Search results for "Hypertension"
MKSAP Quiz: Follow-up evaluation of Alzheimer disease
An 82-year-old woman is seen for follow-up evaluation of Alzheimer disease. Since her last visit 12 weeks ago, she has been taking rivastigmine, with a progressively titrated dosage. The patient's only new symptoms are increasing insomnia, loss of appetite, and occasional diarrhea; she has had no feelings of hopelessness, helplessness, sadness, or guilt. Following a physical exam, Mini–Mental State Examination, and lab tests, what is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2018/08/07/3.htm
7 Aug 2018
Telemedicine connects remote areas with care
Modern medicine is dramatically cutting the distance that patients must travel, even for severe injuries. Consulting by telemedicine reduces delays, improves patient outcomes and brings health care to areas that otherwise wouldn't have it.
https://immattersacp.org/archives/2008/04/one.htm
1 Apr 2008
MKSAP Quiz: Evaluation for primary hyperparathyroidism
A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril. Following a physical exam and lab studies, what is the most appropriate management of this patient?
https://immattersacp.org/weekly/archives/2017/02/14/3.htm
14 Feb 2017
MKSAP Quiz: Incidentally discovered adrenal mass
A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for diffuse abdominal pain and vomiting. A CT scan was obtained that was normal except for the adrenal mass. Her medical history is significant for diet-controlled type 2 diabetes mellitus diagnosed 1 year ago and osteoporosis diagnosed 4 years ago. Following a physical exam and lab studies, in addition to screening tests for pheochromocytoma, what is the most appropriate diagnostic test to perform next?
https://immattersacp.org/weekly/archives/2017/12/12/3.htm
12 Dec 2017
New guideline recommends low-dose aspirin for many fewer patients
Changes to the American College of Cardiology/American Heart Association guideline include no longer routinely giving low-dose aspirin for primary prevention to adults older than age 70 years or to younger patients who are not at high risk.
https://immattersacp.org/weekly/archives/2019/03/26/1.htm
26 Mar 2019
MKSAP Quiz: Pain in the buttocks region
A 79-year-old man is evaluated for pain in the buttocks region. He has been bedbound at home during lymphoma treatment. He describes the pain as severe when sitting and has difficulty finding a comfortable position lying down as well. He has the least pain when standing, but he is unable to stand for very long. Following a physical exam and discovery of a lesion, what is the most appropriate management?
https://immattersacp.org/weekly/archives/2018/07/10/3.htm
10 Jul 2018
Quarter-dose combinations of antihypertensive meds appear safe, effective versus placebo, standard doses
Low-dose antihypertensive regimens could have a broader role in clinical practice, as they yield similar reductions in blood pressure but are better tolerated.
https://immattersacp.org/weekly/archives/2017/06/13/4.htm
13 Jun 2017
New guidance urges caution on testosterone
Internists considering testosterone therapy are ideally positioned to consider a broader differential diagnosis that will actually help the patient.
https://immattersacp.org/archives/2020/05/new-guidance-urges-caution-on-testosterone.htm
1 May 2020
MKSAP Quiz: 4-month history of progressive dyspnea, fatigue
A 61-year-old woman is evaluated for a 4-month history of progressive dyspnea and fatigue without chest pain. Eighteen months ago, she was diagnosed with liver cirrhosis due to nonalcoholic steatohepatitis (NASH). Medical history is also significant for obesity. Medications are propranolol, spironolactone, and lactulose. Following a physical exam, lab tests, and scans, what is the most likely diagnosis?
https://immattersacp.org/weekly/archives/2016/03/22/3.htm
22 Mar 2016
MKSAP Quiz: follow-up visit for gout
A 55-year-old man is evaluated during a follow-up visit for gout. Two years ago, he had been treated with allopurinol and developed a hypersensitivity reaction. Over the past several months, he has had recurrent attacks of acute, episodic swelling of the first metatarsophalangeal joints with increasing involvement of other joints, including the ankles and knees. Laboratory studies showed significant hyperuricemia. History is also significant for Crohn disease, hypertension, chronic kidney disease (estimated glomerular filtration rate of 55 mL/min/1.73 m2), and nonalcoholic fatty liver disease. Current medications are diltiazem and azathioprine, which he has been taking for the past 9 months. Which of these is a contraindication to the use of febuxostat in this patient?
https://immattersacp.org/weekly/archives/2017/01/24/3.htm
24 Jan 2017