Today at MEDS – August 4, 2018

PCOS Update 2018
R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education

Polycystic ovary syndrome is the most common reproductive endocrine disorder, affecting 1 in 15 women in the United States. Secor reviewed the signs, symptoms, risk factors, and pathophysiology of the condition, as well as new research pointing toward its relationship with the gut microbiome. She also covered the work-up, differential, and considerations if pregnancy is desired. The treatment discussion included off-label use of metformin and letrozole.

Hypercalcemia/Parathyroid Disease Unraveled: 3 Cases to Consider
Ji Hyun (CJ) Chun, PA-C, MPAS, BC-ADM, American Society of Endocrine PAs

Chun reviewed the physiology of calcium homeostasis and presented a work-up plan for hypercalcemia and hyperparathyroidism. He shared the surgical criteria for parathyroidectomy, as well as nonsurgical treatment options, and discussed the development, potential consequences, and treatment of vitamin D deficiency.

Osteoporosis: Sticks and Stones May or May Not Break My Bones?
Richard S. Pope, MPAS, PA-C, DFAAPA, CPAAPA, Quinnipiac University

FRAX^® (fracture risk assessment tool), bone mineral density (BMD), vertebral fracture assessment, and trabecular bone score are all validated tools for evaluating osteoporosis, began Pope. Age and previous fractures are perhaps the strongest, independent predictors of fracture risk. Antiresorptive therapy produces a modest increase in BMD. Anabolic therapy with parathyroid hormone increases BMD more than antiresorptive treatment, but it is not yet obvious that fracture protection is greater.

Osteoporosis: Case Studies for Consideration
R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education, and Richard S. Pope, MPAS, PA-C, DFAAPA, CPAAPA, Quinnipiac University

How long should you treat patients with bisphosphonates? How is osteoporosis treatment best monitored? What is the best definition of successful treatment of osteoporosis? Secor and Pope answered these questions and emphasized reviewing with patients diet and lifestyle modifications and their importance to bone health. They also explained how to analyze risk factors beyond the DXA (dual-energy x-ray absorptiometry) score (eg, height loss), and how to target therapy based on co‐morbidities.

Continue to: Men's and Women's Health Issues and Endocrine Disease

Men’s and Women’s Health Issues and Endocrine Disease
Ji Hyun (CJ) Chun, PA-C, MPAS, BC-ADM, American Society of Endocrine PAs, and R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education

Chun and Secor reviewed the physiology and pathophysiology of male hypogonadism, the elements of a comprehensive diagnostic protocol, and appropriate monitoring of patients taking testosterone replacement therapy (TRT). They said that differentiating organic hypogonadism and late-onset hypogonadism (LOH) is of utmost importance to prevent long-term complications of true hypogonadism. While the benefits of treatment clearly outweigh the risks for patients with organic hypogonadism, the benefit-risk ratio for patients with LOH is unclear.

PCOS Update 2018
R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education

Polycystic ovary syndrome is the most common reproductive endocrine disorder, affecting 1 in 15 women in the United States. Secor reviewed the signs, symptoms, risk factors, and pathophysiology of the condition, as well as new research pointing toward its relationship with the gut microbiome. She also covered the work-up, differential, and considerations if pregnancy is desired. The treatment discussion included off-label use of metformin and letrozole.

Hypercalcemia/Parathyroid Disease Unraveled: 3 Cases to Consider
Ji Hyun (CJ) Chun, PA-C, MPAS, BC-ADM, American Society of Endocrine PAs

Chun reviewed the physiology of calcium homeostasis and presented a work-up plan for hypercalcemia and hyperparathyroidism. He shared the surgical criteria for parathyroidectomy, as well as nonsurgical treatment options, and discussed the development, potential consequences, and treatment of vitamin D deficiency.

Osteoporosis: Sticks and Stones May or May Not Break My Bones?
Richard S. Pope, MPAS, PA-C, DFAAPA, CPAAPA, Quinnipiac University

FRAX^® (fracture risk assessment tool), bone mineral density (BMD), vertebral fracture assessment, and trabecular bone score are all validated tools for evaluating osteoporosis, began Pope. Age and previous fractures are perhaps the strongest, independent predictors of fracture risk. Antiresorptive therapy produces a modest increase in BMD. Anabolic therapy with parathyroid hormone increases BMD more than antiresorptive treatment, but it is not yet obvious that fracture protection is greater.

Osteoporosis: Case Studies for Consideration
R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education, and Richard S. Pope, MPAS, PA-C, DFAAPA, CPAAPA, Quinnipiac University

How long should you treat patients with bisphosphonates? How is osteoporosis treatment best monitored? What is the best definition of successful treatment of osteoporosis? Secor and Pope answered these questions and emphasized reviewing with patients diet and lifestyle modifications and their importance to bone health. They also explained how to analyze risk factors beyond the DXA (dual-energy x-ray absorptiometry) score (eg, height loss), and how to target therapy based on co‐morbidities.

Continue to: Men's and Women's Health Issues and Endocrine Disease

Men’s and Women’s Health Issues and Endocrine Disease
Ji Hyun (CJ) Chun, PA-C, MPAS, BC-ADM, American Society of Endocrine PAs, and R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education

Chun and Secor reviewed the physiology and pathophysiology of male hypogonadism, the elements of a comprehensive diagnostic protocol, and appropriate monitoring of patients taking testosterone replacement therapy (TRT). They said that differentiating organic hypogonadism and late-onset hypogonadism (LOH) is of utmost importance to prevent long-term complications of true hypogonadism. While the benefits of treatment clearly outweigh the risks for patients with organic hypogonadism, the benefit-risk ratio for patients with LOH is unclear.

PCOS Update 2018
R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education

Polycystic ovary syndrome is the most common reproductive endocrine disorder, affecting 1 in 15 women in the United States. Secor reviewed the signs, symptoms, risk factors, and pathophysiology of the condition, as well as new research pointing toward its relationship with the gut microbiome. She also covered the work-up, differential, and considerations if pregnancy is desired. The treatment discussion included off-label use of metformin and letrozole.

Hypercalcemia/Parathyroid Disease Unraveled: 3 Cases to Consider
Ji Hyun (CJ) Chun, PA-C, MPAS, BC-ADM, American Society of Endocrine PAs

Chun reviewed the physiology of calcium homeostasis and presented a work-up plan for hypercalcemia and hyperparathyroidism. He shared the surgical criteria for parathyroidectomy, as well as nonsurgical treatment options, and discussed the development, potential consequences, and treatment of vitamin D deficiency.

Osteoporosis: Sticks and Stones May or May Not Break My Bones?
Richard S. Pope, MPAS, PA-C, DFAAPA, CPAAPA, Quinnipiac University

FRAX^® (fracture risk assessment tool), bone mineral density (BMD), vertebral fracture assessment, and trabecular bone score are all validated tools for evaluating osteoporosis, began Pope. Age and previous fractures are perhaps the strongest, independent predictors of fracture risk. Antiresorptive therapy produces a modest increase in BMD. Anabolic therapy with parathyroid hormone increases BMD more than antiresorptive treatment, but it is not yet obvious that fracture protection is greater.

Osteoporosis: Case Studies for Consideration
R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education, and Richard S. Pope, MPAS, PA-C, DFAAPA, CPAAPA, Quinnipiac University

How long should you treat patients with bisphosphonates? How is osteoporosis treatment best monitored? What is the best definition of successful treatment of osteoporosis? Secor and Pope answered these questions and emphasized reviewing with patients diet and lifestyle modifications and their importance to bone health. They also explained how to analyze risk factors beyond the DXA (dual-energy x-ray absorptiometry) score (eg, height loss), and how to target therapy based on co‐morbidities.

Continue to: Men's and Women's Health Issues and Endocrine Disease

Men’s and Women’s Health Issues and Endocrine Disease
Ji Hyun (CJ) Chun, PA-C, MPAS, BC-ADM, American Society of Endocrine PAs, and R. Mimi Secor, DNP, FNP-BC, FAANP, Nurse Practitioner Associates for Continuing Education

Chun and Secor reviewed the physiology and pathophysiology of male hypogonadism, the elements of a comprehensive diagnostic protocol, and appropriate monitoring of patients taking testosterone replacement therapy (TRT). They said that differentiating organic hypogonadism and late-onset hypogonadism (LOH) is of utmost importance to prevent long-term complications of true hypogonadism. While the benefits of treatment clearly outweigh the risks for patients with organic hypogonadism, the benefit-risk ratio for patients with LOH is unclear.