Case Studies (Endocrinology)

A 70-year-old woman with osteoporosis and a recent vertebral fracture has recently completed 5 years of therapy with oral alendronate. Bone density scan was significant for a T score of -2.7 at the left hip (T scores < -2.5 are diagnostic of osteoporosis and suggestive of high fracture risk). What would you recommend at this time?

A 65-year-old woman with osteoporosis and multiple fragility fractures of the spine is on denosumab therapy (a monoclonal antibody that inhibits osteoclast activity). She has sustained a recent vertebral fragility fracture despite compliance with denosumab therapy. What would you recommend?

A patient who is more than ten years postmenopausal has read a few studies online outlining the cardioprotective effects of estrogen. She would like to start menopausal hormone therapy with estrogen. What advice will you provide her with?

A 25-year-old woman with uncontrolled type 2 diabetes mellitus, Graves disease, and thyroid eye disease (TED)  (diagnosed three months earlier) reports to the endocrinology practice for further evaluation. She is noted to have significant proptosis and conjunctival injection. Her glycated hemoglobin A1C is 12.0% (goal of 7% or less). What would you recommend for her severe thyroid eye disease?

A 55-year-old man with a history of hyperlipidemia (well controlled on a diet), presents for his annual physical exam. His blood pressure has consistently been in the 130-138/80-92mmHg range over the past two years. He would like to know if antihypertensive therapy will reduce his risk for cardiovascular death. What will you recommend?

A 60-year-old woman with type 2 diabetes mellitus, hyperlipidemia, and an LDL cholesterol of 150mg/dl. She had a myocardial infarction requiring placement of a drug-eluting stent. Which of these management options will be most helpful in reducing her risk for cardiovascular events.