Search results for "Kidney function"
MKSAP Quiz: Evaluation for primary hyperparathyroidism
A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril. Following a physical exam and lab studies, what is the most appropriate management of this patient?
https://immattersacp.org/weekly/archives/2017/02/14/3.htm
14 Feb 2017
New gout guidelines and 'treat to target'
Guidelines by ACP and by rheumatology societies disagree on the treat-to-target approach to therapy.
https://immattersacp.org/archives/2017/04/gout.htm
1 Apr 2017
MKSAP quiz: Evaluation for recurrent nephrolithiasis
This week's quiz asks readers to determine the most appropriate additional treatment for a 28-year-old man with recurrent nephrolithiasis.
https://immattersacp.org/weekly/archives/2017/04/18/3.htm
18 Apr 2017
MKSAP quiz: Intermittent fever, sweats, fatigue
A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks' duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of pretransplant testing for tuberculosis were negative. Following a physical exam, lab studies, and chest radiograph, what is the most likely cause of her clinical findings?
https://immattersacp.org/weekly/archives/2018/01/30/3.htm
30 Jan 2018
Tailoring anticoagulation more of a reality with DOACs
Direct oral anticoagulants have the potential to replace warfarin for the treatment of many patients with venous thromboembolism, but without a need for routine monitoring, good patient selection is key to their use.
https://immattersacp.org/archives/2018/03/tailoring-anticoagulation-more-of-a-reality-with-doacs.htm
1 Mar 2018
MKSAP Quiz: Exacerbations of heart failure
A 68-year-old man is evaluated at a follow-up appointment. He has a 7-year history of heart failure secondary to ischemic cardiomyopathy. Over the past 6 months, he has had three hospitalizations for exacerbations of his heart failure. He currently has exertional dyspnea while getting dressed, and his maximal activity level is limited to riding to the store with his wife but staying in the car. Following a physical exam and lab studies, what is the most appropriate management?
https://immattersacp.org/weekly/archives/2018/03/13/3.htm
13 Mar 2018
Cardiovascular safety of febuxostat and allopurinol compared in patients with gout and CVD
In a modified intention-to-treat analysis, the primary end point of first occurrence of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or urgent revascularization for unstable angina occurred in 10.8% of patients taking febuxostat and in 10.4% of patients taking allopurinol (hazard ratio, 1.03).
https://immattersacp.org/weekly/archives/2018/03/20/4.htm
20 Mar 2018
MKSAP Quiz: Painless intermittent bloody urine
A 56-year-old man is evaluated for painless intermittent bloody urine of 6 weeks' duration. History is significant for granulomatosis with polyangiitis (formerly known as Wegener granulomatosis) diagnosed 10 years ago, which is now in remission; he was treated with prednisone for 3 years and oral cyclophosphamide for 1 year. Following a physical exam, lab studies, and chest radiograph, what is the most appropriate diagnostic test to perform next?
https://immattersacp.org/weekly/archives/2018/06/12/3.htm
12 Jun 2018
MKSAP Quiz: Abrupt episode of syncope
A 40-year-old man is evaluated in the emergency department for syncope. He was attending a baseball game when he experienced a witnessed, abrupt episode of syncope while seated. He did not experience any prodromal symptoms. Following a physical exam, lab studies, and an electrocardiogram, what is the most appropriate management?
https://immattersacp.org/archives/2018/07/mksap-quiz-abrupt-episode-syncope.htm
1 Jul 2018
MKSAP Quiz: 5-year history of recurrent gout
A 53-year-old man is evaluated for a 5-year history of recurrent gout attacks involving the base of the great toes, mid feet, and ankles. Episodes are becoming more frequent and severe. History is also significant for hypertension and stage 3 chronic kidney disease. Following a physical exam and lab studies, what is the most appropriate next step in management?
https://immattersacp.org/weekly/archives/2018/12/11/3.htm
11 Dec 2018