Thomas B. Repas, DO, FACP, FACE, CDE, is an endocrinologist, lipidologist and physician nutrition specialist in clinical practice at the Regional Medical Clinic Endocrinology and Diabetes Education Center in Rapid City, SD. Dr. Repas is the former chairman of the professional diabetes advisory committees of the Wyoming and the Wisconsin Diabetes Prevention and Control Programs. He is board certified in the areas of endocrinology, diabetes and metabolism, clinical lipidology, internal medicine and nutrition, and is also a certified diabetes educator.

Hot thyroid nodules can sometimes be cancer

January 23, 2014
Thomas B. Repas, DO, FACP, FACE, CDE

A woman presented with hyperthyroidism. Her TSH was <0.01.  Radioactive iodine uptake and scan revealed an area of increased uptake on the right with suppression…

The true heroes of clinical research

October 22, 2013
Thomas B. Repas, DO, FACP, FACE, CDE

One of my patients mentioned to me that he was taking an investigational drug as part of a clinical research study. “Thank you for your participation,” I…

Examination of comet tail artifact and other echogenic foci on thyroid ultrasound

August 14, 2013
Thomas B. Repas, DO, FACP, FACE, CDE

Echogenic foci are commonly identified on thyroid ultrasound. Some echogenic foci such as microcalcifications are associated with increased risk for malignancy, while…

Case 3 denied: Blood glucose test strips in type 1 diabetes

May 20, 2013
Thomas B. Repas, DO, FACP, FACE, CDE

Patient 3 is an elderly gentleman with type 1 diabetes. He has erratic, unpredictable glycemic control with frequent hypoglycemia and hypoglycemic unawareness. After…

Case 2 denied: Testosterone therapy in Klinefelter's syndrome

March 21, 2013
Thomas B. Repas, DO, FACP, FACE, CDE

Patient 2 is a 43-year-old-man with hypogonadism due to Klinefelter’s syndrome treated with transdermal testosterone gel. He had done well without adverse drug…

Case 1 denied: Calcitriol is a vitamin

February 20, 2013
Thomas B. Repas, DO, FACP, FACE, CDE

One of the more frustrating aspects of medical practice is fighting with insurance companies to get our patients the care they need. As preventionists, endocrinologists…

Ultrasound in hyperthyroidism

January 15, 2013
Thomas B. Repas, DO, FACP, FACE, CDE

I saw a 32-year-old man in consultation for hyperthyroidism. His thyroid-stimulating hormone was <0.01 and both free T4 and free T3 were elevated. He had…

Beware: Nutritional supplements may be contaminated with anabolic steroids

December 11, 2012
Thomas B. Repas, DO, FACP, FACE, CDE

A young man was referred to me for evaluation of low testosterone and gynecomastia. The initial total testosterone was 57 ng/dL; results of a repeat testosterone…

Gene-expression classifier: A new diagnostic test for indeterminate FNAs

November 21, 2012
Thomas B. Repas, DO, FACP, FACE, CDE

Cytologically indeterminate fine needle aspiration results are common. From 15% to 30% FNA biopsies of thyroid nodules are indeterminate or suspicious, including atypia…

Which of these patients has acromegaly?

November 2, 2012
Thomas B. Repas, DO, FACP, FACE, CDE

In this blog post, I present three cases involving patients suspected of having possible acromegaly and discuss follow up. After reading, please share your…