Volume 51 - Issue 6 - June 2011

Consultant

06/16/2011

BONNIE FAHERTY, PhD, APRN-BC
Northridge, Calif

BONNIE FAHERTY, PhD, APRN-BC Northridge, Calif
Suggest the use of a snorkel, so the swimmer doesn’t have to twist through the water.
06/16/2011
06/16/2011

MAUREEN BAILEY, PA-C
Greer, SC

MAUREEN BAILEY, PA-C Greer, SC
<p>If you want to monitor a nevus or other suspicious lesion, place a piece of clear tape over it and trace the borders with an ink pen.</p>
06/16/2011
06/16/2011

D. BRADY PREGERSON, MD
Los Angeles

D. BRADY PREGERSON, MD Los Angeles
<p>Topical aspirin can provide quick local relief from the pain of a bee sting.</p>
06/16/2011
06/16/2011

JONATHAN REIMER, MD
Augusta, GA

JONATHAN REIMER, MDAugusta, GA
<P>Often, I want a rapid test for occult blood in the office, such as when I need to distinguish invasive from noninvasive gastroenteritis; detect bleeding associated with esophagitis, gastritis,...
06/16/2011
06/16/2011

MOHAMMED BASHA, MD
Gainesvill, Fla

MOHAMMED BASHA, MD Gainesvill, Fla
<p>During the neurological examination, the optimal approach is to test the higher functions first, motor power next, and sensory capacity last.</p>
06/16/2011
06/16/2011

STEPHEN REPLOGLE, DO
Yuma, Ariz

STEPHEN REPLOGLE, DO Yuma, Ariz
<p>Distinguishing gas from more serious causes of abdominal pain can be done by applying pressure rapidly and then slowly to the abdomen.</p>
06/16/2011
Dermatologic Disorders
Dermatologic Disorders
06/15/2011

STEVEN Q. WANG, MD

STEVEN Q. WANG, MD
​What do you suspect is the cause of the nail deformity?
06/15/2011
06/15/2011

By SARA STOUT, DO and DAVID EFFRON, MD

Dr Stout is an attending physician in the department of emergency medicine at MetroHealth Medical Center and senior instructor and ultrasound fellow of emergency medicine at Case Western Reserve University School of Medicine, both in Cleveland. Dr Effron is assistant professor of emergency medicine at Case Western Reserve University, attending physician in the department of emergency medicine at the MetroHealth Medical Center, and consultant emergency physician at the Cleveland Clinic Foundation, all in Cleveland.

By SARA STOUT, DO and DAVID EFFRON, MD Dr Stout is an attending physician in the depar...
<p>A 28-year-old man presents to the emergency department (ED) with left upper extremity paralysis and left lower extremity numbness, which he first noted on awakening that morning. Five days earlier...
06/15/2011
06/14/2011

CHRISTIAN J. FIDLER, MD and RONALD N. RUBIN, MD—Series Editor

Dr Fidler is senior fellow in hematology/oncology at Temple-Fox Chase Cancer Program in Philadelphia.
Dr Rubin is professor of medicine at Temple University School of Medicine and chief of clinical hematology in the department of medicine at Temple University Hospital in Philadelphia.

CHRISTIAN J. FIDLER, MD and RONALD N. RUBIN, MD—Series EditorDr Fidler is senior fellow...
<p>A previously healthy 39-year-old woman is evaluated for a lesion found by her dentist on her right tonsil. Her medical history is unremarkable, and her only medication is a multivitamin...
06/14/2011
06/14/2011

Sandra Lipovaca, MD, Jacob J. Rosenberg, MD,
Dominick Sabatino, MD, and Sujatha Kosuri, MD
Nassau University Medical Center

At the time this case was written, Dr Lipovaca was a senior pediatric resident (she is now a pediatrician in Las Vegas) and Dr Rosenberg was associate program director (he is now practicing in Ontario) in the department of pediatrics at Nassau University Medical Center in East Meadow, NY. Dr Sabatino is director of hematology/oncology and Dr Kosuri is an attending physician-hematology/oncology in the department of pediatrics at Nassau University Medical Center.

Sandra Lipovaca, MD, Jacob J. Rosenberg, MD, Dominick Sabatino, MD, and Sujatha Kosuri,...
<p>A 3-year-old Hispanic boy with a history of pica presented for a well-child checkup. He had missed numerous checkups, and his immunizations were delayed. His development was appropriate for...
06/14/2011
06/14/2011

ALEXANDER C. LEUNG, MBBS, FRCPC, FRCP(UK&Irel), FRCPCH
University of Calgary

ANTHONY CHI FAI NG, MBChB, FRCS(Edin), FRCSEd(Urol)
Chinese University of Hong Kong

WM. LANE M. ROBSON, MD, FRCPC, FRCP(Glasg)
Childrens’ Clinic, Calgary, Alberta

Dr Leung is clinical professor of pediatrics at the University of Calgary in Alberta. Dr Ng is professor of surgery at the Chinese University of Hong Kong. Dr Robson is medical director of the Childrens’ Clinic, Calgary, Alberta.

ALEXANDER C. LEUNG, MBBS, FRCPC, FRCP(UK&Irel), FRCPCH University of Calgary ANTHO...
<p>For 3 months, a 46-year-old woman had had intermittent right-sided loin pain. She had no dysuria, increased frequency or urgency, daytime wetting or dampness, nocturia, or bed-wetting. There was no...
06/14/2011
06/13/2011

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas

DAVID L. KAPLAN, MD—Series EditorUniversity of Missouri Kansas City, University of Kans...
<p><span style="font-size: x-small;"><strong>Case 4: </strong></span>For the past 2 weeks, a 32-year-old woman has noticed itchy bumps on her right hand. She is a...
06/13/2011
06/13/2011

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas

DAVID L. KAPLAN, MD—Series EditorUniversity of Missouri Kansas City, University of Kans...
<p> </p><p><span style="font-size: small;"><strong><span style="font-size: x-small;">Case 3: ...
06/13/2011
06/13/2011

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas

DAVID L. KAPLAN, MD—Series EditorUniversity of Missouri Kansas City, University of Kans...
<p><span style="font-size: x-small;"><strong>Case 2: </strong></span>This tender, solitary, inflamed nodule appeared 6 weeks earlier on the forearm of a 60-year-old...
06/13/2011
06/13/2011

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas

DAVID L. KAPLAN, MD—Series EditorUniversity of Missouri Kansas City, University of Kans...
<p><span style="font-size: small;"><strong>Case 1:</strong></span></p><p>A collagen vascular disease—which has not yet been differentiated—was recently...
06/13/2011
allergic reaction
allergic reaction
06/13/2011

Nasir Ahmed, MD
High Springs Pediatrics, High Springs, Fla

Nasir Ahmed, MD High Springs Pediatrics, High Springs, Fla
A 12-year-old boy had severe pruritus all over his body, watery and puffy eyes, and a husky voice.
06/13/2011
Asymmetric Bilateral Cervical Ribs
Asymmetric Bilateral Cervical Ribs
06/13/2011

HASAN RIAZ, MD, DAT C. PHAM, MD, and ROBERT ZAIDEN, MD
University of Florida College of Medicine, Jacksonville

HASAN RIAZ, MD, DAT C. PHAM, MD, and ROBERT ZAIDEN, MD University of Florida College of...
<p><img src="/sites/default/files/images/1106Con_PCRib.jpg" style="border: 1px solid black; float: left; margin-left: 8px; margin-right: 8px;" width="150"...
06/13/2011
Calciphylaxis
Calciphylaxis
06/13/2011

RAJA SHEKHAR R. SAPPATI BIYYANI, MD and SALIM M. SAIYED, MD
Case Western Reserve University
MetroHealth Medical Center, Cleveland

RAJA SHEKHAR R. SAPPATI BIYYANI, MD and SALIM M. SAIYED, MD Case Western Reserve Univer...
<p><img src="/sites/default/files/images/1106Con_PCCalci_A.jpg" style="border: 1px solid black; float: left; margin-left: 8px; margin-right: 8px;" width="150"...
06/13/2011
Photoclinic
Photoclinic
06/13/2011

KEVIN MARQUES, MD, KERI SANDERS, MD,
DAVID ELDRIDGE, MD, and KEITH NELSON, MD
East Carolina University School of Medicine, Greenville, NC

KEVIN MARQUES, MD, KERI SANDERS, MD, DAVID ELDRIDGE, MD, and KEITH NELSON, MD East Caro...
Dyspareunia and a tender right labial mass prompted a 20-year-old woman to present to the emergency department. She reported regular menses, was nulliparous, and had been treated for pelvic inflammatory...
06/13/2011
Koebner Phenomenon
Koebner Phenomenon
06/13/2011

ADAM A. MARTIN, MD, JULIA K. PADGETT, MD, and KIRA B. MAYO, BS
University of Virginia School of Medicine, Charlottesville, Va

ADAM A. MARTIN, MD, JULIA K. PADGETT, MD, and KIRA B. MAYO, BS University of Virginia S...
<p><img src="/sites/default/files/images/1106Con_PCKoebner_A.jpg" style="border: 1px solid black; float: left; margin-left: 8px; margin-right: 8px;" width="150"...
06/13/2011
Introducing Consultant360
Introducing Consultant360
06/13/2011

JULIE BOWEN
Editorial Director

JULIE BOWENEditorial Director
At Consultant, our mission is to bring you authoritative, practical clinical advice that you can put to use in your practice today.
06/13/2011
Pigmentary Changes
Pigmentary Changes
06/13/2011

NOAH S. SCHEINFELD, MD, JD
Columbia University

Dr Scheinfeld is assistant clinical professor of dermatology at Columbia University and assistant attending physician at St Luke’s–Roosevelt and Beth Israel Hospitals in New York.

NOAH S. SCHEINFELD, MD, JD Columbia University Dr Scheinfeld is assistant clinical pro...
Pigmentary changes occur in the skin with aging.
06/13/2011
Fundus Medley
Fundus Medley
06/10/2011

LEONID SKORIN, Jr, DO
Mayo Clinic Health System–Albert Lea, Minnesota

Dr Skorin is an ophthalmologist at the Mayo Clinic Health System in Albert Lea, Minnesota. He is also assistant professor of ophthalmology, College of Medicine, Mayo Clinic.

LEONID SKORIN, Jr, DO Mayo Clinic Health System–Albert Lea, Minnesota Dr Skorin is an ...
The following cases deal with ocular issues.
06/10/2011
05/13/2011

Gregory W. Rutecki, MD—Series Editor

Dr Rutecki is professor of medicine at the University of South Alabama College of Medicine in Mobile. He is also a member of the editorial board of CONSULTANT.

Gregory W. Rutecki, MD—Series Editor Dr Rutecki is professor of medicine at the Univer...
<p>I was awakened from some dogmatic slumbers when I moved to Mobile, Alabama. As an internist, I was used to being consulted for the purpose of assigning risk in patients scheduled to undergo...
05/13/2011
GI Disorders
GI Disorders
04/28/2011

NICHOLAS J. TALLEY, MD, PhD
University of Newcastle

Dr Talley is pro-vice chancellor and professor, University of Newcastle, Australia, and adjunct professor of medicine at Mayo Clinic, and University of North Carolina.

Dr Talley is a consultant for AccreditEd, ARYx, Astellas Pharma Inc. US, Astra Zeneca, Care Capitol, Edusa Pharma, Eisai, Inc., Elsevier, Focus Medical, In2MedEd, Johnson & Johnson, Meritage Pharma, NicOx, Novartis, Ocera, Salix, Sanofi-Aventis, Spire Learning, Theravance, and XenoPort.
He has received financial support from GlaxoSmithKline, Dynogen, and Tioga.

NICHOLAS J. TALLEY, MD, PhD University of Newcastle Dr Talley is pro-vice chancellor a...
Irritable bowel syndrome is characterized by abdominal pain or discomfort, bloating, and constipation or diarrhea; the pain is typically relieved by defecation.
04/28/2011