More articles from 1-Minute consult
- In postmenopausal women who have had a subtotal (simple) hysterectomy, how much estrogen is enough, and how do you test for deficiency?
A standard dosage can be titrated upward according to symptoms.
Should speculations about immune-mediated adverse effects of Lyme disease vaccine deter us from giving it?The vaccine is safe, but should not replace simple common-sense precautions in tick-infested areas.
Should patients receiving long-term gastric acid inhibition therapy be evaluated for vitamin B12 deficiency?Very few patients actually deplete their body stores of vitamin B12 but supplementation is benign.
Can calcium and vitamin D supplementation adequately treat most patients with osteoporosis?Although calcium and vitamin D play an important role in treating osteoporosis, they are not adequate by themselves.
- What tests are necessary to diagnose Alzheimer disease?
For most patients with dementia, a clinical diagnosis is adequate.
What do you recommend for a patient with a Pap smear indicating atypical cells?The finding of atypical squamous cells of undetermined significance (ASCUS) should prompt a test for human papillomavirus.
What is the appropriate initial dose of corticosteroids to treat giant cell arteritis?A lower dose than traditionally used may be enough to control symptoms and prevent blindness while minimizing adverse effects.
When should asymptomatic bacteriuria in the elderly be treated?It is common, it is not proved to be harmful, and treatment is not proved to be beneficial.
- When do you x-ray ankle sprains in patients with acute ankle injuries?
Many are sprained, but few are fractured.
How should patients taking the discontinued diabetes drug troglitazone be managed?The newer insulin sensitizers appear safe, but monitoring for hepatotoxicity is still warranted.