Nutrient Biomarker(s) Symptoms of deficiency Vitamin A Visual impairment reduced night vision Vitamin B1 Wernicke encephalopathy Nystagmus, ataxia Ophthalmoplegia Peripheral neuropathy Vitamin B12 Serum vitamin B12 Anaemia Peripheral neuropathy…
Fig. 23.1 Edmonton obesity staging system (Reprinted by permission from Macmillan Publishers Ltd.: Sharma and Kushner [27] copyright 2009) What are the main points that should be considered when taking…
Test Number of abnormal values Threshold (equal or greater than) in mmol/L Organisation 0 h 1 h 2 h 3 h 50 g OGCT 1 – 7.2 – – CC,…
Fig. 20.1 Family pedigree What is your diagnosis now? Evidence now suggested that Jennifer did not have type 1 diabetes. We then considered whether she had evidence for type 2…
Results Normal range 24 h urinary free cortisol 564 nmol/day (vol 1.62 L) <147 nmol/day 24 h urinary free cortisol 489 nmol/day (vol 1.93 L) <147 nmol/day 1 mg…
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…
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…
Ovulatory disorders Hypothalamic/pituitary failure Hypothalamic/pituitary dysfunction Ovarian failure Tubal damage Previous pelvic/abdominal surgery Past peritonitis Past Pelvic infections Endometriosis Congenital abnormalities Uterine or peritoneal disorders Fibroids Endometrial polyps Endometriosis Modifiable…
MEN 2A MEN 2B MTC (100 %) MTC (100 %) Phaeochromocytoma (50 %) Phaeochromocytoma (50 %) Parathyroid adenoma (25 %) Mucosal neuromas: tongue/lips (95 %) Typical facies: swollen lips/thick eyelids…
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…
