Volume 52 - Issue 10 - October 2012

Consultant

pityriasis rosea
pityriasis rosea
10/12/2012

DAVID L. KAPLAN, MD—Series Editor: 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: Dr Kaplan is clinical assistant professor of dermato...
After 1 month of scratching this slightly pruritic rash on his trunk, a 12-year-old boy was referred for consultation.
10/12/2012
DermClinic
DermClinic
10/12/2012

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

DAVID L. KAPLAN, MD—Series Editor: 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...
A 66-year-old woman’s psoriasis suddenly worsened after she underwent a biopsy of a tumor in her breast. The biopsy report revealed no evidence of breast cancer
10/12/2012
10/12/2012
This slightly itchy rash had slowly spread over a 37-year-old man’s trunk during the past month. The patient is otherwise healthy and denies the use of any new medications, soaps, or detergents.
10/12/2012
Skin
Skin
10/12/2012

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

DAVID L. KAPLAN, MD—Series Editor: 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...
One year ago, a 34-year-old woman cut her thumb with a knife while preparing dinner. This asymptomatic growth has developed at the site. She has no other lesions.
10/12/2012
diaphragmatic hernia
diaphragmatic hernia
10/12/2012

MARK MacELWEE, MD, FAAP
ZACHARY HARTSELL, MPAS, PAC
Mayo Clinic Arizona, Division of Hospital Internal Medicine, Phoenix

MARK MacELWEE, MD, FAAP ZACHARY HARTSELL, MPAS, PAC Mayo Clinic Arizona, Division of Ho...
<p class="p1"><img src="/sites/default/files/images/Screen%20shot%202012-10-12%20at%202.17.23%20PM.png" alt="Diaphragmatic hernia" title="Diaphragmatic...
10/12/2012
Myositis Ossificans
Myositis Ossificans
10/12/2012

SHAILJA PATEL, MD
SATYAJEET ROY, MD, FACP
Cooper University Hospital, Cherry Hill, NJ

SHAILJA PATEL, MD SATYAJEET ROY, MD, FACP Cooper University Hospital, Cherry Hill, NJ ...
<p class="p1"><img src="/sites/default/files/images/Screen%20shot%202012-10-12%20at%201.51.31%20PM.png" alt="sartorius musculature" title="sartorius...
10/12/2012
Pneumonia
Pneumonia
10/12/2012

NELSON L. TURCIOS, MD
Robert Wood Johnson University Hospital,
New Brunswick, NJ

NELSON L. TURCIOS, MD Robert Wood Johnson University Hospital, New Brunswick, NJ ...
<p>An 18-year-old girl was referred for evaluation of “uncontrolled asthma.” She had a long-standing history of recurrent coughing, wheezing, and documented pneumonias that were treated with frequent...
10/12/2012
syringomyelia
syringomyelia
10/12/2012

JOHN WHYTE, MD, MPH
Silver Spring, Md

ANTHONY L. FILLY, MD
University of California, San Francisco

JOHN WHYTE, MD, MPH Silver Spring, Md ANTHONY L. FILLY, MD University of California, S...
<p>A 37-year-old man presents to the emergency department (ED) with a headache that developed approximately 3 days earlier. The throbbing headache has worsened over the past few days...
10/12/2012
crowned dens syndrome
crowned dens syndrome
10/12/2012

LUCIANA FUNTOWICZ, MD
ELIZABETH B. WINDGASSEN, MD
LESTER E. MERTZ, MD
Mayo Clinic, Scottsdale, Arizona

Dr Funtowicz is a consultant in the division of consultative medicine, Mayo Clinic, Scottsdale, Arizona, and instructor in medicine, College of Medicine, Mayo Clinic. Dr Windgassen is a consultant in the division of consultative medicine, Mayo Clinic, Scottsdale, Arizona and instructor in medicine, College of Medicine, Mayo Clinic.
Dr Mertz is a consultant in the division of rheumatology, Mayo Clinic, Scottsdale,
Arizona and an assistant professor of medicine, College of Medicine, Mayo Clinic.

 

The authors report that they have no conflicts of interest and no relevant financial relationships to disclose.

 

LUCIANA FUNTOWICZ, MD ELIZABETH B. WINDGASSEN, MD LESTER E. MERTZ, MD Mayo Clinic, Scot...
<p><strong><img alt="birefringent crystals" height="90" src="/sites/default/files/images/Screen%20shot%202012-10-12%20at%2010.51.40%20AM.png"...
10/12/2012
Abdominal Pain
Abdominal Pain
10/12/2012

CAROLYN J. SACHS, MD, MPH
SHAWN KAKU, MD
University of California, Los Angeles

Dr Sachs is professor of medicine at the emergency medicine center of the University of California, Los Angeles, Medical Center. Dr Kaku was a chief resident at the same institution and a recent graduate from the UCLA emergency medicine program, and is currently a critical care fellow at Stanford University.

 

CAROLYN J. SACHS, MD, MPH SHAWN KAKU, MD University of California, Los Angeles Dr Sach...
<p>Because abdominal pain is such a common chief complaint, arriving at an exact diagnosis is often challenging. The dangerous triad of vascular emergencies (mesenteric ischemia, abdominal aortic...
10/12/2012
Warfarin
Warfarin
10/12/2012

GREGORY W. RUTECKI, MD—Series Editor
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—Series Editor University of South Alabama Dr Rutecki is profess...
<p><strong><em><img alt="dieulafoy lesion" height="90" src="/sites/default/files/images/Screen%20shot%202012-10-12%20at%2010.15.57%20AM.png"...
10/12/2012
Human gastrointestinal tract
Human gastrointestinal tract
10/11/2012

DAVID EFFRON, MD
Case Western Reserve University

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.

 

DAVID EFFRON, MD Case Western Reserve University Dr Effron is assistant professor of e...
<p>A 35-year-old man presents to your office with a worm (shown here) that he found in the toilet after a morning bowel movement. He denies any recent fever, chills, nausea, or vomiting. He...
10/11/2012
Influenza Vaccine
Influenza Vaccine
10/11/2012
<p>Each year, influenza takes its toll—particularly among the elderly. In the United States, about 3000 people succumb to this viral infection in years with low influenza activity; during epidemics,...
10/11/2012
musculoskeletal injuries
musculoskeletal injuries
10/11/2012
Here we present 6 cases of musculoskeletal disorders, including episternal ossicle, blount disease, and Baker's cyst.
10/11/2012
Type 2 Diabetes
Type 2 Diabetes
10/11/2012

ANNIE HAASE, MD and KIM A. CARMICHAEL, MD—Series Editor
Washington University

KIM A. CARMICHAEL, MD—Series Editor: Dr Carmichael is associate professor of medicine, department of internal medicine, division of endocrinology, diabetes, and lipid research at Washington University School of Medicine in St Louis, Missouri.

ANNIE HAASE, MD and KIM A. CARMICHAEL, MD—Series EditorWashington UniversityKIM A. CARM...
The relationship between chromium and diabetes was first noted in the 1950s when diabetes developed in chromium-deficient rats as a result of insulin resistance, which was reversed by chromium...
10/11/2012
Vision Loss
Vision Loss
10/11/2012

Ronald N. Rubin, MD—Series Editor
Temple University

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, both in Philadelphia.

Ronald N. Rubin, MD—Series Editor Temple University RONALD N. RUBIN, MD—Series Editor:...
This patient, who has had type 1 diabetes for a long time, is experiencing the complication of diabetic retinopathy.
10/11/2012
Oral Lesions
Oral Lesions
10/11/2012

WILLIAM LAWSON, MD, DDS
Mount Sinai School of Medicine

Dr Lawson is professor of otolaryngology at the Mount Sinai School of Medicine in New York City.

WILLIAM LAWSON, MD, DDS Mount Sinai School of Medicine Dr Lawson is professor of otola...
<p>Viral and fungal infections, autoimmune conditions, immunodeficiency, drug reactions, contact allergy, and trauma all can precipitate punctate oral lesions. Herpetic lesions must be distinguished...
10/11/2012
Primary Care
Primary Care
10/11/2012
<p><strong><em>Editor’s note: </em></strong><em>In a recent issue (</em><em>CONSULTANT</em><em>, August 2012, page 547), Dr Gregory...
10/11/2012
marijuana
marijuana
10/11/2012

GREGORY W. RUTECKI, MD
University of South Alabama

GREGORY W. RUTECKI, MD University of South Alabama
Fibromyalgia, or for that matter many chronic pain syndromes, are not uncommon in primary care.
10/11/2012