General Internal Medicine
Questions discussed in this category
How would you adjust statin therapy in these patients?
Butt et al., PMID 39818225
Desgagnés et al., PMID 39836424
Assume no epidural/cord compromise. Is kypho/vertebroplasty, radiation therapy, or conservative management (brace, antiresorptive therapy) the superio...
If a patient who has Familial Hypocalciuric Hypercalcemia (FHH) is misdiagnosed as PHPT (Primary Hyperparathyroidism) and treated with Cinacalcet, wil...
Changes in criteria for hyperparathyroid surgery. In the 2022 5th International conference on asymptomatic hyperparathyroidism, the experts have chang...
For a patient whose sodium remains 142 despite water deprivation from 8 pm to 8 am, with urine osm of about 500, is further testing needed?
Patient had intolerance to methimazole and then developed agranulocytosis with PTU. FT4 is 2.9 (upper normal range is 1.7). I have started the patient...
Zha et al., PMID 35487459
Do you base the decision off of the acuity and course of symptoms? The degree of estradiol elevation? Other factors?
Can 25 OH vitamin D be converted to activated vitamin D outside of PTH mediated mechanisms in some organs?
No evidence for acromegaly or Pagets.
The patient has very low urinary calcium despite calcium supplements, vitamin D used to be low now normal. Continues to have elevated PTH with normal ...
Or other therapy - e.g., tolvaptan? Free water restriction may hinder QOL. Salt tablets may raise levels more quickly but have risks of edema and hype...
If so, when? Does surgery need to be timed with last dose of Prolia injection?
Patient does not have hypercalcemia.
Can a diagnosis of acromegaly be made with just an elevated IGF-1 level in patients with features of acromegaly?
What level or additional signs/symptoms trigger a workup? What does your workup typically consist of?
Does it depend on location of radiation, length of radiation, and time since radiation?
If so, how long should OCPs be held to reliably trust the dex suppression test results?
Young, previously healthy male with normal growth presenting with two syncopal episodes. Currently, only symptom is mild fatigue. Labs showed: Cortiso...
And is there a preferred diagnostic test? Whenever cyclic hypercortisolemia is suspected, it is advised that evaluation should be repeated for months,...
Female is in her later 40s with surgical oophorectomy taking Sertraline 50 mg daily and prn Trazodone and Lamotrigine. Has some weight loss and fatigu...
Without a discrete mass to biopsy, is there any utility of any blind biopsies to rule out IgG4 related disease, infectious or neoplastic process?
Are there specific features that suggest drug-induced uveitis versus de novo uveitis?
Does denosumab effect knee replacement or hip replacement? Should replacement occur right before or after injection?
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Papers discussed in this category
Annals of surgery, 2014-01
Perioper Med (Lond), 2018 Jun 08
The Journal of clinical endocrinology and metabolism, 2016-05
Cancer Chemother Pharmacol, 2021 Mar 31
J Bone Miner Metab, 2020 Jul 12
Clinics (Sao Paulo, Brazil), 2018 Dec 10
Metabolites, 2020 Jul 11
Protein & cell, 2014 Jul 12
Trends in biochemical sciences, 2016 Jan 05
The New England journal of medicine, 2015 Sep 17
The New England journal of medicine, 2020 Sep 24
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2019-02
European journal of endocrinology, 2023 Jul 20
World journal of surgery, 2004 Apr 19
The New England journal of medicine, 1980-04-17
International journal of endocrinology, 2015 Oct 20
Calcified tissue international, 2022 Oct 26
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2020 Sep
European journal of endocrinology, 2022 Nov 22
Journal of cardiovascular development and disease, 2022 Sep 08
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2018-10-05
Genes, 2022 Oct 17
JAMA, 2007-01-24
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2017-07
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2019 Dec 01
JAMA network open, 2022 Oct 03
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2022 Oct 17
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020 Mar 16
Frontiers in endocrinology, 2022 Aug 18
Stroke, 2007-12
The New England journal of medicine, 2006 Aug 10
European heart journal, 2020 Jan 01
Journal of the American Heart Association, 2023 Sep 08
The New England journal of medicine, 2011-12-01
Thyroid : official journal of the American Thyroid Association, 2020 May 07
Journal of thyroid research, 2020 Apr 14
BMJ open, 2024 Oct 09
JAMA network open, 2024 Jul 01
The Journal of clinical endocrinology and metabolism, 2024 Jan 18
The Journal of clinical endocrinology and metabolism, 2024 Dec 09
JAMA network open, 2025 Jan 02