An open letter to Heather Bresch: What is legal is not always ethical
Dear Ms. Bresch, I couldn’t help but notice the barrage of negative press you’ve received lately regarding the significant price increases in EpiPens. A 461 percent increase since 2007, to be exact. People who require this medication for themselves or their children are up in arms about spending over $600 for a twin pack of autoinjectors. Most of these people have life-threatening anaphylaxis if they are exposed to certain allergens. To them, whether or not they have an EpiPen could mean life or death. Now, I don’t want to bore you with the medical stuff. You are not a clinician; you are a business woman. I know you ...
Source: Kevin, M.D. - Medical Weblog - September 3, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Meds Medications Source Type: blogs

A patient presents with painless diarrhea. What should you do next?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is evaluated for a 1-year history of loose stools. She reports approximately four episodes per day without abdominal pain. She has not had nausea, vomiting, weight loss, bright red blood per rectum, or melena. On physical examination, temperature is 36.7 °C (98.1 °F), blood pressure is 115/85 mm Hg, pulse rate is 76/min, and respiration rate is 18/min; BMI is 25. No rashes are noted. Abdominal examination is normal. Rectal examination demonstrates normal resting anal tone. Laboratory studie...
Source: Kevin, M.D. - Medical Weblog - August 29, 2015 Category: Journals (General) Authors: Tags: Conditions GI Source Type: blogs

Cannabinoid Hyperemesis Syndrome
Thankfully, cannabinoid hyperemesis syndrome isn’t a life- or limb-threatening condition. Malpractice attorneys would be having a field day if it were. I have been attuned to this condition only for the past several years, but it’s apparent that this condition remains diagnostically elusive.   Every new case I pick up has presented previously to my or another community emergency department multiple times without anyone making the diagnosis. And the patient almost always has a trail of CT scans, abdominal ultrasounds, and other imaging studies as well as hundreds of dollars in laboratory testing. It’s known that th...
Source: M2E Too! Mellick's Multimedia EduBlog - December 3, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Cannabinoid Hyperemesis Syndrome
Thankfully, cannabinoid hyperemesis syndrome isn’t a life- or limb-threatening condition. Malpractice attorneys would be having a field day if it were. I have been attuned to this condition only for the past several years, but it’s apparent that this condition remains diagnostically elusive.   Every new case I pick up has presented previously to my or another community emergency department multiple times without anyone making the diagnosis. And the patient almost always has a trail of CT scans, abdominal ultrasounds, and other imaging studies as well as hundreds of dollars in laboratory testing. It’s known that this...
Source: M2E Too! Mellick's Multimedia EduBlog - December 3, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Lessons Learned from a Medical Mission
Nurses can serve as excellent physician extenders.My mentors in austere medicine warned me that with an interpreter I would be lucky to see 30 patients per day. That concerned me because the local missionaries indicated at our first organizational meeting in the Dominican Republic that we were expecting to see 100 patients per day. On top of that, 100 cards were being handed out at each of the four locations we would be visiting.   As the single physician in the group of 19 team members (seven nurses), these seemed like very high expectations. Working in a setting that uses physician extenders and emergency medicine resid...
Source: M2E Too! Mellick's Multimedia EduBlog - May 2, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs