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 with abdominal bloating and epigastric discomfort

mksap

August 13, 2011

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

A 64-year-old man is evaluated for a 3-month history of abdominal bloating and mid-epigastric discomfort associated with a 6.8-kg (15-lb) weight loss. The patient has no significant medical history and takes no medications.

On physical examination, vital signs are normal, and the only significant finding is mild …

An apology to patients with chronic fatigue syndrome

Toni Bernhard, JD

Conditions and Diseases

August 12, 2011

I’ve been sick since 2001 when I failed to recover from what appeared to be an acute viral infection. It has left me mostly house-bound, often bed-bound. In effect, I’ve had the flu without the fever for almost ten years: the aches and pains, the dazed sick feeling, the low grade headache, the severe fatigue. It cost me my career as a law professor; it cost me the ability to …

How a nephrologist assesses your kidney function

Michael Aaronson, MD

Conditions and Diseases

August 12, 2011

Doctors use laboratory values to interpret your medical condition. With respect to kidney disease, the BUN and the creatinine help your nephrologist (as well as your internist and family physician) determine if your kidneys are working correctly. These two tests are commonly ordered for many reasons and are invaluable tools to help your doctor assess your condition. Let’s define what BUN (pronounced by spelling out the letters “B”, “U”, …

Women with these 5 pelvic symptoms should call their doctor

Neil Baum, MD

Conditions and Diseases

August 11, 2011

For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life — nothing that time or simple treatment won’t cure.

However, there are a few symptoms that warrant a call to the doctor. This article will cover when you should call your doctor for problems “down there”?

1. Pelvic pain. Pain at the time of ovulation is referred to as Mittelschmerz. However, if …

Fever in children: 5 facts you must know

Natasha Burgert, MD

Conditions and Diseases

August 11, 2011

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A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs.

Many parents fear their child getting a fever or have “fever phobia.” I certainly can understand why. Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children …

ACP: New COPD guideline addresses an important health issue

Fred Ralston Jr., MD

Conditions and Diseases

August 8, 2011

A guest column by the American College of Physicians, exclusive to KevinMD.com.

It is easy to continue practice patterns we establish over the years. In my daily life as a general internist I am more likely to look for more information on a condition I don’t see regularly than on one that I see all the time. While we want …

How smog affects the human body

Rick Donahue, MD

Conditions and Diseases

August 6, 2011

We all know that outdoor aerobic exercises like running and biking are good for your health. But during the hottest days of summer, it’s not just excess heat we have to worry about, but smog, the concentrated air pollution you can often see hovering over the cityscape. During the hot summer months, smog can become a serious health problem in the Boston area. We are often downwind from the Midwest’s …

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How smog affects the human body

MKSAP: 76-year-old woman with abnormal thyroid function tests

mksap

Conditions and Diseases

August 6, 2011

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

A 76-year-old woman is reevaluated after results of thyroid function tests performed 2 weeks ago are abnormal. The patient otherwise feels well. She has a history of hypertension, atrial fibrillation, gastroesophageal reflux disease, and depression. Current medications are metoprolol, amiodarone, warfarin, omeprazole, and sertraline.

On physical examination, …

Cosmetic gynecology continues to grow during the recession

Marie Myung-Ok Lee

Conditions and Diseases

August 4, 2011

Though the recession has blunted overall demand for cosmetic surgeries, one subcategory appears to be entering a growth phase, at least judging from the fifth annual Congress on Aesthetic Vaginal Surgery, held late last year in a luxury resort outside Tucson. There, about 60 doctors, most of them OB-GYNs, converged to discuss the expanding field of “cosmetic GYN”—elective surgeries for women seeking to “rejuvenate” and/or “beautify” their vaginas. Attendance at …

Doctors diagnose diabetes 10 years later than the disease warrants

Roxanne B. Sukol, MD

Conditions and Diseases

August 4, 2011

I like my patients vertical. Not horizontal.

If I can help it, I want to make sure that nobody gets a disease that could have been prevented. Sure, accidents happen. And illnesses show up every day in the lives of people who did nothing to deserve them, and who could have done nothing to prevent them. But not all illnesses.

Physicians know that newly diagnosed diabetic patients present to the doctor …

What is the best type of infant thermometer?

Dr. Charles

Conditions and Diseases

August 4, 2011

A fever in an infant can be the first sign of an illness. While a rise in body temperature above 100.4 degrees Fahrenheit is part of a healthy immune system response, it does signal potential danger and need for further evaluation. Since a reading may lead to a call or visit to the child’s doctor or emergency room, accuracy is key. What is the best type of infant thermometer?

A …

Educated online by people with diabetes

Steve Woodruff

Conditions and Diseases

August 4, 2011

Recently, I saw one of my sons blithely dipping a chip into salsa, happily munching away while multi-tasking at something else – not a care in the world about his food.

It brought a smile to my face – but there was a touch of sadness with it.

You see, my work has brought me into contact with a number of PWDs (People With Diabetes) who are active on-line. And as I’ve …

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Educated online by people with diabetes

The different ways hysterectomy can be performed

Suzanne Hall, MD

Conditions and Diseases

August 3, 2011

When you and your gynecologist have decided on hysterectomy as the treatment of choice for your gynecologic diagnosis, there are several routes by which a hysterectomy may be accomplished. A total hysterectomy is the surgical removal of the uterus, and when indicated, the additional removal of the fallopian tubes and ovaries (termed salpingoophorectomy) may be recommended.

There are several routes by which a hysterectomy can be performed. You and your gynecologist …

How prevalent are false diagnoses of disease?

George Lundberg, MD and Clifton Meador, MD

Conditions and Diseases

July 31, 2011

Recently, we expressed concern about the effects on the accuracy of the diagnostic process of the increasing numbers of well and worried well entering the medical care system.

One of the consequences of this influx of well people (and the concomitant reduction in disease prevalence) is the generation of more false positive test results and false diagnoses of nonexistent diseases.

The medical literature is filled with studies on the accuracy of …

Complications of pregnancy and the conspiracy of silence

Silvio Aladjem, MD

Conditions and Diseases

July 31, 2011

Most pregnancies are completely straightforward. A woman gets pregnant, she has a normal pregnancy that lasts nine months, she delivers a healthy baby, and she takes her baby home. End of story. But not all pregnancies are so straightforward. Complications develop. Challenges arise. Doctors guide their patients through unknown experiences, and parents make choices they couldn’t have dreamed possible before embarking on the road to parenthood.

Complications of pregnancy occur anywhere …

MKSAP: 33-year-old man with stretch marks in his groin

mksap

Conditions and Diseases

July 30, 2011

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

A 33-year-old man is evaluated because of the recent appearance of stretch marks in his groin that extend to his thighs. He has a history of long-standing psoriasis that at times has involved much of his body, including his intertriginous areas. His topical treatments include tar-containing …

Diagnosing Alzheimer’s disease sooner or later

James P. Richardson, MD, MPH

Conditions and Diseases

July 29, 2011

A recent Harvard School of Public Health survey of more than 2500 adult in six different countries has found that Alzheimer’s disease is more dreaded than any other disease save cancer. The same survey also demonstrated that 85% of respondents would want to know their diagnosis as soon as possible if they began to show symptoms. The survey was reported recently at the Alzheimer’s Association International Conference (AAIC) meeting …

How telemedicine helped a stroke patient

Matthew Gibson, MD

Conditions and Diseases

July 28, 2011

My attending doctor (a neurologist) and I were sitting at the nurses’ station discussing a patient who had presented with a seizure when his pager beeped.

“Hold on, I have to call this in”, he said. I listened to snippets of the conversation. “How long has he been like that?” “How far away is the helicopter?” “Alright, let me run to my office and set up my equipment.”

He hung up …

Screening for mental disorders in children and adolescents

Kelly J. Kelleher, MD

Conditions and Diseases

July 27, 2011

For many academics and researchers, the debate is over: The use of mental health screening questionnaires in a routine fashion in primary care offices greatly increases the detection of mental disorders among children and adolescents. With such information, the American Academy of Pediatrics, Bright Futures, the US Preventive Services Task Force and others have weighed in. Screening is the order of the day, at least for adolescent depression. The remaining …

MKSAP: 52-year-old man with coronary artery disease

mksap

Conditions and Diseases

July 23, 2011

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

A 52-year-old man is evaluated regarding treatment of his coronary artery disease. He had a myocardial infarction 8 years ago and was treated with a coronary stent placed in his right coronary artery. Over the last 8 years he did well with medical therapy, with only …

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