Tag Archives: Featured

Sudden Creatine Kinase Elevation When an Athlete Starts Boxing: Looking Deeper Prior to Knocking the Statin Out

A 55-year-old Caucasian man with a prior computed tomography calcium score in the 75th percentile for age, sex, and race at age 39 years, and on long-term high-intensity statin therapy presented with episodic myalgia. He reported 3 episodes within the past year of sudden severe quadriceps pain that self-resolved within 2 days. His activities included biking […]

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House Calls

When I was a medical student, 50 years ago, physicians, especially pediatricians, internists, and family physicians, were still making house calls as part of their provision of care for their patients.1 The symbol of the practicing physician at that time was the “black bag,” which contained diagnostic tools like the stethoscope, ophthalmoscope, tuning fork, reflex hammer, […]

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Acute Epigastric Pain as the Cause of Urgent Gastrectomy in a Healthy Patient

A 63-year-old man with no surgical history, taking no medication,was referred to the emergency department for epigastric pain and nausea that had started afew hours earlier. A sore throat had begun 24hours previously. Physical examination revealed normal temperature, hemodynamic stability, a distended abdomen with abdominal guarding that was very painful on palpation, and no mass […]

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Unusual Cause of Persistent Cough: ‘Pill Aspiration’

A 57-year-old woman with carcinoid syndrome was referred to the pulmonary clinic by her primary care physician (PCP) for persistent cough for the past 6 weeks. She was evaluated by her PCP approximately 6 weeks earlier for cough, which the patient thought started after she had aspirated one of her medications. Results from initial clinical […]

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Medical Axioms: The Pithy Little Sayings That Reflect Deeper Knowledge

  I love axioms. Perhaps it is the result of hearing them from one of my earliest mentors in medical school. Or perhaps it is the result of advice given me by my journalist/English teacher mother who told me that everything you write can be improved by condensation. Whatever the underlying reason, I continue to […]

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