May 2017

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Managing superbugs in your community

General internists are poised to assume a key role in tackling the increasingly formidable threat of antimicrobial resistance.

Prepping IM residents for primary care

Although most patient visits and more than 60% of procedures now occur in the outpatient setting, most of the focus on residency training is on critically ill patients in the hospital.

Minding your P's and M's

In medicine, internists need to mind not just their "P's and Q's" but their "P's and M's," that is, evidence-based practice and evidence-based medicine.

What now for health care reform after a first try fails?

ACP's lobbying agenda includes working on a bipartisan basis to shore up health insurance markets, give people more choices of coverage, and protect coverage for the most vulnerable covered by Medicaid.

Helping older patients 'age in place'

Internists can help patients live at home as they age by assessing physical functioning, watching for changes in functioning, and directing them to available resources.

Genes, environment hold the keys to healthy aging

Living into one's centenarian years involves a little bit of genetic luck, and a lot of healthy lifestyle choices.

Warning on IBS drug for patients without gallbladders

This column reviews details on recent recalls, warnings, and approvals.

Can we stop the superbugs?

This issue covers antibiotic resistance among bacteria, ways to teach ambulatory care during a hospital residency, and a pair of stories about geriatrics.

MKSAP Quiz: 8-year history of joint pain

A 50-year-old man is evaluated for an 8-year history of joint pain, particularly in the hands, and progressively worsening fatigue. Medical history is otherwise unremarkable. He takes ibuprofen as needed. There are swelling and tenderness of the second and third metacarpophalangeal (MCP) joints bilaterally, and tenderness but no swelling of the fourth and fifth MCP joints bilaterally. There is bony hypertrophy of the first MCP joints and knees bilaterally. The proximal interphalangeal joints and wrists are normal. Following a physical exam, lab studies, and a radiograph, what is the most appropriate diagnostic test to perform next?