General Internal Medicine

Do you ever continue medications such as rate-control agents for tachyarrhythmias, anticoagulation for blood clots, immunosuppression to prevent trans...

1 Answer available

For elderly patients (i.e. older than 80) with only one documented episode of paroxysmal atrial fibrillation following a stress event (such as acute illness/steroid administration) and a CHADsVASc score greater than 1, how would you counsel them on the risks/benefits of anticoagulation and subsequent monitoring for afib recurrence?

6 Answers available

What is the next best osteoporosis treatment option for patients who completed 2 years of teriparatide, but has contraindication to bisphosphosnate therapy (e.g. history of atypical femur fracture)?

1 Answer available

Is there any benefit in maintaining statin or aspirin therapy in patients >75 years old with stable, multivessel ischemic heart disease in light of challenges encountered with polypharmacy?

2 Answers available

Would you use a parathyroid hormone analog for treatment of osteoporosis in a patient with mildly elevated AlkPhos of unclear etiology?

1 Answer available

What is your approach to bisphosphonate use in patients with advanced chronic kidney disease and osteoporosis?

1 Answer available

During treatment of severe osteoporosis with PTH analogs (abaloparatide), would a rise in alkaline phosphatase level >200 (in the setting of normal GGT) warrant discontinuation of medication?

There is concern for elevation in alkaline phosphatase as a precursor for bone pathology, such as an increase in risk of bone malignancy, potentially ...

1 Answer available

Does aspirin dose (81 mg vs 325 mg) matter for secondary stroke prevention?

Should some patients get 325 mg instead of 81mg at least for a certain amount of time, such as patients in the acute phase of ischemic stroke or patie...

1 Answer available

How would you approach the work up of SLE in a patient over 80 years old?

How would you work up an elderly female with persistent anemia secondary to warm AIHA requiring almost monthly transfusion, with positive ANA,dsDNA (b...

3 Answers available

What criteria are used to choose a specific dose of aspirin in ischemic stroke?

We have seen 81 vs 162 vs 325 mg up to 1300 mg.

3 Answers available

What duration of dual antiplatelet therapy do you use for secondary prevention of ischemic stroke due to intracranial atherosclerotic disease?

While some have the practice of 90 days per SAMMPRIS trial, the lower rates of ischemic stroke in the medical therapy group were driven by events with...

8 Answers available

Would you recommend PFO closure in patients >60 years old with presumed paradoxical embolism as their mechanism of stroke?

2 Answers available

How do you approach a mildly positive finding on an autoimmune encephalitis panel when there is no other evidence of encephalitis (such as elevated CSF protein, abnormal imaging, or EEG findings)?

For example, a GAD65 Ab of 0.07 when the cut-off is 0.02. Does this answer change if you consider adult vs pediatric populations?

2 Answers available