All News

An easy, inexpensive way to differentiate between solid and cystic scrotal masses is to shine a flashlight on one side of the mass (ideally, in a darkened room) to see whether it transilluminates. Cystic masses will usually transilluminate, whereas solid masses will not.

What are the current recommendations for treatment of a moderately symptomatic Zenker diverticulum in a healthy 75-year-old man who takes no medications?

Because it relaxes the lower gastroesophageal sphincter, peppermint exacerbates gastroesophageal reflux disease (GERD). Counsel patients with GERD to avoid very strong breath mints, as well as other peppermint candies.

A 17-year-old student complains of worsening pain on the lateral side of his right foot that began 2 weeks earlier and now causes him to limp.

The next time you need to visualize the ear canal during cerumen removal, don't reach for an otoscope, which can obstruct the canal. Instead, use a nasal speculum to open up the ear canal.

When warm soaks are recommended--whether for a sore muscle, an injured tendon, or a hematoma that has developed at a venipuncture site--I advise patients to try the following method: place a washcloth soaked in warm water on the affected area, then cover it with a disposable diaper, using the diaper's self-stick tabs to secure it. The diaper prevents the washcloth from being rapidly cooled by outside air and keeps the patient's clothes dry.

Shortness of breath and cough were the sole complaints of a 49-year-old man who had no significant medical history. He was given antibiotics for a possible bronchitis. The patient returned a week later because his symptoms had not improved. At this time, a chest film showed a right-sided mediastinal mass, and a CT scan of the thorax located the mass in the posterior mediastinum.

For each of the following questions, choose the most appropriate answer and record your answer in the space provided on page S11.

Lesions that resembled fungi on the abdomen of a 50-year-old woman had persisted for a year despite treatment with over-the-counter selenium sulfide and antifungal creams. She had no associated symptoms.

Nail involvement can be seen in all types of psoriasis. Note the characteristic discoloration and hyperkeratosis.

Routine chest radiographs reveal a left lower lobe density in a 70-year-old man

I prescribed clopidogrel, 75 mg/d, for an 81-year-old man who had had a suspected transient ischemic attack (TIA); he was already taking aspirin (81 mg/d). Shortly after clopidogrel therapy was started, the patient began to bruise easily.

Alcohol is unique in the pantheon of abusable substances. In addition to the association between chronic, heavy drinking and cirrhosis of the liver, peripheral neuropathies, dementia, and other medical and behavioral problems (eg, those that lead to traffic fatalities), there is also an association between moderate use and lowered rates of coronary artery disease and stroke--as the following articles describe.

The next time a young patient presents with epistaxis, try this approach. Thoroughly soak several cotton balls with phenylephrine, and pack them in the bleeding nostril.

he use of suction can help you avoid the unpleasant odor and splatter that often occur during abscess drainage.

Offer patients a glass of water when you ask them to swallow during a thyroid examination.

This 41-year-old woman rushed to the emergency department with a swollen, blistered tongue and difficultly in swallowing and speaking. Twenty minutes earlier she had eaten fish (for the first time in her life).

Three days after having eaten fish, a 66-year-old woman with a known allergy to fish and a history of schizophrenia was brought to the emergency department because of macroglossia--a presentation of anaphylaxis.