Internal Medicine

Endocrinology   

Questions discussed in this category



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?

Clinical scenario where an indeterminate pathology on initial FNA was followed by a “benign” result on a 2nd FNA.

Do you avoid using these agents only in patients with history of medullary thyroid cancer or pancreatic cancer? Are there other cancer risks we should...

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...

Some data showed early enteral nutrition improves outcomes in DKA. Some thought that enteral nutrition could counteract the insulin gtt.

The new SCCM guidelines suggest an upper limit of 200 compared to the conventional 180.

With the time intervals recommended after taking each medicine, I am wondering how patients should be counseled.

If they are already on a preparation that contains animal products, would you change it?

Would you consider testosterone therapy if he is otherwise asymptomatic?

What is your evaluation approach for RAI response?  What cumulative dose do you use in practice for deciding a patient is RAI refractory?

Do treatments for osteoporosis have a large enough effect on tooth movement to make Invisalign less effective?

Many patients are interested in romosozumab for "maximizing bone gain" and preventing future fractures. Some have had anabolic therapy with teriparati...

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 ...

After replacing Vitamin D, what will be your first treatment of choice? Labs including ALP and calcium levels are normal. T scores are -3 or above. Th...

There is literature showing small changes in both free T4 and TSH (despite steady state) in the first few hours after ingestion of L-T4. In occasional...

If not, what can be possible causes for a postmenopausal woman to have FSH, LH < 0.3 with low E2, and being asymptomatic and doing well otherwise? ...

A male patient in his 30s with two lumbar compression fractures (non-traumatic) and a Z-score of -2.6 in the spine, Z-score -0.5 in hips. History of 3...

Can a diagnosis of acromegaly be made with just an elevated IGF-1 level in patients with features of acromegaly?

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,...

I’ve seen several such patients who have no secondary causes for bone loss, on adequate calcium/vitamin D, and compliant with denosumab who do n...

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...

Should this patient population be treated differently? At our institution, we have started using EPIC to screen many patients for osteoporosis and ou...

The female patient is in her late 70s with cardiac disease (likely due to chronic hyperthyroidism that was missed due to non-suppressed TSH). I’...

Elderly male with primary hypothyroidism, HTN, and progressive worsening cognition over several months. PCP has been increasing LT4 dose as outpatient...

Is patch or gel HRT with ASA prophylaxis a reasonable option after counseling? Or do you add a prophylactic DOAC? 

The patient has no personal history of VTE, but has positive family history of VTE.  Any prophylactic anticoagulation options? How would manage...


Papers discussed in this category


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European journal of cancer (Oxford, England : 1990), 2012-07

The New England journal of medicine, 2015 Sep 17

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