MYRNA Y. MUNAR, PharmD, BCPS, and HARLEEN SINGH, PharmD

Physicians should be aware of medications that can cause adverse reactions and failure of therapy if dosages are not adjusted properly in patients with chronic kidney disease. Initial dosages can be determined using published guidelines but should be adjusted based on patient response and drug concentrations.

PATRICIA EVANS, MD, and SUSAN BRUNSELL, MD

Many uterine fibroid tumors are asymptomatic and may be diagnosed incidentally. Several imaging modalities are available to evaluate their size and position. Treatment should be individualized and may include hysterectomy, myomectomy, uterine artery embolization, myolysis, and medical treatment.

JENNIFER K. CARROLL, MD, MPH, BRIAN HERRICK, MD, TERESA GIPSON, MD, and SUZANNE P. LEE, MD

Acute pancreatitis, a reversible inflammatory process of the pancreas, can be limited to pancreatic tissue or can involve peripancreatic tissues or more distant organ sites. Acute pancreatitis may occur as an isolated attack or may be recurrent and can range in severity from mild to life threatening.

DANIEL F. McCARTER, MD, A. URSULLA COURTNEY, MD, and SUSAN M. POLLART, MD

Impacted cerumen can cause complications such as hearing loss, pain, and dizziness, and it also can interfere with tympanic membrane examination. The overall quality of evidence on treatments is limited, but watchful waiting, manual removal, use of ceruminolytics, and irrigation with or without ceruminolytic pretreatment are options.

Patient information: "Earwax: What You Should Know," p. 1530