MKSAP: 67-year-old man with primary hyperparathyroidism
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril.
On physical examination, temperature is 35.8 °C (96.4 °F), blood pressure is 120/68 mm Hg, pulse rate is 62/min, and respiration rate is 14/min. BMI is 32. The remainder of his examination is unremarkable.
Laboratory studies:
Creatinine
0.9 mg/dL (7...
Source: Kevin, M.D. - Medical Weblog - March 11, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Endocrinology Source Type: blogs
RJL Systems Launches the Quantum V BIA Device for Body Composition Analysis
RJL Systems, a company based in Clinton Township, Michigan, launched last week the latest successor in their line of Bioelectrical Impedance Analysis (BIA) products, the Quantum V. The Michigan-based company, often considered the originators and chief innovators of BIA instrumentation for use in determining body composition, has regularly worked to advance their technology since the 1983 release of their initial FDA-cleared Class II medical device. The Quantum V segmental body composition analyzer seeks to continue that trend by offering increased data acquisition speed, accuracy, specificity, and utility as compared to pr...
Source: Medgadget - February 9, 2017 Category: Medical Equipment Authors: Zach Kaufman Tags: Diagnostics Medicine Sports Medicine Source Type: blogs
Ellie's First Post
Hi, My name is Ellie and I am starting to blog for the first time :)This is me. I am 10 years old, in 5th grade and live in Massachusetts. I have a dog named Tillie and a brother named Will.10 years ago on today my family brought me home for the first time!!!!!And my mom and dad just showed me the video of my mom moon walking out the door of Boston Children ' s Hospital with me for the first time. My parents can be strange!! WHO WALKS BACKWARDS OUT OF A HOSPITAL??????I have broviac CVL and I am the 23rd person on Omegaven, and I am still on Omegaven.I went to clinic this week and I had a DEXA Scan. I had to ...
Source: The Short Gut News - December 11, 2016 Category: Gastroenterology Source Type: blogs
Radiation in Radiology Department & The Truth
Conclusion based on the available present data , seems to suggest : Diagnostic radiation need not be feared , if an indication exists . Screening studies if spaced adequately are extremely beneficial , as they play major role in reducing morbidity/ mortality from the suspecting disease. Appropriateness criterion for each test , as developed by ACR, is less useful in third world countries like India , in view of the cost considerations and major health expenditure coming from out of pocket resourcesFamous Radiology Blog http://www.sumerdoc.blogspot.com
TeleRad Providers a...
Source: Sumer's Radiology Site - August 10, 2016 Category: Radiology Authors: Sumer Sethi Source Type: blogs
Reducing health costs: Patients aren’t going to take the lead
Lena Wright’s best friend was hunched over like a character from a French novel, with spinal bones so thin they would fracture with a fit of sneezing. Determined to avoid that fate, Wright (a pseudonym) asked her primary care doctor to test her for osteoporosis with a DEXA scan, also known as dual energy x-ray absorption. The scan would send two x-ray beams through her bones, one high-energy and the other low. The difference in how much energy passes through her bones would somehow (the wonders of physics!) allow her doctors to calculate the thickness of her skeleton.
If you need to figure out whether you have osteoporos...
Source: Kevin, M.D. - Medical Weblog - April 12, 2016 Category: Journals (General) Authors: Peter Ubel, MD Tags: Policy Endocrinology Source Type: blogs
To Reduce Unnecessary Care, Choosing Wisely Moves from Awareness to Implementation
In 2012 the ABIM Foundation launched the Choosing Wisely campaign with the goal of kick-starting an important and needed national conversation about unnecessary health care tests and procedures. A pervasive and persistent problem in our health care system, unnecessary care was estimated by the Institute of Medicine to amount to $750 billion a year—roughly 30 percent of health care spending—and was projected to keep growing.
Since then, Choosing Wisely has grown precipitously, adding more than 100 new partners and evolving its approach to make a lasting impact. Most recently, through the support of grants from the Rober...
Source: Health Affairs Blog - July 1, 2015 Category: Health Management Authors: Daniel Wolfson and Susan Mende Tags: Costs and Spending Drugs and Medical Technology GrantWatch Health Professionals Quality Choosing Wisely Consumers Effectiveness Health Philanthropy Physicians Source Type: blogs
MKSAP: 54-year-old woman asking advice about bone health
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 54-year-old woman comes to the office for advice regarding maintaining bone health. She has no history of fracture. The patient recently had a lumpectomy and radiation therapy to treat breast cancer, is currently taking tamoxifen, and will begin taking an aromatase inhibitor in 2 months. She underwent menopause at age 52 years and has persistent hot flushes. Her risk factors for osteoporosis include a slim body habitus and a mother who had a hip fracture at age 67 years.
Physical examination findings, includin...
Source: Kevin, M.D. - Medical Weblog - March 21, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Endocrinology Source Type: blogs
MKSAP: 55-year-old man with a wrist fracture and anemia
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is reevaluated during a follow-up examination for a wrist fracture and anemia. The patient is otherwise asymptomatic. He was treated in the emergency department 2 weeks ago after he slipped in his driveway and sustained a right wrist fracture; mild iron deficiency anemia was detected at that time. He had normal results of a routine screening colonoscopy 5 years ago. Since his emergency department evaluation, 3 stool samples have been negative for occult blood. He takes no medication.
On physica...
Source: Kevin, M.D. - Medical Weblog - August 30, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Endocrinology GI Source Type: blogs
Great video that explains how a DEXA scan works for measuring bone, body fat and muscle
This video about how a full body dual-energy x-ray absorptiometry (DEXA) scan works as the best way to measure body composition. However, few clinics provide it since they only use DEXA to measure bone density in the lower back and pelvis. It required special calibration for a full body scan. Talk to your doctor is he can find a local clinic that can do a full body DEXA scan. Your insurance may (Source: Nelson Vergel's HIV Blog)
Source: Nelson Vergel's HIV Blog - July 11, 2014 Category: HIV AIDS Authors: Nelson Vergel Source Type: blogs
Pomalyst Study Cycle 80
Thursday, May 1, 2014, Pomalyst Study Cycle 80:
IgG was higher today than it has been for years, though only slightly. Last month IgG was 1270 mg/dL, now 1340 this month. However, M-Spike was 1.1 g/dL last month, down to 1.0 this month. 1.0 is right in the middle of the range of M-Spike for the last several years. So what are we to believe? Both of those changes are probably within the accuracy limits of the test anyway, so let's call it a draw; my myeloma is still stable.
For whatever it's worth, the Lambda and Kappa light chains didn't change too much either
I'm happy for another month, Pomalyst is ...
Source: Myeloma Hope - May 12, 2014 Category: Cancer Source Type: blogs
Breast Imaging Cuts in Medicare Final Rule May Delay Diagnosis and Treatment and Increase Patient Anxiety
Washington, DC (Nov. 27, 2013) — Drastic reimbursement cuts for image-guided breast biopsies and other medical imaging techniques in the 2014 Medicare Fee Schedule Final Rule may further reduce women’s access to mammography and other breast cancer services. The Centers for Medicare and Medicaid Services (CMS) directly cut imaging reimbursement every year since 2007. This, along with 12 Medicare imaging cuts in the last six years due to legislation, increasingly threatens patient care.
Repeated imaging cuts have reduced funding for many common exams up to 50 percent. This is forcing many facilities to close or cut servi...
Source: radRounds - November 30, 2013 Category: Radiologists Authors: radRounds Radiology Network Source Type: blogs
Can mandibular bone resorption predict hip fracture in elderly women? A systematic review of diagnostic test accuracy
ConclusionIf a patient with a thin or porous mandibular cortex is identified by a chance radiographic finding, additional clinical risk factors need to be considered and the patient referred for further investigation with DXA where necessary. (Source: Dental Technology Blog)
Source: Dental Technology Blog - November 18, 2013 Category: Dentists Source Type: blogs
An Example of Dietary Supplements Doing Nothing
This study was a 6-month randomized, single-blind controlled trial, in which 56 non-obese men and women, aged 38 to 55 yr, were assigned to a dietary supplement (SUP) group or control (CON) group, with a 6-month follow-up.
The SUP group took 10 dietary supplements each day (100 mg of resveratrol, a complex of 800 mg each of green, black, and white tea extract, 250 mg of pomegranate extract, 650 mg of quercetin, 500 mg of acetyl-l-carnitine, 600 mg of lipoic acid, 900 mg of curcumin, 1 g of sesamin, 1.7 g of cinnamon bark extract, and 1.0 g fish oil). Both the SUP and CON groups took a daily multivitamin/mineral supplemen...
Source: Fight Aging! - September 6, 2013 Category: Health Medicine and Bioethics Commentators Authors: Reason Tags: Daily News Source Type: blogs
