Diabetes Type 2

It will be difficult to properly review diabetes here.  You already have all the information you need. There are certain basic themes that recur in internal medicine exams that frequently “trip up” test-takers. The most common is the ever-moving-target of diagnosing diabetes.    Diagnostic criteria: A fasting plasma glucose level of 126 mg/dL (7.0 mmol/L) or higher,… Read more »

Calcium Supplementation

Calcium is required for vascular contraction and vasodilation, muscle function, nerve transmission, intracellular signaling and hormonal secretion, but less than 1% of the total body calcium is needed to support these metabolic functions. Serum calcium is tightly regulated and generally does not fluctuate with changes in dietary intakes.  The body uses bone tissue as a… Read more »


Hyponatremia is the most frequent electrolyte disorder encountered in our clinical practices. 25% of the hospital population and 5% of our out-patients.  Severity of hyponatremia prognosticates adverse outcomes, especially when hyponatremia develops in the hospital. Hyponatremia is defined as a serum sodium level of less than 135 mEq/L and is considered severe when the serum… Read more »

Vitamin D Deficiency

Vitamin D deficiency is highly prevalent in the United States and worldwide. Low levels of 25-hydroxy-vitamin D (25-OH D), the principal circulating storage form of vitamin D, are present in as many as one half of otherwise healthy adults. Because our modern society also provides for inadequate sun exposure, inadequate dietary intake 25-OH D leads to dangerously… Read more »


Hypothyroidism is a condition in which the thyroid gland does not produce sufficient thyroid hormones ( T3 , T4). It results most commonly (in the US) from the autoimmune condition called “Hashimoto’s thyroiditis” which is a cell and antibody mediated immune processes.  Iodine deficiency predominates as a cause in underdeveloped countries (which is most of the rest… Read more »