Is there such a thing as too much information?

December 1, 2016
Is there such a thing as too much information?

By Mariya Rozenblit, MD  

Peer Reviewed

On my first day of internship I was faced with the seemingly simple task of consenting a patient for a blood transfusion. I went over the informed consent form with the patient, explaining the benefits and possible risks, and asked the patient if he had any questions. He did not and happily signed the form. However, I was left wondering if he truly comprehended the information. How much did he know about hepatitis C and HIV and how these …

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Mystery Quiz-The Answer

November 28, 2016
Mystery Quiz-The Answer

Before you read the answer, please review the original Mystery Quiz posted 11/18/16.

Vivian Hayashi MD, Robert Smith MD

The answer to the mystery quiz is aspiration pneumonia.  The CXR (Image 1) shows a total opacification of the right hemithorax.  Importantly, the tracheal air column is deviated to the side of the opacification.  This indicates loss of volume of the right lung due to endobronchial obstruction from aspiration (e.g. gastric contents), endobronchial tumor or foreign body.  Although one might consider pleural effusion, chylothorax and empyema …

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Glucagon People/Insulin People

November 23, 2016
Glucagon People/Insulin People

By Michael Tanner, MD

Glucagon: a 29-amino-acid polypeptide secreted by the alpha cells of the pancreas in response to hypoglycemia or starvation. 

Insulin: a 51-amino-acid polypeptide secreted by the beta cells of the pancreas in response to nutrient consumption. 

It’s December 13th, 1932, Camden, New Jersey. You are playing alto sax and clarinet in the reed section of Bennie Moten’s Kansas City Orchestra. It’s the low point of the Depression, and your boss is feeling it: the financial challenges of running a …

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Primecuts – This Week In The Journals

November 21, 2016
Primecuts – This Week In The Journals

By Maria Sunseri, MD

Peer Reviewed

This week we saw America’s favorite musical deliver an unscripted yet heartfelt message at the end of the performance to audience member Vice President-Elect Mike Pence. And while President-Elect Donald Trump rushed to Twitter to reprimand the Hamilton cast’s message as harassment, the Indiana governor and inadvertent Planned Parenthood donor (albeit in name only) had only good things to say about the hit Broadway show. And while Americans and the medical world continue to navigate the post-election fallout, the …

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Mystery Quiz

November 18, 2016
Mystery Quiz

Vivian Hayashi MD, Robert Smith MD

The patient is an 86 year old man who presented with weakness, lethargy and falls.  His history was noteworthy for an episode of empyema nine years earlier that was managed with tube thoracostomy followed by decortication.  Seven years prior to this admission, upper endoscopy revealed Barrett’s esophagus and adenocarcinoma of the distal esophagus.  An esophagectomy and gastric pull-up was performed.  The patient had intermittent episodes of aspiration over the subsequent years.  Prior to the current admission, the patient complained …

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Primecuts – This Week In The Journals

November 15, 2016
Primecuts – This Week In The Journals

By Andrew ElDabh, MD

Peer Reviewed

This week finally concluded one of the more bizarre election seasons in American political history, as business magnate Donald Trump defeated heavy favorite Hillary Clinton in the 45th presidential election. The merging of reality television and the most powerful position in the

world wasn’t the only big news, as medical journals also had a “huge, tremendous” week that may have received a little less attention.

While many of us were awake and closely following the election coverage, some patients …

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From The Archives: In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

November 10, 2016
From The Archives: In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

Please enjoy this post from the archives dated April 17, 2013

By David G. Rosenthal and Robert Gianotti, MD

Faculty Peer Reviewed

Case: A 33-year-old man comes to your clinic complaining of worsening acne over the last 6 months. You note a significant increase in both BMI and bicep circumference. After several minutes of denial, he reveals that he has been using both injectable and oral anabolic steroids. He receives these drugs from a local supplier and via the Internet. He confides that his libido …

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Gamechanger? Is Spironolactone the Magic Bullet for Resistant Hypertension?

November 9, 2016
Gamechanger?  Is Spironolactone the Magic Bullet for Resistant Hypertension?

By Amar Parikh, MD

Peer Reviewed

Welcome to Gamechangers, a series that takes a critical look at the latest in medical literature to answer one important question: would the results of this article change my practice? Featuring thorough evidence-based review as well as expert commentary, our aim is for this series to help you decide if the results of a given study are, in fact, a gamechanger.

A 65 year-old Hispanic male with type 2 diabetes, hypertension, hyperlipidemia, and erectile dysfunction presents to clinic for

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