Endocrinology

Or other therapy - e.g., tolvaptan? Free water restriction may hinder QOL. Salt tablets may raise levels more quickly but have risks of edema and hype...

1 Answer available

What is the role of radiation therapy for an elderly patient with medullary thyroid cancer who is not a surgical candidate?

What techniques and doses would you prescribe to the primary and regional nodes?

1 Answer available

Would you use romosozumab in a patient with a cardiovascular event more than 2 years prior?

4 Answers available

Would you refer a patient for parathyroidectomy if they have normal calcium levels, mild hyperparathyroidism, and evidence of osteopenia?

2 Answers available

What is the utility of an oral calcium loading test to differentiate FHH from secondary hyperparathyroidism due to low calcium intake?

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 ...

1 Answer available

How do you choose between antithyroid drugs, RAI, and surgery for hyperthyroidism patients with existing cardiovascular disease, given their varying effects on cardiovascular outcomes?

Chiung-Hui Peng et al., PMID 38436957

2 Answers available

Would you discontinue romosozumab in a patient who develops a hemorrhagic stroke while on therapy?

5 Answers available

For a patient with idiopathic hypercalciuria and a history of calcium kidney stones who has not normalized 24-hr urine calcium level on thiazide diuretic, is there evidence for targeting a certain urine calcium level for decreased future risk of nephrolithiasis and osteoporosis?

2 Answers available

Do you recommend continuous glucose monitoring for patients with Type 2 diabetes who are not on insulin?

5 Answers available

Is there a role for levothyroxine in managing the symptoms of a patient with euthyroid Hashimoto’s thyroiditis?

3 Answers available

Do you use denosumab for castration-sensitive prostate cancer with osseous metastases?

Only the mCRPC population was included in the Fizazi et al. study, but the FDA approval is for prevention of skeletal related events from any solid tu...

4 Answers available

Do you recommend osteoporosis medication in postmenopausal females on anastrozole with very low Vitamin D (4.5)?

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...

1 Answer available

When would you offer post-operative concurrent chemoradiation in anaplastic thyroid cancer?

Would you consider it for a patient with good PS but with limited metastatic disease? What dose fractionation would you prefer?

1 Answer available

Is there a role for cinacalcet suppression testing when evaluating patients for suspected primary hyperparathyroidism who also have recurrent calcium containing kidney stone disease?

1 Answer available

When do you check macroprolactin in the evaluation of hyperprolactinemia?

2 Answers available

Following abaloparatide use for osteoporosis treatment, how long do you consolidate with bisphosphonates before considering a drug holiday?

1 Answer available

Do you routinely use 3% sodium chloride and desmopressin to correct hypovolemic hyponatremia in an asymptomatic patient with serum sodium of less than 120 mEq/L?

3 Answers available

Should patients with hypothyroidism hold their morning levothyroxine dose before going to the lab to check free T4/TSH?

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...

3 Answers available

Do you recommend progesterone for endometrial protection in a young woman on estrogen replacement therapy for iatrogenic menopause after definitive radiation therapy for locally advanced cervical cancer?

If so, what do you typically prescribe?

1 Answer available

Is there a role for Vitamin D supplementation in the treatment of Hashimoto’s thyroiditis?

1 Answer available

After completing 12 months romosozumab, what is the next best treatment option for patients with severe osteoporosis, high risk for fracture, and normal kidney function?

1 Answer available

How do you monitor risk of erythrocytosis from testosterone use for female to male transgender patients?

1 Answer available

Given the cardioprotective and renoprotective effects of SGLT2 inhibitors, should we consider administering to patients with well controlled type 1 diabetes despite the risk of DKA?

2 Answers available

Would you do active surveillance or completion thyroidectomy in a patient with 1.6 cm tall cell PTC with posterior margin’s indeterminate and 7 mm isoechoic solid nodule on other side?

Patient is a 41F and overall good surgical risk candidate.

1 Answer available

How do you counsel a patient with hypothyroidism who complains of persistent hypothyroid symptoms despite achieving normal TSH values with levothyroxine?

1 Answer available

Should patients who develop primary hyperparathyroidism after 5 years of Prolia treatment for osteoporosis be referred for parathyroidectomy?

If so, when? Does surgery need to be timed with last dose of Prolia injection?

1 Answer available

How should patients time the ingestion of their alendronate and levothyroxine given issues with food/drug interactions?

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

1 Answer available

Are you offering GLP-1 agonists to patients with CKD and diabetes mellitus?

4 Answers available

In your practice, when do you opt to treat unilateral primary hyperaldosteronism medically rather than surgically?

1 Answer available

How do you distinguish between primary and tertiary hyperparathyroidism in a patient with ESRD?

1 Answer available

Does norethindrone suppress FSH, LH completely?

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? ...

2 Answers available

Do you use the homeostatic model assessment (HOMA) to assess for insulin resistance and change your clinical management of patients?

2 Answers available

What is your daily correction goal for those patients being treated for hypernatremia?

2 Answers available

Would you consider anabolic osteoporosis therapy in a young adult male with multiple non-traumatic vertebral compression fractures and low bone density for age (Z-score -2.6)?

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...

1 Answer available

Can romosozumab be used in patients on dialysis?

1 Answer available

When do you consider stopping denosumab when a patient with osteoporosis is otherwise tolerating it without issues?

Assuming follow-up IV bisphosphonate x2 infusions to prevent rebound fractures

5 Answers available

Would you recommend switching a diabetic CKD patient on oral semaglutide to the subcutaneous form since the benefits in CKD have primarily been reported in studies using subcutaneous GLP-1 receptor agonists?

1 Answer available

Do you use absolute random cortisol levels or delta cortisol levels after ACTH stimulation to diagnose adrenal insufficiency in the critically ill?

2 Answers available

How long do you wait before reassessing a 24 hour urine calcium level in patients with recurrent nephrolithiasis, hypercalciuria, and osteoporosis who are initiated on bisphosphonate therapy?

3 Answers available

Under what circumstances would you refer a patient with mild autonomous cortisol secretion without features of Cushing syndrome for adrenalectomy?

1 Answer available

What is the next step in management of a thyroid nodule that was biopsied and classified as Bethesda III, but Afirma genetic testing reveals parathyroid signature?

Patient does not have hypercalcemia.

2 Answers available

Should Orlistat be considered in the management of hypertriglyceridemia?

1 Answer available

Do patients with an elevated IGF-1 level and features of acromegaly need to have confirmatory growth hormone suppression testing with OGTT?

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

2 Answers available

What is your approach to treating osteoporosis in patients post bariatric surgery?

Are oral bisphosphonates contraindicated with all types of bariatric procedures?

3 Answers available

Is intermittent fasting effective for weight loss?

3 Answers available

In a patient with low-risk papillary thyroid carcinoma in 1 thyroid lobe s/p hemithyroidectomy, how would a diagnosis of Graves' orbitopathy (euthyroid biochemically) affect your classification and TSH target for thyroid-cancer treatment?

Conflicting data exists on whether Graves' disease would increase the aggressiveness of the concomitant thyroid cancer vs having no effect/correlation...

1 Answer available

Do you recommend Alpha Lipoic Acid to patients with diabetic polyneuropathy?

5 Answers available

Would you treat an isolated elevated total cholesterol in a post-menopausal patient who is otherwise healthy and has no significant CV risk factors?

2 Answers available

When do you refer a patient with MODY3 to GI/Hepatology for monitoring/management of hepatic adenomas?

1 Answer available

Can anabolic agents be used in a patient with history of radioactive iodine treatment for hyperthyroidism?

1 Answer available

Would you switch a patient with glucocorticoid induced osteoporosis to romosozumab if a patient sustained a fragility fracture 1 year into treatment with teriparatide?

1 Answer available

How long should T3 be continued in hypothyroid patients who received no symptomatic benefit after starting T3/T4 combination therapy?

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How do you medically manage uncontrolled Graves' disease in a patient awaiting surgery who is intolerant to methimazole and PTU and refusing RAI?

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...

1 Answer available

What is your approach to a patient with a low alkaline phosphatase?

What level or additional signs/symptoms trigger a workup? What does your workup typically consist of?

5 Answers available

Would you give a second round of therapeutic RAI in a patient with PTC s/p total thyroidectomy and I-131 ablation who is found to have recurrent disease in cervical lymph nodes s/p repeat neck dissection?

What dose of RAI would you consider giving if recommended?

2 Answers available

Do you treat hypercalciuria in post menopausal osteoporosis with normal serum calcium and PTH?

2 Answers available

Aside from lifestyle measures such as calcium intake, vitamin D repletion, and weight-bearing exercises and ruling out all secondary causes, what is the preferred approach to managing osteoporosis in young women with Z score of less than -2.5 and planning to get pregnant soon?

2 Answers available

When do you start bisphosphonates empirically, irrespective of DEXA results, in patients going on chronic glucocorticoids?

1 Answer available

Should thyroid hormone replacement be initiated in patients with very prolonged critical illness with associated low thyroid hormone levels?

1 Answer available

Is thyrotropin receptor antibody a good biomarker to predict development of thyroid eye disease?

1 Answer available

Do you delay spinal surgery (e.g. lumbar decompression for stenosis) in men or women with newly diagnosed osteoporosis and multiple thoracic compression fractures (not involving site of potential surgery) in order to initiate anabolic or anti-resorptive therapy to potentially improve surgical healing outcomes?

2 Answers available

Where do you place romosozumab in your treatment sequence for osteoporosis management?

4 Answers available

What are the potential causes for significant discrepancies between predicted A1c by Dexcom CGM and standard serum A1c by lab draw?

I have a longstanding patient with diabetes and a consistently significant difference between CGM average and that predicted by serum A1c. The CGM avg...

1 Answer available

Is history of radiation an absolute contraindication to using parathyroid hormone (PTH) analogues?

Does it depend on location of radiation, length of radiation, and time since radiation?

3 Answers available

Do you adjust the dose or the timing of levothyroxine ingestion in patients on anti-acid medications?

2 Answers available

Should oral combined contraceptives be held prior to overnight dexamethasone suppression test to rule out Cushings?

If so, how long should OCPs be held to reliably trust the dex suppression test results?

2 Answers available

Can combined oral contraceptive use cause falsely elevated 24-hour urine-free cortisol?

2 Answers available

Is there enough evidence now to use injectable semaglutide as a foundational therapy for symptomatic heart failure with preserved ejection fraction in the setting of overweight or obesity?

1 Answer available

In patients with secondary osteoporosis due to primary hyperparathyroidism, should parathyroidectomy be recommended in the setting of recent prior bisphosphonate use?

1 Answer available

How do you approach a patient with biochemical evidence of primary hyperparathyroidism, but normal parathyroid scan?

4 Answers available

Should testosterone replacement be stopped in elderly men who suffered acute stroke even when testosterone levels have been stably in the low-to-mid normal range?

1 Answer available

Would you recommend prescribing testosterone replacement therapy to reduce osteoporosis fracture rates in men with hypogonadism?

1 Answer available

What is your protocol to starting/stopping glucocorticoid replacement in Cushing disease patients after their transsphenoidal resection surgery?

1 Answer available

Have the results of the ancillary study of the VITAL trial, demonstrating that Vitamin D3 supplementation did not reduce the incident rate of fractures in generally healthy midlife and older adults, changed how you prescribe Vitamin D?

PMID 35939577

2 Answers available

How would you approach choosing osteoporosis treatment in a patient with a T score -3.3 in lumbar spine and no prior fracture history who has squamous cell cancer and received radiation therapy?

1 Answer available

How do you manage osteoporosis in patients with anorexia nervosa (who often are young women < 40)?

2 Answers available

Should metformin be used in women with PCOS for weight loss?

1 Answer available

Should patients with mild subclinical hypothyroidism (TSH < 10 mIU/L) be treated with thyroid hormone replacement to improve their lipid profile?

2 Answers available

Should fasting C-peptide levels be used to guide T2DM management?

2 Answers available

What is your approach to a patient on long-term denosumab who now requires multiple invasive dental procedures?

2 Answers available

Is it possible to have undetectable cortisol levels in secondary adrenal insufficiency?

Young, previously healthy male with normal growth presenting with two syncopal episodes. Currently, only symptom is mild fatigue. Labs showed: Cortiso...

2 Answers available

What is your approach to using bisphosphonates in those with severe hypercalcemia and chronic kidney disease?

1 Answer available

How often would you repeat testing in a patient suspected of Cyclic Cushing's?

And is there a preferred diagnostic test? Whenever cyclic hypercortisolemia is suspected, it is advised that evaluation should be repeated for months,...

2 Answers available

Do you recommend continuing SGLT2 inhibitors in patients with diabetic kidney disease and congestive heart failure who have been taking the medication for several years and later develop end stage kidney disease?

3 Answers available

What would be your next step in treating a patient with osteoporosis who developed AFF on denosumab and who then completed one year of romosozumab?

3 Answers available

Is it possible for certain individuals with osteoporosis to be a denosumab "non-responder"?

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...

1 Answer available

Can joint replacement surgery be performed in someone with active Paget’s disease elsewhere?

1 Answer available

What further work-up (if any) should be considered in patients with pituitary microadenoma and stigmata of Cushing's disease but low ACTH and repeatedly normal plasma, urinary, and salivary cortisol levels?

1 Answer available

For a patient with osteopenia or osteoporosis, how long can intravenous zoledronic acid be maintained if there are not adverse events?

1 Answer available

What is the differential for elevated T3 (with suppressed T4 and normal TSH) in a patient not taking any thyroid hormones?

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...

1 Answer available

What is your approach to tapering chronic steroids in patients who are at high risk of HPA suppression?

For example, patients who have been maintained on 5mg of prednisone for years without previous tapering attempts and the rheumatic disease is not acti...

1 Answer available

Is there an indication for adrenalectomy in patients with subclinical Cushing syndrome and adrenal nodule?

1 Answer available

Should lipid lowering therapy be started in patients with isolated elevation in lipoprotein (a) and minimal cardiovascular risk?

2 Answers available

Despite low T scores (-2.5 or worse), what is the actual fracture risk in relatively younger patients (early 50s to mid 60s) with low BMD?

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

1 Answer available

Would you start osteoporosis treatment in patients with low FRAX scores but have T scores lower than -2.5?

1 Answer available

What is the best treatment of isolated elevated DHEA-S in a woman with clinical androgen excess (without PCOS, neoplasm, etc)?

1 Answer available

When would you offer radiation for poorly differentiated thyroid cancer?

3 Answers available

What is the rationale behind the Anesthesiology recommendation to hold one dose of weekly GLP-RA prior to general anesthesia?

There is a current recommendation from the anesthesia society to hold one dose of GLP-RA prior to general anesthesia. Given the long half-life of the ...

1 Answer available

How do you counsel cancer patients when they ask if they should avoid sugar?

9 Answers available

For a TSH producing microadenoma, would you recommend surgery vs methimazole if the patient is elderly and the tumor is relatively small?

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’...

1 Answer available

Would you order a DEXA scan for a cervical cancer patient with osteoporosis?

NCCN cervical cancer guidelines added a new statement - Patients who have received prior pelvic radiation therapy and have osteoporosis may benef...

1 Answer available

What is your approach to progressive calvarial hyperostosis found in an elderly adult not caused by Pagets, acromegaly or hypercalcemia?

No evidence for acromegaly or Pagets.

1 Answer available

Should insulin be started early (prior to optimization of other anti-hyperglycemic medications) in patients with mild-to-moderate diabetes and hypertriglyceridemia refractory to statin and fibrates?

2 Answers available

Should thyroxine hormone be started in women having fertility concerns with high-normal TSH and negative TPO antibody?

2 Answers available

Would atypical fractures of the hip in a parent (treated with bisphosphonate) be considered when calculating the FRAX score for a patient with osteopenia?

2 Answers available

How should very low T scores (worse than -3) be interpreted in very thin patients (BMI < 18)?

1 Answer available

Can subclinical hypothyroidism cause myxedema coma?

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

2 Answers available

In adult women with NCCAH, is there a benefit in using supratherapeutic doses of prednisone in addition to clomiphene to improve fertility rates?

1 Answer available

Should GLP-1 agonists be weaned in patients who have achieved goal weight loss and glycemic control?

1 Answer available

Which medications do you deem necessary to stop prior to measuring plasma renin and plasma aldosterone when evaluating a patient for possible primary aldosteronism?

1 Answer available

Would you give transdermal hormone replacement therapy to a woman with remote history of provoked pulmonary embolism?

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

1 Answer available

Should dopamine agonist treatment stop in pregnant patients with recurrent prolactinoma despite prior surgery?

1 Answer available

Should a short trial of androgen therapy be used in patients with primary adrenal insufficiency suffering from persistent fatigue and hypoactive sexual desire despite sufficient glucocorticoid and mineralocorticoid replacement?

1 Answer available

What is the next best anti-hypertensive medication to start after mineralocorticoid receptor antagonists in patients with primary aldosteronism?

1 Answer available

Is there any indication for obtaining adrenal imaging in patients with MEN2 who have normal plasma or urinary metanephrines?

1 Answer available

How do you manage calcium and vitamin D replacement in scleroderma and myositis patients with dysphagia and malabsorption?

1 Answer available

What is your approach to treating premenopausal woman with OI with a new compression fracture?

2 Answers available

Should patients with asymptomatic GH deficiency be treated with GH replacement therapy if they have prior known severe CAD?

1 Answer available

Does caution have to be used in GH replacement therapy in any and all types of cancer history?

1 Answer available

Is a significant rise in cortisol post cosyntropin stimulation sufficient to rule out adrenal insufficiency in patients with low albumin?

1 Answer available

Can osilodrostat be used indefinitely in poor surgical candidates with cushing syndrome from adrenal adenoma?

1 Answer available

Does your goal rate of correction in patients with chronic hypoosmolar hyponatremia differ based on the degree of hypoosmolarity?

4 Answers available

Should a toe-brachial index be obtained in lieu of resting ABI as an initial screen for PAD in high-risk patients such as those with longstanding diabetes or advanced age with stiffened vessels?

1 Answer available

What treatment would you use in a patient with osteoporosis on denosumab for 10 years who develops ONJ at a site of an old implant?

1 Answer available

In a young female with severe osteoporosis due to congenital estrogen deficiency, can estrogen be prescribed if genetic testing for congenital disorders reveals a heterozygous Factor V Leiden mutation?

No prior thrombosis; no family history of thrombosis. As per endocrine, the only useful therapy for the osteoporosis is estrogen.

1 Answer available

How do you approach long term management of glucocorticoid-induced osteoporosis in patients who develop osteonecrosis of the jaw on antiresorptive agent?

2 Answers available

Are there contraindications to growth hormone therapy in patients who have completed treatment for pediatric cancer?

1 Answer available

Do you recommend stopping Vitamin D supplementation in a patient with hypercalcemia and a low 25(OH)D level?

1 Answer available

When tapering moderate to high doses of long term steroids do you routinely monitor for adrenal insufficiency?

Do you attempt to taper fully or maintain at a low dose?

2 Answers available

Are there any concerns regarding side effects in changing from denosumab to zolendronic acid or vice versa?

1 Answer available

How would you manage a patient with osteoporosis on denosumab who develops significant renal insufficiency where it is difficult to continue denosumab due to increased risk of hypocalcemia (i.e. eGFR in the low 20’s)?

1 Answer available

In which patients with chronic kidney disease and low 25-OH vitamin D levels do you prefer weekly ergocalciferol to daily cholecalciferol supplementation?

1 Answer available

Do you treat low 25-OH vitamin D levels in those with end stage kidney disease?

1 Answer available

In a patient with bisphosphonate induced bilateral atypical femur fractures, how would you approach timing of alternative osteoporosis treatments and surgical management?

2 Answers available

What kinds of dental work do you particularly worry about and try to avoid in patients on bisphosphonates?

2 Answers available

What is your approach to managing hypocalcemia following a parathyroidectomy in patients with end stage kidney disease?

1 Answer available

In a patient who fractures after several years of denosumab therapy, would you wait 6 months after the last denosumab injection to start an anabolic agent or could start an anabolic agent sooner?

1 Answer available

Would you avoid the entire class of bisphosphonates if a patient develops an allergic reaction, or would you consider the use of an alternative bisphosphonate?

2 Answers available

Can denosumab be given every 3 months?

With studies showing non inferiority to zoledronic acid q 3 months in support of bone metastatic disease, would you consider extrapolating this data a...

1 Answer available

When treating patients with immune checkpoint inhibitors, do you routinely check markers of endocrinopathies such as TSH/ACTH, or only when a patient has symptoms?

If so, how often do you check these labs?

1 Answer available

For a patient who would benefit from an anabolic agent for osteoporosis, do you prefer romosuzumab over teriparatide in the absence of contraindications to either agent?

3 Answers available

How do you approach a potential drug holiday in a patient with osteoporosis who has had improvement in BMD after several years of denosumab therapy?

1 Answer available

Do you initiate management of new onset diabetes in a patient on immunotherapy or refer immediately to endocrinology given the risk of rapid worsening?

1 Answer available

How do you approach treatment of osteoporosis in patients with CKD who develop a fragility fracture while on denosumab?

1 Answer available

Do you treat secondary erythrocytosis caused by SGLT2 inhibitor?

1 Answer available

Is history of radiation therapy for uterine cancer an absolute contraindication to parathyroid hormone/parathyroid hormone related protein analogues such as teriparatide and abaloparatide in a patient with severe osteoporosis with multiple spine fractures?

2 Answers available

How do you plan to use adjuvant denosumab in patients with hormone positive breast cancer given the survival advantage seen in the ABCSG-18 trial?

Do you look into their stage/risk to decide? Since patients can experience bone loss after stopping denosumab, how do you plan to discontinue?

1 Answer available

What recommendations do you have for a transgender female patient with history of prothrombin gene mutation who is interested in starting gender affirming hormone therapy?

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

1 Answer available

What dose/fractionation would you use to treat a papillary thyroid cancer with bulky cervical adenopathy and laryngeal invasion with impending airway obstruction that is refusing laryngectomy and surgical management?

1 Answer available

In a patient who completed 5 years of oral bisphosphonate and has a T score persistently in osteoporotic range, what factors help you decide whether it is appropriate to start a drug holiday vs. switch to an alternative agent?

1 Answer available

Do you change management in patients that are taking bisphosphonates and develop atrial fibrillation?

1 Answer available

In postmenopausal osteoporosis, would you switch to romosozumab (rather than a PTH/PTHrP analog) if a patient fractures while on denosumab?

1 Answer available

How do you approach the use of bisphosphonates in reproductive-aged women?

1 Answer available

How long after the presentation of Graves ophthalmopathy is orbital radiotherapy helpful?

If a patient has been treated sucessfully for Graves but has persistent symptoms of diplopia, is radiation therapy helpful? Or is this just a dry and ...

1 Answer available

What is your approach to adjuvant hormone therapy for HR+ breast cancer in post-menopausal women with pre-existing osteoporosis?

Would you consider omitting treatment if small tumor and early stage? Or would you use tamoxifen?

2 Answers available

Would you consider using teriparatide beyond a cumulative maximum of two years now that the black box warning regarding osteosarcoma has been removed?

1 Answer available

For someone with asymmetric Graves ophthalmopathy, do you still treat both eyes, or target the single affected orbit?

1 Answer available

Do you offer adjuvant bisphosphonates to high-risk premenopausal women on ovarian suppression for early-stage breast cancer who would want to consider pregnancy in the future?

Which agents would you select and for how long would you treat them?

1 Answer available

For patients with mild CKD, how do you decide between zoledronic acid and denosumab for bone protection in patients with multiple myeloma?

For pts w/ eGFR between 30-60

1 Answer available

How do you incorporate denosumab into the surgical management of giant cell tumor of bone?

Does the degree of resectability affect your management?

2 Answers available

How do you counsel patients about the risk of osteonecrosis of the jaw with anabolic agents such as teriparatide or romosozumab ?

Would you hold these agents in the setting of invasive dental procedures?

1 Answer available

What strategy do you use to determine the appropriate timing to resume osteoporosis therapy after a drug holiday?

2 Answers available

How do you counsel male-to-female transgender patients on the VTE risk of hormonal therapy?

1 Answer available

In a patient with inflammatory orbital disease without a discrete mass to biopsy and recent bisphosphonate use, how much additional workup would you do if basic labs, urine studies, ANCA serologies, thyroid studies, chest imaging (to r/out sarcoid) are normal, before concluding that the process is likely secondary to bisphosphonate use?

Without a discrete mass to biopsy, is there any utility of any blind biopsies to rule out IgG4 related disease, infectious or neoplastic process?

1 Answer available

When do you include the neck in the RT field for resected thyroid cancer?

1 Answer available

Would you consider use of an oral bisphosphonate (such as alendronate liquid) in a patient with eosinophilic esophagitis?

1 Answer available

How would you approach osteoporosis management in a patient who fractures while on denosumab therapy?

Would you consider keeping the patient on denosumab or would switch to an anabolic agent?

1 Answer available

How do you manage anaplastic thyroid cancer that is progressing through radiation therapy?

2 Answers available

How do you approach prophylaxis against glucocorticoid-induced osteoporosis in patients with end-stage renal disease on dialysis?

1 Answer available

Do you avoid teriparatide in previously irradiated breast cancer patients with osteoporosis given the black box warning for potential risk of osteosarcoma?

1 Answer available

How do you diagnose and treat patients who develop uveitis while on bisphosphonate therapy for osteoporosis?

Are there specific features that suggest drug-induced uveitis versus de novo uveitis?

1 Answer available

Do you routinely offer a bisphosphonate or denosumab to multiple myeloma patients without skeletal lesions?

Recommendations in guidelines are discordant (ASCO vs NCCN vs UptoDate).

2 Answers available

Is there a role for starting an anabolic agent in a patient that developed an atypical femoral fracture while on denosumab sooner than 6 months after the last denosumab dose?

Is there a role for earlier use of anabolic agents to promote bone healing in patients that develop AFFs?

2 Answers available

How do you transition to an anabolic agent in a patient who develops an atypical fracture while on denosumab?

1 Answer available

Do you approach therapy differently for patients with a diagnosis of osteoporosis based on a fragility fracture rather than based on bone mineral density on DXA (assuming no secondary causes of osteoporosis)?

1 Answer available

How do you approach therapy for severe osteoporosis after an initial 12 months of romosozumab?

1 Answer available

How do you approach peri-operative management of anti-resorptive therapies such as denosumab in patients undergoing joint replacement?

Does denosumab effect knee replacement or hip replacement? Should replacement occur right before or after injection?

1 Answer available

What agent would you choose for a patient who needs osteoporosis therapy after a bisphosphonate holiday?

2 Answers available

For patients on a bone-modifying agent for osteoporosis/severe osteopenia in the context of adjuvant AI therapy, how do you manage the bone-modifying agent once their AI course is complete?

1 Answer available

How would you approach patient with metastatic anaplastic thyroid cancer with NGS revealing only ARID1A mutation?

1 Answer available

For patients with cancer receiving a bone-modifying agent (bisphosphonate or denosumab) who suffer a fracture requiring stabilization or reconstruction, how do you manage the bone-modifying agent peri-operatively?

Is there concern for impaired healing? Do you pause therapy and for how long?

1 Answer available

Are stress-dose steroids indicated in patients with adrenal insufficiency receiving radiation therapy?

1 Answer available

How do you manage post-menopausal osteoporosis in a patient with stable bone density and no fractures after three years of holiday after giving zoledronic acid?

1 Answer available

How do you manage osteopenia, osteoporosis and calcium / Vit D supplementation in a patient with calcinosis?

1 Answer available

Is romosozumab an option in a patient who has completed 2 years of teriparatide therapy and has a fracture while on denosumab?

1 Answer available

When treating patients with low bone mineral density, when/how do you monitor bone turnover markers (NTX, CTX, etc)?

1 Answer available

Would you consider an osteoporosis medication in a pre-menopausal/young patient with a low Z score and an ongoing risk factor for secondary osteoporosis such as chronic antiepileptic treatment?

1 Answer available

In which osteoporosis patients would you consider starting with anabolic therapy over antiresorptive therapy?

1 Answer available

Do you regularly do bone density testing to screen for osteoporosis in men with rheumatoid arthritis without any other risk factors?

2 Answers available

Following oral cavity radiotherapy, how do you advise patients on ongoing bisphosphonate therapy and the risk for osteonecrosis?

Do you encourage patients to take a break from/stop taking Fosamax or similar medications for their osteopenia or osteoporosis in order to prevent dev...

1 Answer available

Is there any role for bisphosphonate or alternative bone-modifying agents use in SMM in the absence of other indications for its use?

1 Answer available

Do you consent patients for diabetes insipidus following SRS or fractionated radiation for pituitary tumors?

My understanding is that this risk is exceedingly rare even with treatment in and around the stalk and hypothalamus.

2 Answers available

Would you re-introduce bisphosphonate or denosumab in a bone-only metastatic ER+ breast cancer patient with history of osteonecrosis of the jaw?

2 Answers available

Do you give bisphosphonates after completing adjuvant anti-HER2 therapy and chemotherapy for HER2+ breast cancer to reduce the risk of recurrence?

2 Answers available

When is the best time to start denosumab in men with metastatic prostate cancer?

Should it be started at the initial diagnosis of bone mets?

2 Answers available

Is there a degree of osteoporosis (based on T-score) that would prohibit you from the utilization of an AI in a strong HR+ early stage breast cancer?

What factors if any would influence your decision and what would your approach be?

2 Answers available

Do you routinely use imaging (US, whole body iodine scans etc.) to follow papillary or follicular thyroid cancer after thyroidectomy and RAI therapy?

Is there any evidence that this improves outcomes over a more simple and cost effective follow up of careful physical examination and checking a perio...

1 Answer available

Is it safe to use radioactive iodine therapy for patients with differentiated thyroid cancer and brain metastases?

Does it matter whether the intracranial lesions have been treated with whole brain or SRS/SRT?

3 Answers available

What is your approach to the use of denosumab in patients with metastatic breast cancer with bony involvement?

Do you extrapolate the results of OPTIMIZE-2 and CALGB 70604 showing that an every 12 week dosing of zolendronic acid is noninferior to ever...

1 Answer available

How common is hypothyroidism in postradiation head and neck cancer patients?

Do you treat patients who are clinically hypothyroid but biochemically euthyroid?

3 Answers available

How would you follow patients with differentiated thyroid cancer that no longer picks up iodine after thyroidectomy and RAI, and have thyroglobulin antibodies?

If a patient had a recurrence that was pathologically proven despite negative idodine scans, what imaging scans would you follow up with for surveilla...

1 Answer available

What role does external beam radiotherapy play in the treatment of well differentiated papillary thyroid cancer when a total thyroidectomy and lymph node dissection cannot be performed?

In the case of a partial resection with focal perineural invasion, but no lymphadenectomy due to severe fibrosis from prior radio-ablation for hyperth...

1 Answer available

Based on the recent disease-free survival results from ABCSG-18 presented at San Antonio, do you favor the use of Denosumab in the adjuvant setting?

1 Answer available

Should bone-directed agents, such as denosumab or zoledronic acid, be given when patients are being treated with radium-223?

1 Answer available

Papers discussed in this category

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-04-10

Randomized controlled trial of early zoledronic acid in men with castration-sensitive prostate cancer and bone metastases: results of CALGB 90202 (alliance).

Lancet, 2016 Mar 19

Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial.

Eur. Urol.,

Combining enzalutamide with abiraterone, prednisone, and androgen deprivation therapy in the STAMPEDE trial.

Cancer, 2001-12-01

Hypothyroidism: a frequent event after radiotherapy and after radiotherapy with chemotherapy for patients with head and neck carcinoma.

Neuro-oncology, 2011 Jun 10

Hypofractionated stereotactic radiotherapy with CyberKnife for nonfunctioning pituitary adenoma: high local control with low toxicity.

The Journal of clinical endocrinology and metabolism, 2001-12

Inflammatory cardiovascular risk markers in women with hypopituitarism.

J. Clin. Endocrinol. Metab.,

Body composition in adult growth hormone-deficient men, assessed by anthropometry and bioimpedance analysis.

J. Clin. Endocrinol. Metab.,

Bone loss is correlated to the severity of growth hormone deficiency in adult patients with hypopituitarism.

Lancet,

Premature mortality due to cardiovascular disease in hypopituitarism.

Metab. Clin. Exp.,

Serum lipid levels in growth hormone-deficient men.

J. Neurosurg., 2018 Nov 09

Hypopituitarism after Gamma Knife radiosurgery for pituitary adenomas: a multicenter, international study

Clin Endocrinol (Oxf), 2009 Jul 24

Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK).

Nat Clin Pract Endocrinol Metab,

Radiation-induced hypopituitarism after cancer therapy: who, how and when to test.

Neurosurgery, 2008-01

Predictors and incidence of central diabetes insipidus after endoscopic pituitary surgery.

Clinical neurology and neurosurgery, 2013-02

Diabetes insipidus following resection of pituitary tumors.

Ann. Endocrinol. (Paris),

Pituitary deficiency after brain radiation therapy.

Ann. Endocrinol. (Paris), 2013 Nov 25

Diabetes insipidus.

Lancet,

Adjuvant bisphosphonate treatment in early breast cancer: meta-analyses of individual patient data from randomised trials.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-07-20

Osteonecrosis of the jaw and oral health-related quality of life after adjuvant zoledronic acid: an adjuvant zoledronic acid to reduce recurrence trial subprotocol (BIG01/04).

Curr Treat Options Oncol, 2019 Mar 14

Role of Bisphosphonates in Breast Cancer Therapy.

Leuk. Lymphoma, 2011 Feb 08

Pamidronate versus observation in asymptomatic myeloma: final results with long-term follow-up of a randomized study.

Cancer,

A multicenter, randomized clinical trial comparing zoledronic acid versus observation in patients with asymptomatic myeloma.

Arthritis Rheumatol, 2017 Aug

2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

Current opinion in rheumatology, 2015-05

Current approaches to osteoporosis treatment.

Am J Med, 2012 Nov 20

Bisphosphonate therapy for osteoporosis: benefits, risks, and drug holiday.

Arthritis Care Res (Hoboken), 2017 Aug

2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

JAMA, 2006-12-27

Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial.

Annals of surgery, 2014-01

A prospective, randomized, noninferiority trial of steroid dosing after major colorectal surgery.

Perioper Med (Lond), 2018 Jun 08

Perioperative corticosteroid administration: a systematic review and descriptive analysis.

BMJ, 2008 May 20

Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis.

Circulation,

Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study.

Cancer discovery, 2015-07

ARID1A Deficiency Impairs the DNA Damage Checkpoint and Sensitizes Cells to PARP Inhibitors.

J Immunother Cancer,

alterations function as a biomarker for longer progression-free survival after anti-PD-1/PD-L1 immunotherapy.

J Clin Oncol, 2019 Sep 18

Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease: ASCO Clinical Practice Guideline.

Blood, 2013-10-24

The impact of response on bone-directed therapy in patients with multiple myeloma.

The Lancet. Oncology, 2011-08

Effects of zoledronic acid versus clodronic acid on skeletal morbidity in patients with newly diagnosed multiple myeloma (MRC Myeloma IX): secondary outcomes from a randomised controlled trial.

The Lancet. Oncology, 2018-03

Denosumab versus zoledronic acid in bone disease treatment of newly diagnosed multiple myeloma: an international, double-blind, double-dummy, randomised, controlled, phase 3 study.

Lancet (London, England), 2015-09-19

Denosumab and teriparatide transitions in postmenopausal osteoporosis (the DATA-Switch study): extension of a randomised controlled trial.

Int J Part Ther, 2021 Summer

Initial Experience with Proton Beam Therapy for Differentiated Thyroid Cancer.

N Engl J Med,

Bisphosphonate use and atypical fractures of the femoral shaft.

J Clin Oncol, 2022 Jan 18

Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer: ASCO-OH (CCO) Guideline Update.

The Journal of clinical endocrinology and metabolism, 2022 Jun 16

Critical Illness-induced Corticosteroid Insufficiency: What It Is Not and What It Could Be.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-12-10

Cost-Effectiveness Analysis of Monthly Zoledronic Acid, Zoledronic Acid Every 3 Months, and Monthly Denosumab in Women With Breast Cancer and Skeletal Metastases: CALGB 70604 (Alliance).

Semin Dial, 2010 May 10

Why dialysis patients need combination therapy with both cholecalciferol and a calcitriol analogs.

The Journal of clinical endocrinology and metabolism, 2016-05

The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.

Clinical journal of the American Society of Nephrology : CJASN, 2019-05-07

Rate of Correction of Hypernatremia and Health Outcomes in Critically Ill Patients.

Curr Opin Cell Biol, 1995 Aug

Cell volume regulated transporters of compatible osmolytes.

The lancet. Diabetes & endocrinology, 2017-07

10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension.

Post reproductive health, 2022 Dec 27

Hormone replacement therapy in women with history of thrombosis or a thrombophilia.

Cancer Chemother Pharmacol, 2021 Mar 31

Switching from zoledronic acid to denosumab increases the risk for developing medication-related osteonecrosis of the jaw in patients with bone metastases.

J Bone Miner Metab, 2020 Jul 12

Zoledronic acid sequential therapy could avoid disadvantages due to the discontinuation of less than 3-year denosumab treatment.

Endocrine reviews, 2019-02-01

Systemic Complications of Acromegaly and the Impact of the Current Treatment Landscape: An Update.

Eur J Endocrinol, 2022 Apr 21

Safety of growth hormone replacement in survivors of cancer and intracranial and pituitary tumours: a consensus statement.

Pediatr Hematol Oncol, 2023 Mar 20

Growth hormone after CNS tumor diagnosis: the fundamentals, fears, facts, and future directions.

JAMA, 2021 Apr 13

Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial.

Diabetes therapy : research, treatment and education of diabetes and related disorders, 2017 May 08

A Practical Review of C-Peptide Testing in Diabetes.

Journal of the American Heart Association, 2015 Jun 26

Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Mayo Clinic proceedings, 2023 Jun 29

Progression to Insulin Therapy in Patients With Type 2 Diabetes According to Cardiorespiratory Fitness, Body Mass Index, and Statin Therapy.

The Journal of clinical endocrinology and metabolism, 2011 Dec 28

Update in lipid alterations in subclinical hypothyroidism.

The New England journal of medicine, 2022 Apr 21

Calorie Restriction with or without Time-Restricted Eating in Weight Loss.

The lancet. Diabetes & endocrinology, 2019 Aug 22

Combination denosumab and high dose teriparatide for postmenopausal osteoporosis (DATA-HD): a randomised, controlled phase 4 trial.

The New England journal of medicine, 2019 Mar 23

Levothyroxine in Women with Thyroid Peroxidase Antibodies before Conception.

BMC medicine, 2019-07-10

The TABLET trial: limitations and implications.

JAMA, 2017 Dec 12

Effect of Levothyroxine on Miscarriage Among Women With Normal Thyroid Function and Thyroid Autoimmunity Undergoing In Vitro Fertilization and Embryo Transfer: A Randomized Clinical Trial.

The lancet. Diabetes & endocrinology, 2022 Mar 14

Levothyroxine in euthyroid thyroid peroxidase antibody positive women with recurrent pregnancy loss (T4LIFE trial): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.

The New England journal of medicine, 2020 Sep 24

Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

The Journal of clinical endocrinology and metabolism, 2010 Jan 15

Fertility in women with nonclassical congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

The New England journal of medicine, 2023 Jun 16

Cardiovascular Safety of Testosterone-Replacement Therapy.

Clinics (Sao Paulo, Brazil), 2018 Dec 10

Autophagy and intermittent fasting: the connection for cancer therapy?

Metabolites, 2020 Jul 11

The Pentose Phosphate Pathway Dynamics in Cancer and Its Dependency on Intracellular pH.

Protein & cell, 2014 Jul 12

Regulation of the pentose phosphate pathway in cancer.

Trends in biochemical sciences, 2016 Jan 05

The Warburg Effect: How Does it Benefit Cancer Cells?

The Journal of clinical endocrinology and metabolism, 2005-04

Biochemical and clinical manifestations of dopamine-producing paragangliomas: utility of plasma methoxytyramine.

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

Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status.

The New England journal of medicine, 2018 Oct 01

Fracture Prevention with Zoledronate in Older Women with Osteopenia.

The New England journal of medicine, 2015 Sep 17

Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

The New England journal of medicine, 2020 Sep 24

Dapagliflozin in Patients with Chronic Kidney Disease.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2018-05

Future Osteoporotic Fracture Risk Related to Lumbar Vertebral Trabecular Attenuation Measured at Routine Body CT.

The American journal of medicine, 2016-05

Diagnosing and Treating the Syndrome of Inappropriate Antidiuretic Hormone Secretion.

Clinical journal of the American Society of Nephrology : CJASN, 2018-07-06

Risk Factors and Outcomes of Rapid Correction of Severe Hyponatremia.

Journal of critical care, 2023 May 13

Effects of correction rate for severe hyponatremia in the intensive care unit on patient outcomes.

The Journal of urology, 1992-06

Functional obstructive uropathy: a significant factor in the hyponatremia of psychogenic polydipsia?

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2019-02

THE EVALUATION OF INCIDENTALLY DISCOVERED ADRENAL MASSES.

European journal of endocrinology, 2023 Jul 20

European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors.

JBMR plus, 2021 Aug 30

New Insights Into Osteoclast Biology.

World journal of surgery, 2004 Apr 19

Recovery of bone mineral density in 126 patients after surgery for primary hyperparathyroidism.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-05-10

Twelve-Month Estrogen Levels in Premenopausal Women With Hormone Receptor-Positive Breast Cancer Receiving Adjuvant Triptorelin Plus Exemestane or Tamoxifen in the Suppression of Ovarian Function Trial (SOFT): The SOFT-EST Substudy.

The New England journal of medicine, 2018-07-12

Tailoring Adjuvant Endocrine Therapy for Premenopausal Breast Cancer.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-05-10

Incomplete Estrogen Suppression With Gonadotropin-Releasing Hormone Agonists May Reduce Clinical Efficacy in Premenopausal Women With Early Breast Cancer.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019-04-10

Ovarian Suppression in Adjuvant Endocrine Therapy for Premenopausal Breast Cancer.

Clinical breast cancer, 2023 Mar 28

Ovarian Function Suppression in Premenopausal Women With Concurrent Endocrine Therapy Use.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010 Jun 14

Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial.

The New England journal of medicine, 2023 Aug 25

Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity.

Kidney international, 2022 Nov

Executive summary of the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease: an update based on rapidly emerging new evidence.

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023 Jan 18

The rationale, design and baseline data of FLOW, a kidney outcomes trial with once-weekly semaglutide in people with type 2 diabetes and chronic kidney disease.

Cardiovascular diabetology, 2024 Feb 08

Cardiorenal effectiveness of empagliflozin vs. glucagon-like peptide-1 receptor agonists: final-year results from the EMPRISE study.

Diabetes care, 2011-09

Efficacy and safety of antioxidant treatment with α-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial.

Nutrients, 2023 Aug 18

Effects of Oral Alpha-Lipoic Acid Treatment on Diabetic Polyneuropathy: A Meta-Analysis and Systematic Review.

Endocrine reviews, 2019 Feb 01

Emerging Biomarkers, Tools, and Treatments for Diabetic Polyneuropathy.

The lancet. Diabetes & endocrinology, 2021 Oct 20

Consensus on diagnosis and management of Cushing's disease: a guideline update.

Arteriosclerosis, thrombosis, and vascular biology, 2019-07