Drugs causing Megaloblastic Anemia:
P–>Phenytoin (–>Folate deficiency)
Introducing our newest segment for the UT Southwestern Internal Medicine Blog: Advice for Physicians in Training (though some of this may apply to physicians already in practice)!
We present a “distillation of the advice and wisdom” of 40 practicing physicians, to be dispensed over the next 8 weeks. Look for a new pearl each day!
A thorough history almost always trumps a thorough physical examination. Osler said “Listen to the patient. He is telling you the diagnosis.” He was right.
David Juurlink, Advice for Physicians in Training: 40 Tips From 40 Docs,The Winnower2:e142006.67645 (2014). DOI:10.15200/winn.142006.67645
It’s the middle of winter, with no end in sight. A 28 year old male arrives in your primary care clinic with no past medical history and one complaint: a stuffy nose. For the last 3 days, he has had sinus congestion, a mild cough, and associated headache. He denies fever, sick contacts, myalgias, etc. You suspect a viral infection, noting that the patient should improve without antibiotics, but he insists. He must have antibiotics today, so that he can return to work! Do you give in and send him out with a Z-pack?
Consumer Reports has joined with the ABIM and the Choosing Wisely Campaign to help educate patients about when, where, and how to use antibiotics, in an effort to prevent, as they note, unnecessary harm.
Take a look at the patient resources below – if you like them, print them out and display them in your practice. It just might make your next conversation a bit easier…
The PDF and the poster may help with patient education!