Oncohema Key

Low PTH High PTH Others Destruction of parathyroid glands by surgery or radioactive iodine Vitamin D deficiency or resistance Hypomagnesaemia Autoimmune destruction of parathyroid glands Chronic kidney disease Drugs Irradiation…

Fig. 8.1 Pre-operative MRI pituitary. Pre-contrast T1 weighted images in the coronal (a) and sagittal (b) plain show a homogenous mass arising from the pituitary fossa and invading the left…

Fig. 2.1 Chest x-ray on admission to accident and emergency ECG: rate 50/min regular, flat T waves in III, AVF, V4–6. Urgent CT-head, no abnormality detected. Comment on Her FBC…

Fig. 14.1 Pathways of steroid metabolism. A block due to deficiency of 21-hydroxylase causes accumulation of precursors (17-hydroxyprogesterone, androstenedione, testosterone) and deficiency of glucocorticoids (cortisol) and mineralocorticoids (aldosterone) Classical 21-Hydroxylase…

Differential diagnoses Hirsutism and/or hyperandrogenaemia Oligomenorrhea or amenorrhea Distinctive characteristics Clinical features Laboratory tests Hyperprolactinaemia; prolactinoma Mild or absent Present Galactorrhoea; macroprolactinomas may cause visual disturbances headache, cranial nerve palsies…

Test, units Result Reference range TSH, mIU/l <0.02 0.27–4.2 FreeT4, pmol/l 48 12–22 FreeT3, pmol/l 12.6 3.1–6.8 TRAb, IU/l 7.2 ≤0.9 How would you manage this case? She wants to…

Features due to glucocorticoid insufficiency  Weakness  Malaise  Weight loss  Nausea and vomiting  Hypoglycaemia  Myalgia  Anaemia Features due to mineralocorticoid insufficiency  Hypotension  Dehydration  Hyponatraemia Features due to reduced adrenal androgens  Decreased…

  Serum/plasma Spot urine 24-h urine Osmolality (mOsmol/kg) 298 86 – Sodium (mmol/L) 147 16 114 Potassium (mmol/L) 4.1 3 21 Urea (mmol/L) 2.5 30 215 Creatinine (μmol/L) 58 1.9…