A 47-year-old man is evaluated in endocrine clinic for fatigue, decrease libido. Medical history: HTN and Dyslipidemia. On indapamide and atorvastatin. On examination: vital sign normal, normal axillary and pubic hair. Normal testicular examination and no gynecomastia. Blood work up collected at 3 PM revealed total testosterone (TT) 8 nmoVL (9.9 - 25), LH 5 (3 - 8), FSH 7 (5 -10). What is the next step?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Send AM blood for prolactin and TT levels
Testosterone for diagnosing hypogonadism must be measured in a morning sample (8–10 am) because it varies through the day. A 3 PM level that is only slightly low cannot confirm hypogonadism. So repeat a morning total testosterone, together with prolactin, before doing anything else. Starting testosterone (A) or ordering an MRI (C) on an invalid afternoon sample is premature. Iron studies (B) are not the next step without a confirmed low level.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Low testosterone has to be shown on a serum sample collected between 8 and 10 am; this 3 PM level does not confirm hypogonadism, so replacement is premature.
✓ Pituitary disorder.pdf · p. 4 -
C
ليش غلط
Pituitary MRI is the imaging study if a pituitary hormone deficiency is identified; here the low testosterone has not been confirmed on a morning sample.
✓ Pituitary disorder.pdf · p. 4 -
D
ليش صح
Testosterone is diagnostic only in a serum sample collected between 8 and 10 am; his level was drawn at 3 PM, so a morning repeat is needed first.
✓ Pituitary disorder.pdf · p. 4
- المصدر
- Pituitary disorder.pdf · p. 4
- المحاضرة
- Pituitary Disorders · Endocrinology · Module B
- ظهر في
- MED43 ♂ Quiz B