Sample interview questions: How do you approach the management of patients with endocrine complications of lung disease?
Sample answer:
Assessment
- Detailed history: Inquire about symptoms of endocrine dysfunction, including fatigue, weight changes, polyuria, or menstrual irregularities.
- Physical examination: Assess for signs of Cushing’s syndrome, thyroid enlargement, or gynecomastia.
- Laboratory evaluation:
- Thyroid function tests
- Cortisol levels
- Adrenal function tests
- Bone mineral density scan
- Imaging studies:
- Chest X-ray or CT scan to exclude pulmonary masses or infiltrates
- Ultrasound or MRI to visualize adrenal or thyroid glands
Management
- Thyroid Dysfunction:
- Hypothyroidism: Monitor TSH levels and treat with thyroid hormone replacement therapy.
- Hyperthyroidism: Refer to an endocrinologist for evaluation and treatment.
- Cushing’s Syndrome:
- Identify the underlying cause (e.g., ectopic ACTH production, adrenal tumors)
- Medical management with metyrapone or ketoconazole
- Surgical resection of adrenal tumors
- Adrenal Insufficiency:
- Hydrocortisone replacement therapy
- Educate patients about stress-dosing and salt intake
- Osteoporosis:
- Calcium and vitami… Read full answer