Hemophilia A: Do You Know How to Minimize Bleeding and Manage Complications? Elizabeth DelGiacco, DO; Jessica Katz, MD, PhD  |  December 5, 2016 Hemophilia A is the second most common inherited bleeding disorder, after von Willebrand disease (vWD), with a worldwide incidence of approximately 1 case per 5000 males.[1] Hemophilia A is caused by a deficiency or abnormality of the plasma coagulation protein factor VIII (FVIII). In its severe form, this condition can cause ...

Images in Clinical Medicine Skin Mottling Damien Contou, Nicolas de Prost N Engl J Med 2016; 375: 2187 A 68-year-old woman was admitted to the intensive care unit with respiratory failure and hypotension. Her blood pressure was 70/50 mm Hg, and her heart rate was 125 beats per minute. Physical examination revealed skin mottling on the legs (Panel A). Laboratory values were notable for an arterial- blood lactate level of 4.5 mmol per liter (normal value, <2.0),...

Images in Clinical Medicine Hemothorax after Thoracentesis Ittikorn Spanuchart, Scott Gallacher N Engl J Med 2016; 375: 1878 DOI: 10.1056/NEJMicm1507029 A 65-year-old woman with atherosclerotic cardiovascular disease and renal failure was hospitalized for acute respiratory failure and bilateral pleural effusions associated with pneumonia (Panel A). To rule out the presence of empyema, a diagnostic, ultrasonography-guided thoracentesis was performed in the left lung in th...

Images in Clinical Medicine Diagnosing Myasthenia Gravis with an Ice Pack Wendy W. Liu, Adam Chen N Engl J Med 2016; 375: e39 DOI: 10.1056/NEJMicm1509523 A 68-year-old man presented with unilateral ptosis and no other symptoms. The neurologic examination revealed ptosis of the left eye after a sustained upward gaze (Panel A). The movements of the extraocular muscles were normal. Myasthenia gravis was suspected, and the ice-pack test was performed with the placement of an ...

Medscape > Fast Five Quizzes Quiz: Do You Know Key Signs and Symptoms of Rare Diseases? Germaine L. Defendi, MD, MS; Emmanuel C. Besa, MD; Michael Stuart Bronze, MD September 29, 2016 Rare diseases are defined as conditions that occur in fewer than 200,000 people in the United States. Some of these diseases are at the upper range of prevalence, whereas others are much more rare. Although you may not encounter them frequently in practice, having a keen eye for certain si...

Medscape > Fast Five Quizzes Quiz: Do You Know Key Signs and Symptoms of Rare Diseases? Germaine L. Defendi, MD, MS; Emmanuel C. Besa, MD; Michael Stuart Bronze, MD September 29, 2016 Rare diseases are defined as conditions that occur in fewer than 200,000 people in the United States. Some of these diseases are at the upper range of prevalence, whereas others are much more rare. Although you may not encounter them frequently in practice, having a keen eye for certain si...

Medscape > Fast Five Quizzes Quiz: Do You Know Key Signs and Symptoms of Rare Diseases? Germaine L. Defendi, MD, MS; Emmanuel C. Besa, MD; Michael Stuart Bronze, MD September 29, 2016 Rare diseases are defined as conditions that occur in fewer than 200,000 people in the United States. Some of these diseases are at the upper range of prevalence, whereas others are much more rare. Although you may not encounter them frequently in practice, having a keen eye for certain si...

Medscape > Fast Five Quizzes Quiz: Do You Know Key Signs and Symptoms of Rare Diseases? Germaine L. Defendi, MD, MS; Emmanuel C. Besa, MD; Michael Stuart Bronze, MD September 29, 2016 Rare diseases are defined as conditions that occur in fewer than 200,000 people in the United States. Some of these diseases are at the upper range of prevalence, whereas others are much more rare. Although you may not encounter them frequently in practice, having a keen eye for certain si...

Medscape > Fast Five Quizzes Quiz: Do You Know Key Signs and Symptoms of Rare Diseases? Germaine L. Defendi, MD, MS; Emmanuel C. Besa, MD; Michael Stuart Bronze, MD September 29, 2016 Rare diseases are defined as conditions that occur in fewer than 200,000 people in the United States. Some of these diseases are at the upper range of prevalence, whereas others are much more rare. Although you may not encounter them frequently in practice, having a keen eye for certain si...

Images in Clinical Medicine Emphysematous Cystitis Kai-Yi Tzou, M.D. Yi-Te Chiang, M.D. N Engl J Med 2016; 375: 1779 A 72-year-old woman with poorly controlled hyperlipidemia and diabetes presented to the emergency department with a 5-day history of lower abdominal pain. She also had fever and reported nausea and vomiting. Physical examination revealed lower abdominal tenderness. Blood tests revealed leukocytosis associated with a left shift (neutroph...