Patient Information

In an online educational brochure, the Obesity Action Coalition offers basic information about obesity. “Understanding obesity” is available at http://www.obesityaction.org/wp-content/uploads/Understanding-Obesity-3-15.pdf. It explains body mass index, the difference between overweight and obesity, and treatment options, including behavioral modification, medical weight management, and bariatric surgery.

In an online educational brochure, the Obesity Action Coalition offers basic information about obesity. “Understanding obesity” is available at http://www.obesityaction.org/wp-content/uploads/Understanding-Obesity-3-15.pdf. It explains body mass index, the difference between overweight and obesity, and treatment options, including behavioral modification, medical weight management, and bariatric surgery.

In an online educational brochure, the Obesity Action Coalition offers basic information about obesity. “Understanding obesity” is available at http://www.obesityaction.org/wp-content/uploads/Understanding-Obesity-3-15.pdf. It explains body mass index, the difference between overweight and obesity, and treatment options, including behavioral modification, medical weight management, and bariatric surgery.

In “Taking control of heart failure,” which is available at http://www.hfsa.org/hfsa-wp/content/uploads/2014/06/module1_takingcontrolofheartfailure.pdf, the Heart Failure Society of America describes steps patients can take to actively work with their doctor to optimize treatment. In addition to emphasizing the importance of self-care steps such as complying with medication regimens, eating a low-sodium diet, and remaining physically active, this pamphlet also provides questions patients should ask their doctor to better understand heart failure.

In “Taking control of heart failure,” which is available at http://www.hfsa.org/hfsa-wp/content/uploads/2014/06/module1_takingcontrolofheartfailure.pdf, the Heart Failure Society of America describes steps patients can take to actively work with their doctor to optimize treatment. In addition to emphasizing the importance of self-care steps such as complying with medication regimens, eating a low-sodium diet, and remaining physically active, this pamphlet also provides questions patients should ask their doctor to better understand heart failure.

In “Taking control of heart failure,” which is available at http://www.hfsa.org/hfsa-wp/content/uploads/2014/06/module1_takingcontrolofheartfailure.pdf, the Heart Failure Society of America describes steps patients can take to actively work with their doctor to optimize treatment. In addition to emphasizing the importance of self-care steps such as complying with medication regimens, eating a low-sodium diet, and remaining physically active, this pamphlet also provides questions patients should ask their doctor to better understand heart failure.

The Depression and Bipolar Support Alliance has produced an online brochure to teach patients about common mood disorders. Available at http://www.dbsalliance.org/site/DocServer/DBSA_Uni_Bipolar.v3.pdf?docID=2901, “Mood disorders and different kinds of depression” explains the differences between unipolar and bipolar depression, how each of these conditions is treated, and how patients can talk to their doctor about their diagnosis and treatment.

The Depression and Bipolar Support Alliance has produced an online brochure to teach patients about common mood disorders. Available at http://www.dbsalliance.org/site/DocServer/DBSA_Uni_Bipolar.v3.pdf?docID=2901, “Mood disorders and different kinds of depression” explains the differences between unipolar and bipolar depression, how each of these conditions is treated, and how patients can talk to their doctor about their diagnosis and treatment.

The Depression and Bipolar Support Alliance has produced an online brochure to teach patients about common mood disorders. Available at http://www.dbsalliance.org/site/DocServer/DBSA_Uni_Bipolar.v3.pdf?docID=2901, “Mood disorders and different kinds of depression” explains the differences between unipolar and bipolar depression, how each of these conditions is treated, and how patients can talk to their doctor about their diagnosis and treatment.

In “What Is COPD?” the National Heart, Lung, and Blood Institute provides information to teach patients about chronic obstructive pulmonary disease. This resource, which is available at http://www.nhlbi.nih.gov/health/health-topics/topics/copd, includes illustrations that show patients how COPD affects the bronchioles and alveoli, and an animation that shows the anatomy of the lungs and the damage caused by COPD.

In “What Is COPD?” the National Heart, Lung, and Blood Institute provides information to teach patients about chronic obstructive pulmonary disease. This resource, which is available at http://www.nhlbi.nih.gov/health/health-topics/topics/copd, includes illustrations that show patients how COPD affects the bronchioles and alveoli, and an animation that shows the anatomy of the lungs and the damage caused by COPD.

In “What Is COPD?” the National Heart, Lung, and Blood Institute provides information to teach patients about chronic obstructive pulmonary disease. This resource, which is available at http://www.nhlbi.nih.gov/health/health-topics/topics/copd, includes illustrations that show patients how COPD affects the bronchioles and alveoli, and an animation that shows the anatomy of the lungs and the damage caused by COPD.

The American Stroke Association offers an easy-to-read guide for patients who need to take anticoagulant and/or antiplatelet medication. “Anti-clotting agents explained,” which is available at http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/ManagingMedicines/Anti-Clotting-Agents-Explained_UCM_310452_Article.jsp, explains the differences between these 2 types of therapies, how they work, and what to expect.

The American Stroke Association offers an easy-to-read guide for patients who need to take anticoagulant and/or antiplatelet medication. “Anti-clotting agents explained,” which is available at http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/ManagingMedicines/Anti-Clotting-Agents-Explained_UCM_310452_Article.jsp, explains the differences between these 2 types of therapies, how they work, and what to expect.

The American Stroke Association offers an easy-to-read guide for patients who need to take anticoagulant and/or antiplatelet medication. “Anti-clotting agents explained,” which is available at http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/ManagingMedicines/Anti-Clotting-Agents-Explained_UCM_310452_Article.jsp, explains the differences between these 2 types of therapies, how they work, and what to expect.

The FP recognized that this patient had psoriatic arthritis, which was asymmetric in the knees and present in the patient’s hands.

The FP prescribed topical steroid ointments and referred the patient to Dermatology and Rheumatology, as it was clear that a systemic immunosuppressive agent would be needed for treatment. She ordered an interferon-gamma release assay for tuberculosis (TB) infection, hepatitis B and C serologies, and a comprehensive metabolic profile (as a baseline).

The patient was seen by Dermatology first, and a discussion of treatment choices included a review of methotrexate and various biologic medications. Fortunately, all of the baseline labs were normal and there was no evidence of exposure to TB or hepatitis.

The patient was started on methotrexate weekly to treat his psoriasis and psoriatic arthritis. Daily folic acid was prescribed to prevent the adverse effects of methotrexate. Within weeks, the patient was able to walk better and his skin had begun to clear.

Photo and text courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H, Usatine R. Arthritis overview. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:562-568.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The FP recognized that this patient had psoriatic arthritis, which was asymmetric in the knees and present in the patient’s hands.

The FP prescribed topical steroid ointments and referred the patient to Dermatology and Rheumatology, as it was clear that a systemic immunosuppressive agent would be needed for treatment. She ordered an interferon-gamma release assay for tuberculosis (TB) infection, hepatitis B and C serologies, and a comprehensive metabolic profile (as a baseline).

The patient was seen by Dermatology first, and a discussion of treatment choices included a review of methotrexate and various biologic medications. Fortunately, all of the baseline labs were normal and there was no evidence of exposure to TB or hepatitis.

The patient was started on methotrexate weekly to treat his psoriasis and psoriatic arthritis. Daily folic acid was prescribed to prevent the adverse effects of methotrexate. Within weeks, the patient was able to walk better and his skin had begun to clear.

Photo and text courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H, Usatine R. Arthritis overview. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:562-568.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The FP recognized that this patient had psoriatic arthritis, which was asymmetric in the knees and present in the patient’s hands.

The FP prescribed topical steroid ointments and referred the patient to Dermatology and Rheumatology, as it was clear that a systemic immunosuppressive agent would be needed for treatment. She ordered an interferon-gamma release assay for tuberculosis (TB) infection, hepatitis B and C serologies, and a comprehensive metabolic profile (as a baseline).

The patient was seen by Dermatology first, and a discussion of treatment choices included a review of methotrexate and various biologic medications. Fortunately, all of the baseline labs were normal and there was no evidence of exposure to TB or hepatitis.

The patient was started on methotrexate weekly to treat his psoriasis and psoriatic arthritis. Daily folic acid was prescribed to prevent the adverse effects of methotrexate. Within weeks, the patient was able to walk better and his skin had begun to clear.

Photo and text courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H, Usatine R. Arthritis overview. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:562-568.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The family physician (FP) recognized that this patient was having an attack of gout, which was most likely exacerbated by the new prescription for hydrochlorothiazide. The patient’s serum uric acid level was highly elevated (12.1 mg/dL). No joint aspiration was attempted because the diagnosis was well supported by the history, physical exam, and elevated serum uric acid level.

Crystalline arthritis is caused by the deposition of uric acid crystals (gout) or calcium pyrophosphate dihydrate crystals (calcium pyrophosphate dihydrate crystal deposition disease) resulting in episodic flares with periods of remission.

Treatment for acute cases of gout include nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine. The treatment of chronic gout includes modifications to diet and existing medications and the lowering of urate levels. Patients are encouraged to:

• reduce the intake of purine-rich foods (eg, organ meats, red meats, and seafood)
• increase fluid intake to 2000 mL/d
• lower alcohol intake
• consume dairy products as these may be protective against gout
• change medications. Specifically, discontinue aspirin and consider stopping a thiazide diuretic. Lower urate levels with xanthine oxidase inhibitors (eg, allopurinol), uricosuric agents (eg, probenecid), or uricase agents (eg, pegloticase).

In this case, the FP replaced the thiazide diuretic with a calcium channel blocker. The patient was treated with colchicine to stop the acute inflammation. He was also told to drink less alcohol (or abstain from it) and to avoid red meat in his diet.

Photo courtesy of Robin Treadwell, MD and text courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H, Usatine R. Arthritis overview. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:562-568.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The family physician (FP) recognized that this patient was having an attack of gout, which was most likely exacerbated by the new prescription for hydrochlorothiazide. The patient’s serum uric acid level was highly elevated (12.1 mg/dL). No joint aspiration was attempted because the diagnosis was well supported by the history, physical exam, and elevated serum uric acid level.

Crystalline arthritis is caused by the deposition of uric acid crystals (gout) or calcium pyrophosphate dihydrate crystals (calcium pyrophosphate dihydrate crystal deposition disease) resulting in episodic flares with periods of remission.

Treatment for acute cases of gout include nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine. The treatment of chronic gout includes modifications to diet and existing medications and the lowering of urate levels. Patients are encouraged to:

• reduce the intake of purine-rich foods (eg, organ meats, red meats, and seafood)
• increase fluid intake to 2000 mL/d
• lower alcohol intake
• consume dairy products as these may be protective against gout
• change medications. Specifically, discontinue aspirin and consider stopping a thiazide diuretic. Lower urate levels with xanthine oxidase inhibitors (eg, allopurinol), uricosuric agents (eg, probenecid), or uricase agents (eg, pegloticase).

In this case, the FP replaced the thiazide diuretic with a calcium channel blocker. The patient was treated with colchicine to stop the acute inflammation. He was also told to drink less alcohol (or abstain from it) and to avoid red meat in his diet.

Photo courtesy of Robin Treadwell, MD and text courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H, Usatine R. Arthritis overview. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:562-568.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The family physician (FP) recognized that this patient was having an attack of gout, which was most likely exacerbated by the new prescription for hydrochlorothiazide. The patient’s serum uric acid level was highly elevated (12.1 mg/dL). No joint aspiration was attempted because the diagnosis was well supported by the history, physical exam, and elevated serum uric acid level.

Crystalline arthritis is caused by the deposition of uric acid crystals (gout) or calcium pyrophosphate dihydrate crystals (calcium pyrophosphate dihydrate crystal deposition disease) resulting in episodic flares with periods of remission.

Treatment for acute cases of gout include nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine. The treatment of chronic gout includes modifications to diet and existing medications and the lowering of urate levels. Patients are encouraged to:

• reduce the intake of purine-rich foods (eg, organ meats, red meats, and seafood)
• increase fluid intake to 2000 mL/d
• lower alcohol intake
• consume dairy products as these may be protective against gout
• change medications. Specifically, discontinue aspirin and consider stopping a thiazide diuretic. Lower urate levels with xanthine oxidase inhibitors (eg, allopurinol), uricosuric agents (eg, probenecid), or uricase agents (eg, pegloticase).

In this case, the FP replaced the thiazide diuretic with a calcium channel blocker. The patient was treated with colchicine to stop the acute inflammation. He was also told to drink less alcohol (or abstain from it) and to avoid red meat in his diet.

Photo courtesy of Robin Treadwell, MD and text courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H, Usatine R. Arthritis overview. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:562-568.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com