Endocrinology Rotation Educational Objectives
The educational goals of the Endocrine Elective are for house
officers to develop the ability to independently evaluate, treat
and monitor common endocrine disorders (diabetes, thyroid
dysfunction, lipid abnormalities, metabolic bone disease, and
calcium disorders) and to be familiar enough with the less common
endocrinopathies (adrenal disease, pituitary disease and gonadal
dysfunction) to recognize the abnormality and initiate evaluation
prior to sub-specialty consultation.
- Diabetes mellitus. Differences between Type 1 and
Type 2 diabetes. Natural course of diabetes and its complications.
Appropriate monitoring methodologies to include home glucose
monitoring, glycated proteins and urine protein excretion. Dietary
management and pharmacological therapy to include intensive insulin
programs, non-insulin injectables, oral hypoglycemic medications,. Patient
recommendations for "sick days" and treatment of hypoglycemia.
Management of commonly associated disorders (hyperlipidemia and
hypertension) and their interaction with diabetes management
Appropriate and timely referrals to ophthalmology, podiatry,
dietary and the diabetes education program.
- Thyroid disease. Diagnostic evaluation and
management of the functional thyroid disorders (hypothyroidism and
hyperthyroidism). Treatment options for hypothyroidism and hyperthyroidism.
Evaluation of anatomic thyroid abnormalities (simple goiter, multinodular
goiter and solitary thyroid nodule) to include use of nuclear
medicine procedures, ultrasound studies and fine needle aspiration.
Evaluation of thyroid function tests in the intensive care
- Lipid disorders. NCEP guidelines. Secondary
hyperlipidemia, dietary and pharmalcologic management of
- Metabolic bone diseases. Diagnostic evaluation and
treatment options of osteoporosis and osteopenia. Risk factors for osteoporosis.
The use of bone densitometry. Osteomalacia, Paget's disease.
- Calcium disorders. Diagnosis and management of
hypercalcemia and hypocalcemia. Management of
hyperparathyroidism (medical vs. surgical). Management of critical
hypocalcemia and hypercalcemia. Diagnosis and management of vitamin
- Adrenal disease. Diagnosis and management of
Cushing's syndromes, adrenal failure and pheochromocytoma.
Diagnosis and management of adrenal emergencies (adrenal or
pheochromocytoma crisis). Evaluations of the incidental adrenal
- Pituitary disease. Diagnostic evaluation of
pituitary tumors to include the incidental pituitary mass. The role
of surgery, radiation therapy and medical management. Diagnosis and
management of pituitary apoplexy. Empty sella syndrome. Diagnosis
and evaluation of posterior pituitary dysfunction such as central DI and SIADH
- Gonadal Dysfunction. Diagnostic evaluation of
gynecomastia, hirsutism, amenorrhea and impotence. Androgen and
estrogen replacement therapy.