Check Study Program

Nathan, aged 27 years, comes to see you to request blood tests because he is worried there may be something affecting his progress at the gym. Despite regularly attending the gym and watching what he eats, he feels his progression is too slow. Nathan reveals that for the past three months he has taken on a ‘bulking regime’. This started after a friend mentioned he was looking ‘skinny’. Nathan has been attending the gym daily, lifting heavy weights, and is eating 4000 calories a day to support muscle growth. Despite this, Nathan feels he is not achieving any results. He reports feeling that his muscles are never big enough or defined enough and he is self-conscious about his body. To help improve his progress, he has been trying to fit in more gym workouts, sometimes making him late for work. 1. What further history would you seek from Nathan? 2. What questions would you ask Nathan to better understand his concerns and assess for any related symptoms? 3. What is your most likely diagnosis? 4. What else should you assess for with this diagnosis? 5. What are the barriers to diagnosing this condition? 6. How would you explain your diagnosis to Nathan? 7. What treatment options are available? #Week26_Case5

https://www.healthymale.org.au/mens-health/semen-analysis#:~:text=More%20resources-,What%20is%20semen%20analysis%3F,semen%20can%20change%20between%20samples.

#Male_Infertility_History

Adam (aged 31 years) and Louise (aged 33 years) have been trying to conceive for two years. Louise has undergone fertility assessment and there is no female factor identified to delay or prevent conception. They have regular intercourse and have both adopted healthpromoting behaviours to optimise pre-conception health and maximise chances of conceiving. 1. How do you approach the investigation of male fertility? 2. Why should semen analysis be conducted along with endocrine tests when suspecting male factor fertility? 3. Based on these results, what are your interpretations at this stage? 4. What are your referral pathways at this stage of your investigations? #Week26_Case4

#Klinefelter_Syndrome

Luke, aged 32 years, and Linda, aged 29 years, would like to start a family in the next 12 months. Luke is a plumber and has his own business. Linda has prompted Luke to make this appointment. Luke has not seen a doctor for several years. Luke states he is generally in good health, although he is often quite tired and wants to have more energy as he prepares to start a family in the coming year. 1. When providing consultation to a male patient, do you opportunistically ask the patient about plans for starting a family? 2. What are the key aspects of your history taking and examinations to date that warrant further exploration? 3. What genetic condition is characterised by a finding of small, firm testes in adult (post-pubertal) men? 4. What other tests are important to consider when determining the cause of androgen deficiency? 5. Can Klinefelter syndrome be passed onto offspring? 6. What are the reproductive implications for Luke in this situation? 7. What are the non-reproductive considerations in the management of Klinefelter syndrome? #Week26_Case3

Michael, aged 59 years, is a businessman. He presents with lifestyle-related health decline. He has clearly gained weight. His key concerns are that during the past three months he has been feeling more tired, and he falls asleep on the couch after dinner. He feels all he does is work and sleep, and that he is not enjoying life as much. He also advises he has lost interest in sex. Michael reports that he has learned about ‘andropause’ and the possibility of testosterone treatment to reinvigorate older men on the internet. 1. How do you support Michael to reframe expectations and manage this consultation? 2. When should an adult male genital examination be performed? 3. Why is it important to actively consider androgen deficiency? 4. Discuss any tests or specialist referrals required to confirm the diagnosis. 5. What conclusions can you draw from the blood test results, coupled with your own observations? 6. What are the key factors that indicate Michael does not have primary or secondary androgen deficiency? #Week26_Case2

#Steroid_Withdrawal

#Steroid_Abuse