General Internal Medicine

Is there a role for oral antiviral therapy alone (as opposed to induction with IV) and for what duration? And is there a role for ongoing suppressive ...

1 Answer available

What is your approach to duration of systemic antibiotics for treatment of isolated bacterial endophthalmitis in the absence of bacteremia or other deep-seated metastatic foci of infection?

1 Answer available

How do you approach a patient who has anterior uveitis and is referred for evaluation of ocular TB with a positive Quantiferon gold (as part of their workup) in countries with low TB incidence?

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Does a low serofast RPR titer (such as 1:1 or 1:2) in the setting of a remote history of appropriately treated latent syphilis in a patient with now uveitis of yet unknown etiology referred from ophthalmology for possible ocular syphilis make a diagnosis of ocular syphilis less likely?

What is your approach to guiding ophthalmologists regarding our clinical suspicion for ocular syphilis and does the quantification of the titer help i...

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How do you approach tapering immunosuppression in a patient with a history of Susac Syndrome who has stabilized on MMF and IVIG?

1 Answer available

How do you manage acute keratoconjunctivitis following total skin electron therapy (TSET)?

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How do you manage occlusive bilateral retinal vasculitis with isolated lupus anticoagulant positivity?

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How would you approach the management of HLA-B27-associated recurrent uveitis and inflammatory back pain with a recent history of melanoma?

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Is thyrotropin receptor antibody a good biomarker to predict development of thyroid eye disease?

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Is it safe to use quinacrine in SLE patients with a history of hydroxychloroquine-associated retinopathy?

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Do you routinely obtain baseline vascular imaging (CTA, MRA, PET) in patients with suspected GCA, but negative temporal artery biopsy?

Per 2021 GCA Vasculitis Guidelines: low evidence, but conditional recommendation for CTA neck, chest, abd/pelvis. Is anybody following this or do you ...

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How would you approach management of incidentally identified unilateral retinal vasculitis with subsequent labs revealing +P-ANCA?

Patient is asymptomatic. Labs showed +P-ANCA 1:160. Negative MPO and PR3.

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In a patient with active spondylarthritis and uveitis who cannot take TNF inhibitors, what is your next agent of choice?

1 Answer available

Would you consider utilizing a TNF-inhibitor in a patient with RA/SLE overlap who has already tried methotrexate, hydroxychloroquine, and abatacept?

Female patient in her 20's with RA/SLE has been on steroids and methotrexate, currently on HCQ and Orencia. Failing Orencia with active disease. Want ...

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How long do you continue immunosuppression in patients with Behcet's who have a history of mucocutaneous and ocular disease, but are now in remission?

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How would you approach persistent episcleritis/uveitis due to PR3+ GPA, which needs low dose prednisone to control, despite induction with Rituximab?

Other manifestations improved (renal function has stabilized, fatigue, arthritis, and LCV have resolved). Ophthalmologist has controlled the uveitis u...

1 Answer available

How would you approach a patient who has well controlled SLE on HCQ but develops cotton wool spots on routine ophthalmologic screening?

3 Answers available

What topical therapies do you most commonly prescribe for rashes near the eyes?

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Would you consider use of belimumab in a patient with SLE with recurrent anterior uveitis who failed other treatment options?

Patient failed topical ocular therapies, methotrexate, azathioprine.

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What recommendations do you provide to patients who develop ocular side effects with Dupixent?

Do you refer them to Ophthalmology? Have you had to switch patients off of Dupixent due to their ocular side effects?

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What is your approach to management of ongoing scleritis in SLE despite mycophenolate?

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What is your approach to the workup for an underlying systemic condition in a patient presenting with retinal vasculitis?

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Can giant cell arteritis present with a partial cranial neuropathy?

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Do you generally recommend low dose aspirin for patients with giant cell arteritis?

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Is there a role for radiation therapy in the treatment of a lymphoproliferative disorder involving the orbit?

If so, what dose and fractionation would you recommend?

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What is your steroid-sparing agent of choice to treat GCA given the current tocilizumab shortage?

Thoughts on sarilumab vs methotrexate, or just treat with steroids alone

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How long do you continue steroid-sparing agents such as tocilizumab for GCA once the disease is in remission off steroids?

1 Answer available

What do you use to treat uveitis refractory to conventional synthetic DMARDs and TNF inhibitors?

Are IL-17 or IL-23 inhibitors helpful?

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What are the benefits of sending HLA B27 genotype over HLA B27 antigen when evaluating for spondyloarthritis?

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At what point in GCA management do you typically introduce tocilizumab?

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What would you recommend for a patient with bilateral conjunctival MALT (without systemic disease)?

In this scenario, is systemic treatment better given bilateral involvement? In a patient who has already had cataract surgery and is not at risk for c...

1 Answer available