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A 16-year-old Caucasian girl presented with a 4-year history of facial hair growth, acne and secondary amenorrhoea. On examination, her body mass index was 20 kg/m2 (18C25). Her gums and palmar creases were pigmented. Facial hair was evident on her upper lip and chin, and terminal hair was evident on...

A 32-year-old man presented to the emergency department after becoming acutely unwell. He had a 5-year history of type 1 diabetes mellitus and no other significant medical history. On examination, he was apyrexial, his pulse was 120 beats per minute, his blood pressure was 96/58 mmHg and his respiratory rate...

A 64-year-old man was referred to the foot clinic. He had tripped over his cat 1 week previously and had complained of an ache in his left foot since then. He had a 12-year history of type 2 diabetes mellitus and hypertension. He was taking metformin, gliclazide, pioglitazone, bendroflumethiazide, ramipril,...

A 47-year-old nuclear physics professor was referred for advice before taking up an overseas position, overseeing the dismantling of a reactor at the site of a recent nuclear accident. She stated that she would face a small risk of being exposed to significant radioactive contamination during her work and was...

A 17-year-old boy had panhypopituitarism, including diabetes insipidus, following treatment for a craniopharyngioma. He was taking appropriate replacement therapy. In the transition clinic, he was keen to continue growth hormone replacement therapy following a 12-month break after reaching final height. Which is the most appropriate test to assess his growth...

A 16-year-old boy was referred to the endocrine clinic with symptoms of delayed puberty. On examination, he had a reduced sense of smell, small-sized testes and underdeveloped secondary sexual characteristics. Investigations: serum testosterone3.5 nmol/L (9.0C35.0) serum follicle-stimulating hormone1.0 U/L (1.0C7.0) serum luteinising hormone1.5 U/L (1.0C10.0) serum prolactin220 mU/L (<360) MR...

A 20-year-old man presented with a 6-month history of lethargy and weakness. His brother had been found to have adrenal failure at the age of 18. He had two sisters who were well and there was no other family history of endocrine autoimmune disease. On examination, his blood pressure was...

A 37-year-old woman presented with a 2-year history of increasingly frequent flushing episodes. She described alternating loose bowel motions and constipation. She had also noted menstrual irregularity. She had no respiratory symptoms. She denied headache or chest pain, but complained of palpitations. On examination, she appeared well. Her blood pressure...

A 56-year-old man attended routine follow-up for treatment of hypogonadism of late onset. His only medication was testosterone undecanoate (1 g intramuscular injection, every 12 weeks). He had started this treatment 12 months previously and last received the injection 1 week before review. Digital rectal examination was normal. Investigations (baseline):...

A 58-year-old man presented with tiredness and breathlessness. He had been treated for type 2 diabetes mellitus and hypertension for the past 10 years. He was free of complications. His current medication included ramipril 10 mg daily, rosuvastatin 10 mg daily, metformin 500 mg three times daily, dapagliflozin 10 mg...