Diabetic Ketoacidosis

DAVID E. TRACHTENBARG

Diabetic ketoacidosis occurs when a patient’s plasma glucose concentration is above 250 mg per dL, pH level is less than 7.30, and bicarbonate level is 15 mEq per L orless. Treatment involves fluids, insulin, and monitoring electrolyte levels.

Hyperosmolar Hyperglycemic State

GREGG D. STONER

Hyperosmolar hyperglycemic state is a life-threatening emergency caused by infections,certain medications, noncompliance, undiagnosed diabetes, substance abuse,and coexisting diseases. Vigorous correction of dehydration followed by potassiumand insulin replacement is crucial.

Evaluation of Palpable Breast Masses

SUSAN KLEIN

A thorough clinical breast examination, imaging, and tissue sampling are neededfor definitive diagnosis of breast masses. Fine-needle aspiration can differentiatesolid and cystic masses. Core-needle biopsy allows histologic diagnosis and differentiatesin situ and invasive...

Initial Evaluation of the Patient with Suspected Dementia

ALAN M. ADELMAN, MEL P. DALY

Dementia is a common disorder in older patients. The initial evaluation of apatient with suspected dementia includes the Mini-Mental State Examination,blood chemistry profiles, and structural neuroimaging.

AFP Articles–Start to Finish

JOYCE A. MERRIMAN

Receiving AFP on your desk is routine; you probably never even think about how it gets there. Perhaps you have written a manuscript for AFP and have wondered why it takes time process that involves many people in several states. First, submitted manuscripts are evaluated by...

Newsletter

CARRIE A. MORANTZ

Physicians May See Decrease in Medicare Payments in 2006 | AAFP Backs Effort to Give FDA Regulatory Control of Tobacco Products | HHS Begins Initiative to Reduce Obesity in Blacks | ChiT Web Site Offers Mentoring for Electronic Health Records | National Initiative Underway to...

Quantum Sufficit

AMBER HUNTZINGER, LAURA COUGHLIN

Is beer beneficial to the brain? The Washington Post reports on a recent study that found women who drank light to moderate amounts of beer or wine daily for four years were about 20 percent less likely to experience mental impairment in old age. The study, published in BMJ,...

Hyperglycemic Crises: Improving Prevention and Management

ABBAS E. KITABCHI

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are serious metabolic emergencies that affect patients with type 1 and type 2 diabetes. DKA and HHS are responsible for about 100,000 hospital admissions per year,1 and account for one of every four...

Diary

TONY MIKSANEK

“Doesn’t his face look unusually red?” Otis’s wife asked. Her 54-year-old husband had hypertension treated with sustained-release verapamil. He didn’t smoke cigarettes or consume alcohol. His wife was right; Otis had a ruddy face. Otis reported feeling tired and experiencing...

Anticonvulsant Medications for Migraine Prevention

JOSHUA STEINBERG

A 31-year-old woman asks for help with frequent migraines. She gets good response from abortive medication but had no success with the two preventive medications she has tried. You consider trying an anticonvulsant.

Is Pharmacotherapy Useful in Social Phobia?

CLARISSA KRIPKE

What are the effects of medications for social phobia?

Fibroids (Uterine Myomatosis, Leiomyomas)

ANNE LETHABY, BEVERLEY VOLLENHOVEN

Gonadorelin Analogues (GnRHa) Plus Progestogen (No Significant Difference in Heavy Bleeding Compared with GnRHa Alone, but Adding Progestogen Reduces Vasomotor Symptoms and Hot Flashes Associated with GnRHa). One small randomized controlled trial (RCT) found no significant...

Screening for Family and Intimate Partner Violence

Janelle Guirguis-Blake, Clodagh Cashman

RS, a 37-year-old woman, comes to your office with her four children and elderly mother, who lives with them, for their routine check-ups. She says that her husband has to miss his appointment that day because of work. You see RS first.

Management of Subclinical Hypothyroidism

ANNAMARIE D. IBAY, LYNDA M. BASCELLI, JOAN NASHELSKY

How should patients with subclinical hypothyroidism be managed?

“My Rings Won’t Fit Anymore”

MICAH R. CHAN, MONICA ZIEBERT, DIANA L. MAAS, PENNAPA S. CHAN

A 58-year-old woman presented to establish a primary care relationship. Her chief complaints were chronic pain of the hip and knee and excessive daytime sleepiness. Over the past few years, she felt that her body had been changing. She reported polyuria, excessive...

Aerobic Exercise Effective for Mild to Moderate Depression

DAVID SLAWSON

Metoclopramide for Pain and Nausea in Patients with Migraine

ALLEN F. SHAUGHNESSY

Approach to Non-ST-Segment Elevation Acute Coronary Syndromes

DAVID SLAWSON

Hyperbaric Oxygen Therapy in Patients with Chronic Wounds

HENRY BARRY

Clinical Decision Rules and Stroke Risk in Atrial Fibrillation

MARK EBELL

Aspirin Plus PPI or Clopidogrel in Patients with GI Bleeding?

MARK EBELL

Popular Diets Equally Effective for Losing Weight

DAVID SLAWSON

Estrogen Increases the Risk of Gallbladder Disease

DAVID SLAWSON

Disappointing Outcomes with Alzheimer’s Medication

ANNE D. WALLING

Negative LEEP Is Not Reassuring

ANNE D. WALLING

Standard-Dose Amoxicillin for Acute Otitis Media

CAROLINE WELLBERY

Steroids or Valacyclovir for Vestibular Neuritis

BILL ZEPF

Muscle Weakness as a Risk Factor for Falls in the Elderly

CAROLINE WELLBERY

Adolescent Exposure to Magazine Alcohol Advertising

KARL E. MILLER

Effect of Four Healthy Lifestyle Factors on Mortality Rates

CAROLINE WELLBERY

Use of Cephalosporin with Penicillin Hypersensitivity

RICHARD SADOVSKY

Management of Chronic Diarrhea

RICHARD SADOVSKY

Adverse Effects Associated with Use of Beta Blockers

KARL E. MILLER

Treatments for Acne Vulgaris Based On Severity

CAROLINE WELLBERY

Hypertension: Gaps Between Guidelines and Practice

KARL E. MILLER

American Ginseng Reduces Efficacy of Warfarin

RICHARD SADOVSKY

Cardiovascular Disease and Air Travel Safety

RICHARD SADOVSKY

Nebulized Lidocaine and Nasogastric Tube Insertion

RICHARD SADOVSKY

Soft Drinks Add to Weight Gain and Diabetes Risk

CAROLINE WELLBERY

Guidelines Unclear on Screening for Osteoporosis

CAROLINE WELLBERY

Efficacy of Psychotherapy Delivered by Telephone

CAROLINE WELLBERY

AHRQ Releases Practice Guidelines for Celiac Disease Screening

KAREN HELLEKSON

The Agency for Healthcare Research and Quality has issued a systematic review of the evidence regarding screening patients for celiac disease, a small-bowel malabsorption disorder that results in mucosal inflammation, villous atrophy, and crypt hyperplasia, which occur on...

Practice Guideline Briefs

MATTHEW J. NEFF

AAP Releases Updated Breastfeeding Recommendations

Practice Guideline Briefs

MATTHEW J. NEFF

Cesarean and Vaginal Birth After Previous Cesarean Delivery

HIV Testing on Demand

ANN HARVEY, RONALD H. GOLDSCHMIDT

A 41-year-old healthy male patient often presents at my office requesting human immunodeficiency virus (HIV) testing, but always refuses to give me a reason for his requests. He came in again today, after a previous visit for the same reason two or three months ago. In fact,...

Should Asymptomatic Bacterial Vaginosis Be Treated?

Marjolin’s Ulcer in Chronic Hidradenitis Suppurativa

VICTORIA A. CRAIN, SALIL GULATI, SATYANARAYANAN BHAT, STEPHEN M. MILNER

Diabetic Ketoacidosis: What It Is and How to Prevent It

Diabetic ketoacidosis (say: key-toe-acid-OH-sis), or DKA for short, happens when your body has high blood sugar (also called glucose) and a build-up of acid. If it isn’t treated, it can lead to coma and even death. It mainly affects persons with type 1 diabetes. But, it can...