Endocrinology Consult 🍬
Guide for endocrinology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 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
🔍 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
📞 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.
📝 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 — check timing of cortisol, etc.