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Pretibial MyxedemaThe persistent effects of Graves disease were evident in a 48-year-old woman who had recently emigrated from Haiti to the United States. Thyrotoxicosis had developed several years before she sought treatment in her native country. The patient's obstructive goiter was removed and treatment with thyroxine was begun.
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Abnormal Liver Function Tests:ABSTRACT: Serum levels of aspartate aminotransferase and alanine aminotransferase that exceed 1000 IU/L indicate acute viral hepatitis (A, B and, rarely, C), acute drug toxicity (eg, acetaminophen overdose or isoniazid hepatotoxicity), or ischemic liver injury. In chronic hepatitis (ie, hepatitis B or C or autoimmune), values range from mildly elevated to usually less than 400 IU/L. Elevated levels of alkaline phosphatase and gamma;-glutamyltransferase (GGT) are consistent with cholestatic disease: primary biliary cirrhosis, primary sclerosing cholangitis, idiosyncratic drug reactions, or mechanical biliary obstruction (eg, biliary stones or tumor). Elevation in the GGT level can also be induced by alcohol consumption or medications (eg, phenytoin). Isolated unconjugated hyperbilirubinemia suggests Gilbert syndrome or a hematologic disorder; conjugated hyperbilirubinemia reflects impaired hepatic excretion. Serum bilirubin and albumin and INR have prognostic significance in chronic liver disease; bilirubin and INR are more useful in acute liver failure because albumin has a long half-life.
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Hip Pain, Irregular Skin Lesions in a 12-year-old GirlA symptom and a sign from a triad that is pathognomonic for this patient's condition. What's your Dx?
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Pediatric and Adolescent Migraine: Update on Treatment OptionsIf the goal of headache therapy for adolescent migraineurs is a pain-free adult life, here's a road map.
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Take a Shot at Migraine: 5 Handy In-office InjectablesHeadache is a common complaint in primary care--and sometimes it presents full-blown. You can rescue the patient in distress by keeping 5 common injectables on hand.
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Treatment of Diabetes in Older Adults: Guideline HighlightsThe Numbers: >90% of US adults aged ≥65 yrs have diabetes; 33% of those have T2DM; ~50% of older adults have prediabetes. We highlight new Endocrine Society treatment guidance.
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Pruritic Papulovesicular Rash on Lower Legs: Your Dx?Here are key clues: an intensely pruritic rash on the lower legs that developed within hours after the patient walked through a grassy field near a lake.
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Pruritic Papulovesicular Rash on Lower Legs: Your Dx?Here are key clues: an intensely pruritic rash on the lower legs that developed within hours after the patient walked through a grassy field near a lake.
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New Data on Needle Free Epinephrine Spray Presented at ACAAI 2024A summary of new data presented at the 2024 American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
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Expanding Leg Ulcer in a Young WomanSelf-treatment has done nothing to slow the progress of this lesion which the patient thought might be an insect bite at first. Your Dx?
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Top 3 Atrial Fibrillation Studies in 2018Andexxa, CABANA, and new AF score. Cardiologist and Patient Care author Payal Kohli, MD, highlights 3 pivotal developments from 2018.
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Vaping-related Hospitalization, Mortality: A Quiz on New CDC GuidanceTry your hand at these 8 questions based on the latest CDC guidance on rehospitalization and mortality in patients with vaping-related lung injury.
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New COPD Drugs: 2019 in ReviewFDA 2019 approvals for COPD treatment included a cryotherapy spray and other novel & breakthrough therapies. Updates at-a-glance, here.
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Elevated Phosphorous in CKD: How to Avoid Vascular CalcificationThe optimal choice of medication to bind excess phosphate in patients with advanced CKD won't always be straightforward.
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Considering Aspirin: 8 Questions on Primary CVD PreventionThe role of aspirin in primary prevention of CV disease changed for good with results from 3 pivotal trials. Do you recall results and recommendations? Find out.
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EVAPORATE: Icosapent Ethyl Added to Statins Slowed Coronary Atherosclerosis ProgressionAHA Scientific Sessions 2019: Early results from the EVAPORATE study suggest promise for icosapent ethyl as add-on therapy in patients with high TGs already taking statins.
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4 Dangerous Holiday Food-Drug InteractionsWith the holiday season in full swing, you will want to remind your patients of these 4 hazardous holiday food and drug interactions.
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Risk-Based Kidney Care May Be On the WayNew risk prediction models may help identify patients with and without diabetes at elevated risk for chronic kidney disease, say authors of a recent study.
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ADPKD Quiz: Questions on Disease ProgressionThe risk for end-stage renal disease in patients with ADPKD is high. What factors increase the risk and how is it best managed? Test yourself.
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Investigational Drug Reduces Lp(a) in High-Risk Adults: Daily DoseYour daily dose of the clinical news you may have missed.
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A Confluent, Crusty RashHow would you approach diagnosis of this widespread, nonpruritic rash? Lab work? Skin tests? Or will history and physical findings suffice?
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Optimizing Treatment for Patients With IBDA glance at therapeutic strategies being investigated to improve the treatment and outcomes of patients with ulcerative colitis and Crohn disease.
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Kidney Disease: Three Studies At-a-GlanceHighlighted: Chronic kidney disease and stroke risk, syphilis in ESRD patients, and how healthy diets may reduce CKD incidence.
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Rx Shorts: August 2018Ongoing Shingrix shortage, thyroid medication recalled, reduced opioid manufacturing, and more Rx updates that could impact your practice.
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FDA Approves Oral Sulopenem for the Treatment of Uncomplicated Urinary Tract InfectionsOral sulopenem is the first oral penem approved in the US for treating uUTIs in women with limited options.
