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
Medical errors: Honesty is the best policy
“It’s a definite that you’re all going to screw up, but it’s not a definite that any of you will learn from that,” declared one of our medical school instructors, years ago. “Cultivate the attitude that allows you to own your mistakes, and then, not repeat them.”
How common are medical errors?
Medical errors are, frankly, rampant. A recent study used data analysis and extrapolation to estimate that “communication breakdowns, diagnostic errors, poor judgment, and inadequate skill” as well as systems failures in clinical care result in between 200,000 to 400,00 lives lost per year. What this means is that i...
Source: Harvard Health Blog - October 3, 2016 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Health care Managing your health care Safety Source Type: blogs
The story of the man who could see the invisible
Once upon a time long, long ago there lived a man who could see things that other people simply could not see. He was not born with this skill but cultivated it slowly and continuously with years of focused attention.
He worked as a physician in a large hospital and would sometimes have students go with him to see patients. As far as the students were concerned, he could really see the invisible.
When he was asked what afflicted a patient, he would share his impressions and then carefully and systematically explicate the chain of observational evidence that lead to his indisputable conclusion. For example, after shaking an...
Source: Kevin, M.D. - Medical Weblog - July 25, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mark-e-williams" rel="tag" > Mark E. Williams, MD < /a > Tags: Physician Health IT Hospital Source Type: blogs
Femoral artery calcification
– positive and negative images
Incidentally detected femoral artery calcification on X-ray taken for some other purpose. Both positive and negative images are shown side by side. Negative images were obtained by digital processing of the positive image. Extensive calcification is seen extending from the common femoral artery into superficial femoral artery and profunda femoris artery. Arterial calcifications are more likely to be seen in the elderly and in those with altered calcium metabolism as in chronic kidney disease and hyperparathyroidism. Secondary hyperparathyroidism may occur in chronic kidney disease due ...
Source: Cardiophile MD - September 6, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology X-ray Source Type: blogs
Medullary Nephrocalcinosis-Plain Film
Nephrocalcinosis was a termed coined by Albright in 1934 to describe the deposition of calcium salts in the renal parenchyma in hyperparathyroidism. Radiograph depicting bilateral nephrocalcinosis: Causes of medullary nephrocalcinosis: HyperparathyroidismMedullary sponge kidneyTuberculosis of the kidneysRenal tubular acidosisMilk-alkali syndromeSarcoidosisFrom Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at sales@teleradproviders.com (Source: Sumer's Radiology Site)
Source: Sumer's Radiology Site - July 15, 2014 Category: Radiologists Authors: Sumer Sethi Source Type: blogs
Clinical SPECT/CT—Time for a New Standard of Care
I haven't been able to attend the SNMMI (Society of Nuclear Medicine and Molecular Imaging) meeting in quite a while. It is unfortunately scheduled on the first week of June, and even if I can score the week off, I'm usually off on vacation with the family.This year's meeting was in Vancouver, my most favorite city on the planet, so I'm doubly deprived. It's in St. Louis next year, and I'm going to try my best to be there.One of the highlights of the SNM (I still can't get used to the new title) is, not coincidentally, the "Highlights" lecture at the end of the meeting. There are several different sections of this concludi...
Source: Dalai's PACS Blog - October 14, 2013 Category: Radiologists Source Type: blogs
Tendoachilles tear-MRI
57 year old male, with history of slipping on the staircase,
shows on MRI an apparent tendoachilles discontinuity and disruption of
approximately 3 cms in the critical zone of vascularity from the calcaneum (4
cms) with paratendon edema with no retraction of the ends, suggestive of partial tear. Case by Dr MGK Murthy, Mr Gupta and Mr Venkat
Teaching
points :
Lateral
head of the gastrocnemius from the lateral femoral condyle joints the medial
head fibres (from medial femoral condyle) at the junction of proximal and mid
calf with soleus fibres joining them 3 to 4 cms down to form tendoachilles....
Source: Sumer's Radiology Site - September 6, 2013 Category: Radiologists Authors: Sumer Sethi Source Type: blogs
MKSAP: 58-year old woman with fatigue and weight loss
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year old woman is evaluated for a 3-week history of fatigue and weight loss. The patient has no significant medical history and takes no prescription medication, but she does take a daily over-the-counter multivitamin and a calcium supplement. She has a 50-pack-year smoking history.
Physical examination reveals a lethargic, ill-appearing woman. Temperature is 37.3 °C (99.1 °F), blood pressure is 136/78 mm Hg, pulse rate is 95/min, and respiration rate is 12/min. Other physical examination findings are unre...
Source: Kevin, M.D. - Medical Weblog - August 10, 2013 Category: Family Physicians Tags: Conditions Cancer Endocrinology Source Type: blogs
Considering Reversal Cells in Osteoporosis
Researchers are digging deeper into the mechanisms underlying the loss of bone that accompanies aging. A complete understanding of how imbalances occur between ongoing bone creation and destruction that takes place at the cellular level should eventually lead to ways to manipulate that process:
By analyzing biopsy specimens from patients with postmenopausal osteoporosis and primary hyperparathyroidism, investigators have begun to pay increasing attention to "reversal cells," which prepare for bone formation during bone remodeling. The hope is that these reversal cells will become critical therapeutic targets that may some...
Source: Fight Aging! - June 11, 2013 Category: Health Medicine and Bioethics Commentators Authors: Reason Tags: Daily News Source Type: blogs
