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Endocrinology – topics
Hypothalamus & Pituitary Neuroendocrinology Pituitary masses and tumors Posterior pituitary disorders Thyroid Diagnostic testing for suspected thyroid disease Hyperthyroidism Hypothyroidism & Thyroiditis Nontoxic diffuse goiter Thyroid nodule Thyroid cancer Adrenal Cortex Adrenal cortex Endocrine hypertension Endocrine pancreas Type 2 diabetes mellitus Type 1 diabetes mellitus Hypoglycemia Obesity Lipid disorders Mineral Metabolism Osteoporosis Rickets & Osteomalacia Kidney stones Reproductive endocrinology Hormonal contraception Hormonal therapies Testicular disorders Pregnancy and endocrine changes Pediatric endocrinology Disorders of sexual development Growth disorders Multi-organ endocrine disorders Multiple endocrine metaplasia (MEN) HIV/AIDs – endocrine problems
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Sarcoidosis
multisystem disease characterized by non-caseating granulomas etiology is unknown Presentation Lungs: dry, non-productive cough, dyspnea, chest pain Eyes: blurry vision, conjunctivitis, eye pain, uveitis (common), iritis Skin: erythema nodosum, papules, macules, nodules, lupus pernio Heart: arrhythmias, cardiomyopathy Diagnosis diagnosis of exclusion initial labs: CBC, serum chemistry (ALT, AST, ALP, BUN, Cr, Ca, other electrolytes), urinalysis, 24 h urine excretion of calcium, CRP, ESR, tuberculin skin test imaging: CXR, ECG pulmonary function tests: spirometry, diffusion capacity of carbon monoxide (DLCO)- single breath biopsy (skin, lymph nodes or conjunctiva) of affected area, and if no suitable area is present then bronchoscopy with transbronchial biopsy. Management Corticosteroids are the mainstay therapy when required.…
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Hypercalcemia
Normal Ca in mg/dL: 8.4 – 10.2 (lab value from nbme.org) Normal Ca in mmol/L: 2.18 – 2.58 (lab value from mcc.ca) Sample Case: A 40 year old man arrives in the clinic complaining of polyuria, constipation and malaise. He has normal vital signs and no significant findings on physical exam. On laboratory testing, his serum calcium is elevated at 11 mg/dL (2.74 mmol/L). What is the best next step in management? First, you need to recognize that he has hypercalcemia. The most common cause of hypercalcemia in patients arriving in the clinic is primary hyperparathyroidism. To diagnose hyperparathyroidism, you first need to get the parathyroid hormone (PTH) level. Remember,…
