What is this sign?

What is this sign?

Written by Kai Swenson, MD Edits and video by Alex Perino, MD A 45 year old woman with a past medical history of Hodgkin’s lymphoma treated with mantle field radiation whose neck veins were incidentally noted on a thorough physical exam. The patient was in sinus rhythm on telemetry throughout the exam. What is the

Abraham Verghese Asks: “Why Are We Doing This Teaching?”

Abraham Verghese Asks: “Why Are We Doing This Teaching?”

Errol Ozdalga, MD; @eozdalga Clinical Assistant Professor, Stanford School of Medicine We teach bedside medicine. We emphasize the importance of the physical exam and how it can help care for your patient and also create an environment where the person you are caring for develops trust. We have taught this now for over 6 years (when the

Will the Healing Touch Go Out the Door With the Stethoscope?

Will the Healing Touch Go Out the Door With the Stethoscope?

As technology advances – putting many valuable tools right in our smartphones and transforming ultrasound machines into portable, handheld devices – some are beginning to question what’s in store for the stethoscope. NPR Health’s “Shots” blog asked recently if the stethoscope was a “timeless tool or outdated relic.” Medical students still use stethoscopes to learn,

What is the name of this sign?

Figure 1. From (1) with permission. In case you didn’t spot it here is another example: Figure 2. Same patient with more obvious example on left ear. Answer Below…       Answer: Diagonal earlobe crease (DELC). 1. What eponym is associated with this sign? Answer: Frank’s – named after Dr Sanders T. Frank observed

What Is The Specific Cause of This Patient’s Clubbing?

Figure 1. Obvious clubbing in patients toes. Note the relative severity in the toes compared to the hands. From (1) with permission. The causes of clubbing are a favourite bedside question on rounds. They can be divided into: Pulmonary (commonest – think neoplasm until proven otherwise). Bronchial carcinoma Mesothelioma Bronchiectasis Cystic fibrosis Interstitial fibrosis Cardiac

The Jugular Venous Pulse – Circa 1957

In 1902 Sir James Mackenzie published a book entitled “The Study of the Pulse. Arterial, venous, and hepatic and of the movements of the heart” that described his studies on the jugular pulse using what would later and famously be known as the “Mackenzie polygraph”. He was the first to make recordings of the arterial

Do You Know How to Measure an Ankle Brachial Index?

The ankle brachial index (ABI) is a common and useful exam in the outpatient setting to detect peripheral arterial disease. ABI’s should be measured in all people over the age of 50 if they are a diabetic or a smoker. It should also be checked in patients over the age of 60. While many doctors

This patient presents with chest pain. What’s the diagnosis?

This 32 yr old patient presents with chest pain. Based on the pictures, can you diagnose what the most likely cause is? The cause of chest pain is Aortic dissection. This is a patient with Marfan’s Syndrome. A majority of adults with Marfan’s syndrome have aortic dilation and if untreated can lead to aortic dissection.

The History of Pulsus Paradoxus

Given our recent post and Stanford 25 session on pulsus paradoxus, we wanted to continue the theme with a historical perspective: According to this article, cardiac tamponade was first noted by the Cornish physician Richard Lower in the following quote: “The envelope becomes filled in hydrops of the heart; the walls of the heart are

Do you know how to measure pulsus paradoxus?

Pulsus paradoxus is an exaggeration of the normal drop in blood pressure that occurs during inspiration. It’s seen in disease states such as cardiac tamponade and less commonly constrictive pericarditis. Watch the video below or visit our website to learn more! Today’s Stanford Medicine 25 session was about Pulsus Paradoxus. Thanks to Dr. Ronald Witteles