Matthew Spitzer, MD

A 52-year-old woman with a history of hypothyroidism and a left thyroid nodule presents to the endocrine clinic for follow-up. She was initially referred 7 years prior for goiter on physical exam.

A 43-year-old woman with type 2 diabetes mellitus, hypertension, gastroesophageal reflux disorder and obesity presented to the ED with severe epigastric pain radiating to her back, nausea and vomiting for 1 day. She had not consumed alcohol for 3 months. Outpatient medications included: metformin 500 mg by mouth once daily; lisinopril 10 mg by mouth once daily; and omeprazole 20 mg by mouth once daily; each taken for 1.5 years prior to presentation. She was not taking a dipeptidyl peptidase IV inhibitor, glucagon-like peptide-1 analog or any other medications.