Darren B. Taichman, MD, PhD
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From the Editors of Annals of Internal Medicine and Education Guest Editor, Gretchen Diemer, MD, FACP, Associate Dean of Graduate Medical Education and Affiliations, Thomas Jefferson University.
Ask your learners what symptoms should prompt consideration of ME/CFS.
How is the diagnosis of ME/CFS established?
What observations in patients with ME/CFS prompted these investigators to hypothesize that altering B-cell function might improve symptoms in ME/CFS? Use the paper's discussion and the accompanying editorial to help frame your discussion.
What do the results of this study, in conjunction with prior experience of rituximab use in ME/CFS, tell us about the potential role of placebo effects?
Ask your learners to list the potential clinical manifestations of hypertriglyceridemia.
Review the normal physiology of triglyceride transport and metabolism. What are the causes of chylomicronemia syndrome?
What factors may contribute to severe hypertriglyceridemia in persons with a genetic predisposition? Use the Table to prepare for a teaching session.
What is the “buttock shelf” in the Köbberling type of partial lipodystrophy? Show Figure 2 to your learners.
How is chylomicronemia syndrome treated? Review the algorithm provided.
Start a teaching session with a multiple-choice question. We've provided one below!
What are the potential harms and benefits of DTC genetic testing?
Ask your learners whether patients have asked for interpretation of DTC genetic test results.
What information do DTC genetic tests provide? How reliable are the results?
Are 23andMe test results comprehensive?
Why is the positive predictive value of 23andMe results limited?
When should your learners refer patients for genetic counseling?
Do your learners believe it is their responsibility to provide counseling on the results of tests they did not order or recommend?
Ask your learners how they decide whether a patient with atrial fibrillation should receive anticoagulant therapy.
How is the CHA2DS2-VASc score calculated? At what score is anticoagulation recommended in men and women? Why?
Have your learners ever considered how often the CHA2DS2-VASc score changes? Should they? What do the results of this study suggest? How often do your learners think CHA2DS2-VASc scores should be recalculated?
Ask your learners why we screen for hypertension.
How should BP be measured? Are you sure your learners do it correctly? Observe them, and use the information in the Box to assess how well they do.
Ask your learners about the process for BP measurement in their practice. Who does it, and how? Are they sure it is done correctly? Ask them to quietly observe and report back on whether the measurements are being done correctly.
Which definition of hypertension do your learners use?
What is masked hypertension?
When should ambulatory monitoring be used? How do your learners arrange for this?
What laboratory testing should be ordered in patients with newly diagnosed hypertension?
How does the American Heart Association approach to treatment differ between stage 1 and stage 2 hypertension?
Use the provided multiple-choice questions to help introduce topics for teaching. Be sure to log on and enter your answers to earn CME/MOC credit for yourself!
Provide a copy to your learners to enjoy, or show it to them at a workstation, on your phone, or on your tablet.
Ask if patients have failed to recognize or acknowledge that your learners are physicians. Why does this happen? Does it happen more frequently to women physicians?
How should we respond when it occurs? Should we be offended?
Although this situation is comically portrayed here, might it pose a problem for patient care? What about for physician well-being? What can be done to remedy the situation?
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Taichman DB. Annals for Educators - 7 May 2019. Ann Intern Med. 2019;170:ED9. doi: 10.7326/AWED201905070
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Published: Ann Intern Med. 2019;170(9):ED9.
Cancer Screening/Prevention, Cardiology, Chronic Fatigue Syndrome/Fibromyalgia, Coronary Risk Factors, Hematology/Oncology.
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