For patients with a persistent cough
who cannot take codeine, a combination
of benzonatate (1 or 2 100-mg
capsules tid prn), along with dextromethorphan
and guaifenesin (2 or
3 tsp tid prn), can be effective.
Drs Gary Quick, Theodore Ruff, and Pam Wilson’s “What’s Wrong With This
Picture?” case of a woman with splenic laceration resulting from an assault by a
male friend (CONSULTANT, May 2002, page 714) seems to have missed the
“elephant in the living room.”
A 34-year-old woman complains of headaches that interfere with work. Her first headache episode, approximately 6 years
earlier, was relatively mild. Initially, she experienced attacks only once every 3 to 4 months and managed them effectively
with over-the-counter (OTC) agents. However, in the last 6 months the attacks have become more frequent—they occur at
least twice a month—and are so severe that she misses work.
In a 65-year-old man with a family history of colorectal carcinoma, an initial screening coloscopic examination revealed 2 arteriovenous malformations. These delicate red lesions with a vascular network and irregular edges were found in the cecum.
The family of a 50-year-old
alcoholic man brings him to your
office. They are concerned about
his health and note that they had not
seen him for several months before
he reappeared. The patient complains
of generalized weakness, fatigue, and
For 36 hours, a 75-year-old woman had experienced weakness of the right side of the face. She was unable to close the right eye and drooled from the right side of the mouth. There was no weakness, numbness, or tingling of the extremities.
A 59-year-old woman presented for a routine physical examination. She had no physical complaints and took no medications. During the physical examination, bilateral, flat, slightly elevated, yellowish cutaneous lesions were noted above and below the skin folds of the patient's eyelids.
A 32-year-old previously healthy
woman presents to the emergency
department with skin lesions, suprapubic
pain, and generalized myalgia of
1 week’s duration. Trimethoprim-sulfamethoxazole
for a presumed urinary
tract infection is prescribed, and the
patient is discharged. The symptoms
persist; she is hospitalized 2 days later.