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JAMA Diagnostic Test Interpretation | May 24/31, 2016 Elevated Hemoglobin or Hematocrit Level Robyn M. Scherber, MD, MPH; Ruben A. Mesa, MD JAMA. 2016;315(20):2225-2226. doi:10.1001/jama.2016.2435. A 71-year-old woman presented for evaluation of an elevated hemoglobin level (16.2 g/dL) that was incidentally discovered during a recent emergency department visit. She reported night sweats and some excessive fatigue over the last few months. She was unaware of any family his...
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JAMA Diagnostic Test Interpretation HbA1c in the Evaluation of Diabetes Mellitus Derek T. O'Keeffe, MB, BCh, BAO, PhD; Spyridoula Maraka, MD; Robert A. Rizza, MD JAMA 2016; 315: 605-606 A 76-year-old man presented to his physician's office, requesting assistance managing his type 2 diabetes. He was diagnosed 18 months previously, based on a fasting blood glucose level of 200 mg/dL (11 mmol/L), and was prescribed metformin. The metformin was discontinued 12 months later...
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JAMA Diagnostic Test Interpretation HbA1c in the Evaluation of Diabetes Mellitus Derek T. O'Keeffe, MB, BCh, BAO, PhD; Spyridoula Maraka, MD; Robert A. Rizza, MD JAMA 2016; 315: 605-606 A 76-year-old man presented to his physician's office, requesting assistance managing his type 2 diabetes. He was diagnosed 18 months previously, based on a fasting blood glucose level of 200 mg/dL (11 mmol/L), and was prescribed metformin. The metformin was discontinued 12 months l...
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Medscape > Fast Five Quizzes Quiz: Are You Able to Confront Clostridium Difficile Infections? Michael Stuart Bronze, MD January 04, 2016 Clostridium difficile is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile infection commonly manifests as mild to moderate diarrhea, occasionally with abdominal cramping. In rare cases, patients with C difficile infection can present w...
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Medscape > Fast Five Quizzes Quiz: Are You Able to Confront Clostridium Difficile Infections? Michael Stuart Bronze, MD January 04, 2016   Clostridium difficile is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile infection commonly manifests as mild to moderate diarrhea, occasionally with abdominal cramping. In rare cases, patients with C difficile infection can pr...
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Teachable Moment | December 2015 The Importance of Clinical Context When Interpreting Serum Ammonia Levels A Teachable Moment Joseph W. Howells; Patricia A. Short JAMA Intern Med. 2015;175(12):1902-1903. doi:10.1001/jamainternmed.2015.5772. Story From The Front Lines病历摘要 A man in his early 40s presented to his primary care physician with intermittent anxiety attacks and progressive fatigue. An active duty service member, the patient had a history of panic disorder sinc...
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Teachable Moment | December 2015 LESS IS MORE The Value of the History and Physical Examination—Sailing Through Medicine With Modern Tools A Teachable Moment Maen D. Abou Ziki; David N. Podell; Danise M. Schiliro JAMA Intern Med. 2015;175(12):1901-1902. doi:10.1001/jamainternmed.2015.5768. Story From The Front Lines病历摘要 A middle-aged woman presented to the emergency department with severe ankle pain, generalized body aches, malaise, and petechial rash over her extremit...
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JAMA Diagnostic Test Interpretation Hyperkalemia Biff F. Palmer, MD; Deborah J. Clegg, PhD JAMA 2015; 314: 2405-2406 一名64岁男性患者患有2型糖尿病,高血压和慢性肾病(CKD)。患者因新发无力就诊。6个月前患者发生心肌梗塞合并心功能衰竭,射血分数35%。使用药物包括赖诺普利(lisinopril)、美托洛尔(metoprolol)、胰岛素和呋塞米。一周前,患者被诊断为右下肢蜂窝织炎,使用了7天的复方新诺明。2天前患者出现全身无力,且在过去24小时内进行性加重。体格检查发现右下肢蜂窝织炎缓解。患者上肢及下肢肌...
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JAMA Diagnostic Test Interpretation Hyperkalemia Biff F. Palmer, MD; Deborah J. Clegg, PhD JAMA 2015; 314: 2405-2406 A 64-year-old man with type 2 diabetes, hypertension, and chronic kidney disease (CKD) presented with new weakness. Six months ago he had a myocardial infarction complicated by heart failure with an ejection fraction of 35%. His medications were lisinopril, metoprolol succinate, insulin, and furosemide. One week ago, he was diagnosed with cellulitis ...
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Medscape > Fast Five Quizzes Quiz: How Much Do You Know About Systemic Lupus Erythematosus? Herbert S. Diamond, MD November 03, 2015 系统性红斑狼疮(SLE)是一种慢性炎性疾病,病情可反复发作及缓解。SLE可以影响任何器官系统,但主要累及皮肤、关节、血液系统及神经系统。SLE的自然病程从相对良性表现到迅速进展甚至致死性疾病。 你对这种疾病的了解有多少? 问题1:已知以下哪种疾病能够增加SLE罹患率及病死率? 答案:骨质疏松 解答: European League Against Rheumatism (EULAR) task force 认为...
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