- As chronic kidney disease progresses, patients may present with comorbidities such as hypertension, cardiovascular disease, dyslipidemia, and anemia.
Basal cell carcinomaThis solitary, nonresolving erythematous lesion has been present on the mid thigh of a 73-year-old woman for several months. She reports that the lesion is asymptomatic, has not changed in size, and has never bled.
contact dermatitis<p><img src="/sites/default/files/images/Screen%20Shot%202012-12-11%20at%201.24.53%20PM.png" alt="contact dermatitis" title="contact dermatitis" style="margin-left: 5px; margin-right: 5px; float: left;" height="90" width="90"><br>A pruritic rash of a few months’ duration on the palmar surfaces of both hands prompts a 43-year-old woman to seek medical care.</p>
Hernia<p><img src="/sites/default/files/images/1212Con_PCHernia.jpg" alt="hernia" title="Grynfeltt-Lesshaft Hernia" style="margin-left: 5px; margin-right: 5px; float: left;" height="90" width="90"><br>A 52-year-old man presented to general internal medicine clinic with a 3-day history of stabbing left flank pain. He denied any fever, chills, dysuria, hematuria, nausea, vomiting, diarrhea, or constipation. Physical examination was significant for left flank tenderness.</p>
Bone fractures<p><img src="/sites/default/files/images/1212Con_PCBoxer_AB.jpg" alt="boxer's fracture" title="boxer's fracture" style="float: left; margin-left: 5px; margin-right: 5px;" height="90" width="90">An 18-year-old boy presented to the emergency department with pain and swelling of the left hand and inability to move the fingers. The symptoms had developed after he had punched a wall during an altercation with a friend.</p>
appendicitis<p><img src="/sites/default/files/images/Screen%20Shot%202012-12-11%20at%2011.26.46%20AM.png" alt="appendicitis" title="appendicitis" style="float: left; margin-left: 5px; margin-right: 5px;" height="90" width="90"><br>Right upper quadrant and epigastric pain, accompanied by nausea and vomiting, prompted a 50-year-old woman to seek medical attention. She had a history of irritable bowel syndrome and a remote history of kidney stone disease, spinal fusion, and tubal ligation.</p>
pruritic, Pruritic Dermatitis<p>A 72-year-old woman with a history of hypertension and degenerative joint disease presents with severe vulvar pruritus of 10 years’ duration. The itching worsens with hot weather, anxiety, and stress. The patient also complains of intermittent dysuria. She feels depressed and remains isolated because of embarrassment related to the constant vulvar itching.</p>
Chest painA 50-year-old man presents to the emergency department (ED) with midsternal chest discomfort. The pain started at 3:00 AM and was 6/10 in intensity; it was relieved by 2 sublingual nitroglycerin tablets.
hip replacement, HIV, HIV infectionDue to his age, an older man with HIV infection presents for a preoperative risk assessment before a total hip replacement.
Alopecia, hair loss<p><br /> This 40-year-old woman complains of “hair loss,” although she has not noticed any unusual amounts of hair on her brush or comb or in the sink when she shampoos. She says that the problem has been slowly progressive for several years. She has not noticed any change in her scalp skin, and she denies a history of illness or joint pain in the preceding several years.</p>
Cancer, Pain<p>Pain need not be an unbearable fact of life for most adults who have, or who have been treated for, cancer. Cancer-related pain can usually be controlled.</p>
Kidney<p><img alt="" height="90" src="/sites/default/files/images/generic%20icon3_4.jpg" style="float:left" width="90" /><br /> Does acute kidney injury predict later health problems? And, do the kidneys completely recover? Since my first goal in this venue is to focus on primary care issues, I avoid overemphasizing nephrology. But, in my role as a subspecialist, I have been asked two questions repeatedly. First, does acute kidney injury (AKI) predict other problems later? Second, does AKI always recover completely? Recent studies may provide answers.</p>
corneal abrasion, Eyes<p>“You’ll shoot your eye out!” the classic warning to Ralphie Parker in the 1983 movie <em>A Christmas Story</em> elucidates the danger of BB guns, but somehow that caution has not transferred to Airsoft guns. Although Airsoft pellets are not as damaging as BBs, physicians should be aware of the significant ocular trauma these pellets can inflict on their patients.<sup>1-5</sup> Airsoft guns are gas- or spring-powered replicas of real firearms capable of reaching velocities of 74.9 m/s.5 Case reports and laboratory studies have found injuries from Airsoft pellets to include hyphema, corneal abrasion, epithelial edema, traumatic mydriasis, iridodialysis, damage to the trabecular meshwork, cataracts, commotio retinae, retinal hemorrhage, and globe rupture.</p>
CONSULTANTIn this, the last issue of our 52nd year of publication, we want to extend our thanks to the following reviewers who appraised at least one manuscript for us in 2012.
CONSULTANT<p>As we look forward to 2013, our 53rd year of publication, we are pleased to announce the launch of the tablet edition of Consultant—and a new online contest, Photo Quiz Challenge, on the official Web site of our journal, www.Consultant360.com.</p>