Sample interview questions: How do you approach the management of patients with endocrine complications of kidney transplantation?
Sample answer:
Assessment and Evaluation:
- Conduct a comprehensive medical history, including pre-transplant renal function, prior endocrine disorders, and immunosuppressive therapies.
- Perform a thorough physical examination to assess signs of endocrine dysfunction, such as thyroid enlargement, Cushingoid features, or diabetes symptoms.
- Obtain relevant laboratory investigations, including thyroid function tests, glucose metabolism tests, and adrenal function assessment.
Management of Specific Endocrine Complications:
- Hypothyroidism:
- Monitor thyroid function regularly and adjust levothyroxine dosing based on biochemical parameters.
- Consider early referral to an endocrinologist for expert management.
- Hyperthyroidism:
- Rule out thyroiditis or iodine-induced hyperthyroidism.
- Initiate appropriate antithyroid medication and monitor response closely.
- Diabetes:
- Optimize immunosuppressant therapy to mitigate diabetogenic effects.
- Implement glucose monitoring and adjust insulin or oral hypoglycemic agents accordingly.
- Consider early referral to a diabetes specialist for glucose management optimization.
- Cushing Syndrome:
- Assess for exogenous sources of corticosteroids or adrenal gland dysfunction.
- Initiate corticosteroid tapering or adrenal surgery as indicated.
- Addison’s Disease:
- Prescribe glucocorticoid replacement therapy and monitor cort… Read full answer