A 51-year-old woman presents to the emergency department with dyspnea, which began 4 days ago. She reports no chest pain, palpitations, hemoptysis, fevers, chills, weight loss, recent travel, immobility, or surgery. One week ago she noticed cramping in her right calf, but that has since resolved. Her history includes hypertension, hypothyroidism, and immune-mediated glomerulonephritis with prot...

A 49-year-old female presents with ptosis, diplopia and dysphagia and is diagnosed with myasthenia gravis by electromyography (Figure 1). The patient reports some improvement of her symptoms with pyridostigmine, but due to increasing symptoms, she has been placed on prednisone and mycophenolate mofetil. She is otherwise healthy and takes no other medications. Computed tomography imaging shows n...

D.S., a 65-year-old woman, presented for a gynecologic examination stating that she wished to discontinue annual cervical cancer screening. Her physical examination was within normal limits, and a liquid-based Pap test with a broom and a cytobrush was obtained. Her medical history was signifi cant for stable multiple sclerosis, for which she takes glatiramer 20 mg subcutaneously daily. Her obst...

A collection of Curbside Consultation published in AFP is available at http://www.aafp.org/afp/ curbside. Case Scenario A 16-year-old girl and her parents presented to my office for her wellness evaluation. The patient has generalized anxiety disorder with comorbid major depression, for which she has been prescribed a serotonergic antidepressant. She is a high school student, lives with her par...

The wish to have a child is a deep instinctual urge; the ability to care for the child is not innate and must be nurtured. In fact, many new mothers feel torn between their desire for a child and their wish to be free of long involvements and responsibilities. Becoming a mother is a testing time for a woman. Then she takes on the truly feminine role as opposed to just being a sex partner in a r...

DOI: 10.4103/1319-3767.114510 A 60‐year‐old lady with history of reflux disease and breast cancer status post‐lumpectomy and lymph node dissection followed by chemotherapy and now in remission, was admitted with progressively increasing nausea and vomiting of 2 months duration. She also described episodic epigastric abdominal pain, which increased on food intake and led to vomiting, which broug...

A 55-year-old woman comes to a psychiatrist complaining of experiencing a depressed mood over the past 3 months. She notes that her mood has been consistently low (3 on a scale of 1 to 10, with 10 being the best she has ever felt), and she describes her condition as “just not me.” She has also noticed a decrease in energy and a weight gain of 6 to 7 lb occurring over the same period of time, al...

In clinical practice, functional mood stability—which can on occasion be achieved with optimum lithium therapy—is the gold standard that both clinicians and patients strive to attain. To facilitate this endeavor, guidelines on lithium therapy have become increasingly sophisticated; they not only provide therapeutic indications and plasma levels with respect to efficacy, but also inform practiti...

Before an outstanding article in 1999 by Richard Holton, weakness of will was identified as an agent's action contrary to his or her better judgment, while other better choices are available. The contemporary account of weakness of will (i.e., Holton’s theory) explains it in terms of intention. Accordingly, weakness of will happens if an agent fails to stick to his or her previously formed inte...