Table of Contents
From the Editor
- Sometimes the look is worth the walk
We do not routinely look at blood smears today. The need for expediency and efficiency limit the time spent on activities with a low yield for influencing care. And yet, for some conditions in some patients, going back to the basics can be clinically rewarding, and even memorable.
The Clinical Picture
- Megaloblastic anemia due to severe vitamin B12 deficiency
The 75-year-old patient presenting with altered mental status and pancytopenia had a history of peptic ulcer disease and subtotal gastrectomy.
- A large, painless bulla on the right foot
A patient with a history of type 2 diabetes and diabetic neuropathy had a hemoglobin A1c of 10.3% at presentation.
Review
- Clinical impact of 2020 American Heart Association statement on menopause and cardiovascular disease risk
The statement supports the notion that the transition of menopause itself leads to increased cardiovascular risk and mortality.
- Discontinuing antidepressants: Pearls and pitfalls
To date, no formal schedule for tapering antidepressants has been validated. The maxim “slower is better” applies.
Symptoms to Diagnosis
- A painful mass in the jaw
The patient presented with a painful mass in the left side of her jaw, headache, lockjaw, painful swallowing, night sweats, and unintentional weight loss.
Medical Grand Rounds
- Evaluation and management of orthostatic hypotension: Limited data, limitless opportunity
Orthostatic hypotension is common and can have serious consequences. The author offers a systematic approach to evaluation and management.
Review
- Cardiac considerations in liver transplantation
Today’s transplant patients are older and more likely to have cardiac comorbidities, and effects of advanced liver disease on the circulatory system pose challenges in perioperative management.