Professional Fulfillment Zone

Career and Professional Development Center Highlights From Internal Medicine Meeting 2026We had a bla

Patients Before Paperwork

Advocacy in ActionLatest ACP AdvocacyACP advocates for you on policy changes that will make a difference in your daily work, your professional development, and your patients' health.Read here!The Importance of the Childhood Immunization Schedule for Internal Medicine

Noteworthy Resources for Well-being

New! WBC Social Share ZoneAttention all WBCs and ACP Chapter Leaders! Please take some time to explore our new Social Share Zone. We have compiled shareable graphics and resources highlighting well-being that you can use on social media, in presentations, or at your events. In addition, you will find resources on trauma education, physician suicide awareness, and ACP's Mini But Mighty Skills.Social Share Zone

In the News

May Is Mental Health Awareness MonthAs Mental Health Awareness Month, May is a time to raise awareness of and reduce the stigma surrounding behavioral health conditions and highlight the ways in which mental illness and addiction can affect all of us—patients, clinicians, families, and our society at large.

From the Trenches

“Difficult Patients,” Persistent Symptoms, and the Biopsychosocial ModelAnnals of Internal Medicine: C. Lemogne, MD, PhD; and P. Cathébras, MD, MScDifficult patients challenge our care models, our skills, and our capacity for empathy. The editorialists discuss an article by Jackson and colleagues that provided an important map of where and with whom difficulty tends to arise.Read here!

May 15, 2026

Building Trust and Relationships at ACP's Internal Medicine Meeting 2026“How do we begin to rebuild trust?

Patients Before Paperwork

Advocacy in Action Congressional News and Perspectives ACP Champions Reauthorization of the Dr. Lorna Breen Health Care Provider Protection Act Passage of the reauthorization bill would expand the national education and awareness campaign and continue to provide solutions to reduce health care worker burnout.

Noteworthy Resources

ACP: Design Your Own Well-being Program Explore these tools to create a well-being program tailored to any organization's needs and budget. View here!

In the News

April 18-20 is the ACP Internal Medicine Meeting in Boston. Join us on Friday, April 19, from 3:30-4:30 p.m. for a Networking Social. by the American College of Physicians Explore the ACP Internal Medicine Meeting 2024 well-being page to design an experience best suited to your well-being and professional fulfillment interests and needs. Save the date and join your fellow WBCs and meet other meeting attendees and ACP Leaders at the Networking Social in the Career and Professional Development Center (Exhibit Hall AB).

From the Trenches

I.M. Ready | March 2024 Learn how to 'Live Your Best Life' by Jennifer Kearney-Strouse

Physical Fitness During Adolescence and Long-Term Risk for Type 2 Diabetes Mellitus

Oral Prednisolone in the Treatment of Acute Gout

Medicine and Nonmedicine Options for the Treatment of Adults With Major Depressive Disorder

Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention

Mechanical Symptoms and Arthroscopic Partial Meniscectomy in Patients With Degenerative Meniscus Tear

Hematuria as a Marker of Occult Urinary Tract Cancer

Screening for Depression in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement

Screening for Breast Cancer: Recommendations From the U.S. Preventive Services Task Force

Acupuncture for Treatment of Menopausal Hot Flashes

Heart Problems in Adults Who Survived Cancer as Children

Changes coming to dues cycle

ACP announces the release of the all-new ACP MKSAP℠

Brochures mailed to patients may aid deprescribing efforts, study finds

MKSAP Quiz: 3-week history of repeated coughing

SGLT-2, GLP-1 effects on cardiovascular risk differ by age

New ACP guideline on migraine prevention advises starting with monotherapy

Put words in our mouth

Call for fall 2025 Board of Governors resolutions

Health care costs lower for patients with diabetes in years after bariatric surgery vs. before

MKSAP Quiz: Follow-up for osteoporosis

Family-support nurse in ICU increased communication, emotional support | ACP Hospitalist

Take a quiz about the July 23 issue! | ACP Hospitalist

Sync with psych | ACP Hospitalist

Rules for consults | ACP Hospitalist

Paramedian approach to lumbar puncture increased procedure service's success rates | ACP Hospitalist

Outcomes improved with synergistic colistin plus meropenem for resistant gram-negative infections | ACP Hospitalist

OPAT with vancomycin via midline catheters associated with higher complication risk | ACP Hospitalist

ATS updates guideline on community-acquired pneumonia | ACP Hospitalist

Ventilators, other devices recalled | ACP Hospitalist

Transfusions provide mortality benefit early in hospitalization, but not later | ACP Hospitalist

A Young Man With Recurrent Syncope | Annals of Internal Medicine: Clinical Cases

A 35-year-old man presented with recurrent syncope. On examination, wooly hair and palmoplantar hyperkeratosis were seen. Cardiac magnetic resonance imaging showed late gadolinium enhancement, and a genetic test ultimately confirmed the diagnosis of Carvajal syndrome.

Purple Urine Bag Syndrome: “Treated” and Untreated | Annals of Internal Medicine: Clinical Cases

An elderly man with chronic constipation presented with purple urine.

Prostate Adenocarcinoma With Atypical Immunohistochemistry Presenting With a Cheerio Sign | Annals of Internal Medicine: Clinical Cases

The most common cancer in men is prostate cancer. The Cheerio sign is the computed tomography finding of multiple pulmonary nodules with central lucency resembling the ring-shaped Cheerio breakfast cereal. Unlike bone metastasis, pulmonary involvement is less common. The Cheerio sign has malignant and benign etiologies. Thyroid transcription factor-1 (TTF-1) stain is commonly used in the diagnosis of primary lung cancer. TTF-1 positivity in cancers of prostate origin is rare, with only case reports and small case series available in the literature. Metastatic prostate cancer presenting with a Cheerio sign has not been reported in the literature.

“Trench Foot” on the Banks of Lake Geneva: A Severe Case of Nonfreezing Cold Injury | Annals of Internal Medicine: Clinical Cases

Formerly known as “trench foot” or “immersion foot,” nonfreezing cold injury (NFCI) is a rare condition mainly seen among vulnerable groups. We report the case of a homeless male diagnosed with NFCI after having spent 2 days in rainy, cold weather. He presented with white, wrinkled feet and sensorimotor loss. Imaging revealed thrombosis of the leg arteries. No revascularization procedure was possible, and the patient developed soft tissue necrosis requiring bilateral transtibial amputation. Our case highlights the high morbidity linked with NFCI and the need for early recognition and treatment by medical health professionals along with the implementation of preventive measures.

Management of Acute Episodes of Clarkson Disease (Monoclonal Gammopathy-Associated Systemic Capillary Leak Syndrome) With Intravenous Immunoglobulins | Annals of Internal Medicine: Clinical Cases

Monoclonal gammopathy-associated idiopathic systemic capillary leak syndrome (ISCLS, Clarkson disease) is a rare disorder defined by transient but recurrent bouts of hypotensive shock and anasarca resulting from plasma extravasation. Although prophylactic treatment with high-dose intravenous immunoglobulins (IVIG, 1–2 g/kg/mo) prevents most disease flares, its utility for acute episodes of ISCLS is unclear. Here, we report the results of a retrospective study of subjects with acute ISCLS treated at or near the onset of symptoms with IVIG. We found that administration of IVIG with minimal additional intravenous fluids was safe and associated with rapid clinical improvement. IVIG given close to the onset of ISCLS-related symptoms is associated with a favorable outcome.

Fecal Transplant Sustained Colitis Remission on Immunotherapy Resumption | Annals of Internal Medicine: Clinical Cases

Immune checkpoint inhibitors are increasingly used to treat various cancers, but they can cause immune-related adverse events that lead to treatment cessation. Here we report 2 cases of immune-mediated colitis that were treated with fecal microbiota transplant. Both cases had sustained colitis remission, which allowed resumption of immunotherapy.

A Rare Case of Paraneoplastic Dermatomyositis in a Patient With Metastatic Endometrial Cancer | Annals of Internal Medicine: Clinical Cases

Dermatomyositis (DM) is a rare autoimmune myopathy that presents with muscle weakness and characteristic skin manifestations. Certain malignancies are associated with DM, such as stomach, colorectal, ovarian, lung, pancreatic, and non-Hodgkin lymphoma. However, there are only rare reports of endometrial cancer with DM. In this report, we describe a case of anti–TIF-1-gamma and anti-Mi-2 antibody positive DM in a patient with stage IV endometrial cancer. This case illustrates the importance of considering DM as a paraneoplastic syndrome regardless of both stage and type of malignancy.

Giant Cell Tumor in Axial Skeleton With Neurologic Symptoms | Annals of Internal Medicine: Clinical Cases

A healthy 34-year-old man exhibited progressive lower-extremity numbness and weakness. Computed tomography revealed a mass compressing the thoracic spine with associated pathologic fracture. Biopsy showed findings compatible with giant cell tumor of the bone, and H3F3A gene mutation testing confirmed the diagnosis present in the axial skeleton. He was successfully managed with T3–T7 fusion, T5 corpectomy, and physical therapy. This case highlights an atypical presentation of an uncommon neoplasm with associated neurologic deficits.

An Unusual Cause of Acute Abdominal Pain: A Case Report and Review of the Diagnostic Reasoning | Annals of Internal Medicine: Clinical Cases

Spontaneous bladder rupture is a rare cause of acute abdominal pain. This case report reviews the clinical presentation of a patient with this unusual disorder and discusses the steps that the clinician used to reach the diagnosis. The concept of how clinicians use problem representations and illness scripts to arrive at a differential diagnosis, and ultimately a diagnosis, is discussed.

Pancreatic-Pleural Fistula in a Patient With Recurrent Pancreatitis and Unknown Pancreatic Divisum | Annals of Internal Medicine: Clinical Cases

Recurrent acute pancreatitis (RAP) affects less than 1% of the population and can rarely be associated with severe extra-abdominal complications. We herein present a case of RAP due to a congenital anomaly with a rare thoracic complication that was undiagnosed by classic imaging method to highlight a unique presentation of an uncommon clinical entity.