Right hip pain in a high schoolfootball playerA 15-year-old boy complains ofright hip pain that began the day before,when he felt a "pop" during footballpractice. His medical history issignificant only for several ligamentousinjuries in both ankles and fracturesof the right lateral malleolusand the left medial malleolus, whichhealed uneventfully. He denies anabolicsteroid use and alcohol use.
Place domestic violence pamphlets inthe women’s restroom.
In his article, "Dyslipidemia: Closing the Treatment Gap"(CONSULTANT, April 1, 2003, page 451), Dr David Nashrecommends statin therapy for all eligible elderly patients.
Here is a painless way to locate andremove splinters. First, inject the areawith a local anesthetic. Then, startingat the point of entry, use a scalpelto make an incision along the track ofthe splinter while you simultaneouslyapply pressure at the opposite, deepend.
Instead of using a catheter to documentpatent nares on a newborn, firstevaluate the quality of the neonate’ssuck with a clean, bare finger andthen place the wet finger under thenose to feel exhalation.
To reduce children’s anxiety aboutblood drawing and immunization,keep a toy bear or doll in the examinationroom and let your young patientsuse a syringe without a needleto give it a “shot.”
I have been a pediatrician/family physician for about 40years, and I have been exposed to most diseases.
When should children who have a family history of either type 1 or type 2 diabetesbe screened for prediabetes?
Good nutritional care can improve the short-and longtermcourses of many illnesses that are common in olderadults. The experts who have contributed to this handbookdiscuss the disorders that can seriously affect andbe affected by nutrition, and they present specific recommendationsfor secondary prevention and management.
I read with interest Dr Robert Blereau’s “Photoclinic” caseof a young woman with epulis of pregnancy (CONSULTANT,May 2002, page 784) (Figure), in which the author notesthat the condition usually regresses spontaneously after delivery.
A46-year-old white man is hospitalized with increasing dyspnea of 3weeks’ duration. He has a history of stable chronic obstructive pulmonarydisease secondary to heavy smoking (2 packs of cigarettes a day for 27years, discontinued 6 years previously) and uses inhaled bronchodilators.
A healthy 11-year-old boy complains of a “bump below his kneecap” that hurts to touch and whenhe jumps. He first felt slight pain a month earlier. Since then, he has occasionally complained ofpain and a bump on the right knee.
After cimetidine was releasedin the late 1970s,case reports of clinicallysignificant drug interactionsquickly emerged.1-3Controlled trials soon validated theseinitial clinical observations. Since1983, when a comprehensive reviewof cimetidine drug interactions waspublished,4 more interactions havebeen reported, as use of this agenthas increased because of cost constraintsand the rapid growth of managedcare. Examples of well-documentedinteractions are listed in theTable.
Soaking a small child’s injured handsin water to clean them can be difficultand traumatizing.
This tip can enhance the effectivenessof cryotherapy for warts.
When you examine a young child’sear, have him or her sit sideways onthe parent’s lap.
Three years ago, my patient sustained a burn from a hot greasespill. Biopsy has shown that the nubby areas (Figure)are live skin; however, I am unsure of how to treat thewound.
Use this ABCDE mnemonic to distinguishnecrotizing fasciitis, which usuallyrequires surgery, from cellulitis,which can be treated with antibioticsalone:
Cuts from coral are notorious forhealing slowly and painfully, primarilybecause proteinaceous material fromthe live coral is deposited into thewound.
A 38-year-old overweight woman presents with an asymptomatic rash ofat least 2 months’ duration that had not responded to a combinationcorticosteroid/antifungal agent. She has mild hypertension and type 2 diabetesmellitus that is being managed with diet and exercise. She is otherwisehealthy.
