How Should I manage This Young Woman's Painful Genital Ulcers
February 2nd 2015A 29-year-old female accountant is seen by you for painful lesions in the vulva. Her past medical history is notable only for the use of the hormonal contraceptive patch. She has been married for one year and denies a past history of herpes. Examination reveals two mildly tender grouped ulcerative lesions on the left labia.
A Simple Solution to Embolism in Atrial Fibrillation
February 2nd 2015For patients with non-valvular atrial fibrillation, preventing stroke using anti-coagulation medication is the standard of care. This study looked at using a device that closes off the left atrial appendage of the heart to determine if it too would lower the risk of stroke.
Vegetarian Diet Reverses Coronary Artery Disease
February 2nd 2015This study was a prospective cohort of 198 self-selected, adult patients with documented coronary artery disease, cerebrovascular disease, carotid artery disease, or peripheral arterial disease who followed a strict, plant-based dietary intervention in addition to standard medical therapy. The study examined compliance with diet as well as adverse cardiovascular events in both adherent and nonadherent patients.
60-Year-Old Man With Skipped Heartbeat, Shortness of Breath and Light-headedness
February 2nd 2015A 60 year-old man presents with complaints of a skipped heartbeat, shortness of breath and some light-headedness while sitting. When he is active, he has none of these symptoms. He is able to walk, climb stairs and even exercise on his elliptical without symptoms.
Young Girl with a Pruritic Rash
February 2nd 2015This 8-year-old girl came down with this itching rash following a horseback ride and a soak in a whirlpool spa. Other than itching, she has no symptoms and is in good health with no significant past medical history or medications.
Why Does This Patient Have Acute Severe Abdominal Pain Following Barium Enema
February 2nd 2015One day following sigmoidoscopy for an anal stricture, this 61-year-old obese woman was admitted to the emergency department in shock. Earlier that morning, she had a barium enema without evidence of free air inferior to the diaphragm. Acute abdominal pain developed several hours later.
Another Viral Update: Making a Case for Herd Immunity
February 2nd 2015Another viral outbreak has hit the United States causing fear and hysteria as well as action from public health officials. The index case for this outbreak occurred in my home state, California, and its spread has far exceeded that seen with Ebola virus.