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Displaying 91 - 100 of 241 in ACP Store

Advancing Nutrition in Medical Practice Recordings Package

Expert clinician-educators will provide physicians with evidence-based practical knowledge and skills to integrate nutrition into their practice, sharing updates based on the latest research. A range of practical topics will be covered, including culinary medicine, nutrition in chronic disease prevention and treatment, and the role of nutrition in hospital settings. Attendees will learn how to translate nutrition science into pragmatic applications, including cooking, dietary counseling, and providing patients with facts on dietary supplements. The course will promote interdisciplinary teamwork, including collaborative care with registered dieticians, and will approach nutrition through an inclusive lens that is respectful of diverse cultures and food traditions.

Continuous Glucose Monitoring Practice Cases

Continuous Glucose Monitoring (CGM) Practice Cases: (1 hour of CME) This educational activity is Part 2 of a two-part series focused on the use of continuous glucose monitoring (CGM) in the care of adult patients with type 2 diabetes mellitus. CGM provides patients with an awareness of rising or falling glucose levels and allows them to engage in more proactive management of their glucose. Once you are familiar with who is eligible for CGM, the available options, and interpretation of the data reports, test your knowledge with the cases that follow. If you are unfamiliar with CGM technology and interpretation of glucose trend data or need a refresher, please refer to Part 1 before continuing to these practice cases.

Continuous Glucose Monitoring

Continuous Glucose Monitoring (CGM): (2 hours of CME) This is Part 1 of a two-part series focused on the use of continuous glucose monitoring (CGM) in the care of adult patients with type 2 diabetes mellitus. CGM technology captures glucose trend data because glucose levels are continually measured. The resulting awareness of rising or falling glucose levels allows patients to engage in more proactive management of their glucose. CGM is a common tool for individuals with type 1 diabetes. Recent improvements in CGM technology and decreasing costs have led to increasing use of this technology in the management of type 2 diabetes. Internal medicine physicians and clinicians will receive practical tips for patient engagement and shared decision making. A systematic process for interpretation of CGM glycemic data is also presented.

Decision Making In Perioperative Medicine: Clinical Pearls, 2nd Edition

Decision Making In Perioperative Medicine: Clinical Pearls, 2nd Edition

ACP MKSAP Subscription

ACP MKSAP is an all-digital subscription. You can choose between a one-year or three-year subscription term. ACP MKSAP’s state-of-the-art platform offers all subscribers the same premium version of MKSAP, including its highly structured and expert-created educational content, unparalleled questions, and innovative and intuitive online learning features.

Teaching Medicine Series - 7 Book Boxed Set

Teaching Medicine Series - 7 Book Boxed Set

Teaching and Coaching in the Hospital

Teaching and Coaching in the Hospital

ACP POCUS 13: PEARLS - An Ultrasound Physical Examination

This module introduces the internal medicine physician to a method for examining patients with ultrasound based on well-recognized acoustic windows. When combined, these windows provide a framework for a multisystem ultrasound physical examination that integrates cardiac, pulmonary, and abdominal views. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

ACP POCUS 12: Upper Extremity Musculoskeletal

Learn how to use POCUS to scan hand, wrist, and shoulder abnormalities that you may encounter in practice. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

ACP POCUS 11: Lower Extremity Musculoskeletal

Learn how to use POCUS to scan for knee and ankle abnormalities that you may encounter in practice. This resource is part of the Advanced Point-of-Care Ultrasound (POCUS) series and will prepare you to participate in the American College of Physicians (ACP) live Practical POCUS Skills for Internal Medicine Physicians course. Completion of assigned online learning activities is required prior to arrival at ACP training courses. Visit the website for further information about ACP’s POCUS Pathway, a comprehensive collection of live, hands-on training options.

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Displaying 91 - 100 of 500 in Annals of Internal Medicine: Clinical Cases

Hyperbaric Oxygen Therapy for Scleroderma Wounds: A Report on Two Cases and Literature Review | Annals of Internal Medicine: Clinical Cases

Systemic sclerosis-associated wounds are often refractory to conventional wound care and pharmacotherapy. Hyperbaric oxygen (HBO2) therapy has a longstanding, yet infrequently documented, history of success healing wounds in patients with systemic sclerosis. Here, we present 2 cases of scleroderma-associated cutaneous wounds, unresponsive to standard treatments, successfully treated with HBO2. Additionally, we reviewed the current literature for articles that used HBO2 adjunctively with wound care in systemic sclerosis. These published studies showed an overall success rate of 81%.

Bevacizumab Results in Ongoing Resolution of Bleeding From Gastrointestinal Arteriovenous Malformations After Treatment Discontinuation | Annals of Internal Medicine: Clinical Cases

Angiodysplasias cause gastrointestinal (GI) bleeding in patients with end-stage renal disease (ESRD). We present a novel case of a 62-year-old man with a history of recurrent GI bleeding requiring multiple transfusions secondary to angiodysplasias in the stomach, duodenum, and small bowel. Therapeutic endoscopic treatments were ineffective and, in total, required 40 units of packed red blood cells in 1 year. He was treated with bevacizumab and achieved a dramatic response of being transfusion free after the first dose. While various treatments for bleeding angiodysplasias exist, refractory cases require innovative approaches. Our case illustrates the successful use of bevacizumab in managing transfusion-dependent anemia secondary to angiodysplasias in ESRD.

When Palpitations and Hand Weakness Point to the Aorta: An Atypical Case of Aortic Dissection | Annals of Internal Medicine: Clinical Cases

Aortic dissection (AD) is a life-threatening condition often presenting with varied symptoms, complicating early diagnosis. We present a case of a 58-year-old woman with untreated hypertension and a remote history of cardiac ablation who presented with persistent palpitations and transient left-hand weakness, but without chest or back pain. An incidental AD was identified during imaging for a suspected transient ischemic attack. Effective blood pressure management and prompt cardiothoracic intervention, with successful surgical repair, enabled favorable outcomes. This case underscores the diagnostic challenges posed by atypical AD presentations, highlighting the importance of maintaining high index of suspicion in at-risk population.

A Gastrointestinal Anomaly: Squamous Cell Carcinoma of the Tongue Reemerging as a Metastatic Colonic Polyp | Annals of Internal Medicine: Clinical Cases

Squamous cell carcinoma (SCC) metastasizes often to the liver, lungs, and lymph nodes. Gastrointestinal metastasis is not widely documented. A 75-year-old man with SCC of the tongue in remission status post chemoradiation presented with anemia and thrombocytopenia. Colonoscopy showed multiple polyps and a large ulcer over the transverse colon. The pathology department reported lymphovascular invasion and a positive p16 staining, an immunohistologic finding associated with high-risk human papillomavirus. Managing metastatic SCC of the colon poses a clinical challenge owing to its low occurrence and absence of treatment protocols. Further research into the mechanisms underlying SCC metastasis, particularly to the gastrointestinal tract, is warranted.

Gluten-Induced Hemoptysis: A Case Report of Lane–Hamilton Syndrome | Annals of Internal Medicine: Clinical Cases

Lane–Hamilton syndrome describes the co-occurrence of idiopathic pulmonary hemosiderosis and celiac disease. A 24-year-old man presented with fatigue and several weeks of scant hemoptysis. Investigations revealed profound anemia and left lower lobe ground-glass opacities on computed tomography scan of the chest. Transbronchial biopsies showed hemosiderin-laden macrophages. Ancillary investigations revealed elevated tissue transglutaminase level and celiac disease was confirmed on duodenal biopsy despite the absence of gastrointestinal symptoms. He was treated with a gluten-free diet and a tapering course of prednisone with excellent response. This case highlights that hemoptysis can be the only presenting symptom for Lane–Hamilton syndrome, warranting thorough investigations for celiac disease.

Resolution of Corticosteroid Refractory Checkpoint Inhibitor–Induced Pneumonitis With Tocilizumab and Mycophenolate Mofetil Therapy | Annals of Internal Medicine: Clinical Cases

A 69-year-old woman with metastatic esophageal cancer, undergoing treatment with FOLFOX (folinic acid, fluorouracil, and oxaliplatin), pembrolizumab, and trastuzumab, developed fever and hypoxemia following her fourth treatment cycle. Clinical presentation and radiographic findings confirmed a diagnosis of immune-related pneumonitis. Her condition deteriorated despite high-dose glucocorticoid therapy, necessitating intensive care unit management. Administration of tocilizumab and mycophenolate mofetil resulted in a dramatic improvement within 48 hours, leading to extubation and eventual hospital discharge. This case underscores the critical role of intensified immunosuppressive therapy for managing steroid-refractory pneumonitis and highlights tocilizumab as a potential agent to reduce mortality in this challenging clinical scenario.

Chronic Tenosynovitis Caused by Mycobacterium terrae: A Case Report Highlighting a Diagnostic Challenge | Annals of Internal Medicine: Clinical Cases

We report a rare case of chronic tenosynovitis of the upper extremity caused by Mycobacterium terrae, an infrequent and underdiagnosed pathogen. A 64-year-old man presented with persistent pain and swelling in the hand following a minor puncture wound. Despite multiple empirical treatments, including corticosteroids, antibiotics, and antifungals, the condition progressed over several months (Figure 1). Surgical intervention, histopathologic examination revealing granulomatous inflammation, and prolonged microbiological culture ultimately identified M terrae. Susceptibility-guided antimicrobial therapy resulted in complete clinical resolution. This case highlights the diagnostic complexity of M terrae infections and emphasizes the importance of considering atypical pathogens in cases of chronic tenosynovitis, especially when conventional therapies fail.

Occult JAK2+ Myelofibrosis Presenting With Splanchnic Vein Thrombosis | Annals of Internal Medicine: Clinical Cases

Splanchnic vein thrombosis (SVT) is a rare manifestation of venous thromboembolism within the portal, mesenteric, hepatic, and/or splenic veins. Major risk factors include abdominal cancer, cirrhosis, and myeloproliferative neoplasms (MPNs). Myeloproliferative neoplasms can be associated with JAK2 V617F mutations, representing unique thrombotic risk factors. Discussed below is an atypical case of occult JAK2+ myelofibrosis with normal blood counts presenting as SVT, which would have been missed without high clinical suspicion. This case demonstrates the need to test for thrombophilia syndromes, JAK2, and occult MPNs in otherwise unexplained SVT to optimize treatment and prevent life-threatening manifestations such as portal hypertension sequelae and cirrhosis.

Cytomegalovirus-Related Splenic Infarcts: Viral Twist and a Vascular Phenomenon | Annals of Internal Medicine: Clinical Cases

Cytomegalovirus (CMV) infections in an individual who is immunocompetent can range from asymptomatic to infectious mononucleosis syndrome. More severe complications are seen in individuals who are immunocompromised, and these complications are associated with life-threatening conditions. One of them is CMV-associated thrombosis, commonly seen in individuals who are immunocompromised, who are transplant recipients, or who are people living with HIV/AIDS. In this case report, we present a unique case of acute CMV infection in a 35-year-old healthy individual who is immunocompetent and who developed the rare complication of isolated splenic infarction.

Foodborne Listeria monocytogenes Rhombencephalitis and Brainstem Abscess During a National Outbreak: Case Report and Literature Review | Annals of Internal Medicine: Clinical Cases

We report a rare case of Listeria monocytogenes rhombencephalitis with brainstem abscess in a previously healthy adult amid a nationwide outbreak linked to deli meat. The 56-year-old man exhibited rapid neurologic deterioration, requiring intensive care and prolonged antibiotic therapy. Diagnostic imaging confirmed multiple brainstem abscesses, and aggressive antibiotics stabilized his condition. This case underscores the importance of prompt recognition and treatment of neurolisteriosis, especially in foodborne outbreaks, as well as the potential for severe complications in otherwise healthy individuals, highlighting the need for heightened vigilance even among patients who are not immunocompromised.

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