Case Studies in Diabetology and Endocrinology Sanjay Chatterjee, Sudip Chatterjee
INDEX
Page numbers followed by b refer to box, f refer to figure, t refer to table and fc refer to flowchart.
A
Abdomen
CT scan of 15f
ultrasonography of 18
Abscess 45
Acanthosis nigricans 28, 121f
Acetylcholinesterase inhibitor test 153
Achalasia 14
cardia 13f, 83
Acidosis, systemic 19
Addison's disease 11, 68
Adenoma, unilateral 8
Adrenal function, evaluation of 105t
Adrenal glands
bilateral 2f
normal 8f
Adrenal histoplasmosis 1
treatment of 2
Adrenal hyperplasia
bilateral 8, 9f
unilateral primary 8
Adrenal incidentaloma 4
Adrenal insufficiency 16, 138
evolving primary 14
severity of 2
Adrenal tuberculosis 16
Adrenal-dependent causes 7
Adrenocortical insufficiency 124
Alacrima 13f, 14
Alanine aminotransferase 117
Albumin 11, 30, 169
creatinine 50
low 20
normal 20
Albuminuria, absence of 37
Aldosteronism, primary 9
Alkaline phosphatase 21, 30
bone-specific 20
Alkaline urine, presence of 19
Allgrove's syndrome 14
Amenorrhea, etiology of 118
Amitriptyline 77
Amyloidosis 84
Analgesia 65
Androgen deprivation therapy 58
Angioplasty with stenting 91f
Angiotensin-converting enzyme 82
Angular cheilitis 14
Anion gap 18
Ankle foot orthosis 89f
Anorexia 11
Antibiotics, systemic 78
Anticholinesterase medications 153
Anti-glutamic acid decarboxylase 24
Antihyperglycemic agents 50
Antihypertensive medications 6
Antinuclear antibody 18
Antipsychotics 58
Antiretroviral therapy 58
Anti-thyroid peroxidase 108
Antitubercular therapy 16
Anxiety 124
Aorta, coarctation of 6
Appetite, increased 100
Arginine vasopressin 113
Arthritis 166
debilitating 136
Ascites 51
Aspartate aminotransferase 117
Asymptomatic disease 133
Atherosclerotic cardiovascular disease 48, 49
Atrial fibrillation 164, 170
paroxysmal 163
Atrophic pancreas 62
Autistic behavior 109
Autoimmune adrenal insufficiency 152
Autoimmune diabetes 29, 68
adults, late onset 29
Autoimmune disease 12, 101, 104, 124
Autoimmune hypophysitis 137
Autoimmune polyendocrine syndrome 12
Autoimmune regulator 12
Autoimmune thyroid disease 152, 153
Autonomic nervous system abnormalities 14
Azoospermia 66
persistent 66
simulates obstructive 66
B
Balloon dilatation 91, 92f
Barefoot walking, history of 94
Behavioral disorder 107
Bilirubin 11
total 30, 60
Biochemistry, baseline 60t
Biothesiometer 97f
Bleeding, regular cyclic 26
Blood
biochemistry 78
cell count 45
routine 11
sodium concentration 112
transfusions 25
Blood glucose
chart 40t
fasting 38
increase 58, 58t
less 123
level 31t
low 124
Blood pressure 11, 138
systolic 67
visit-to-visit systolic 37
Blood sugar 39, 40
high 40
Body mass index 117, 123
low 60
Body weight, changes in 101t
Brachial index 90
Breast cancer 104
Brown tumors 128, 132
C
Calcium
channel 77
supplementation 23
Cancer death, cause of 62
Capillary blood glucose reading 71t
Carbimazole 164, 165
Cardinal symptoms 11
Cardiovascular disease 49
Carpal tunnel syndrome 74, 136
Celiac disease 68
Cell-mediated immunity 16
Cellulitis 45, 65, 85
differential diagnosis of 87
mimic in diabetes 44
Central venous sinus thrombosis 110, 111
Charcot foot, diagnosis of 87
Charcot's arthropathy 87
Charcot's foot 86
Charcot's joint 84
acute 84
Charcot's neuro-osteoarthropathy 85
demonstrates 85
Charcot's osteoarthropathy 87
Charcot-Marie-Tooth disease 84
Chills 27
Cholangiopancreatography, magnetic resonance 61f
Cholesterol 50
Common bile duct, dilatation of 61f
Conductance regulator, transmembrane 66
Confusional state, acute 129
causes of 132b
Conjunctival congestion 150f
Conjunctival edema 150f
Consciousness, loss of 142
Coronary artery bypass 47
Cortical cells, hypertrophy of 16
Corticotropin 140
Cough 27
Coxsackievirus infection 71
C-peptide level, fasting 27
C-reactive protein 45, 158
Creatine phosphokinase 64
Creatinine 11, 21, 30, 100
kinase 45
Crohn's disease 101
Cryptococcosis 2
Cushing's syndrome 7
Cushingoid appearance 118
Cystic fibrosis 66
related diabetes 66
Cystinosis 22
Cytomegalovirus infection 2
D
Deep tendon reflexes 156
Deep venous thrombosis 45, 65
Deferasirox 23
Dehydration
absence of 111
severe 78
Delusional symptoms 30
Dementia care 32
Diabetes 27, 46, 135
and breast 41
and heart failure 48
and hypogonadism 26
care 32
complication of 46, 63
double 69, 71
duration of 77
family history of 68
hand syndrome, tropical 34
in adult, late onset 67
ketosis prone 29
management 28
optimize 26
risk factors of 25
systems of 68
Diabetes mellitus 25, 32, 38, 72, 84, 105
long-standing 44, 64
male hypertensive with 134
management of type 2 54, 58
type 1 25, 33, 41, 64, 68, 71, 111, 152
type 2 25, 37, 42, 44, 50, 54, 57, 69, 75, 79, 90, 96, 110, 120, 127, 129, 136
Diabetic cardiomyopathy 48
Diabetic complications 37
Diabetic foot
infection 93, 94
infection, severe 94
neuropathic 96
osteomyelitis 94
Diabetic ketoacidosis 27, 28, 28f, 132
diagnosis of 38, 78
management of 38
manifestation of 77
Diabetic kidney disease 94
Diabetic lumbosacral plexopathy 65
Diabetic mastopathy 41
diagnosis of 43t
Diabetic muscle infarction 44
Diabetic myonecrosis 44, 45
diagnosis of 44
differential diagnosis of 45t
Diabetic nephropathy, advanced 35
Diabetic neuropathy 75, 77
Diabetic peripheral neuropathy 96
Diabetic retinopathy 35
evidence of 36f
Diabetic truncal radiculoneuropathy 75
Dipeptidyl peptidase-4 49
Disability, learning 32
Distended gastric shadow 78f
Distension 78
Dizziness, symptoms of 112
Dorsalis pedis 94
Duloxetine 77
Dysglycemia, cases of 122
Dyslipidemia 170
Dysmorphic facial features 109
Dysuria 27
E
Eating disorder 33
Echogenicities 65
Ectopic adenomas 132
Edema 51
Ejaculation, premature 166
Ejection fraction 46
preserved 48, 51
regional 48
Elbow joints 134
Electrolytes 138
Electromyography, single-fiber 153
Empagliflozin 47
Endocrine 26, 132
conditions 5
emergency 78
Endocrinology consultation 138
Endoscopic fundoplication 83
End-systolic volumes 48
Eosinophilia 11
Erythrocyte sedimentation rate 23, 34, 45, 64, 70
Esophageal manometry 13
Estrogen 101
Estrogen replacement 24f
therapy 101
Euthyroidism, restoration of 150
Excisional biopsy, treatment with 43
Extraocular muscle
infiltration of 153
motility 153
Eyeballs, enlarging 100
F
Facial hirsutism 116
Factitious 124
Fanconi's syndrome 20
Fatty acid oxidation 78
Febuxostat 47
Femoral epiphyseal dysgenesis 21f
Femur, left 18f
Fever 27
low grade 78
Fibrocalculus pancreatic diabetes 60, 66
Flatbush diabetes mellitus 28
Fleshy nose 74
Fluorine-labeled fluorodeoxyglucose 125
Fluoroquinolones 123
Folic acid 23
Follicle-stimulating hormone 24, 25, 66, 100, 108, 117, 142, 143
Foot
temperature assessment 88f
ulcers, recurrent 94
Forefoot 86
Fragile X syndrome 109, 109t
Fringe nerve damage 86
Fungal infections 2
G
Gabapentin 77
Gap metabolic acidosis 78
Gastric dilatation, acute 77
causes of 79
Gastroesophageal reflux 83
Gastrointestinal blood flow 113
Gastrointestinal endoscopy 21
upper 82
Gastroparesis, severe 79
Genetic insulin resistance 25
Genu valgum deformity 21f
Gestational thyrotoxicosis 154, 155
Giant cell granuloma 127f
Gingival mass 127f
Glargine 47
Glimepiride 106
Globulin 11, 30
Glomerular filtration rate 50
estimated 49
Glomerulosclerosis 36
Glossitis 14
Glucagon-like peptide-1 receptor agonist 49
Glucocorticoid 58, 164
remediable aldosteronism 8
Glucosamine 59
Glucose
monitoring system
continuous 80
helped 79
parameters, stable 39t
values, postprandial 80
Glucosuria 20
Glutamic acid decarboxylase 28, 29
Glycemia 134
Glycemic control 63, 66, 79
deterioration of 67
poor 30t
Glycosylated hemoglobin 23, 25, 27t, 34t, 49f, 76, 80
Glycosylation end products 42
Gonadotropin 140
releasing hormone 143
Gout 85, 87
Graves’ disease 151, 154, 155, 164
diagnosis of 101, 152
Graves’ ophthalmopathy, sign of 152
Growth hormone 140
deficiency 25, 106
excessive 135
secreting pituitary macroadenoma 74
Gynecomastia 166, 167
bilateral 102f
H
Hair
on axilla, absent 102f
on body, absent 102f
on face, absent 102f
Headache 74, 142
symptoms of 112
Healing after amputation 92f
Heart failure 46, 48, 51
hospitalization for 50, 51
prevention of 52t
risk of 48
symptoms of 52t
Hematoma 65
Hematuria 5
Hemoglobin 13, 23, 34, 60
abnormal 81
case of 23
E-beta thalassemia 23, 25
Hemorrhagic infarct, subacute 110f
Hepatitis C antibodies 103
Hepatotoxicity 166
Hexosamine 59
Hip joint, X-ray of 21f
Hirsutism 121f
Histoplasma 2
Histoplasmosis 2
Hormone
adrenocorticotropic 14, 117, 142
therapy 105
Hot flashes in men 136, 137
Human chorionic gonadotropin 154
Human immunodeficiency virus 2, 117
Human leukocyte antigen 28, 29
Hungry bone syndrome 133
Hydrocortisone 10, 11
Hydroxytryptophan 125
Hyperactivity disorder, attention deficit 170
Hyperaldosteronism, primary 6
Hypercalcemia 62, 128
causes of 130b
Hyperglycemia
incidence of 58
treatment algorithm 49f
uncontrolled 134
Hyperglycemic state, unexplained 57
Hypergonadotropic hypogonadism 103
Hyperhidrosis 136
Hyperparathyroidism, primary 127
Hyperphagia, symptoms of 106
Hyperplasia, causes 148
Hyperprolactinemia 143
Hypertension 5, 9, 48, 63, 129, 136
causes 5
for secondary 5b
endocrine causes of 7b
paroxysmal 4
presence of 4
systemic 127
Hyperthyroid child 165
Hyperthyroidism 100, 101
Hypertrichosis 147f
Hypertriglyceridemia 110, 111
Hypocalcemia, biochemical 133
Hypochromic anemia, mild microcytic 20
Hypoechoic mass 42
Hypoglycemia 11, 123, 146
attack 40
cases of 125t
lower risk of 55
symptoms of 124
workup for 123, 124
Hypogonadism 106
correction of 25
Hypogonadotropic hypogonadism 25
Hypokalemia 11, 19, 20, 157
Hypokalemic paralysis 157
Hypokalemic periodic paralysis, familial 156, 156t
Hypokinesia 46
global 47f
Hyponatremia 10, 11, 113fc
epidemiology of exercise-associated 112
exercise-associated 112
management of exercise-associated 114t
prevention of exercise-associated 114
Hypoparathyroidism 26
Hypophosphatemia 20
Hypophysitis, clinical suspicion of 138
Hypopituitarism 124, 140
Hypotension 78
Hypothalamic–pituitary–gonadal axis 143f
Hypothalamo-pituitary region 147f
Hypothyroid 163
Hypothyroidism 129, 131
and infection 52
clinical stigma of 146f
primary 148
secondary 144
I
Immunofluorescent antinuclear antibody 34, 35
Infected hand, diabetic with 33
Infection, acute 27
Inflammatory cells 2f
Infrared thermometer, handheld 87
Inherited developmental disability, cause of 109
Insensate foot 87
Insulin 123, 150
action 79
infusion 78
injection 40
levels of 125
pen devices 82
regimen 28
regular 47
resistance, signs of 28
therapy, basal-bolus 24
Insulinoma 124
imaging for 124
tumors-like 124
Intellectual disability 109
Interferon-5α 58
Interleukin 113
Intramuscular injection 152
Intrathyroidal vascularity 152
Intravascular coagulation, disseminated 140
Intravascular hemolysis 140
Intravenous
fluids 69, 78
potassium 78
Irritation 85
Ischemic cardiomyopathy 48
Ischemic diabetic foot 90
Islet cell autoimmunity 29
Islet tyrosine phosphatase 2 antibodies 24, 29
Isotonic saline 114
J
Jaundice, obstructive 62
Juvenile rheumatoid arthritis 101
K
Kayser-Fleischer ring 21f
Ketoacidosis, absence of 111
Ketosis-prone diabetes, classification of 29t
Kidney
disease, chronic 49
injury in dengue, acute 71
Klebsiella pneumonia 34
Knee
joints 134
prosthesis, below 95f
Köbberling type 118
L
Lacrimal gland, absent 13f
Langerhans, islets of 71
Left ankle and foot 84
Left foot
acute charcot of 85f
swollen 87f
Left leg, deep skin ulcers on 103f
Left thumb
gangrene in 33f, 34f
ulceration in 33f
Leprosy 84
Leucocyte count, total 23, 34, 60, 158
Lid-edema 150f
Lip biopsy specimens 18f
Lipoatrophy 118
Lipodystrophy 118
acquired
generalized 118
partial 118
familial partial 115, 118
Lipoprotein
high-density 105, 106, 117
low-density 50, 105, 106
Liquid chromatography, high performance 81
Liver
dysfunction 27, 52
function test 34, 50, 105, 106
Lowe's syndrome 22
Lower jaw, brown tumor of 127
Lower limb amputations 95
Lumbar hernia 76f
Lumbar swelling, left-sided 76f
Lumpectomy 41
Luteinizing hormone 24, 25, 66, 100, 105, 108, 117, 139, 142, 143
Lymphadenopathy 15
Lymphocytic infiltration 42f, 156
Lymphocytic mastitis 41
M
Macroglossia 73, 74, 134, 135f
Macroorchidism 109
boy with 107
Macroprolactinoma 143
Male infertility, treatable cause of 142
Malnutrition 78
Mandibular mass, left 128f
McCune-Albright syndrome 108
Mental retardation 109
mild 106
Metabolic abnormalities 79
Metabolic acidosis 19, 78
Metabolic disorders 118
Metabolic syndrome 68, 104
Metatarsal heads 86
Metatarsophalangeal joints 84
Metformin 106
Methimazole 165
Microvascular dysfunction 48
Mineralocorticoid receptor 6
Monofilament test 97f
Mortality, associated 51
Mosaic Klinefelter syndrome 103
Mucous membranes 13
Muscle
abscess 65
atrophy 76f
right vastus anterior 63f
rupture 65
weakness 19, 157fc
Musculoskeletal abnormality 146
Myasthenia gravis 153
Myasthenic symptoms 153
Mycobacterium tuberculosis 16
Myonecrosis 63
Myxedema coma 158, 160, 161t
N
Narcotics 65
Nausea 78
symptoms of 112
Necrotizing fasciitis 45, 65
Neostigmine 152f
before 152f
minutes after 152f
Nephrocalcinosis 19
right-sided 18f
Nephrolithiasis 19, 132
Nephropathy 44, 55
Nerve stimulation test, repetitive 152
Neuroglycopenic symptoms 124
Neuro-osteoarthropathy 85
Neuropathic assessment 97
Neuropathic joints 84
Neuropathic osteoarthropathy 86
Neuropathic pain 77
Neuropathic ulcers 97
Neuropathy 44, 55
Neuropsychiatric symptoms 128
Neutrophil 11
Nonhealing ulcers 94
Nonsteroidal anti-inflammatory drugs 113
Nonstructural protein 1 70
Noradrenaline reuptake inhibitors 77
Normoglycemia, spite of 81
Nuclear thyroid receptor 170
O
Obesity 106
Ocular myasthenia gravis 151, 152
Oligomenorrhea 120
Ophthalmoplegia 152, 153
Oral antidiabetic agents 63, 71
Oral calcium, long-term 133
Oral hypoglycemic agents 28
Organic cardiac lesions 103
Osteitis fibrosa cystic 132
Osteomyelitis 8587
joint 84
Osteoporosis 128
Ovaries 120
P
Pancreas 123, 124
Pancreatic adenocarcinoma 60
Pancreatic beta cells 125
Pancreatic cancer, risk of 62
Pancreatic duct, course of main 61f
Pancreatic dysfunction 66
Pancreatitis 128
chronic 62
tropical calcific 62
Paraneoplastic syndromes 124
Parathyroid
adenoma 131f
dependent causes 7
Parathyroidectomy 133
right inferior 127
Parkinsonism 129
Pedal pulses, palpation of 91f
Peripheral artery disease 90, 94
Peripheral neuropathy 94, 97
Peripheral pulses 94
Peripheral vascular disease 55
Pernicious anemia 152
Pertechnetate thyroid 156
Pheochromocytoma without hypertension 3
Phosphorus 17
Pituitary 134
damage 140
dependent causes 7
dysfunction 25, 141
failure, chronic 141
gland 138f
hyperplasia
diffuse 147f
secondary 148
hypofunction 137
macroadenoma 108, 135f
mass 148
resistance 170
thyrotrophic cells 148
Plasma
aldosterone concentration 6
glucose
fasting 24, 27, 34, 64, 100, 105, 106, 110, 142
postprandial 27, 34, 64, 105, 106
osmolality 138
renin activity 6
Polyarthralgia, complaints of 134
Polycystic ovarian syndrome 115, 118, 120, 121
diagnosis of 115
Polyethylene glycol 142
Polysomnogram 107
Polyurethane-coated fiberglass 97
Post-amputation 91f
healed stump 95f
Postmenopausal ladies 17
Post-pacemaker implantation 10
Potassium 11, 13, 21, 105
Prader orchidometer beads 108
Pregabalin 77
Pregnancy hormones 155
Proinsulin 125t
Prolactin 100, 140, 148
Prolactinoma 142
effects of 143fc
Proptosis eye ball 150f
Propylthiouracil, role of 165
Protein, total 11, 30
Pseudofracture 17
Pseudomonas aeruginosa 34
Psoriasis 101
Psychiatric illnesses 31
Puberty
delayed 106
girl with delayed 23
Pulse generator 10
Pyomyositis, tropical 65
Pyuria 5
R
Radioiodine therapy 157
Red blood cells 117
Refractory rickets 20, 21
Rehydration drinks 114
Renal biopsy 37
Renal dysfunction 27
Renal failure, develop 140
Renal functions, normal 20
Renal parenchymal disease 5
Renal stones 128
Renal tubular acidosis 19
distal 17
Retinopathy 37, 44, 55
Rheumatoid joint pain 85
Rickets in children, cause of 22
Rigorous glycemic control 46
S
Salicylates 123
Salivary glands, minor 18f
Salt, pinch of 112
Schirmer's test 18
Seborrhea 134
Septic joint pain 85
Septic shock 123
Serotonin 77
Serum 78
amylase 11
bicarbonate 18
calcium 17, 132, 133
C-receptive protein 86
electrolytes 124
glutamic-oxaloacetic transaminase 23, 70
glutamic-pyruvic transaminase 23, 70,160
lipase 11
phosphate 21
potassium 18
triglyceride level, high 110
Sex hormone binding globulin 167
Shakiness 124
Short stature 14
Sinus
tachycardia 47f, 170
tract 86
Sjögren's syndrome 19
Sleep apnea
obstructive 5, 107
syndrome 136
Snake bite 140
Sodium 11, 105
supplements 114
Somatostatin analogs 58
Spastic dysarthria 21
Splenectomy 23
Sports medicine community 112
Staphylococcus aureus 34
Statin 58
postdischarge 47
Steatorrhea
in adolescence 62
in childhood 62
Steroid replacement therapy 138
Stomach, barium meal of 82f
Stress, repetitive 87
Stroke 55
Subcutaneous fat 115
reduced 116f
Subcutaneous insulin, multi-dose 47
Subtrochanteric fracture 18f
left-sided 17f
Sulfonylureas 123
Sweating 124
Symptomatic disease, treatment for 133
Syringomyelia 84
T
Tachycardia 78, 124
Temper tantrums 104, 106
Testes, localize 105
Tetracosactrin, injection 15
Thalassemia care 26
Thermoregulatory dysfunction 161
Thiazide diuretics 58
Thrombocytopenic purpura, idiopathic 101
Thrombophlebitis 65
Thyroglobulin 169
Thyroid 101, 146
autoantibodies 101
autoimmunity 101
binding globulin 154
dependent causes 7
disorder 124
treatment of 152
dysfunction 101
management of 153
function 101t
creatinine normal 27
in pregnancy 154
tests 15, 100, 156
hormone 140
replacement 148
ophthalmopathy 149
stimulating hormone 24, 101, 105, 106, 108, 117, 139, 142, 148, 159, 169
cases of 168
Thyroidectomy 157
Thyroiditis 156, 162
factitia 164
painless 156
subacute 163, 163f
Thyrotoxic periodic paralysis 156, 156t, 157f
Thyrotoxic symptoms 152
Thyrotoxicosis 155, 166
diagnosed in pregnancy, differential diagnosis of 154
in pregnancy, management of 155
Thyrotropic cells 169
Thyrotropin release hormone 148, 170
Thyroxine 140, 145, 169
binding globulin 169
dose of 11
free 24, 101
low 148
replacement 148
surreptitious intake of 164
Tibial artery, posterior 84
Toes, blackening of 90f
Total contact cast 87, 88, 89f
Transabdominal ultrasound 125
Transaminases, normal 20
Trans-sphenoidal pituitary surgery 136
Transthyretin 169
Trauma fracture, low 17
Tricyclic antidepressants, efficacies of 77
Triglycerides 105, 106
Triiodothyroacetic acid 170
Triiodothyronine, free 101
Triple A syndrome 13, 14
Truncal radiculoneuropathy 77
Tuberculosis 16
Tubular functions, derangement of 22
Turner's syndrome 100, 100f, 101
Tyrosine
kinase inhibitors 58
phosphatase 2 antibodies 28
Tyrosinemia 22
U
Ulcer 86
debridement of 97
Undescended testes, bilateral 106
Urea 11, 30
Uric acid 30
Urinary
sulfonylurea 125t
tract infections 5
Urine
anion gap 18
ketones 78
V
Vas deferens, congenital absence of both 66
Vascular dementia, diagnosis of 129
Vasculitis, risk of 166
Vein thrombosis, profound 85
Venous thromboembolism 111
Vision, blurring of 142
Visual field defects 74
Vitamin D
concentrations 17
deficiency of 22, 132
doses of 20
resistant rickets 22
Vitiligo 101, 124
Vomiting 78
W
Whipple's triad 124
Wilson's disease 2022
Wound
closure 98f
ultrasonic debridement of 92f
Wrist joints 134
X
X chromosome 101
Y
Yeast cells, small 2f
×
Chapter Notes

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