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Point Scale for Metabolic Obesity in People with Normal Body Weight (MONW)

Disorders of metabolic obesity with normal body weight (MONW) are widely recognized risk factors for the development of cardiovascular diseases and type 2 diabetes. Despite this, MONW is not diagnosed in clinical practice. Continue reading “Point Scale for Metabolic Obesity in People with Normal Body Weight (MONW)”

Diagnosis of Congenital Adrenal Hyperplasia

Congenital Adrenal Hyperplasia (CAH) is a disease of multiple hormonal imbalances. Mutations in CYP21A2 (the gene encoding 21-hydroxylase, a cytochrome P-450 enzyme) result in lack of 21-hydroxylase, which is required for the production of cortisol and aldosterone in the adrenal cortex. A deficiency of this enzyme has cascading effects. Reduced cortisol leads to overproduction of pituitary corticotropin, which stimulates the accumulation of cortisol precursors and their subsequent diversion through the steroid pathways that produce adrenal androgens. Today, the classic form is the most common cause of atypical genitalia in 46,XX newborns and of primary adrenal insufficiency during childhood. Continue reading “Diagnosis of Congenital Adrenal Hyperplasia”

Diagnostic Criteria for Familial Hypercholesterolemia (FH)

The clinical diagnosis of FH is founded on personal and family history, physical examination, and lipid concentrations. Three groups have developed clinical diagnostic tools for FH: the US MedPed Program, the Simon Broome Register Group in the United Kingdom, and the Dutch Lipid Clinic Network. Continue reading “Diagnostic Criteria for Familial Hypercholesterolemia (FH)”

Testing to Diagnose Hormone-Secreting Pituitary Tumors

Pituitary adenomas account for approximately 15% of intracranial tumors. Management of these benign tumors requires diagnosis of the specific intrasellar disease and comprehensive, multidisciplinary treatment of local mass effects and peripheral endocrinopathies. Since tumors can produce different hormones, their consequences and management vary widely. Continue reading “Testing to Diagnose Hormone-Secreting Pituitary Tumors”

Criteria to Initiate Evaluation for Growth Hormone Deficiency (GHD)

Tools for the diagnosis of GHD include auxology, radiographic assessment of bone age, measurement of insulin-like growth factor 1 (IGF-I) and IGF binding protein 3 (IGFBP-3), provocative growth hormone (GH) testing, cranial magnetic resonance imaging (MRI), and, in certain cases, genetic testing. Growth velocity and the degree of short stature are primary considerations in the decision to pursue evaluation for GHD. Continue reading “Criteria to Initiate Evaluation for Growth Hormone Deficiency (GHD)”

Diagnosis of Subclinical Hyperthyroidism

In overt hyperthyroidism, serum levels of free T4 and triiodothyronine (T3) or levels of T3 alone are elevated, and serum thyrotropin (TSH) levels are suppressed. In subclinical hyperthyroidism, levels of free T4 and T3 are normal, thyrotropin levels are suppressed, and thyroid hormone levels are usually in the middle to upper range of normal. Continue reading “Diagnosis of Subclinical Hyperthyroidism”

Summary of the ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD

The updated American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Treatment of Blood Cholesterol (GTBC) has been long-awaited since the latest update of the Adult Treatment Panel III (ATP III) guidelines in 2004. The updated GTBC recommends a significant paradigm shift in lipid-loweringdrug therapy for atherosclerotic cardiovascular disease (ASCVD) risk reduction, which has led to questions regarding their content and their implementation.
Continue reading “Summary of the ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD”

Management Guidelines for Patients with Thyroid Nodules

As defined by the American Thyroid Association’s task force on the management of thyroid nodules and differentiated thyroid cancer, a thyroid nodule is a discrete lesion within the thyroid gland that is radiologically distinct from the surrounding thyroid parenchyma.
Continue reading “Management Guidelines for Patients with Thyroid Nodules”

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