MKSAP: 24-year-old woman with sickle cell anemia

Conditions
January 21, 2017

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

A 24-year-old woman undergoes routine evaluation. She is pregnant at 12 weeks’ gestation. Medical history is notable for homozygous sickle cell anemia (Hb SS). She has had multiple uncomplicated painful crises treated at home with hydration, nonopioid analgesia, and incentive spirometry. She requires hospital management for these episodes approximately twice per year. She has declined …

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MKSAP: 24-year-old woman with sickle cell anemia

Permission to take my patients’ plasma. It’s a harder decision than you think.

Conditions
April 6, 2016

“I hereby authorize xxx, my patient, to donate plasma up to two times per week.”

I moved to Cleveland over the summer to start work as a full-time primary care internist. Within a few weeks, I started receiving a form in my mailbox that I had never seen during my training in San Francisco: an authorization request for my patients to donate their plasma.

By the time the fourth form came, I realized …

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Permission to take my patients’ plasma. It’s a harder decision than you think.

MKSAP: 28-year-old woman with progressive dyspnea and fatigue

Conditions
December 12, 2015

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

A 28-year-old woman is evaluated for a 1-week history of progressive dyspnea and fatigue. She was diagnosed with Hodgkin lymphoma 2 months ago and is receiving chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). She takes no other medications.

On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 134/82 mm Hg, pulse rate …

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MKSAP: 28-year-old woman with progressive dyspnea and fatigue