In the previous two volumes of this series, we presented classic problems in internal medicine as illustrated by actual cases cared for in our institution. It has been gratifying for us to see the interest that these volumes have generated with students and trainees. We remain committed to the case method of instruction, and believe that there is no better method to learn medicine than to have an individual patient problem as the basis for study of pathophysiology, natural history, diagnosis and management. We hope that our readers find this third volume as enjoyable and instructive as the editors found it. Juan M. Bowen, MD Ernest L. Mazzaferri, MD, FACP xiii Acknowledgement The editors are grateful to Jeff Smith and Jenny Riegler for their unflagging professionalism and patience. xiv Contents Case 1 Mitral Regurgitation - Chronic Versus Acute: Implications for Timing of Surgery • . • • • . . • . . . . . • . . . . . . . . . . . 1 Harisios Boudoulas, MD Charles F. Wooley, MD Advances and diagnostic imaging in a surgical technique have changed the approach to mitral valve regurgitation. This chapter provides an expert's perspective. Case 2 Cystic Fibrosis in Adults .. • •••••••••••• 36 Andrew Libertin, MD John S. Heintz, MD As children with cystic fibrosis grow into adulthood, the internist assumes a greater role in their care. Case 3 Thrombotic Thrombocytopenic Purpura . . . . . . . . . . 51 . . . Donald E. Thornton, MD Earl N. Metz, MD, FACP Patients with ITP continue to present difficulties in diagnosis and management. Two experts discuss the current approach to ITP.

While medical schools usually emphasize the teaching of advanced scientific fundamentals through a carefully planned, formal curriculum, few focus on the equally crucial “hidden curriculum” of professional attitudes, skills, and behaviors. This concise and practical guide helps educators effectively prepare students for seldom-taught issues that arise daily in the practice of clinical medicine. In this volume, experienced clinician-educators offer real-world examples of various pedagogical and clinical scenarios, providing evidence- and theory-based approaches to managing three areas of growth: professional development, professionalism, and teaching. Acknowledging human fallibility, the editors begin with a framework that institutions, educators, and learners can use to promote well-being, outlining strategies for mindfulness training, relaxation techniques, appreciative inquiry, narrative medicine, and positive psychology. They then apply these strategies to additional developmental topics like failure, burnout, and improving resilience, social identity formation, and graceful self-promotion. The editors move on to discuss power differentials. They suggest ways of combatting microaggressions faced by women and minorities, fostering a safe learning environment where learners feel comfortable advocating in the setting of ethical dilemmas, recognizing and avoiding student mistreatment, and encouraging humility. They close with implications for the classroom, explaining the benefits and pitfalls of electronic health records and social media, the positive and negative attributes of role models, how to comfortably navigate controversial topics like gun ownership and abortion, and teaching empathy. With helpful infographics and case studies, this volume is a valuable resource for frontline educators who wish to help learners navigate the transition from layperson to medical professional.

The history of medicine has come to occupy a significant place in our understanding of modern society and the American cultural fabric. To fully understand and appreciate American medicine in the twentieth century one must contend with the twin processes of specialization and professionalization. Grand Rounds considers the critical period for these two processes, the years between World War I and the Vietnam era. A diverse group of contributors (clinicians as well as historians and "participant-observers") outline broad themes involved in the evolution of modern internal medicine and trace the origins of sub­specialties such as cardiology, gastroenterology, rheumatology, infectious diseases, and nephrology. Paul Beeson, Rosemary Stevens, and others discuss the literature, diagnostic approaches, and therapeutic research in the field. Grand Rounds will be of interest to historians of science and medicine, students of American civilization, and medical practitioners.

50 Studies Every Internist Should Know presents key studies that shape today's practice of internal medicine. Selected using a rigorous methodology, the studies cover topics including: preventative medicine, endocrinology, hematology and oncology, musculoskeletal diseases, nephrology, gastroenterology, infectious diseases, cardiology, pulmonology, geriatrics and palliative care, and mental health. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies. This book is a must-read for health care professionals and anyone who wants to learn more about the data behind clinical practice.

This instant gold standard title is a major contribution to the field of clinical medical ethics and will be used widely for reference and teaching purposes for years to come. Throughout his career, Mark Siegler, MD, has written on topics ranging from the teaching of clinical medical ethics to end-of-life decision-making and the ethics of advances in technology. With more than 200 journal publications and 60 book chapters published in this area over the course of his illustrious career, Dr. Siegler has become the pre-eminent scholar and teacher in the field. Indeed his work has had a profound impact on a range of therapeutic areas, especially internal medicine, pediatrics, surgery, oncology, and medical education. Having grown steadily in importance the last 30 years, clinical ethics examines the practical, everyday ethical issues that arise in encounters among patients, doctors, nurses, allied health workers, and health care institutions. The goal of clinical ethics is to improve patient care and patient outcomes, and almost every large hospital now has an ethics committee or ethics consultation service to help resolve clinical ethical problems; and almost every medical organization now has an ethics committee and code of ethics. Most significantly, clinical ethics discussions have become a part of the routine clinical discourse that occurs in outpatient and inpatient clinical settings across the country. This seminal collection of 46 landmark works by Dr. Siegler on the topic is organized around five themes of foundational scholarship: restoring and transforming the ethical basis of modern clinical medicine, the doctor-patient relationship, education and professionalism, end-of-life care, and clinical innovation. With introductory perspectives by a group of renowned scholars in medicine, Clinical Medical Ethics: Landmark Works of Mark Siegler, MD explains the field authoritatively and comprehensively and will be of invaluable assistance to all clinicians and scholars concerned with clinical ethics.

Written by Nicholas J Talley, Simon O’Connor and Brad Frankum, this engaging and instructive text provides practical pathways to diagnosis and up-to-date strategies for implementing evidence-based treatments for prevalent conditions. Learn how to: identify what is clinically important understand and investigate disease create an effective strategy for treatment use technological diagnostic tools. This new edition of Essentials of Internal Medicine 4e describes established and trusted diagnostic techniques to equip students and trainees with the skills to succeed in their profession. The visually dynamic text offers a framework of knowledge covering core facts and addressing difficult-to-master topics such as: holistic approach to patient treatment the importance of diagnosis the physician's role in public health the physician as scholar. Contributions from expert clinicians leading the advancement of medicine globally Need-to-know ‘clinical pearls’ throughout each chapter Memory jog lists and tables Multiple choice questions with end-of-chapter answers and extensive explanations Enhanced eBook version included with purchase

Building on established diagnostic techniques, Essentials of Internal Medicine 3e presents a modern approach to internal medicine, equipping the reader with the skills to become an effective internist. This text presents practical approaches to diagnosis and up to date strategies for implementing evidence-based treatments for prevalent conditions. Learn how to: - Identify what is clinically important - Understand and investigate disease - Create an effective strategy for treatment - Utilize technological diagnostic tools now available - Color illustrations to enhance recognition and learning - Clinical pearls - Memory jog lists and tables - Multiple choice questions with answers and explanationsContent has been organized around themes of: - Holistic approach to patient treatment - The importance of diagnosis - The physician's role in public health - The physician as scholar