Systems

Cancer Survivors – Who are they, what are their needs, and how can medical providers meet these needs?

December 6, 2017
Cancer Survivors – Who are they, what are their needs, and how can medical providers meet these needs?

By Maria Garcia-Jimenez, MD/MHS, Abinav Baweja, MD, and Nicole LaNatra, MD

Peer Reviewed

Clinical vignette

A 65-year old woman with history of invasive breast cancer presents to her primary care provider for regular follow up. She was diagnosed with breast cancer over 10 years ago and received chemotherapy, radiation, and hormonal therapy with aromatase inhibitors. She follows with several providers including an oncologist, surgical oncologists, and a gynecologist. In your clinic, she reports concerns of neuropathy and arthralgia, and mentions that since retiring she worries …

Read more »

Core IM podcast: 5 Pearls on Iron Deficiency Anemia

November 15, 2017

Listen to 5 Pearls segment of Iron Deficiency Anemia! By Dr. Cary Blum MD, Marty Fried MD and Shreya P. Trivedi MD; Illustration by Mike Natter MD

Time Stamps:

  1.  Should patients be screened for iron deficiency? If so, who and how often? (1:40)
  2.  What are the indications for diagnostic endoscopy in iron deficient patients? (3:23)
  3. How should you advice patients to take oral iron? What is optimal dosing? (5:53)
  4.  In which patients would you consider IV iron? What are the risks? (11:41)
  5.  Throwback Question: What is a medication overuse HA? (14:44)

Read more »

Is Potassium Supplementation Beneficial in Hospitalized Patients?

October 25, 2017
Is Potassium Supplementation Beneficial in Hospitalized Patients?

By Sara Stream, MD

Peer Reviewed

As resident physicians, we are taught to supplement serum potassium to a goal level of 4.0 mEq/L in all hospitalized patients. While the dangers of severe potassium abnormalities are well established, the benefit of routine potassium supplementation of normal serum levels in the general hospitalized population is unclear.

Potassium is predominantly an intracellular ion with 98% of total body potassium located in the intracellular space. The accepted reference range for serum potassium levels is 3.5 to 5.0 mEq/L. The …

Read more »

Core IM Podcast: 5 pearls on Headaches

October 18, 2017

Listen to CORE IM’s first 5 Pearls segment on Headaches!

Time Stamps

  1.   What are the indications for imaging for HA? (1:36)
  2.   What is your approach to abortive therapy for migraines? (4:45)
  3.   How do you diagnose medication overuse HA? (6:41)
  4.  What is your approach to migraine prophylaxis? (8:29)
  5. What are some evidence based nonpharmacological therapies for migraines?  (10:42)

Read more »

Spotlight: Subacute Endocarditis: The Great Masquerader

October 11, 2017
Spotlight: Subacute Endocarditis: The Great Masquerader

By  Helen Ma, MD

Peer Reviewed

Our new Spotlight series uses case vignettes to explore diagnosis, pathophysiology, and management of a wide variety of diseases seen in the outpatient and inpatient settings.  Articles in the Spotlight section contain clinical pearls that will be highlighted in the case discussion.  While the occasional zebra may appear, the goal of the series is to provide clinically relevant information, and each case has been selected specifically for the relevance of its learning points rather than its rarity. 

Learning objectives

Read more »

Reducing Readmission in Sickle Cell Disease: The Role of the Patient-Centered Medical Home

October 6, 2017
Reducing Readmission in Sickle Cell Disease: The Role of the Patient-Centered Medical Home

By Leonard Naymagon, MD

Peer Reviewed

Vaso-occlusive crisis (VOC), or pain crisis, is the most common clinical manifestation of sickle cell disease (SCD) and is responsible for the majority of emergency department (ED) visits and inpatient hospitalizations among sickle cell patients . A retrospective analysis of over 100,000 in-hospital encounters for VOC in 2005 and 2006 demonstrated 30-day and 14-day rehospitalization rates of 33.4% and 22.1% respectively . These findings were most pronounced among 18- to 30-year-olds, with 41.1% rehospitalized within 30 days and 28.4% …

Read more »

Alzheimer’s Disease 2.0: State of Diagnosis

October 4, 2017
Alzheimer’s Disease 2.0: State of Diagnosis

By Karen McCloskey, MD

Peer Reviewed

In May 2012, The U.S. Department of Health and Human Services unveiled the “National Plan to Address Alzheimer’s Disease,” in response to legislation signed by President Obama in January, 2011 establishing the National Alzheimer’s Project Act.  The overarching goal of the Plan is to “prevent or effectively treat Alzheimer’s Disease by 2025.”   We now have an estimated 5.5 million people who are living with this illness and these numbers are only expected to grow with the aging population̶ the …

Read more »

Life and Limb: Battlefield Medicine from WWII to Today

September 29, 2017
Life and Limb:  Battlefield Medicine from WWII to Today

By Eric Jeffrey Nisenbaum, MD

Peer Reviewed

Mr. O is a 93-year-old man with a past medical history notable for severe Alzheimer’s dementia and amputation of the left upper extremity secondary to wounds received in WWII who was brought in from his nursing home with fever and dyspnea for two days.  His physical exam was notable for inspiratory crackles at the right lung base.  His CBC was notable for an elevated WBC with left-shift and a chest x-ray revealing a right lower lobe infiltrate. He …

Read more »