit. A year earlier, he began to experience recurrent chest pain, but an ECG had shown normal T waves.
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Pretibial MyxedemaThe persistent effects of Graves disease were evident in a 48-year-old woman who had recently emigrated from Haiti to the United States. Thyrotoxicosis had developed several years before she sought treatment in her native country. The patient's obstructive goiter was removed and treatment with thyroxine was begun.
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Abnormal Liver Function Tests:ABSTRACT: Serum levels of aspartate aminotransferase and alanine aminotransferase that exceed 1000 IU/L indicate acute viral hepatitis (A, B and, rarely, C), acute drug toxicity (eg, acetaminophen overdose or isoniazid hepatotoxicity), or ischemic liver injury. In chronic hepatitis (ie, hepatitis B or C or autoimmune), values range from mildly elevated to usually less than 400 IU/L. Elevated levels of alkaline phosphatase and gamma;-glutamyltransferase (GGT) are consistent with cholestatic disease: primary biliary cirrhosis, primary sclerosing cholangitis, idiosyncratic drug reactions, or mechanical biliary obstruction (eg, biliary stones or tumor). Elevation in the GGT level can also be induced by alcohol consumption or medications (eg, phenytoin). Isolated unconjugated hyperbilirubinemia suggests Gilbert syndrome or a hematologic disorder; conjugated hyperbilirubinemia reflects impaired hepatic excretion. Serum bilirubin and albumin and INR have prognostic significance in chronic liver disease; bilirubin and INR are more useful in acute liver failure because albumin has a long half-life.
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Pediatric and Adolescent Migraine: Update on Treatment OptionsIf the goal of headache therapy for adolescent migraineurs is a pain-free adult life, here's a road map.
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Treatment of Diabetes in Older Adults: Guideline HighlightsThe Numbers: >90% of US adults aged ≥65 yrs have diabetes; 33% of those have T2DM; ~50% of older adults have prediabetes. We highlight new Endocrine Society treatment guidance.
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Pruritic Papulovesicular Rash on Lower Legs: Your Dx?Here are key clues: an intensely pruritic rash on the lower legs that developed within hours after the patient walked through a grassy field near a lake.
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Pruritic Papulovesicular Rash on Lower Legs: Your Dx?Here are key clues: an intensely pruritic rash on the lower legs that developed within hours after the patient walked through a grassy field near a lake.
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Elinzanetant Demonstrates Clinically Meaningful Reductions in Menopausal Vasomotor Symptoms, Meta-analysis ShowsElinzanetant reduced VMS frequency and intensity, and improved sleep and quality of life, according to the meta-analysis to be presented at the ACOG 2025 meeting.
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Expanding Leg Ulcer in a Young WomanSelf-treatment has done nothing to slow the progress of this lesion which the patient thought might be an insect bite at first. Your Dx?
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Top 3 Atrial Fibrillation Studies in 2018Andexxa, CABANA, and new AF score. Cardiologist and Patient Care author Payal Kohli, MD, highlights 3 pivotal developments from 2018.
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Vaping-related Hospitalization, Mortality: A Quiz on New CDC GuidanceTry your hand at these 8 questions based on the latest CDC guidance on rehospitalization and mortality in patients with vaping-related lung injury.
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New COPD Drugs: 2019 in ReviewFDA 2019 approvals for COPD treatment included a cryotherapy spray and other novel & breakthrough therapies. Updates at-a-glance, here.
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Elevated Phosphorous in CKD: How to Avoid Vascular CalcificationThe optimal choice of medication to bind excess phosphate in patients with advanced CKD won't always be straightforward.
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Considering Aspirin: 8 Questions on Primary CVD PreventionThe role of aspirin in primary prevention of CV disease changed for good with results from 3 pivotal trials. Do you recall results and recommendations? Find out.
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EVAPORATE: Icosapent Ethyl Added to Statins Slowed Coronary Atherosclerosis ProgressionAHA Scientific Sessions 2019: Early results from the EVAPORATE study suggest promise for icosapent ethyl as add-on therapy in patients with high TGs already taking statins.
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4 Dangerous Holiday Food-Drug InteractionsWith the holiday season in full swing, you will want to remind your patients of these 4 hazardous holiday food and drug interactions.
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Risk-Based Kidney Care May Be On the WayNew risk prediction models may help identify patients with and without diabetes at elevated risk for chronic kidney disease, say authors of a recent study.
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ADPKD Quiz: Questions on Disease ProgressionThe risk for end-stage renal disease in patients with ADPKD is high. What factors increase the risk and how is it best managed? Test yourself.
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AAA Screening in Primary Care: Criteria, Implementation, and Patient CommunicationEmergency medicine physician Kabiul Haque, MD, discusses USPSTF screening guidelines for abdominal aortic aneurysm.
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A Confluent, Crusty RashHow would you approach diagnosis of this widespread, nonpruritic rash? Lab work? Skin tests? Or will history and physical findings suffice?
