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 BOF 32

 

   

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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

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