Contemporary Internal Medicine

Case 1 Chronic Liver Disease and Neurologic Abnormalities.- In this case study of Wilson’s disease, the author discusses contemporary views of its pathophysiology and clinical features, along with the differential diagnosis of chronic liver disease..- Case 2 Dyspnea and Rapidly Enlarging Goiter.- A patient with Hashimoto’s thyroiditis and thyroid lymphoma provides the framework for a discussion of these increasingly more common disorders. The author includes a summary of the clinical approach to nodular goiter..- Case 3 Atheroembolic Disease Mimicking Systemic Vasculitis.- This case highlights the clinical and laboratory features of atheromatous embolic disease of the kidneys, emphasizing laboratory features of the disease which may lead to diagnostic confusion..- Case 4 Erythrocytosis.- A patient with polycythemia furnishes the setting for a discussion of the pathophysiology, differential diagnosis, and treatment of a classic problem in internal medicine..- Case 5 Obstructive Sleep Apnea.- A patient with snoring, nightmares, and palpitations during sleep provides the basis for a discussion of the current concepts in the diagnosis and treatment of obstructive sleep apnea, an important but frequently misdiagnosed condition..- Case 6 Dyspnea and Cirrhosis.- A case of alpha-1-antitrypsin deficiency is reviewed by an author who has done pioneering work in this area. The inheritance, pathophysiology, and clinical features of the disorder are discussed in detail..- Case 7 Chest Pain in a Young Man.- This case study of a young patient with coronary artery disease emphasizes the logical evaluation of this common problem. The author analyzes testing strategies based on current concepts of medical decision-making..- Case 8 A Reactive Arthropathy.- A patient with low back painand joint complaints sets the stage for a discussion of the distinctive features, diagnosis, and treatment of the sero-negative spondyloarthropathies..- Case 9 Community Acquired Pneumonia.- In this case study of a patient with pneumonia, the author reviews the current diagnostic and treatment decisions involved in this common and difficult clinical problem..- Case 10 Lens Subluxation and Tall Stature.- A patient with Marfan syndrome is the motivation for a discussion of the clinical features, diagnosis, and pathophysiology of this important disorder..- Case 11 Breast Cancer in a Premenopausal Woman.- This case study highlights the major contemporary clinical issues surrounding this tragic problem which is among the most difficult dilemmas facing the practicing physician..- Case 12 Recurrent Fever, Chills, Pyuria, and Bacteriuria in an Adult Male Following Urinary Catheterization.- A case study of chronic prostatitis leads to a discussion of the causes, contemporary diagnostic approaches, and treatment of recurrent urinary tract infections..- Case 13 Fever and Bloody Diarrhea.- A patient with infectious bloody diarrhea is presented with emphasis on the essential epidemiologic and clinical features. Recently recognized pathogens such as Campylobacter jejuni are discussed..- Case 14 Chest Pain and Heart Murmur in a Young Woman.- This is a case of mitral valve prolapse, the most common heritable disorder of connective tissue with cardiovascular manifestations. The author discusses the causes, cardiac dynamics, diagnosis, and complications of mitral valve prolapse..- Case 15 Peptic Ulcer Disease.- A patient with peptic ulcer disease provides the backdrop for a discussion of recent developments in the etiology, pathophysiology, diagnosis, and treatment of this common problem..- Case 16 Microcytic Anemia.- A case of thalassemia provides the framework for a discussion of the distinctions between iron deficiency anemia, hemoglobinopathies, and other reasons for microcytosis..- Case 17 Recurrent Abdominal Pain and Edema.- In this case of hereditary angioedema, the crucial clinical distinction between this life-threatening disease and other urticarial disorders is discussed..- Case 18 Hepatitis in a Chinese Student.- This discussion focuses on the clinical evaluation of chronic hepatitis, with emphasis on the appropriate interpretation of serological tests for hepatitis..- Case 19 A Woman with Rheumatoid Arthritis.- The author reviews pertinent clinical issues in the diagnosis and treatment of rheumatoid arthritis..- Case 20 Aortic Stenosis.- The clinical features, natural history, and current therapy of obstructive aortic valvular disorders are discussed in the context of a patient with aortic stenosis..- Case 21 A Case of Weakness and Fatigue in a Teenager.- A patient with Addison’s disease provides the circumstances for a clinical discussion of acute and chronic adrenal insufficiency..- Case 22 Practical Approach to Syncope.- A common and potentially serious clinical problem is discussed from the vantage point of the electrophysiologic derangements that may cause syncope..- Case 23 Thrombocytopenia.- A patient with idiopathic thrombocytopenia gives insight into our contemporary understanding of the pathophysiology, diagnosis, and treatment of the immune thrombocytopenias..- Case 24 New Onset of Dyspnea in a Middle-Aged Man.- A patient with dilated cardiomyopathy provides the basis for a discussion of this disorder. The author summarizes innovative diagnostic and therapeutic approaches which have been developed in the past decade..- Case25 Test Case.- A patient with acute myocardial infarction forms the framework for an approach to the contemporary management of this disorder. The author provides a step-by-step guide to management in a question-and-answer format..