An algorithm for managing warfarin resistance

Some patients need higher-than-expected doses of warfarin to reach their target INR. The cause can be acquired (poor circulation, drug...


Clinical approach to colonic ischemia

Ischemic colitis is one of the diagnoses that should be considered when patients present with abdominal pain, diarrhea, and intestinal bleeding....

IM Board Review

A 72-year-old man with a purpuric rash

He has multiple medical problems and a new rash that appeared 2 weeks ago. Now he presents to the emergency department confused and diaphoretic....

The Clinical Picture

Salmonella-related mycotic pseudoaneurysm

A 74-year-old man is admitted to the hospital with a 7-day history of fever, rigors, chest pain, and general weakness. He underwent coronary...

The Clinical Picture

Unilateral cotton wool spots: An important clue

The patient has sudden loss of vision in one eye and unilateral cotton wool spots on funduscopy. What is the cause?

IM Board Review

A 43-year-old woman with chest pressure

She has acute chest discomfort, a 25-pack-year smoking history, and a family history of myocardial infarction and deep vein thrombosis. What is...