Volume 51 - Issue 10 - October 2011

Consultant

Hidradenitis Suppurativa
Hidradenitis Suppurativa
10/05/2011

DAVID L. KAPLAN, MD—Series Editor

University of Missouri Kansas City, University of KansasDr 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 Ka...
Chronic sun exposure produces actinic skin changes—referred to as dermatoheliosis—such as actinic comedones.
10/05/2011
10/05/2011

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 50-year-old woman is concerned about a persistent white papule that erupted on her chest a few months ago. The lesion is asymptomatic.</p>
10/05/2011
10/05/2011

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 42-year-old man presents with an asymptomatic, annular, keratotic lesion of several months’ duration on his upper arm.</p>
10/05/2011
10/05/2011

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 pruritic, papular eruption arose on a 38-year-old woman’s forehead 1 week earlier. A day before the rash erupted, the patient was given a permanent wave.</p>
10/05/2011
10/05/2011

SERLE M. EPSTEIN, MD, FACP
Yale University

Dr Epstein is a private practitioner of internal medicine and primary care. He is an associate clinical professor, department of internal medicine, Yale University School of Medicine, in New Haven, Connecticut.

SERLE M. EPSTEIN, MD, FACP Yale University Dr Epstein is a private practitioner of int...
<p>Zamora-Chinchipe Province in Ecuador is home to about 90,000 people and abuts other Andean provinces of similar size. Most residents of this agrarian region are indigenous Shuar, Saraguro, or mixed...
10/05/2011
Interactive Features
Interactive Features
10/05/2011
<p>Does your patient who received last year’s influenza vaccine need to be revaccinated this fall? What about a child who was given 1 dose of vaccine last year—will 1 dose suffice this...
10/05/2011
10/05/2011

SHAUN ISAAC, MD
Bayfront Medical Center, St Petersburg, Fla

Dr Isaac is an internist and geriatrician at Bayfront Medical Center in St Petersburg, Fla.

SHAUN ISAAC, MD Bayfront Medical Center, St Petersburg, Fla Dr Isaac is an internist a...
<p>A 48-year-old woman with a 50-pack year smoking history presented with worsening dyspnea and progressive weight loss of 25 lb over the previous 4 months. In addition, she had a...
10/05/2011
10/05/2011
<p><strong>Case 1:</strong> Rheumatoid vasculitis<br /> <strong>Case 2:</strong> Idiopathic dermatomyositis<br /> <strong>Case 3:</strong> Progressive...
10/05/2011
Epilepsy
Epilepsy
10/04/2011

By ALEXANDER K. C. LEUNG, MD
and ANDREW S. WONG, MD

Dr Leung is clinical professor of pediatrics at the University of Calgary and pediatric consultant at Alberta Children’s Hospital in Calgary. Dr Wong is a family medicine resident at the University of Calgary.

By ALEXANDER K. C. LEUNG, MD and ANDREW S. WONG, MD Dr Leung is clinical professor of ...
The clinical diagnosis of tuberous sclerosis complex (TSC) in this patient is based on the presence of facial angiofibromas and hypomelanotic macules
10/04/2011
10/04/2011

HALIMA S. JANJUA, MD, ROSE AYOOB, MD, 
and JOHN DAVID SPENCER, MD
Nationwide Children’s Hospital

Drs Janjua, Ayoob, and Spencer are neph rology fellows in the department of pediatrics, division of nephrology at Nationwide Children’s Hospital in Columbus, Ohio.

HALIMA S. JANJUA, MD, ROSE AYOOB, MD,  and JOHN DAVID SPENCER, MD Nationwide Child...
Renal artery stenosis is an important cause of surgically correctable hypertension in children.
10/04/2011
10/04/2011

ERIC PEEPLES, MD
Phoenix Children’s Hospital

MEERA VARMAN, MD, ANTHONY YAGHMOUR, MD,
and ARCHANA CHATTERJEE, MD
Creighton University School of Medicine

Dr Peeples is a pediatric resident at Phoenix Children’s Hospital. Dr Varman is associate professor in the division of pediatric infectious disease, Dr Yaghmour is assistant professor in the division of general pediatrics, and Dr Chatterjee is professor and chief of the division of pediatric infectious disease, all in the department of pediatrics at Creighton University School of Medicine in Omaha, Nebraska.

ERIC PEEPLES, MD Phoenix Children’s Hospital MEERA VARMAN, MD, ANTHONY YAGHMOUR, MD, a...
<p>A 4-year-old Latino boy with mosaic Turner syndrome (45,XY/45,XO) presented with fever, temperature up to 40.5ºC (105ºF), of 3 days’ duration. He also had swelling on the right side...
10/04/2011
10/04/2011

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 EditorDr Rutecki is professor of medicine at the Universi...
<p>What has long been the “state of the art” for cervical cancer screening in primary care? Everyone would appropriately answer the Pap smear, of course. Has it worked? Despite false-positive and...
10/04/2011
10/04/2011

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, MD University of South Alabama Dr Rutecki is professor of medicine...
<p>A curious thing happened along what has been a muddy and meandering road to health care reform. </p>
10/04/2011
10/04/2011

NATASHA SIDHU, MD and PISESPONG PATAMASUCON, MD
University of Nevada School of Medicine, Las Vegas

NATASHA SIDHU, MD and PISESPONG PATAMASUCON, MDUniversity of Nevada School of Medicine,...
<p>A 4-year-old boy of Nicaraguan descent was hospitalized because of worsening perium<span>bilical abdominal pain. The pain began 6 days </span>earlier and was...
10/04/2011
10/04/2011

TENECIA DEANS, MD and STACY HIGGINS, MD
Emory University School of Medicine, Atlanta

TENECIA DEANS, MD and STACY HIGGINS, MDEmory University School of Medicine, Atlanta ...
<p>For 4 days, a 62-year-old woman with type 2 diabetes mellitus had constant, severe, crampy abdominal pain associated with nausea, non-bloody emesis, and anorexia, but not fever. She reported that...
10/04/2011
10/04/2011

NOAH S. SCHEINFELD, MD, JD
Columbia University

NOAH S. SCHEINFELD, MD, JD Columbia University
<p>The most common ulcer on the lower back and buttocks is the decubitus ulcer (also known as the pressure sore, or bedsore). Most of these ulcers occur in elderly patients, particularly those who...
10/04/2011
Review Article
Review Article
10/04/2011

REBECCA KOWALCZYK, MD
University of Nebraska

SUNANDA KANE, MD
Mayo Clinic College of Medicine

At the time this article was written, Dr Kowalczyk was a resident at the Mayo Clinic College of Medicine in Rochester, Minn. She is now a gastroenterology fellow at the University of Nebraska. Dr Kane is professor of medicine in the division of gastroenterology and hepatology at the Mayo Clinic College of Medicine in Rochester.

REBECCA KOWALCZYK, MD University of Nebraska SUNANDA KANE, MD Mayo Clinic College of M...
<p>Inflammatory bowel disease (IBD) encompasses a variety of clinical signs and symptoms, and the diagnosis is made with a combination of modalities, including radiographic, endoscopic, and pathologic...
10/04/2011
Anticoagulants and Antiplatelet Agents
Anticoagulants and Antiplatelet Agents
10/04/2011

VIKRAM R. PARALKAR, MD
University of Pennsylvania

RONALD N. RUBIN, MD
Temple University

Dr Paralkar is a hematology-oncology fellow at the University of Pennsylvania. 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, both in Philadelphia.

VIKRAM R. PARALKAR, MDUniversity of PennsylvaniaRONALD N. RUBIN, MDTemple UniversityDr ...
<p>Heparin and warfarin have been mainstays of anticoagulation for decades. Advantages of these agents include their low cost and ready reversibility of anticoagulant effect; however, their major...
10/04/2011