Showing 21-40 of 54 for: Essential Evidence Topics > Endocrine and nutrition 
- Hypercalcemia
Essential Evidence Topics, 10-Nov-2021
Overall Bottom Line: The majority of asymptomatic patients with hypercalcemia have primary hyperparathyroidism. Primary hyperparathyroidism with mild hypercalcemia is a benign disease and may not require therapy. Initial treatment of symptomatic or sev
- Hyperkalemia
Essential Evidence Topics, 19-Jul-2021
Overall Bottom Line: Patients with hyperkalemia who are clinically unstable require urgent admission to the critical care unit for immediate reduction of their serum potassium. Intravenous calcium provides immediate correction of life-threatening hyperk
- Hyperlipidemia
Essential Evidence Topics, 22-Nov-2021
Overall Bottom Line: Screen all adults 40 years and older for lipid disorders. Statins reduce overall mortality in primary and secondary prevention of CAD. Nicotinic acid, fibric acid derivatives, and ezetimibe improve lipid profiles, but do not reduc
- Hypernatremia
Essential Evidence Topics, 29-Apr-2021
Overall Bottom Line: Infants and the elderly are more susceptible to hypernatremia. Diagnosis can be established by assessing the hypothalamus-arginine vasopressin (AVP)-renal axis; determine serum osmolality, urine osmolality, urine sodium, and serum g
- Hyperparathyroidism
Essential Evidence Topics, 13-Dec-2019
Overall Bottom Line: Primary hyperparathyroidism (PHPT) is diagnosed by an elevated or high-normal total serum calcium concentration, corrected for serum albumin concentration, in the setting of inappropriately normal or elevated intact parathyroid hormon
- Hyperprolactinemia
Essential Evidence Topics, 17-Oct-2019
Overall Bottom Line: Symptoms of hyperprolactinemia include galactorrhea (rare in men), amenorrhea or irregular menstruation, decreased libido, and infertility. Many patients are asymptomatic. Begin work-up by ruling out pregnancy. It is also important
- Hyperthyroidism
Essential Evidence Topics, 4-Jan-2023
Overall Bottom Line: Graves' disease is the most common cause of hyperthyroidism. Thyroid-stimulating hormone (TSH) has sensitivity greater than 98% and specificity greater than 92% when used to confirm suspected thyroid disease and is the best initial
- Hypoaldosteronism
Essential Evidence Topics, 1-Oct-2021
Overall Bottom Line: If metabolic acidosis with normal anion gap is present, the urine anion gap (UAG = urinary sodium – urinary potassium – urinary chloride) may be used as a marker for renal elimination of acid. If the UAG is positive, it suggests renal
- Hypocalcemia
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: Suspect hypocalcemia when at risk patients present with tetany, extra-pyramidal symptoms, seizures, change in mental status, prolonged QT interval in ECG, hypomagnesemia, unexplained skin or dental abnormalities. Most mild hypocalcemi
- Hypoglycemia
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: The cause of hypoglycemia can usually be identified on the basis of history, with a focus on medications and the circumstances surrounding episodes. Obtain a glucose measurement at the time of symptoms. Biochemical hypoglycemia must
- Hypokalemia
Essential Evidence Topics, 28-Jun-2021
Overall Bottom Line: Mild hypokalemia (3.0-3.5 mmol/L) is often asymptomatic. With moderate hypokalemia (2.5-3.0 mmol/L), patients may experience ECG changes, fatigue, myalgias, or GI symptoms; with severe hypokalemia (2.0-2.5 mmol/L), patients may also p
- Hypokalemic periodic paralysis
Essential Evidence Topics, 29-Jul-2022
Overall Bottom Line: Hypokalemic periodic paralysis (HPP) is characterized by episodic reversible attacks of muscle weakness associated with decreased serum potassium levels. It occurs in familial and thyrotoxic forms. The McManis short exercise test ca
- Hyponatremia
Essential Evidence Topics, 28-Jun-2021
Background: OVERALL BOTTOM LINE Hyponatremia represents a relative excess of water compared with sodium in the extracellular fluid; the most common cause is syndrome of inappropriate antidiuretic hormone (SIADH). Among patients with severe hyponatremi
- Hypoparathyroidism
Essential Evidence Topics, 11-Jan-2021
Overall Bottom Line: Hypoparathyroidism is a rare endocrine disorder. If hypoparathyroidism is suspected (ie, incidental hypocalcemia) measure serum parathyroid hormone (PTH), serum ionized calcium and total calcium-corrected for albumin. In patients wi
- Hypopituitarism
Essential Evidence Topics, 26-Jan-2022
Overall Bottom Line: Signs and symptoms of hypopituitarism are nonspecific; they represent a composite of the signs and symptoms of the target hormone deficiencies caused by the syndrome. Measure the functioning of each pituitary axis independently with
- Hypothyroidism (adult)
Essential Evidence Topics, 13-Feb-2022
Overall Bottom Line: Hypothyroidism is common; the leading cause is chronic autoimmune thyroiditis. Hypothyroidism is diagnosed with a confirmed sensitive TSH (sTSH) level >10.0 mU/L; some authors suggest using a low FT4 in conjunction with a sTSH >
- Hypothyroidism (congenital)
Essential Evidence Topics, 13-Jan-2023
Overall Bottom Line: At birth there are no signs or symptoms; therefore, screening with thyroid-stimulating hormone is critical. Know your local system. Screening before 48 hours (term infants) or <7 days (preterm) may result in false positive result
- Insulinoma
Essential Evidence Topics, 2-Mar-2023
Overall Bottom Line: Consider insulinoma in patients who have an overnight fasting glucose level of less than 45 mg/dL (2.5 mmol/L) and symptoms of hypoglycemia that are relieved by glucose. Confirm diagnosis with serum insulin, proinsulin, high C-pepti
- Malnutrition
Essential Evidence Topics, 9-Aug-2020
Overall Bottom Line: The 2 item Malnutrition Screening Tool (MST) is supported with good evidence as having at least moderate validity, reliability, and agreement for performing a nutrition assessment. Use the subjective global assessment (SGA) in hospit
- Metabolic syndrome
Essential Evidence Topics, 25-Jan-2021
Overall Bottom Line: As part of their cardiovascular risk assessment, patients should be screened for obesity, hypertension, hyperlipidemia, and diabetes. Lifestyle changes such as diet, exercise, and weight loss decrease the eventual laboratory diagnosi
