BookRajesh K. Garg, James V. Hennessey, Alan Ona Malabanan, Jeffrey R. Garber, editors.
Summary: A user-friendly, pocket-sized reference for all physicians faced with endocrine care and challenges in hospitalized patients, this handbook covers the most common issues leading to an inpatient endocrine consult, providing differential diagnoses, a reasonable and practical approach to investigating and managing the condition, and advice for follow-up. Conditions discussed include thyrotoxicosis and thyroid storm, calcium disorders, osteoporosis, Cushing's syndrome, pheochromocytoma and paraganglioma, primary hyperaldosteronism, hypoglycemia in diabetic and non-diabetic patients, and endocrine issues during pregnancy, among others. Suggestions for further reading are included, providing more context for well-established clinical approaches. Written by experts with years of experience providing endocrinology consultations in a hospital setting, Handbook of Inpatient Endocrinology is a valuable, high-yield resource for endocrine residents and fellows, but it will be equally useful for any busy hospitalist or primary care physician when endocrinology consults are not available.
Contents:
Intro
Preface
Contents
Contributors
1: Pituitary Apoplexy
Definition
Precipitating Factors/Patients at Risk
Diagnosis
Obtain Detailed Clinical History
Perform Detailed Physical Exam Including Cranial Nerves and Visual Fields
Evaluation of Endocrine Dysfunction/Laboratory Assessment
Imaging
Management
Consider Initiation of Corticosteroid Treatment
Acute Intervention: Surgery vs. Conservative Treatment
Postoperative Care
Monitor for Signs and Laboratory Abnormalities Suggestive of Diabetes Insipidus (DI)
Assess Pituitary Reserve Visual Assessment
Follow-Up After Discharge
Check Electrolytes After 1 Week
Reassess Pituitary Function After 4 to 8 Weeks
Suggested Reading
2: Panhypopituitarism
Definition and Significance
Identify Causes of Hypopituitarism
Mass Lesions
Traumatic Brain Injury
Medications
Hypophysitis
Systemic Diseases
Genetic Causes
Vascular
Diagnosis of Hypopituitarism in the Hospital
Assess Anterior Pituitary Function
Adrenal Axis
Thyroid Axis
Other Axes
Assess Posterior Pituitary Function
Imaging
Management of Hypopituitarism in the Hospital Management of Hypopituitarism at the Time of Discharge
Suggested Reading
3: Postoperative Management After Pituitary Surgery
Assess Hormone Status Before Surgery if Possible
Intraoperative/Postoperative Steroids
Patient with Unknown Adrenal Function Prior to Surgery
Patients Known to Have Preexisting Adrenal Insufficiency
Patients Known to Have Normal Adrenal Function Preoperatively and Patients with Cushing's Disease
Diabetes Insipidus/Sodium Management
Arrange Endocrine Follow-Up Within 1-2 Weeks of Discharge
Suggested Reading 4: Severe Thyrotoxicosis and Thyroid Storm
Performing the History for Thyrotoxicosis
Assess Symptoms of Thyrotoxicosis
Assess for the Etiology of Thyrotoxicosis
Assess for Medications That Affect Thyroid Status
Performing the Physical Exam for Thyrotoxicosis
Key Findings in Thyrotoxicosis
Specific Exam Findings in Different Causes of Thyrotoxicosis
Assessing for Thyroid Storm
Making a Diagnosis of Thyroid Storm
Obtain Thyroid Function Tests
Biochemical Findings in Thyrotoxicosis
Obtain Testing to Identify Underlying Illnesses