Volume 51 - Issue 9 - September 2011

Consultant

09/09/2011

ROLI AGRAWAL, MD and SARAH KIZILBASH, MD
Dr Agrawal is a radiology resident and Dr Kizilbash is a pediatric hospitalist at Wayne State University School of Medicine in Detroit.

William Yaakob, MD—Series Editor
Dr Yaakob is a radiologist in Tallahassee, Fla.

ROLI AGRAWAL, MD and SARAH KIZILBASH, MD Dr Agrawal is a radiology resident and Dr Kizi...
<p>An 18-year-old boy presents with pain and swelling of his left thigh that developed suddenly 2 days earlier. He denies any recent traumato the site, fevers, or weight loss.</p>
09/09/2011
Interactive Features
Interactive Features
09/09/2011
<p>The cornerstone of asthma management is patient education—and an active partnership between patients and their health care teams. Guidelines from the Expert Panel of the National Asthma Education...
09/09/2011
09/09/2011

GREGORY W. RUTECKI, MD, 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, MD—Series Editor Dr Rutecki is professor of medicine at the Un...
<p>Have you noticed that as central venous catheters, pacemakers, and defibrillators have become more common, complications consequent to their use, such as upper extremity...
09/09/2011
09/09/2011
The mucocutaneous lesions seen in these photographs—facial cutaneous papules and oral papillomas—are among the most constant diagnostic features of what disease?
09/09/2011
09/09/2011

L. ASHLEY BEECH, MD, RITA K. CYDULKA, MD, and DAVID EFFRON, MD

Dr Beech is a third-year resident in the department of emergency medicine at MetroHealth Medical Center. Dr Cydulka is professor at Case Western Reserve University and attending physician in the department of emergency medicine at the MetroHealth Medical Center. Dr Effron is assistant professor 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.

L. ASHLEY BEECH, MD, RITA K. CYDULKA, MD, and DAVID EFFRON, MDDr Beech is a third-year ...
<p>A 58-year-old woman complains of generalized weakness, diplopia, and dysphagia. Symptoms began 1 week earlier and have progressively worsened. She can no longer walk without assistance. Has not...
09/09/2011
Ophthalmology
Ophthalmology
09/09/2011

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

Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

DAVID L. KAPLAN, MD—Series Editor University of Missouri Kansas City, University of Kan...
Woman with atopic dermatitis has itchy eyelids that have bothered her intermittently for several years.
09/09/2011
09/08/2011

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

Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

DAVID L. KAPLAN, MD—Series EditorUniversity of Missouri Kansas City, University of Kans...
<p>This asymptomatic, light-colored patch appeared on a 16-year-old girl’s upper arm 1 month ago. For the past week, she has applied a topical antifungal cream, but the lesion...
09/08/2011
09/08/2011

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

Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

DAVID L. KAPLAN, MD—Series EditorUniversity of Missouri Kansas City, University of Kans...
<p>A 53-year-old woman is concerned about this asymptomatic, slow-growing lesion on her left cheek, which she first noticed a few months ago. She denies bleeding or pain.</p>
09/08/2011
09/08/2011

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

Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

DAVID L. KAPLAN, MD—Series EditorUniversity of Missouri Kansas City, University of Kans...
A 47-year-old woman cut her finger while chopping celery earlier in the week. For the past 4 days, she has applied an antibiotic ointment to the wound, but the site has become itchy and more red and...
09/08/2011
09/08/2011
<p><em>[Editor’s note: In his Top Papers of the Month column, “Biological Agents and the Risk of Mycobacterial Disease: A Primary Care Concern”...
09/08/2011
09/08/2011
<p>I enjoyed Dr Gregory Rutecki’s Top Papers of the Month column “The Ritual of Preoperative Consultation: Essential or Superfluous?” (CONSULTANT, June 2011, page 361), in which he mentioned that for...
09/08/2011
09/08/2011

RICHARD A. HONAKER, MD
Carrollton, Tex

RICHARD A. HONAKER, MDCarrollton, Tex
<p>On many of our patient charts, we have red, blue, and yellow dots to alert us to 3 particular problems:</p>
09/08/2011
09/08/2011

CHRISTINE JONES, NP
La Quinta, Calif

CHRISTINE JONES, NPLa Quinta, Calif
<p>Nocturia is often caused by non-urinary issues. During the physical examination, don’t forget to “look down” to detect lower extremity edema or cystocele in your female patients.</p>
09/08/2011
09/08/2011

MANJARI DEVIDI, MD, MS
SUNIL DACHA, MD
Chicago 

MANJARI DEVIDI, MD, MSSUNIL DACHA, MDChicago 
<p>Patients with diabetic ketoacidosis (DKA) frequently have hyperglycemia. Serum sodium in these patients should not be corrected for hyperglycemia to calculate the anion gap for acidosis because...
09/08/2011
09/08/2011

BENJAMIN BARANKIN, MD
Toronto

BENJAMIN BARANKIN, MDToronto
<p>For melasma that does not respond to over-the-counter hydroquinone creams coupled with excellent UV protection, try betamethasone valerate 0.1% cream mixed 1:1...
09/08/2011
09/08/2011

GREGORY W. RUTECKI, MD
University of South Alabama

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, MDUniversity of South AlabamaDr Rutecki is professor of medicine at...
<p>A recent issue of the <em>Annals of Internal </em><em>Medicine </em>focused on women’s health from a number of perspectives. Among the...
09/08/2011
09/08/2011

SANJEEV TULI, MD and SONAL TULI, MD
University of Florida College of Medicine, Gainesville

SANJEEV TULI, MD and SONAL TULI, MDUniversity of Florida College of Medicine, Gainesvil...
<p>The mother of a 3-month-old boy brought her baby for evaluation of a generalized rash of 3 weeks’ duration. She had a similar severely itchy rash on her right shoulder and...
09/08/2011
Photoclinic
Photoclinic
09/08/2011
FADI I. JABR, MD, Dickson, Tenn NEDAA SKEIK, MD, Rochester, Minn
FADI I. JABR, MD, Dickson, Tenn NEDAA SKEIK, MD, Rochester, Minn
A 64-year-old woman with a history of recurrent kidney stones presented with severe left flank pain radiating to the left lower quadrant of 4 days’ duration. She brought with her a large fragmented 70-mg...
09/08/2011
09/08/2011

RAJAN ARORA, MD and SALEM RAZA, MD

RAJAN ARORA, MD and SALEM RAZA, MD
<p>The family of a 3-year-old girl was concerned about a painful lump in her right palm that they suspected was the result of a spider bite. The lesion had developed 2 days earlier and had...
09/08/2011
Feature
Feature
09/08/2011

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...
The skin of elderly persons possesses a greater number of benign growths and neoplasms than the skin of younger and middle-aged persons.
09/08/2011
Feature
Feature
09/08/2011

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...
The skin of elderly persons possesses a greater number of benign growths and neoplasms than the skin of younger and middle-aged persons.
09/08/2011
Feature
Feature
09/08/2011

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...
The skin of elderly persons possesses a greater number of benign growths and neoplasms than the skin of younger and middle-aged persons.
09/08/2011
Pain
Pain
09/08/2011

STEVEN A. KING, MD, MS
New York University

Dr King is in private practice in pain medicine in New York and is clinical professor of psychiatry at New York University School of Medicine. He is board-certified in pain medicine and psychiatry and is a licensed acupuncturist.

STEVEN A. KING, MD, MSNew York UniversityDr King is in private practice in pain medicin...
Chronic pain is a significant public health problem that affects over 100 million American adults.1Multiple guidelines have been propagated on the management of chronic pain, but many patients still suffer...
09/08/2011
What's The Take-Home?
What's The Take-Home?
01/20/2011

RONALD N. RUBIN, MD—Series Editor

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.

RONALD N. RUBIN, MD—Series Editor Dr Rubin is professor of medicine at Temple Universi...
<p>During the past 2 days, a 29-year-old woman has noted shortness of breath when walking and taking care of her 4-week-old daughter. She never experienced such symptoms previously.</p>
01/20/2011