Table of Contents
From the Editor
The Clinical Picture
- Electrocardiographic changes in amitriptyline overdose
A 49-year-old woman was unresponsive after taking an unknown quantity of amitriptyline.
- Umbilical hernia in a patient with cirrhosis
Ascites is the major predisposing factor, since it causes muscle wasting and increases intra-abdominal pressure.
- An unusual cause of vitamin B12 and iron deficiency
Testing for ova and parasites was negative, but video capsule endoscopy revealed a tapeworm in the distal duodenum.
1-Minute Consult
- Should thiopurine methyltransferase (TPMT) activity be determined before prescribing azathioprine, mercaptopurine, or thioguanine?
Testing can identify patients at risk of life-threatening myelosuppression on these drugs.
Cardiovascular Board Review
- A continuous cardiac murmur
A 45-year-old woman presents with progressive shortness of breath and a continuous murmur over the entire precordium.
Review
- Bell palsy: Clinical examination and management
Bell palsy is characterized by acute facial mononeuropathy of unclear cause presenting with unilateral facial weakness.
- Marijuana is both antiemetic and proemetic
Chronic marijuana use can have an emetic effect. Patients shower or bathe in extremely hot water to relieve the symptoms.
- Care of the aging HIV patient
Today, more than 50% of all HIV-infected people in the United States are over age 50.
- Urologic applications of botulinum toxin
Botulinum toxin is approved for neurogenic detrusor overactivity and overactive bladder refractory to drug therapy.
Current Drug Therapy
- Ceftaroline fosamil: A super-cephalosporin?
Ceftaroline fosamil is the first beta-lactam with clinically useful activity against methicillin-resistant Staphylococcus aureus.