Endocrine care

269 articles · Since 2011

Articles, page 10

A physician’s experience with a false positive test result

July 14, 2015Jul 14, 2015

“Your wife has gestational diabetes.” My heart stopped when my wife’s physician called to tell me this. “I want you to tell her because it’ll be easier to give it some time and let it sink in. Tell her to…

Let me give some background information. I’m …

Drugs and prescribing

Do heartburn drugs cause osteoporosis? A gastroenterologist answers.

Michael Kirsch, MD

July 7, 2015Jul 7, 2015

Every week, I am asked by patients if their heartburn medicine causes osteoporosis. The most effective heartburn medicines are called proton pump inhibitors, or PPIs. If you watch more than an hour of TV per week, then you have seen…

Many of them are now available over-the-counter at reduced dosages.

Patients today are incredibly informed, and sometimes …

Patient voices

Managing your health is difficult on a student’s budget

Bridget Lovett

June 23, 2015Jun 23, 20153

In 2008, at the age of 22, I was diagnosed with hypothyroidism and began my experience with the American health care system and how to care for myself in it. When I was in the process of diagnosing my illness, I went to Oregon Health and Science University in Portland to meet with an endocrinologist and have my ultrasound results interpreted. …

Real physician voices, twice a week

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Conditions and diseases

How do we feel about algorithm-driven prescriptions?

James C. Salwitz, MD

June 3, 2015Jun 3, 20154

Much of medicine is no harder than Mom, a Band-Aid and a scrapped knee. Flu shots save lives, give flu shots. Bleeding causes anemia, give iron or, if severe, blood. There is a fracture, fix it. A boil hurts, lance…

Perhaps medicine is so simple that it can be automated. Instead of a doctor at all, …

Conditions and diseases

Eliminating hypothyroidism from iodine deficiency

Christopher Johnson, MD

May 15, 2015May 15, 2015

One of the words we don’t use anymore is cretin; it’s long been a derogatory slur rather than a precise description of something. But a century ago cretinism actually meant a specific thing: a person, generally a child, who was severely damaged by a lack of thyroid hormone during early development, particularly fetal development. Now we call the condition congenital hypothyroidism. A few cases still exist, which is why we …

Conditions and diseases

MKSAP: 44-year-old man with a family history of diabetes

mksap

March 28, 2015Mar 28, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 44-year-old man is evaluated during a routine examination. He is concerned about his general health and risk of diabetes mellitus. He has no…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 44-year-old man is evaluated during a routine examination. He is concerned about his general health and risk of diabetes mellitus. He has no medical problems. Both parents and his sister have type 2 diabetes mellitus.

On physical examination, temperature is normal, blood pressure is 130/79 mm Hg, pulse rate is 66/min, and …

Conditions and diseases

MKSAP: 54-year-old woman asking advice about bone health

mksap

March 21, 2015Mar 21, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old woman comes to the office for advice regarding maintaining bone health. She has no history of fracture. The patient recently had a…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 54-year-old woman comes to the office for advice regarding maintaining bone health. She has no history of fracture. The patient recently had a lumpectomy and radiation therapy to treat breast cancer, is currently taking tamoxifen, and will begin taking an aromatase inhibitor in 2 months. She underwent menopause at age 52 …

Conditions and diseases

MKSAP: 60-year-old man with type 2 diabetes mellitus

mksap

March 7, 2015Mar 7, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old man is evaluated as a new patient. He was diagnosed with type 2 diabetes mellitus during a health insurance evaluation 6 months…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 60-year-old man is evaluated as a new patient. He was diagnosed with type 2 diabetes mellitus during a health insurance evaluation 6 months ago. At that time, metformin was initiated. Medical history is otherwise unremarkable.

On physical examination, blood pressure is 145/94 mm Hg; other vital signs are normal. BMI is 29. …

Physician voices

Here’s an example of bad primary care

Richard Young, MD

February 11, 2015Feb 11, 201534

As much as I have given the "ologists" and other members of the dysfunctional U.S. health care system a hard time in previous posts, it’s only fair that I call out bad family medicine as well. I have a great…

As much as I have given the “ologists” and other members of the dysfunctional U.S. health care system a hard time in previous posts, it’s only fair that I call out bad family medicine as well. I have a great example.

I recently saw patient who is relatively new to the area who had seen another family physician in my community. He is 39-year-old male, and his only significant potential health …

Read more…

Here’s an example of bad primary care

Conditions and diseases

The hardest and often worst part of medicine: The waiting

Sarah Mongiello Bernstein, MD

January 5, 2015Jan 5, 20152

My brother wears a scar around his neck. It represents his second surgery for papillary thyroid cancer. The first started off the same way. Ugly, red and angry. Curving like an ominous smile around his neck, like a noose. That’s how it felt too — the lump in his throat growing as he sat quietly, alone in a doctor’s office. It’s interesting how physical scars are a visual manifestation of …

Conditions and diseases

MKSAP: 38-year-old man with a mass in his right neck

mksap

December 6, 2014Dec 6, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a mass in his right neck that he first noticed 2 weeks ago while shaving. The patient also…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 38-year-old man is evaluated for a mass in his right neck that he first noticed 2 weeks ago while shaving. The patient also reports experiencing a pressure sensation when swallowing solid foods for the past year and daily diarrhea for the past 2 months. His personal medical history is unremarkable. His …

Physician voices

Two patient result letters: Which one did this physician send?

Lucy Hornstein, MD

December 2, 2014Dec 2, 201423

Middle-aged lady, twenty pounds overweight. Doing everything I can, doctor. Everything imaginable. Diet: I eat practically nothing. Exercise: all the time! Weight Watchers doesn’t work. Jenny Craig, South Beach, the Zone; I’ve tried it all. Nothing works. Have to lose…

Middle-aged lady, twenty pounds overweight.

Doing everything I can, doctor. Everything imaginable. Diet: I eat practically nothing. Exercise: all the time! Weight Watchers doesn’t work. Jenny Craig, South Beach, the Zone; I’ve tried it all. Nothing works. Have to lose weight. Have to lose weight.

Yada, yada, yada.

Oh look: A few years back I diagnosed you as hypothyroid and gave you some Synthroid. …

Conditions and diseases

MKSAP: 67-year-old man with type 2 diabetes mellitus

mksap

November 29, 2014Nov 29, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated following a recent diagnosis of type 2 diabetes mellitus. On physical examination, blood pressure is 134/84 mm Hg; other…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 67-year-old man is evaluated following a recent diagnosis of type 2 diabetes mellitus.

On physical examination, blood pressure is 134/84 mm Hg; other vital signs are normal. BMI is 30. The remainder of the examination is unremarkable.

Laboratory studies show an HbA1c of 7.8%, blood urea nitrogen 15 mg/dL (5.4 mmol/L), and serum …

Medical education

A medical student diagnosed with cancer

Cherie Fathy

November 7, 2014Nov 7, 20146

Ironically, we had just finished our endocrine unit when I noticed a lump in my neck. Perhaps school had made me more vigilant, or perhaps I merely fell into the realm of hypochondriac medical student, but I couldn’t ignore this…

I set up an appointment with my doctor fully expecting a diagnosis of medical student neuroticism. Instead she agreed that it was …

Read more…

A medical student diagnosed with cancer

Conditions and diseases

Preparing for a growing caseload of endocrine emergencies

Dr. Glenn Matfin

November 1, 2014Nov 1, 2014

When an unconscious person is first brought to the emergency room, there may be little indication if the individual has diabetes or a thyroid condition. Since millions of people have common hormone health conditions like these, emergency room clinicians and…

When an unconscious person is first brought to the emergency room, there may be little indication if the individual has diabetes or a thyroid condition.

Since millions of people have common hormone health conditions like these, emergency room clinicians and other acute care providers need to watch for cases where an endocrine disorder is causing or contributing to a medical emergency.

More than 29 million people in the United States have diabetes, …

Conditions and diseases

MKSAP: 42-year-old man with severe burning and stabbing pain

mksap

October 25, 2014Oct 25, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 42-year-old man is evaluated for a 6-day history of severe burning and stabbing pain in both feet that is worse in the toes.…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 42-year-old man is evaluated for a 6-day history of severe burning and stabbing pain in both feet that is worse in the toes. The pain is more severe at night, is aggravated when the bed sheets touch his skin, and is partially relieved when he walks or massages his feet. The …

Health technology

Improve patient behavior with virtual assistants

Thomas Morrow, MD

October 19, 2014Oct 19, 20146

Few will argue that the overall health of Americans has deteriorated in the past quarter century. Diabetes or prediabetes afflicts nearly 120 million people. Roughly two of three Americans are either overweight or obese. Pharmaceutical companies focus on drug discovery as a solution. Thousands of apps for smart phones are being developed to change our destructive behavior. But, lacking in both of these is a true solution, one that draws …

Conditions and diseases

The Fault in Our Stars: Should thyroid cancer be renamed?

James Flory, MD

October 18, 2014Oct 18, 20142

John Green’s novel -- and recent film -- The Fault In Our Stars (TFIOS) is a new classic of young adult fiction, deservedly famous, and it’s easy to see why. The story is simultaneously deeply sad and really funny, mostly…

John Green’s novel — and recent film — The Fault In Our Stars (TFIOS) is a new classic of young adult fiction, deservedly famous, and it’s easy to see why. The story is simultaneously deeply sad and really funny, mostly due to the narrator, Hazel. She is an intensely likable 16-year-old, who charms you even while she explains, stoically, that she is dying of thyroid cancer that has spread to …

Conditions and diseases

MKSAP: 72-year-old unconscious woman in the ER

mksap

September 20, 2014Sep 20, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated in the emergency department for loss of consciousness. Her son, who brought her in, says she seemed confused and…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 72-year-old woman is evaluated in the emergency department for loss of consciousness. Her son, who brought her in, says she seemed confused and agitated when he spoke to her on the telephone less than 2 hours ago. The patient has an 8-year history of type 2 diabetes mellitus. She had strict …

Conditions and diseases

MKSAP: 55-year-old man with a wrist fracture and anemia

mksap

August 30, 2014Aug 30, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is reevaluated during a follow-up examination for a wrist fracture and anemia. The patient is otherwise asymptomatic. He was treated in…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 55-year-old man is reevaluated during a follow-up examination for a wrist fracture and anemia. The patient is otherwise asymptomatic. He was treated in the emergency department 2 weeks ago after he slipped in his driveway and sustained a right wrist fracture; mild iron deficiency anemia was detected at that time. He …

Endocrine care

Articles, page 10

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