Endocrine care

269 articles · Since 2011

Articles, page 9

MKSAP: 37-year-old man with low libido and fatigue

June 10, 2017Jun 10, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history…

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

A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history is otherwise unremarkable. He takes no medications.

On physical examination, vital signs are normal. BMI is 35. The remainder of the examination, including genital examination, is normal.

Laboratory studies:

Luteinizing hormone

…

Conditions and diseases

MKSAP: 67-year-old man with primary hyperparathyroidism

mksap

March 11, 2017Mar 11, 2017

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing.…

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

A 67-year-old man is evaluated for a recent diagnosis of primary hyperparathyroidism after an elevated serum calcium level was incidentally detected on laboratory testing. Medical history is significant only for hypertension, and his only medication is ramipril.

On physical examination, temperature is 35.8 °C (96.4 °F), blood pressure is 120/68 mm Hg, pulse rate …

Physician voices

Success is not congratulated as easily as failure is shamed

Judy Salz, MD

February 25, 2017Feb 25, 20173

“Bask in the glory, toots. You deserve it!” I received this text message from my very dear friend a few days ago after an extraordinary occurrence. I’m a retired internist, and recently my clinical acumen and intervention saved another friend’s…

“Bask in the glory, toots. You deserve it!”

I received this text message from my very dear friend a few days ago after an extraordinary occurrence.

I’m a retired internist, and recently my clinical acumen and intervention saved another friend’s life. That is a statement of fact, not a boast. And that’s why I’m writing about it.

The patient, a retired surgeon, hosted our circle of friends’ New Year’s Eve party a little …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Conditions and diseases

MKSAP: 40-year-old man with type 1 diabetes mellitus

mksap

December 31, 2016Dec 31, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man with type 1 diabetes mellitus presents to the office. He seeks advice on his diabetes management as he intensifies his exercise…

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

A 40-year-old man with type 1 diabetes mellitus presents to the office. He seeks advice on his diabetes management as he intensifies his exercise routine in preparation for participation in a 10-K race. He reports prolonged hypoglycemia during intense exercise, despite eating a meal prior to the activity. His insulin regimen is insulin …

Conditions and diseases

MKSAP: 34-year-old man with fatigue, low libido, and infertility

mksap

December 17, 2016Dec 17, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old man is evaluated for a 2-year history of fatigue, low libido, and infertility. His family history is notable for a brother with…

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

A 34-year-old man is evaluated for a 2-year history of fatigue, low libido, and infertility. His family history is notable for a brother with infertility. His medical history is unremarkable, and he takes no medications.

On physical examination, vital signs are normal. His height is 195.6 cm (77 in), and his weight is 86.2 …

Patient voices

This patient’s story illustrates the barriers to health care

Niran S. Al-Agba, MD

October 29, 2016Oct 29, 20166

Prior to her death, a courageous young woman named Jess Jacobs, who suffered from POTS (postural orthostatic tachycardia syndrome), wrote about the worst health care experience of her life. It is a somewhat horrifying account of hospitalization in Washington D.C.…

When I came across the story of another young woman afflicted with this disease, it …

Conditions and diseases

A story for those who pontificate about patient behavior

Patricia Salber, MD

October 8, 2016Oct 8, 2016

I was offered my choice of bisphosphonates after breaking my shoulder and ended up with a diagnosis of osteoporosis. I initially opted for Reclast, a drug that only requires one dose a year albeit by IV infusion. I made an appointment to get the drug several weeks later. I wanted to have time to research my options. After reading as much as I could during that time, I made an …

Conditions and diseases

MKSAP: 64-year-old woman with an incidental pituitary adenoma

mksap

September 17, 2016Sep 17, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old woman is seen for follow-up evaluation. Two weeks ago, she was in a car accident, and an incidental pituitary adenoma was found…

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

A 64-year-old woman is seen for follow-up evaluation. Two weeks ago, she was in a car accident, and an incidental pituitary adenoma was found on a cervical spine CT scan. She has no residual injuries from the car accident.

She is otherwise healthy and takes no medications. She went through menopause at age 51. …

Conditions and diseases

MKSAP: 57-year-old man with substernal chest pain

mksap

August 27, 2016Aug 27, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is admitted to the hospital for evaluation of substernal chest pain. His medical history is significant for type 2 diabetes mellitus,…

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

A 57-year-old man is admitted to the hospital for evaluation of substernal chest pain. His medical history is significant for type 2 diabetes mellitus, coronary artery disease, hypertension, and hyperlipidemia. He manages his diabetes as an outpatient with diet, exercise, and metformin. His other medications are aspirin, metoprolol, atorvastatin, and sublingual nitroglycerin as …

Conditions and diseases

MKSAP: 66-year-old man with polyuria and polydipsia

mksap

July 23, 2016Jul 23, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man is evaluated in the office after being treated in the emergency department for an exacerbation of chronic obstructive pulmonary disease. While…

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

A 66-year-old man is evaluated in the office after being treated in the emergency department for an exacerbation of chronic obstructive pulmonary disease. While in the emergency department, he was noted to have a random blood glucose level of 211 mg/dL (11.7 mmol/L). His HbA1c was 7.8% at the time. A repeat random …

Conditions and diseases

MKSAP: 52-year-old woman with type 2 diabetes mellitus

mksap

June 25, 2016Jun 25, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%.…

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

A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%. Management at this time is with lifestyle modifications. She has worked closely with a diabetes educator and a nutritionist since her diagnosis. She has lost 3.2 kg (7 lb) …

Drugs and prescribing

What’s behind the rising cost of insulin?

Peter Ubel, MD

June 15, 2016Jun 15, 201612

She drew the life-saving medication into the syringe, just 10 cc of colorless fluid for the everyday low price of, gulp, several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a “specialty drug,” to…

The price of many drugs has been on the rise of late, not just new …

Conditions and diseases

MKSAP: 54-year-old man with fatigue

mksap

June 11, 2016Jun 11, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is evaluated because of fatigue. He also notes constipation and cold intolerance. Medical history is significant for tonsillar squamous cell carcinoma…

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

A 54-year-old man is evaluated because of fatigue. He also notes constipation and cold intolerance. Medical history is significant for tonsillar squamous cell carcinoma treated with radiation 3 years ago. There is no family history of thyroid disorders.

On physical examination, the skin is dry. Mild periorbital edema is present. The thyroid is of …

Read more…

MKSAP: 54-year-old man with fatigue

Health technology

Insurance companies cannot dictate which medical devices we prescribe

David Ahn, MD

May 27, 2016May 27, 20166

The diabetes community has been set ablaze after UnitedHealthcare announced an agreement for Medtronic devices to be the “preferred” in-network, durable medical equipment (DME) provider of insulin pumps. Starting July 1, 2016, UnitedHealthcare patients will be funneled toward using a…

Many diabetes advocates have eloquently voiced their outrage …

Health policy

Reducing health costs: Patients aren’t going to take the lead

Peter Ubel, MD

April 12, 2016Apr 12, 201636

Lena Wright’s best friend was hunched over like a character from a French novel, with spinal bones so thin they would fracture with a fit of sneezing. Determined to avoid that fate, Wright (a pseudonym) asked her primary care doctor to test her for osteoporosis with a DEXA scan, also known as dual energy x-ray absorption. The scan would send two x-ray beams through her bones, one high-energy and the …

Conditions and diseases

MKSAP: 48-year-old woman with type 1 diabetes mellitus

mksap

March 26, 2016Mar 26, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old woman returns for a follow-up visit for management of type 1 diabetes mellitus. She reports doing well since the last visit. Overall,…

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

A 48-year-old woman returns for a follow-up visit for management of type 1 diabetes mellitus. She reports doing well since the last visit. Overall, she believes that most of her blood glucose levels are at goal, but is concerned about occasional episodes of hyperglycemia occurring in the morning before breakfast. She eats a bedtime snack …

Conditions and diseases

Osteoporosis: A silent assailant turned me from physician to patient

Karen S. Sibert, MD

September 25, 2015Sep 25, 2015

It’s amazing how quickly my role changed from physician to patient, thanks to a silent assailant: osteoporosis. I went to the gym in the morning before work 12 days ago, as I often do now that my children are all…

It’s amazing how quickly my role changed from physician to patient, thanks to a silent assailant: osteoporosis.

I went to the gym in the morning before work 12 days ago, as I often do now that my children are all grown up and out of the house. First, a couple of light sets of leg exercises served as a warm-up, and then I started a set with a barbell on my …

Conditions and diseases

Test your medicine knowledge: 52-year-old man concerned about his weight

mksap

August 22, 2015Aug 22, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old man is evaluated during a routine examination. He is asymptomatic but is concerned about his weight. Medical history is significant for prediabetes…

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

A 52-year-old man is evaluated during a routine examination. He is asymptomatic but is concerned about his weight. Medical history is significant for prediabetes and elevated cholesterol levels. He smokes one or two cigars a week. He drinks one or two alcoholic beverages a few nights each week. He does not get …

Physician voices

After surgery, the scars will always remain

Bruce Campbell, MD

August 17, 2015Aug 17, 20153

"To be trusted is a greater compliment than to be loved." - George MacDonald As we adjust her position on the surgical table, I spot some short, vertical scars on the front of her neck. The parallel slashes sit directly…

“To be trusted is a greater compliment than to be loved.”
– George MacDonald

As we adjust her position on the surgical table, I spot some short, vertical scars on the front of her neck. The parallel slashes sit directly over her enlarged thyroid — a goiter — and appear to have been deliberately placed. There are two sets of scratches, one set on either side of the neck, nearly identical in length and evenly …

Conditions and diseases

What is the diagnosis in this woman with an enlarging neck mass?

mksap

August 15, 2015Aug 15, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 78-year-old woman is evaluated for a rapidly enlarging neck mass that has been present for 4 weeks and is associated with neck discomfort,…

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

A 78-year-old woman is evaluated for a rapidly enlarging neck mass that has been present for 4 weeks and is associated with neck discomfort, dysphagia, and hoarseness. The patient has had Hashimoto thyroiditis and hypothyroidism since age 24 years and has been taking levothyroxine since that time.

Physical examination reveals an older woman …

Endocrine care

Articles, page 9

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular