MKSAP: 68-year-old man with dyspnea on exertion
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old man is evaluated for a 3-year history of dyspnea on exertion. He experiences no headaches or blurred vision. Medical history is notable for a stroke 2 years ago. He is a smoker with an 80-pack-year smoking history. Medications are hydrochlorothiazide, lisinopril, aspirin, and simvastatin.
On physical examination temperature is 36.7 °C (98.0 °F), blood pressure is 145/84 mm Hg, pulse rate is 88/min, and respiration rate is 16/min. Oxygen saturation breathing ambient air is 88%. He has facial pleth...
Source: Kevin, M.D. - Medical Weblog - January 23, 2016 Category: Journals (General) Authors: mksap Tags: Conditions Pulmonology Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 7
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Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 7.
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Source: Cardiophile MD - January 23, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Test your medicine knowledge: 62-year-old man is evaluated during a routine visit
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 62-year-old man is evaluated during a routine visit. He is asymptomatic and walks 1 mile most days of the week. Medical history is significant for aortic stenosis, type 2 diabetes mellitus, hypertension, and hyperlipidemia. Medications are aspirin, metformin, lisinopril, metoprolol, and rosuvastatin.
On physical examination, the patient is afebrile, blood pressure is 130/66 mm Hg, pulse rate is 68/min, and respiration rate is 14/min. BMI is 29. Cardiac examination reveals a grade 2/6 early-peaking systolic mur...
Source: Kevin, M.D. - Medical Weblog - November 14, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Heart Source Type: blogs
Test your medicine knowledge: 59-year-old man with gout
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 59-year-old man is evaluated for a 6-month history of gout. He was doing well on colchicine and allopurinol but developed hypersensitivity to allopurinol, which resolved with cessation of the agent. He then began to have more frequent gout flares; two flares occurred in the past month and were treated with prednisone. History is also significant for hypertension, chronic kidney disease, and dyslipidemia. Current medications are colchicine, lisinopril, metoprolol, and simvastatin.
On physical examination, tempe...
Source: Kevin, M.D. - Medical Weblog - November 7, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Rheumatology Source Type: blogs
What medications have you been able to stop on the Wheat Belly lifestyle?
I posed this question on the Wheat Belly Facebook page recently and received an overwhelming response. Here, I share a partial list of the responses: medications people have been able to stop by following the Wheat Belly lifestyle.
Just take a look at this incredible list: these represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat the inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, and other abnormal effects all caused by wheat and grains.
The list includes anti-inf...
Source: Wheat Belly Blog - October 6, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle asthma cholesterol diabetes drugs gluten grains hypertension prescription medication reflux Source Type: blogs
Test your medicine knowledge: 58-year-old man with type 2 diabetes
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year-old man is evaluated during a routine appointment. He is asymptomatic. He was diagnosed with type 2 diabetes mellitus 4 years ago and has hypertension, dyslipidemia, and obesity. His medications are enteric-coated low-dose aspirin, lisinopril, fluvastatin (20 mg/d), and metformin.
His calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohort Equations is 10%.
On physical examination, blood pressure is 126/78 mm Hg and pulse rate is 72/min. The remainder of the ex...
Source: Kevin, M.D. - Medical Weblog - October 3, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Diabetes Heart Source Type: blogs
The Orange Juice Clue
The parents of a 16-month-old boy who presented to the ED were concerned that he was too sleepy. His initial point-of-care glucose was noted to be 42 mg/dL, and he was somnolent but arousable, and was given orange juice.
Twenty minutes later, the child’s symptoms had completely resolved. Toxicology was consulted for evaluation of a possible toxic ingestion, and a medication inventory was recommended.
Differential Diagnosis of Hypoglycemia in Children
n Ethanol intoxication
n Beta blocker intoxication
n Salicylate toxicity
n Sulfonylurea
n Insulin injection
n Endocrine disorder (hypopituitarism, Addison’s disease,...
Source: The Tox Cave - September 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Orange Juice Clue
The parents of a 16-month-old boy who presented to the ED were concerned that he was too sleepy. His initial point-of-care glucose was noted to be 42 mg/dL, and he was somnolent but arousable, and was given orange juice.
Twenty minutes later, the child’s symptoms had completely resolved. Toxicology was consulted for evaluation of a possible toxic ingestion, and a medication inventory was recommended.
Differential Diagnosis of Hypoglycemia in Children
n Ethanol intoxication
n Beta blocker intoxication
n Salicylate toxicity
n Sulfonylurea
n Insulin injection
n Endocrine disorder (hypopituitarism, Addison’...
Source: The Tox Cave - September 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Test your medicine knowledge: 60-year-old asymptomatic man
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 60-year-old asymptomatic man is evaluated during a routine examination. He has a long history of heart murmur. With normal daily activities, he has not experienced shortness of breath, chest discomfort, or palpitations.
Blood pressure is 138/78 mm Hg, pulse rate is 82/min and regular, and respiration rate is 16/min. BMI is 27. Cardiac examination shows normal jugular venous pressure with hepatojugular reflux. There is a regular rhythm and a grade 3/6 holosystolic murmur at the apex that radiates to the axilla....
Source: Kevin, M.D. - Medical Weblog - July 18, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Heart Source Type: blogs
MKSAP: 38-year-old pregnant woman with hypertension and diabetes
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 38-year-old woman is evaluated during a follow-up visit. She has a history of well-controlled hypertension and type 1 diabetes mellitus. She is at 16 weeks’ gestation with her first pregnancy. Prior to conception she was taking lisinopril, which was discontinued in anticipation of the pregnancy, and labetalol was initiated. Other medications are insulin glargine, insulin lispro, and a prenatal vitamin.
On physical examination, she appears in good health. Blood pressure is 135/80 mm Hg. There is no edema....
Source: Kevin, M.D. - Medical Weblog - April 26, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Diabetes Heart OB/GYN Source Type: blogs
MKSAP: 25-year-old woman comes for a preconception evaluation
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old woman comes for a preconception evaluation. She has a history of hypertension that is well controlled with lisinopril. Medical history is otherwise unremarkable.
On physical examination, blood pressure is 134/86 mm Hg in both upper extremities; other vital signs are normal. Results of the cardiovascular examination are unremarkable. There is no edema, cyanosis, digital clubbing, or radial artery-femoral artery pulse delay.
Laboratory studies reveal normal electrolytes, complete blood count, thyroid...
Source: Kevin, M.D. - Medical Weblog - January 24, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Heart Source Type: blogs
Medications After a Heart Attack
From: www.secondscount.orgYour heart attack recovery will include medications. Taking these medications exactly as prescribed is one of the best tools at your disposal for avoiding death in the months following a heart attack. According to an article published in Circulation, the journal of the American Heart Association, heart attack patients who had not filled any of their prescriptions within 120 days of being discharged from the hospital had 80 percent greater odds of death than those who filled all of their prescriptions.Medications you are likely to be prescribed after a heart attack fall int...
Source: Dr Portnay - January 23, 2015 Category: Cardiology Authors: Dr Portnay Source Type: blogs
MKSAP: 74-year-old man with fever and chills
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 74-year-old man is evaluated in the emergency department for a 3-day history of fever and chills as well as confusion. He has a 5-week history of a nonhealing ulcer on the plantar surface of his left foot. He has diabetes mellitus, hypertension, and peripheral vascular disease for which he takes metformin, glyburide, lisinopril, chlorthalidone, and aspirin. He has no known medication allergies.
On physical examination, temperature is 39.0 °C (102.2 °F), blood pressure is 92/60 mm Hg, pulse rate is 108/min, a...
Source: Kevin, M.D. - Medical Weblog - January 17, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Diabetes Infectious disease Source Type: blogs
MKSAP: 32-year-old woman with systemic lupus erythematosus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old woman is evaluated as a new patient. She is planning to attempt conception with her partner. She has a history of systemic lupus erythematosus complicated by chronic kidney disease that has been inactive for several years off of treatment. She has had borderline blood pressure elevations since the diagnosis of kidney disease. She was also diagnosed with impaired fasting glucose and mild hyperlipidemia 2 years ago, both of which have been treated with dietary changes. Her current medications are cal...
Source: Kevin, M.D. - Medical Weblog - December 28, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Medications OB/GYN Source Type: blogs
MKSAP: 50-year-old man with cirrhosis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 50-year-old man is evaluated in follow-up for a recent diagnosis of cirrhosis secondary to nonalcoholic steatohepatitis. He has a history of asthma, type 2 diabetes mellitus, hyperlipidemia, and obesity. His current medications are inhaled fluticasone, montelukast, insulin glargine, insulin lispro, simvastatin, and lisinopril.
On physical examination, temperature is 37.5 °C (99.5 °F), blood pressure is 120/70 mm Hg, pulse rate is 80/min, and respiration rate is 16/min; BMI is 31. Abdominal examination reveal...
Source: Kevin, M.D. - Medical Weblog - December 13, 2014 Category: Journals (General) Authors: mksap Tags: Conditions GI Source Type: blogs
