The Oct. 27, 2020 session of Duke Medicine LEADS featured Diana McNeill, MD, MACP, presenting "Clinical Dilemmas in Endocrinology."
Here are pearls and takeaways from the session:
- Biotin interferes with your free T4 assay. If you see a patient with elevations in TSH and FT4 ask about Biotin supplements.
- As part of your hypercalcemia work up, consider checking a PTHrp in the appropriate patient when you are concerned about cancer and hypercalcemia.
- Megace and intermittent use of oral steroids can cause adrenal insufficiency and lead to an adrenal crisis in patients.
- HbA1C only diagnoses 30% of cases of diabetes. Post prandial elevated blood sugars, reactive hypoglycemia, or gestational diabetes can be harbingers of diabetes. Consider checking for diabetes with a different confirmatory test like a fasting blood glucose or glucose tolerance test if you suspect diabetes and your patient has a normal HbA1C.
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions
