Rotations 2.0 Episode 31 Vitamin D

Episode 31 Vitamin D

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Epic Dramatic Cinematic Mover Underscore by Aleksei Bezruchko

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

 Answers for Episode 30 Testosterone Deficiency

Question 1: Diagnosis and Management

A 58-year-old male presents with fatigue, decreased libido, and erectile dysfunction. His total testosterone (TT) level is 11.5 nmol/L on two separate morning measurements. His free testosterone (FT) is 210 pmol/L. Luteinizing hormone (LH) is elevated. Which of the following is the most appropriate next step?

C. Initiate lifestyle modification and consider testosterone therapy

Question 2: Adverse Effects

A 65-year-old man on long-acting testosterone undecanoate injections presents for routine follow-up. His hematocrit has increased from 46% to 55% over the past 6 months. He is otherwise asymptomatic. What is the most appropriate management?

B. Switch to a transdermal testosterone formulation

Question 3: Contraindications

A 52-year-old male with a history of prostate cancer (Gleason 7, treated with radical prostatectomy 2 years ago) presents with symptoms of testosterone deficiency. His PSA is undetectable, and digital rectal exam is normal. His TT is 7.8 nmol/L. What is the most appropriate next step?

B. Begin testosterone therapy with close monitoring

Paper for next week:

FNU Tanvir , Gurkamal Singh Nijjar , Smriti Kaur Aulakh , Yasmeen Kaur , Sumerjit Singh ,

Kanwarmandeep Singh , Abhinandan Singla , Ajay Pal Singh Sandhu , Shivansh Luthra , Harman Antaal (August 24, 2024) Gastroesophageal Reflux Disease: New Insights and Treatment Approaches. Cureus 16(8): e67654.

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