Diagnosis of thyroid disease is primarily a laboratory diagnosis. When the TSH is elevated and thyroid hormone levels low, or when TSH is suppressed and the thyroid hormone levels are high, it is trivial to diagnose hypo- and hyperthyroidism, respectively. In such cases, the treatment is relatively straightforward as well. However when the tests are not straightforward, one is unable to initiate treatment until the diagnosis is certain. Two major conundrums faced by physicians caring for thyroid patients are when 1) the levels of TSH and thyroid hormone are not complementary or 2) when the thyroid hormone levels don’t match the clinical symptoms. This presentation will unravel the seeming contradictions between clinical presentation and laboratory analysis of such thyroid tests.
Highlights from the recent AACE/ATA hypothyroidism guidelines are reviewed in this activity.
Recently new therapeutic options have emerged to better control hyperglycemia, while also improve cardiovascular outcomes in patients with diabetes. This Expert Perspective explores commonly asked questions about type 2 diabetes and cardiovascular risk and discusses exciting new research around available and emerging therapies which can help mitigate cardiovascular risk in your patients with diabetes.
The primary goal of this integrated, multi-interventional curriculum of both live and online activities is to provide an educational initiative for primary care physicians, physician assistants (PAs) and nurse practitioners (NPs) on the advantages and disadvantages of prandial insulin, the clinical profiles of GPL-1 receptor agonists, and the benefits of combining GLP-1 receptor agonists with basal insulin.
In this activity, Dr. Hennessey uses a patient case to review best practices for primary care clinicians to assess and manage pituitary disease. Using one case as an example, he reviews the diagnostic parameters to be considered in correctly identifying the endocrine etiologic reasons behind hyperprolactinemia.
Dr. Brent discusses three cases illustrating application of clinical guidelines for thyroid disease management. He provides practical tips and advice on how to diagnose and manage hypothyroidism in pregnancy and recognize and treat amiodarone-associated hyperthyroidism. Dr. Brent also reviews thyroid function test patterns associated with nutritional supplements containing thyroid hormone.
In this activity, Dr. Katz will discuss common endocrine disrupting chemicals found in plastics today and their effect on health. He will also outline strategies to limit exposure and mention steps, both physicians and patients can take to increase awareness about the long-term health effects of EDCs.
Evidenced-based guidelines have been developed by several professional associations to address the diagnosis and management of thyroid diseases, including thyroid nodules, hypothyroidism, and hyperthyroidism. The recommendations from these guidelines discussed in this activity, address current controversies and challenges in thyroid disease management and common dilemmas faced by the primary care provider. Clinical issues in thyroid nodule management include the use of ultrasound, appropriate nodules for fine needle aspiration, indeterminate thyroid cytology, nodules in multinodular goiters, and approach to the incidentally discovered thyroid nodule. Controversies in the treatment of hypothyroidism include, approach to initiation and monitoring therapy, TSH targets, use of T4/T3 combinations and thyroid extracts, use of branded vs. generic levothyroxine products, and treatment in special populations, such as the elderly and pregnant women. Challenges in the management of hyperthyroidism include, selecting the appropriate therapy for the thyrotoxic patient, initiating and monitoring antithyroid drug treatment, duration of antithyroid drug treatment, treatment of subclinical hyperthyroidism, and management of drug-associated thyrotoxicosis, especially that associated with the use of amiodarone. Clinical cases will be used to illustrate the application of clinical practice guidelines.
This activity will provide the learner with an overview of adrenal and pituitary dysfunction, including recognition of initial presentation, differential diagnosis and therapeutic interventions. The clinical considerations of adrenal and pituitary dysfunction will be described, outlining a functional approach to identification, evaluation, and appropriate referral of patients with significant pituitary disorders.