Endocrinology Consult 🍬

πŸ“‹ Key Info to Have Ready

  • Patient identifiers: full name, DoB, MRN, and location
  • Reason for admission – may be unrelated to reason for consult
  • Reason for endocrine consult and timeline – e.g. new hyperglycaemia, hyponatraemia, thyroid issue
  • Past Medical History: diabetes, adrenal disorders, thyroid disease, pituitary disease
  • Current medications: steroids, insulin, thyroxine, antithyroid drugs
  • Recent observations: BP (orthostatic?), HR, glucose trends
  • Relevant labs: HbA1c, U&E, TFTs, cortisol, calcium, osmolality
  • Endocrine-specific tests: ACTH, renin/aldosterone ratio, 9am cortisol, etc. if done

πŸ” Investigations to Know

  • HbA1c (if hyperglycaemia)
  • TSH and Free T4 (for thyroid issues)
  • Cortisol levels (e.g. 9am cortisol, Synacthen test)
  • U&E and serum osmolality (for sodium issues)
  • Urine osmolality if suspecting SIADH
  • Calcium, phosphate, PTH if electrolyte abnormality

πŸ“ž Example Script

  • Hi, this is [Your Name], the intern from [Team Name]. I'm calling to request an endocrinology consult for a [Age] year-old [M/F] patient, admitted with [reason for admission], but with an endocrine concern of [e.g. persistent hyperglycaemia, new thyrotoxicosis, severe hyponatraemia].
  • They have a background of [e.g. type 2 diabetes, hypothyroidism], and are currently [hemodynamically stable/unstable]. Their most recent labs show [relevant results], and we’re hoping for your input on [diagnosis/management/investigation].
  • Let us know if you'd prefer further tests before review.

πŸ“ Tips

  • Clarify what you're asking the endocrine team for: advice vs formal review
  • Have recent glucose or sodium trends on hand
  • Make sure to check and mention steroid use
  • Endocrinology often relies on specific time-based tests β€” check timing of cortisol, etc.