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If elderly patients or those withchronic lung disease have troubleholding their breath in while you tryto listen for carotid bruits, have themtake a deep breath, exhale, and holdtheir breath out.

Pharmacists must write on prescriptionlabels exactly what physicianswrite on their scripts.

To allay children’s fears about immunizationsor allergy shots, keep apocket-sized, battery-operated radioin the office.

Long-term nasal spray use carriesthe potential for rebound congestion.

A 42-year-old man complains of persistent right shoulder pain that for the past 6 months hasprevented him from participating in his usual weight-lifting routine and affected daily activities.He is able to comb his hair and scratch his back with his right hand with no increase in pain, butreaching across his body causes discomfort. NSAIDs provide only modest relief.

Many women have difficulty in rememberingto take their birth controlpills every day.

A 101-year-old woman has had an occasionallypruritic and tender growthon her face for about 2 months. Thegrowth has doubled in size over the past2 weeks. She has no personal or familyhistory of cancer or significant dermatologicdisorders.

A 59-year-old woman complainsof progressively worsening bloatingand right upper quadrant pain thatbegan 1 day earlier. She denies feverand trauma. Her medical history includescholecystectomy for cholelithiasisand several emergency departmentvisits for treatment of woundssustained in falls. She has a history ofalcohol abuse, for which she now receivescounseling. However, she admitsthat she occasionally has boutsof heavy drinking.

Here's an effective and fun way tohelp toddlers with toilet training.

Thick, dry calluses on the heel canbe painful and can bleed if they crack.I have found this at-home treatmenteffective.

“Put yourself out of business"

A 59-year-old woman presents with generalized facialswelling and dyspnea that has progressed graduallyover the past month. The patient also reports a sensationof pressure in her neck and ears and swelling of the lowereyelids, neck, upper chest, and upper limbs. The bloodvessels on her upper chest are prominent. A dry, irritatingcough has worsened.

When you examine a tender abdomen,palpate as lightly as possible while youask about the patient’s job, family, andhobbies.

I recommend a simple exercise tohelp would-be joggers avert laterproblems.

I recently diagnosed type 2 diabetes mellitus in a 33-year-old man who has no diabeticsymptoms, proteinuria, or evidence of nephropathy. His blood pressure is low(100/60 mm Hg).

Patients on a low-fat diet who dislikethe color, taste, or consistency of fatfreemilk can try adding nonfat milkpowder.

My patient has a test-proven Candida allergy. Because hepatitis B virus (HBV)vaccine contains yeast, another physician would not give it to him. I administereda diluted dose and then a full-strength dose of the HBV vaccine, and the patienthad no adverse reaction.

My patient is a 78-year-old man who complains of severe exhaustion, lack of energy,and hot flashes.