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Thoracic society releases guidelines on pulmonary hypertension in sickle cell patients

The American Thoracic Society recently released clinical practice guidelines to help clinicians identify and manage patients with sickle cell disease who are at increased risk for death from pulmonary hypertension.
https://immattersacp.org/weekly/archives/2014/03/18/4.htm
18 Mar 2014

MKSAP Quiz: increasing asthma symptoms

A 24-year-old woman is evaluated for increasing asthma symptoms. Her symptoms now require her to use her as-needed albuterol inhaler two to three times per week, and she has been waking up at night at least once a week with asthma symptoms that require her inhaler. She is still able to perform most of her daily activities, including regular exercise, if she uses albuterol for prevention. She is allergic to house dust mites, ragweed, grass, trees, and cats. Following a physical exam and spirometry, what is the most appropriate treatment?
https://immattersacp.org/weekly/archives/2014/03/25/3.htm
25 Mar 2014

CONFERENCE COVERAGE The American Heart Associationmight want to start ...

the critical care sec-tion in the department of anesthesiology atthe University of Chicago Medicine, duringthe Society of Critical Care Medicine’sAnnual Congress in San Francisco inJanuary. ... coronary care unit. This question can befound in MKSAP 16 in the General InternalMedicine section, item 101.
https://immattersacp.org/archives/2014/04/acpi-201404-puzzle_t2.pdf
25 Mar 2014

Potential changes questioned for advanced cardiac life support

The Advanced Cardiac Life Support guidelines are due out in 2015 and may pose some shocking changes: faster beats-per-minute chest compressions, a de-emphasis on hypothermia, and a new length of time for continuing cardiopulmonary resuscitation.
https://immattersacp.org/archives/2014/04/cardiac.htm
1 Apr 2014

MKSAP Quiz: 1-year history of cough

A 38-year-old man is evaluated for a 1-year history of cough with mucoid sputum and a 6-month history of mildly progressive dyspnea. He has a 12-pack-year history of smoking. He has no history of asthma, allergies, skin disease, or liver disease. Following physical and pulmonary exams and lab studies, what is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2014/06/10/3.htm
10 Jun 2014

Tackling tPA and stroke outcomes through telemedicine

Thirteen “spoke” hospitals across the U.S. without on-site stroke experts used telemedicine to increased their use of recombinant tissue plasminogen activator (tPA) to treat acute ischemic stroke.
https://immattersacp.org/archives/2014/07/telemedicine.htm
1 Jul 2014

Combining smoking cessation therapies improves abstinence rates

Varenicline in combination with nicotine replacement therapy was more effective than varenicline alone in helping smokers quit, a study found.
https://immattersacp.org/weekly/archives/2014/07/15/2.htm
15 Jul 2014

MKSAP Quiz: management of COPD

A 72-year-old woman is evaluated during a routine examination. She has very severe COPD with multiple exacerbations. She has dyspnea at all times with decreased exercise capacity. She does not have cough or any change in baseline sputum production. She is adherent to her medication regimen, and she completed pulmonary rehabilitation 1 year ago. She quit smoking 1 year ago. Her medications are a budesonide/formoterol inhaler, tiotropium, and an albuterol inhaler as needed. Following a physical and pulmonary exam, what is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2014/10/21/3.htm
21 Oct 2014

Hepatitis C drugs offer new options

The approval of multiple drugs in 2013 and 2014 that are able to cure hepatitis C without the use of interferon has dramatically changed the screening, treatment, and epidemiologic paradigms of the virus. Soon, internists will be involved in this rapidly changing area of health care.
https://immattersacp.org/archives/2015/01/hepatitis.htm
1 Jan 2015

MKSAP Quiz: dyspnea in a patient with end-stage COPD

A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. He is uncomfortable, with chronic air hunger that has gradually increased over the past 2 weeks. Otherwise, his symptoms have been stable without change in cough, sputum production, or fever.
https://immattersacp.org/weekly/archives/2015/02/03/3.htm
3 Feb 2015

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