BOF: 32
58 -year-old male presents with impotence. He is known to
have diabetes mellitus, which is controlled with metformin. He has had a left
hip replacement in the past. He shaves daily and there has been no change in
body hair. He does not smoke, drinks approximately 12 units of alcohol a week.
On examination he is obese with a blood pressure of
140/80 mmHg, normal secondary sexual characteristics
Investigations
Haemoglobin 14.2 g/dl
White cell counts 9.4 x109/l
Platelets 188
Sodium 140 mmol/l
Potassium 4.3 mmol/l
Urea 6.8 mmol/l
Creatinine 120 µmol/l
Alkaline phosphatase 90 iu/l
AST 40 iu/l
Gamma GT 42 (NR 10-50)
HbA1c 7.4 %
Fasting plasma glucose 7.2 mmol/l
Testosterone 6.8 nmol/l (NR 9.8 – 33) level
FSH 4.4 mU/l (NR 3-12 mU/l)
LH 5.2 (NR 3-10 mU/l)
Which of the following would you arrange to further
investigate this patient?
a)
Ferritin
b)
Testicular ultrasound
c)
Oestrogen levels
d)
Prolactin levels
e)
MRI head
