...The cases detailed in this chapter are based on real-life patients and are intended to provide the clinician with important presentations and clinical points which may occur in ...
More ...The cases detailed in this chapter are based on real-life patients and are intended to provide the clinician with important presentations and clinical points which may occur in day-to-day practice.To simplify the presentations, the cases are given in the same format. Only positive clinical history, examination findings, and relevant investigations are given.Abbreviations are used for conciseness and are as follows: PMH=past medical history; DH=drug history; O/E=on examination; WC=waist circumference; TT=total testosterone; SHBG=sex hormone-binding globulin; cFT=calculated free testosterone (Vermuelen’s equation); FBC=full blood count; BMD=bone mineral density; CRP=C-reactive protein; CAD=coronary artery disease; IHD=ischaemic heart disease; CABG=coronary artery bypass graft; MI=myocardial infarction; NSTEMI=non-ST-elevation myocardial infarction; PCI=percutaneous coronary intervention. GTN=glyceryl trinitrate; CVA=cerebrovascular accident; BPH=benign prostatic hypertrophy; DRE=digital rectal examination; LOH=late-onset hypogonadism; AMS=Aging Males’ Symptoms score; PRL=prolactin; TRT=testosterone replacement therapy; COPD=chronic obstructive pulmonary disease; MSU=midstream urine.Normal ranges are: TT 8.4–28.7 nmol/l; SHBG 17–66 nmol/l; cFT >220 pmol/l; LH 2–10 iu/l; FSH 2–10 iu/l; IGF1 103–310 mcg/l; PRL 30–600 miu/l; TSH 0.38–5.5 miu/l; fT4 10.1–18.7 pmol/l; E2 <160 pmol/l; PSA 0–4 mcg/l.WC >94 cm is one of the criteria for the metabolic syndrome. HbA1c > 48 mmol/mol (6.5%) indicates less-than-ideal diabetes control.
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