May 2014
- Medical Student Perspectives: Tips for Finding Balance: Running Through the Journey of Medical School
- My Kind of Medicine: LTC(P) Kent J. DeZee, MD, MPH, FACP, MC, US
- IMIG Update: June 1 Application Deadline
- Analyzing Annals: Virtual Autopsy With Multiphase Postmortem Computed Tomographic Angiography Versus Traditional Medical Autopsy to Investigate Unexpected Deaths of Hospitalized Patients. A Cohort Study
- Winning Abstracts: Internal Medicine 2014 Student Abstract Winners
- Subspecialty Careers: Pulmonary Disease
- In the Clinic: Pulmonary Hypertension
- Highlights from ACP Internist® & ACP Hospitalist®
Medical Student Perspectives: Tips for Finding Balance: Running Through the Journey of Medical School
The rigor of preparing for course exams, shelf exams, and the looming board exams is emotionally, physically, and mentally taxing. Despite the challenges of completing medical school, it is important to remember the necessity for work-life balance. Not only is it important for maintaining success in school and a life-long career, but it also gives a broader perspective that will help us relate to the patients we will help every day. As the USMLE Step 1 exam approached last year, I decided to intentionally set a goal to help me maintain life balance under the rising stress load.
MoreMy Kind of Medicine: Real Lives of Practicing Internists: LTC(P) Kent J. DeZee, MD, MPH, FACP, MC, US
Was it mere chance that an ROTC medical student from the frosty state of Ohio was assigned to do his medical internship and residency in the sunny islands of Hawaii? And was it beginner's luck when the Tripler AMC pulmonary department took him surfing and he successfully rode his first wave? Probably-but Hawaiians are more likely to attribute Dr. DeZee's good fortune to "aumakua," his ancestral guardian spirit. In Hawaiian culture, the aumakua is a revered member of the ohana (meaning "family") who imparts wisdom or intercedes on behalf of members of the ohana.
MoreIMIG Update: June 1 Application Deadline
The ACP IMIG Sponsorship Program provides funding and resources to internal medicine interest groups in U.S. medical schools. The application for 2014-2015 is now available! The deadline to apply is June 1, 2014.
MoreAnalyzing Annals: Virtual Autopsy With Multiphase Postmortem Computed Tomographic Angiography Versus Traditional Medical Autopsy to Investigate Unexpected Deaths of Hospitalized Patients. A Cohort Study
"Virtual" autopsy by postmortem computed tomography can replace medical autopsy to a certain extent but has limitations for cardiovascular diseases. This study found that the addition of angiography to postmortem computed tomography resulted in the ability to detect cardiovascular diagnoses similar to that of traditional medical autopsy.
MoreWinning Abstracts from the 2014 Medical Student Abstract Competition: Internal Medicine 2014 Student Abstract Winners
Congratulations to all of our 2014 Medical Student Abstract Competition winners!
MoreSubspecialty Careers: Pulmonary Disease
From the word pulmo, Latin for "lung." Pulmonary medicine is the diagnosis and management of disorders of the lungs, upper airways, thoracic cavity, and chest wall. The pulmonary specialist has expertise in neoplastic, inflammatory, and infectious disorders of the lung parenchyma, pleura and airways; pulmonary vascular disease and its effect on the cardiovascular system; and detection and prevention of occupational and environmental causes of lung disease. Other specialized areas include respiratory failure and sleep-disordered breathing.
MoreIn the Clinic: Pulmonary Hypertension
The pulmonary vascular bed is normally a low-resistance, high-capacitance circuit capable of accommodating the entire cardiac output at pressures approximately 15%-20% of those in the systemic circulation. In pulmonary hypertension (PH), elevated pulmonary arterial pressure places a burden on the normally thin-walled right ventricle as it works to maintain normal blood flow. Without effective therapy, right heart dysfunction leads to progressive symptoms and is often fatal. Pulmonary hypertension is frequently a result of common left-sided heart or lung diseases.
In the Clinic is a monthly feature in Annals of Internal Medicine that focuses on practical management of patients with common clinical conditions. It offers evidence-based answers to frequently asked questions about screening, prevention, diagnosis, therapy, and patient education and provides physicians with tools to improve the quality of care. Many internal medicine clerkship directors recommend this series of articles for students on the internal medicine ambulatory rotation.
Highlights from ACP Internist® & ACP Hospitalist®
Updated blood pressure guidelines may have created more questions than closure, internists have found, as they try to determine how aggressively to treat hypertension and what goals to set for subpopulations of patients, such as those with diabetes. Experts react to the "paradigm shift" in lowering hypertension.
A 59-year-old woman is evaluated in the emergency department for midsternal chest pain. The pain began several hours ago as a vague ache in her left upper sternal region that progressed in intensity and severity. The pain abated spontaneously after approximately 45 minutes. She had no further chest pain until several hours later, when it recurred unprovoked by exertion. She has no shortness of breath, nausea or vomiting, syncope, previous history of chest pain, or known cardiac disease or risk factors for venous thromboembolism. Medical history is significant for hyperlipidemia and hypertension. She does not smoke cigarettes. Medications are simvastatin, aspirin, lisinopril, and hydrochlorothiazide. Following a physical exam, electrocardiogram and chest radiograph, what is the most appropriate initial management?
The debate over best practice may leave hospitalists wondering in which camp they and their hospitals belong.
There is much more to checking a pulse than noting its presence or absence.