Conditions and Diseases

Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

MKSAP: 64-year-old man seen after an intraoperative liver biopsy

mksap

November 10, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 64-year-old man is evaluated in follow-up after recent abnormal findings on intraoperative liver biopsy. Two days ago he underwent right colon resection for a large villous adenoma with high-grade dysplasia. At the time of surgery, an abnormal-appearing liver was noted and biopsy was performed. His medical history is notable for type 2 …

The carefully crafted way of how health misinformation spreads

Mary Chris Jaklevic

Conditions and Diseases

November 9, 2018

Effective clickbait doesn’t just happen. It’s carefully crafted.

Take this wildly misleading article from CNN: Not exercising worse for your health than smoking, diabetes, and heart disease, study reveals.

It’s one example — among many generated daily by various news outlets — of how a mundane observational study can be transformed into viral internet gold. In the days after it was published, this story was liked and …

PSA-based screening for prostate cancer: Interpreting the changing guidelines

Kenneth Lin, MD

Conditions and Diseases

November 8, 2018

Comparing the 2018 U.S. Preventive Services Task Force (USPSTF) recommendation statement on prostate cancer screening in the October 15th issue of American Family Physician with its previous recommendation, the first question family physicians ought to ask is: What new evidence compelled the USPSTF to move from recommending against PSA screening in all men to determining that there was a small net benefit for screening in some men? …

A CT scan for kidney cancer? It may depend on where you live.

Peter Ubel, MD

Conditions and Diseases

November 8, 2018

About one in fifty people reading this essay will be diagnosed with kidney cancer at some time in their life. In fact, one out of one people writing this essay has already been diagnosed with kidney cancer. (I had a small tumor removed from my left kidney not long after I turned 50.) But how many people diagnosed with kidney cancer have been overdiagnosed with the condition? And what does moving to Florida have …

We need more behavioral health treatment in primary care

Hans Duvefelt, MD

Conditions and Diseases

November 8, 2018

I don’t know how many times a patient has told me, “I was in therapy once, and it didn’t help.”

My response is always: “That’s like saying ‘I saw a movie once and I didn’t like it’.”

That usually breaks the ice just a little.

In primary care, we certainly run into a few patients with chronic mental health problems that could use some long-term, in-depth counseling. But usually, patients in my practice …

Why it’s important to determine who’s truly penicillin-allergic

Karen S. Sibert, MD

Conditions and Diseases

November 6, 2018

A true allergic reaction is one of the most terrifying events in medicine. A child or adult who is highly allergic to bee stings or peanuts, for instance, can die within minutes without a life-saving epinephrine injection.

But one of the most commonly reported allergies — to penicillin — often isn’t a true allergy at all. The urgent question that faces physicians every day in emergency rooms and operating rooms is …

Explain hemoglobin A1c in 2 minutes

Adeleke Adesina, DO

Conditions and Diseases

November 5, 2018

It was a slow day in the emergency department. I was sitting across the bedside from my patient who came in for a left forearm infection checkup. She was a 73-year-old female with a history of diabetes. She was elegant and soft-spoken. Prior to examining her wound, which had been worsening, I asked her what her A1c number is. She wondered what an A1c number was, and I explained that …

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Explain hemoglobin A1c in 2 minutes

Prescribing unnecessary antibiotics is the path of least resistance

Emily O'Rourke, MD

Conditions and Diseases

November 4, 2018

During my urgent care shifts, I see 20 to 30 people with viral upper respiratory infections. They are all feeling miserable, and they just want to feel better. They want an impressive-sounding diagnosis to justify their suffering to themselves, their spouses, and their bosses. They want a prescription medication which will immediately cure their illness, so they can get back to their lives. Their faces fall when they receive their …

MKSAP: 79-year-old man with a sacral ulcer

mksap

Conditions and Diseases

November 3, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 79-year-old man is evaluated for pain in the buttocks region. He was diagnosed with non-Hodgkin large B-cell lymphoma 6 months ago. Although his lymphoma has responded well to therapy and he is without evidence of active disease, he required hospitalization three times for chemotherapy-associated complications during his treatment course. He has been …

Stop blaming senior moments

William R. Shankle, MD

Conditions and Diseases

November 2, 2018

“He’s having a senior moment.” That dismissive phrase seems harmless, but, in reality, it leads to devastating, debilitating disease.

I firmly believe that a generation from now, people will not know the pain of watching a loved one slip into oblivion. But the only way we will get there is we stop dismissing memory loss and other behaviors as “normal aging.”

The recent news that former Supreme Court Justice Sandra Day O’Connor …

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Stop blaming senior moments

Beware of food sensitivity tests on Facebook

Roy Benaroch, MD

Conditions and Diseases

November 2, 2018

Facebook. Where else could I stumble on a video of a baby hippo taking a bath, or Toto’s Africa performed on solo Harp? But among the shares and silliness and talent, there’s a dark side to Facebook. It’s become a fast way for quacks to push their scams and empty your wallet.

Just today in my feed I received a promoted post about a “food sensitivity test.” I’m not going to link directly …

What can politicians do to address the opioid crisis?

Linda Girgis, MD

Conditions and Diseases

November 2, 2018

I doubt there is anyone living in the U.S. who doesn’t realize we have an opioid crisis here. Politicians debate the solutions to abating the high death rate that comes along with it, however, they fail to acknowledge that there are Americans in pain. Yes, we need to be sure opioids are prescribed judiciously. However, we also need to treat patients in pain.

As a doctor, it is not always easy …

Does that patient really need antibiotics?

Uchenna Umeh, MD

Conditions and Diseases

November 1, 2018

For those of you who have been following my story since this summer of 2018, you will remember that I quit my nine-to-five job to pursue a career in public speaking on a more semi-permanent basis. I started working essentially full-time with a national telemedicine company. I am extremely excited about the opportunity and very satisfied with the options it has given me to stay home — while I complete …

Our role as parents in the opioid epidemic

Jim Schroeder, PhD

Conditions and Diseases

October 31, 2018

A few months ago, I was having lunch with a friend. He mentioned a recent outpatient surgery that he had and indicated that upon being discharged, he was given a prescription for 30 pain pills. Although the recovery was uncomfortable, the pain was not overwhelming. But, as a precaution, it was assumed that he needed this powerful pain relief to be available even after he told the provider that he …

Transdiagnostic therapies in primary care

Hans Duvefelt, MD

Conditions and Diseases

October 30, 2018

I learned a new word recently: transdiagnostic, which refers to something that is applicable across a spectrum of conditions. It seems that this is becoming an increasingly popular concept in treating anxiety disorders.

No wonder. As I researched this word, I read this:

As of 2013, there are twelve anxiety-disorder diagnoses and over twenty-five subtypes and categories of these disorders, with specific treatments for about half of them. Research has …

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Transdiagnostic therapies in primary care

The Ellen Show broadcasts potentially harmful information about ovarian cancer screening

Jennifer Gunter, MD

Conditions and Diseases

October 30, 2018

Ethical OB/GYNs everywhere sighed heavily when they realized from the action on their Facebook and Twitter feeds that the Ellen Show broadcasted incorrect and potentially harmful information about ovarian cancer screening to almost 4 million people. Millions more will likely hear about it on social media.

Ellen Pompeo, who plays a doctor on the television show Gray’s Anatomy, decided to play doctor in real life and used her celebrity platform to recommend …

The man that scares me and the man I love

Cindy Winebrenner, MD

Conditions and Diseases

October 27, 2018

There is a man. He is in my house. I don’t know where he came from. But he just came into my house. And now he is living there. And I am afraid of him. I do not know who he is. There is a man in my house. I am so scared. I don’t know why he came. But he is there. And he tells people he is my …

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The man that scares me and the man I love

MKSAP: 30-year-old woman is evaluated for a 2-month history of diarrhea

mksap

Conditions and Diseases

October 27, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever or blood in the stool. She works …

What we can learn from the tragic deaths of CEOs

Joel Kahn, MD

Conditions and Diseases

October 26, 2018

An excerpt from Dead Execs Don’t Get Bonuse$: The Ultimate Guide to Surviving Your Career With a Healthy Heart.

The details of the careers and tragic deaths of these CEOs are a matter of public record, and the disruption that followed their deaths was enormous. Take Ranjan Das, for example. …

Is cancer truly the enemy?

Ken Dixon, MD

Conditions and Diseases

October 26, 2018

Cancer is the enemy. So, our immediate desire is to get rid of it, throw it away, and never hear from it again. Current therapies that require living tissue are proving that false. We know that your living tumor tissue is like your fingerprint, unique to each individual patient. It contains information specific to you, your genetic make-up, your cancer and ultimately the thought is, your treatment. If kept alive, …

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Is cancer truly the enemy?