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There was no such thing as “then” when there was no time. Augustine, Confessions, Book XI, Chapter 13, Paragraph 15    

The term meaning increased number of cells: 

II Corinthians and Romans

“As I opened my heart to appreciate how skillfully he spoke, the recognition that he was speaking the truth crept in at the same time, though only by slow degrees.” Augustine, Confessions, Book V, Chapter 14, Paragraph 24  

A fifty-four-year-old requests systemic hormone therapy for hot flashes. Her history includes estrogen-receptor positive breast cancer treated two years ago. Which management is most appropriate? 

A twenty-six-year-old has a palpable breast mass. Ultrasound shows a well-circumscribed solid lesion consistent with fibroadenoma and no suspicious features. She has no pain and prefers minimal intervention. She is anxious and wants to be sure nothing important is missed. She asks if there is anything that should be done today rather than waiting until the next visit. Which management is most appropriate?

A fifty-two-year-old has severe vasomotor symptoms affecting sleep and work. She is eighteen months since last menses and has an intact uterus. She has no contraindications to hormone therapy. Which regimen is most appropriate?

A thirty-four-year-old at thirty-four weeks gestation has elevated blood pressure and proteinuria on testing. She reports new headaches. Which diagnosis should guide management? 

A forty-eight-year-old reports leakage with coughing and exercise. She denies urgency and nocturia. Physical exam is unremarkable. Which initial management is most appropriate?

A forty-nine-year-old reports ten months without menses and new hot flashes. She has no headaches or galactorrhea and denies pregnancy risk. Vital signs are normal. She is anxious and wants to be sure nothing important is missed. She asks if there is anything that should be done today rather than waiting until the next visit. Which is the most appropriate next step?