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.