Endocrinology

There are currently 3 sets of guidelines that outline the management of thyroid nodules. A case in point here.

Would you biopsy a 1-cm mobile nodule in the thyroid area of this 55-year-old woman who had mantle field radiation for a childhood cancer?

A 38-year-old woman became pregnant during the time she was undergoing evaluation for a pituitary adenoma. Here, see the case unfold.

Has this teen been abused? Cast your votes and see if you’ve answered this and the 4 other questions in this week’s quiz correctly.

A little bit of knowledge can be a dangerous thing, and I am proof. There is a lot more to the saga and much of the information is essential to decision making in primary care practice on whether or not testosterone replacement is indicated.

Aldosterone has significant effects on vascular function and can decrease flow-mediated vasodilation.

Elevated serum gastrin will help confirm the presence of gastrinoma or multiple endocrine neoplasia type 1.

Incretin-based T2DM therapy is not a direct cause of pancreatitis or pancreatic cancer asserts the European Medicines Agency.

The news: elevated levels of FGF are a new risk factor for death in chronic kidney disease-a clinical situation replete with cardiovascular disease. Here: how practice should change in the face of these newly identified nontraditional cardiovascular risk factors in CKD.

Once-weekly exenatide, the recently approved GLP-1 receptor agonist, may help improve treatment adherence and outcomes in patients with type 2 diabetes.

Frequent coffee drinkers have a lower risk than those who drink little or no coffee, of death related to heart and respiratory disease, stroke, and infections.

Acanthosis nigricans is a nonspecific increase of the thickness of the prickle cell layer of the skin and most commonly seen in obese persons.

Prenatal and Postpartum Depression Not Limited to Mothers

For several years, an asymptomatic mass had been growing on the neck of a 54-year-old-man. Physical examination revealed a firm, nontender mass located slightly left of midline at the level of the hyoid bone.

A 16-year-old boy with asymptomatic, hyperpigmented, hairy lesion on his left upper back. The pigmentation, first noted 5 years earlier, had progressively spread across his torso. The coarse and dark hair confined to the hyperpigmented area had appeared at age 13 years. Medical history uneventful. Review of systems showed no abnormalities. No family history of similar skin lesions.

A 71-year-old African American man presented to the emergency department (ED) with chest pain, dyspnea, and hemoptysis. He had had a few ED visits for similar symptoms within the previous 4 weeks.

A 36-year-old woman presented to the emergency department with loss of vision in the right eye that had initially involved the peripheral field and progressed over 2 months to the central and nasal fields. During this period, she also had headaches, vomiting, and generalized weakness. She had had amenorrhea for 1 year.

Intensive control of blood glucose levels reduces the development and progression of certain microvascular complications of type 2 diabetes but does not reduce cardiovascular risk, according to the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study investigators.

For every recognized case of celiac disease, 8 more remain undiagnosed. The reason for this disparity is contingent on the varying presentations of the disease.

A 73-year-old man presents for follow-up after having sustained a wrist fracture aboard a cruise ship.

A 77-year-old man of Japanese ancestry with a history of well-controlled hypertension was seen in the morning for a routine examination. His blood pressure was normal as were the results of a complete blood cell count and liver function tests. About 6 hours later, he presented to the emergency department with acute abdominal pain accompanied by nausea, vomiting, fever, and chills. He denied headaches, palpitations, and diaphoresis.

During a routine physical examination, multiple, randomly distributed, fleshcolored nodules were noted on the trunk, arms, and face of a 62-year-old man. The lesions measured 0.5 to 1.0 cm and appeared slightly pedunculated. The patient had had the lesions since he was a teenager; they were not painful. He also had hypertension, for which he was taking lisinopril (20 mg once daily).

Right upper quadrant pain of 24 hours’ duration prompted a 20-year-old man with a history of gastritis to seek medical attention. The pain was sharp and nonradiating, with no alleviating or aggravating factors. The patient occasionally consumed alcohol and regularly smoked cigarettes (tobacco and marijuana). He denied nausea, vomiting, diarrhea, and diaphoresis. Right upper quadrant pain of 24 hours’ duration prompted a 20-year-old man with a history of gastritis to seek medical attention. The pain was sharp and nonradiating, with no alleviating or aggravating factors.

A 77-year-old woman is brought for evaluation by her family. The patient had previously been alert and active; however, for the past week, she has been difficult to arouse and, when awake, has been delusional and has behaved abnormally. In addition, for the past 2 weeks, she has complained of abdominal discomfort related to constipation.

Levothyroxine is one of the most commonly prescribed medications for the treatment of hypothyroidism as well as the suppression of thyroid neoplasms.1 Most patients with hypothyroidism require lifelong therapy with levothyroxine; therefore, the likelihood of drug interactions is high.