General Primary Care&nbsp;&nbsp;&nbsp;

Do you consider co-prescribing hormone therapy and anticoagulation in a patient with prior DVT and uncontrollable VSM uncontrolled by non-hormonal therapies?

What is your approach to patients who insist on testosterone replacement therapy despite normal testosterone levels on repeated labs?

Prompted by nonspecific symptoms that could be related to low testosterone or many other conditions (i.e., fatigue, poor sleep) especially with all th...

What is your medication of choice when considering outpatient alcohol withdrawal management (diazepam vs chlordiazepoxide vs lorazepam)?

For your recommended medication, are you doing a scheduled set dose, or is it primarily symptom-driven?

What is your approach to a situation where DILI is suspected secondary to an important medication (e.g., anticoagulation, antibiotics, etc.), but the diagnosis is uncertain and the liver injury is relatively mild?

Are there situations in which you would continue the possible offending agent with close monitoring?

Do you have any concerns about lower extremity compression (e.g., compression stockings, intermittent pneumatic compression, etc.) worsening ascites in a patient with portal hypertension?

What additional therapies can be helpful for vaginal dryness causing dyspareunia in premenopausal woman already using lubrication?

Any specific lubricant more effective than another?

Do you provide empiric doxycycline for Lyme Disease to asymptomatic patients after a tick bite who haven't developed Erythema migrans or are not sure it was an Ixodes tick?

How do you recommend counseling patients on the prognosis of advanced cancer as a generalist who is not highly specialized in cancer literature or cancer-directed therapies?

What is your approach to isolated alkaline phosphatase without other laboratory abnormalities?

What are your next diagnostic steps/tests?

What is your preferred laboratory test to assess treatment response or infection resolution in patients with bacterial pneumonia?

For example, do you find trending WBC, procalcitonin, CRP, etc., more or less helpful?

Is there an age cutoff where you consider the risks of monoclonal antibody therapy outweigh any potential benefit(s) in early-onset dementia?

When do you recommend limited or targeted respiratory pathogen testing versus a full respiratory pathogen panel in a patient presenting with URI symptoms?

In other words, are there benefits to identifying URI pathogens that do not necessarily have targeted therapies (e.g., rhinovirus, non-COVID-19 Corona...

Do you recommend treatment of male partners for patients with recurrent bacterial vaginosis?

Vodstrcil et al., PMID 40043236.

How do you define treatment-resistant depression in your practice?

What strategies do you use to counsel patients on continuing an antidepressant until therapeutic doses versus switching agents if they perceive a lack...

Would you continue or stop anticoagulation for a DVT/PE in a patient with active cancer who has completed 6 months of therapy?

Mahé et al., PMID 40162636

Is there a role for use of GLP-1/GIP receptor agonists in the management of substance use disorders, whether or not they meet other inclusion criteria for their use?

Other than oxybutynin or mirabegron, what pharmacological and non-pharmacological treatments would you consider for increased urinary frequency (not caused by infection, medications, or resulting in incontinence)?

Would you pursue a colonoscopy for a patient in their 20s with constipation and rectal bleeding if they had a first-degree relative who died young from a "carcinoid tumor"?

How do you risk-stratify this otherwise low-risk young patient given the lack of specific guidelines for this rare cancer? Additionally, at what point...

What do you think about using conventional thoracic imaging methods (e.g., X-ray, CT, etc.) to determine if a pleural effusion is of adequate size to consider thoracentesis?

How do you consider and approach transition to hospice in a patient with HFrEF who does not appear to tolerate GDMT?

What is your approach to duration of fidaxomicin in a patient receiving treatment for first C difficile infection while also receiving concurrent antibiotics for an infection?

Do you extend the course of fidaxomicin past initial 10 days to at least 3-7 days after completion of antibiotics?

How do you counsel patients on GLP-1 agonists for weight loss who wish to space out their medication or take a "drug holiday" to temporarily increase their appetite?

For example, if someone has an upcoming vacation or family gathering, is it okay to temporarily stop their medication to increase their appetite?

Do you routinely take a cancer history from patients being evaluated for atopy?

There is a longstanding debate about the association of atopy with cancer risk. Significant literature evidence (mostly epidemiological) supports the ...

What adjunctive therapies beyond an antisecretory agent (e.g., PPI, H2RA, etc.) do you find most helpful in managing the acute symptoms of PUD?

For example, do you routinely supplement with calcium carbonate, magnesium hydroxide, aluminum hydroxide, simethicone, sucralfate, etc.?

What do you think about chronic suppressive therapy for HSV-2 in a patient with positive antibodies but no prior clinical outbreak?

Would you expect the presence of antibodies to indicate either immunity from contracting the infection, or otherwise risk of transmitting a latent inf...

How do you counsel non-diabetic patients who wish to start metformin to reduce the risk of developing dementia?

How do you counsel patients with metabolic syndrome who decline statin therapy and have low coronary calcium scores regarding their long term CVD risk?

How do you counsel patients who express concerns about receiving multiple vaccinations at once versus spacing them out over time?

How do you decide whether average-risk patients should undergo annual or biennial breast cancer screening?

How do you counsel someone about metformin use for type 2 diabetes mellitus who is also on a GLP-1 agonist and achieved goal HbA1c, but prefers not to be on metformin anymore?

What are some practical ways to incorporate cardiac POCUS in the primary care setting?

For example, do you find it most useful for outpatient disease assessment/management, consideration of further imaging or specialist referral, or tria...

How do you decide the maximum amount of volume to remove during a therapeutic thoracentesis?

Do you use the traditional strict limit of 1.5 L, or do you consider removing more volume if a patient appears to tolerate it?

How do you decide whether to use lung POCUS versus CT as the next step when a chest X-ray is equivocal for pneumonia?

What is your preferred screening tool for colon cancer in an average-risk patient?

Do you recommend starting with oral or intramuscular B12 supplementation in patients with newly diagnosed deficiency?

How do you counsel patients who ask if they should take a daily multivitamin?