Dr Aled Rees, Consultant Endocrinologist, School of Medicine, Cardiff UniversityDr Miles Levy, Consultant Endocrinologist, University Hospitals of LeicesterDr Andrew Lansdown, Consultant Endocrinologist, University Hospital of Wales, Cardiff

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• Preface viiPart 1 Introduction 11 Introduction to endocrinology 2Part 2 Disorders of the hypothalamic–pituitary axis 52 The hypothalamic–pituitary axis and its assessment 63 Acromegaly 84 Cushing’s syndrome 105 Hypopituitarism and non-functioning pituitary adenomas 126 Prolactinoma and hyperprolactinaemia 14Part 3 Disorders of thirst and fluid balance 177 Hypernatraemia and diabetes insipidus 188 Hyponatraemia and SIADH 20Part 4 Thyroid disorders 239 Thyroid function 2410 Hyperthyroidism: clinical presentation and investigation 2611 Hyperthyroidism: management and ophthalmopathy 2812 Hyperthyroidism: special circumstances 3013 Hypothyroidism 3214 Goitre, thyroid nodules and cancer 34Part 5 Disorders of calcium homeostasis 3715 Physiology of calcium, PTH and vitamin D metabolism 3816 Hypercalcaemia 4017 Hypocalcaemia 4218 Osteoporosis 44Part 6 Disorders of the adrenal gland 4719 Steroid physiology and biochemical assessment 4820 Adrenal insufficiency 5021 Adrenocortical tumours 5222 Disorders of the adrenal medulla 54Part 7 Disorders of the reproductive system 5723 Physiology of the reproductive system 5824 Growth, puberty and sexual differentiation 6025 Menstrual disturbance 6226 Hyperandrogenism 6427 Menopause and HRT 6628 Male hypogonadism 6829 Gynaecomastia 7030 Infertility 72Part 8 Neuroendocrine tumours 7531 Neuroendocrine tumours 7632 Neuroendocrine tumours: management 7833 Inherited endocrine tumour syndromes 8034 Spontaneous hypoglycaemia 82Part 9 Endocrine emergencies 8535 Adrenal crisis 8636 Pituitary apoplexy 8837 Myxoedema coma 9038 Thyroid storm 9239 Acute hyponatraemia 9440 Severe hypercalcaemia 9641 Acute hypocalcaemia 98Part 10 Diabetes mellitus 10142 Overview 10243 Diagnosis and monitoring 10444 Classification 10645 Type 1 diabetes: aetiology and clinical presentation 10846 Type 1 diabetes: insulin and other therapies 11047 Type 2 diabetes: aetiology and clinical presentation 11248 Type 2 diabetes: treatment 11449 Macrovascular complications 11650 Microvascular complications 11851 Diabetic foot disease 12052 Diabetic ketoacidosis 12253 Hyperglycaemic hyperosmolar state 12454 Hypoglycaemia 12655 Peri-operative management 12856 Management of acute illness 13157 Insulin infusions 13458 Pregnancy and diabetes 13659 Genetics of diabetes 13860 The multidisciplinary team 14061 Lipid disorders 14262 Appetite and weight 14463 Obesity and anorexia 146Index 148

Dr Aled Rees, Consultant Endocrinologist, School of Medicine, Cardiff UniversityDr Miles Levy, Consultant Endocrinologist, University Hospitals of LeicesterDr Andrew Lansdown, Consultant Endocrinologist, University Hospital of Wales, Cardiff

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• Preface viiPart 1 Introduction 11 Introduction to endocrinology 2Part 2 Disorders of the hypothalamic–pituitary axis 52 The hypothalamic–pituitary axis and its assessment 63 Acromegaly 84 Cushing’s syndrome 105 Hypopituitarism and non-functioning pituitary adenomas 126 Prolactinoma and hyperprolactinaemia 14Part 3 Disorders of thirst and fluid balance 177 Hypernatraemia and diabetes insipidus 188 Hyponatraemia and SIADH 20Part 4 Thyroid disorders 239 Thyroid function 2410 Hyperthyroidism: clinical presentation and investigation 2611 Hyperthyroidism: management and ophthalmopathy 2812 Hyperthyroidism: special circumstances 3013 Hypothyroidism 3214 Goitre, thyroid nodules and cancer 34Part 5 Disorders of calcium homeostasis 3715 Physiology of calcium, PTH and vitamin D metabolism 3816 Hypercalcaemia 4017 Hypocalcaemia 4218 Osteoporosis 44Part 6 Disorders of the adrenal gland 4719 Steroid physiology and biochemical assessment 4820 Adrenal insufficiency 5021 Adrenocortical tumours 5222 Disorders of the adrenal medulla 54Part 7 Disorders of the reproductive system 5723 Physiology of the reproductive system 5824 Growth, puberty and sexual differentiation 6025 Menstrual disturbance 6226 Hyperandrogenism 6427 Menopause and HRT 6628 Male hypogonadism 6829 Gynaecomastia 7030 Infertility 72Part 8 Neuroendocrine tumours 7531 Neuroendocrine tumours 7632 Neuroendocrine tumours: management 7833 Inherited endocrine tumour syndromes 8034 Spontaneous hypoglycaemia 82Part 9 Endocrine emergencies 8535 Adrenal crisis 8636 Pituitary apoplexy 8837 Myxoedema coma 9038 Thyroid storm 9239 Acute hyponatraemia 9440 Severe hypercalcaemia 9641 Acute hypocalcaemia 98Part 10 Diabetes mellitus 10142 Overview 10243 Diagnosis and monitoring 10444 Classification 10645 Type 1 diabetes: aetiology and clinical presentation 10846 Type 1 diabetes: insulin and other therapies 11047 Type 2 diabetes: aetiology and clinical presentation 11248 Type 2 diabetes: treatment 11449 Macrovascular complications 11650 Microvascular complications 11851 Diabetic foot disease 12052 Diabetic ketoacidosis 12253 Hyperglycaemic hyperosmolar state 12454 Hypoglycaemia 12655 Peri-operative management 12856 Management of acute illness 13157 Insulin infusions 13458 Pregnancy and diabetes 13659 Genetics of diabetes 13860 The multidisciplinary team 14061 Lipid disorders 14262 Appetite and weight 14463 Obesity and anorexia 146Index 148

Dr Aled Rees, Consultant Endocrinologist, School of Medicine, Cardiff UniversityDr Miles Levy, Consultant Endocrinologist, University Hospitals of LeicesterDr Andrew Lansdown, Consultant Endocrinologist, University Hospital of Wales, Cardiff

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• Preface viiPart 1 Introduction 11 Introduction to endocrinology 2Part 2 Disorders of the hypothalamic–pituitary axis 52 The hypothalamic–pituitary axis and its assessment 63 Acromegaly 84 Cushing’s syndrome 105 Hypopituitarism and non-functioning pituitary adenomas 126 Prolactinoma and hyperprolactinaemia 14Part 3 Disorders of thirst and fluid balance 177 Hypernatraemia and diabetes insipidus 188 Hyponatraemia and SIADH 20Part 4 Thyroid disorders 239 Thyroid function 2410 Hyperthyroidism: clinical presentation and investigation 2611 Hyperthyroidism: management and ophthalmopathy 2812 Hyperthyroidism: special circumstances 3013 Hypothyroidism 3214 Goitre, thyroid nodules and cancer 34Part 5 Disorders of calcium homeostasis 3715 Physiology of calcium, PTH and vitamin D metabolism 3816 Hypercalcaemia 4017 Hypocalcaemia 4218 Osteoporosis 44Part 6 Disorders of the adrenal gland 4719 Steroid physiology and biochemical assessment 4820 Adrenal insufficiency 5021 Adrenocortical tumours 5222 Disorders of the adrenal medulla 54Part 7 Disorders of the reproductive system 5723 Physiology of the reproductive system 5824 Growth, puberty and sexual differentiation 6025 Menstrual disturbance 6226 Hyperandrogenism 6427 Menopause and HRT 6628 Male hypogonadism 6829 Gynaecomastia 7030 Infertility 72Part 8 Neuroendocrine tumours 7531 Neuroendocrine tumours 7632 Neuroendocrine tumours: management 7833 Inherited endocrine tumour syndromes 8034 Spontaneous hypoglycaemia 82Part 9 Endocrine emergencies 8535 Adrenal crisis 8636 Pituitary apoplexy 8837 Myxoedema coma 9038 Thyroid storm 9239 Acute hyponatraemia 9440 Severe hypercalcaemia 9641 Acute hypocalcaemia 98Part 10 Diabetes mellitus 10142 Overview 10243 Diagnosis and monitoring 10444 Classification 10645 Type 1 diabetes: aetiology and clinical presentation 10846 Type 1 diabetes: insulin and other therapies 11047 Type 2 diabetes: aetiology and clinical presentation 11248 Type 2 diabetes: treatment 11449 Macrovascular complications 11650 Microvascular complications 11851 Diabetic foot disease 12052 Diabetic ketoacidosis 12253 Hyperglycaemic hyperosmolar state 12454 Hypoglycaemia 12655 Peri-operative management 12856 Management of acute illness 13157 Insulin infusions 13458 Pregnancy and diabetes 13659 Genetics of diabetes 13860 The multidisciplinary team 14061 Lipid disorders 14262 Appetite and weight 14463 Obesity and anorexia 146Index 148