|
Initial |
Annual |
2 yearly |
5 yearly |
Pre-pregnancy |
| Growth/Short stature |
Height, Weight according to TS norms Record GH therapy |
Height, Weight |
|
|
Height, Weight |
| Blood Pressure |
Blood Pressure (arms and leg) Treat hypertension |
Blood Pressure (arms and leg) Monitor and treat hypertension |
|
|
Blood Pressure (arms and leg) |
| Clinical Examination |
Complete examination |
Complete examination with reference to ongoing issues/ complication screening |
|
|
Complete examination with reference to ongoing issues/ complication screening |
| Cardiac |
ECG, Echocardiogram. MRI if aortic dilation or echocardiogram not available Consider antibiotic prophylaxis Treat IHD risk factors Cardiologist review if aortic root dilatation |
ECG, Echocardiogram if previously abnormal MRI if aortic root dilatation |
|
ECG, Echocardiogram (if previously normal) |
MRI. Cardiologist review mandatory |
| Renal |
Ultrasound (if not previously performed) Creatinine clearance MSU Urinary microalbumin U&E, Creatinine Treat UTIs and hypertension Nephrologist review if abnormal |
Hb, U+E, creatinine MSU if previously abnormal |
Hb, U+E, creatinine Creatinine clearance MSU every 2 years if previously normal |
|
Hb, U+E, creatinine Creatinine clearance MSU |
| Gynaecological |
Breast examination If sexually active: Vaginal examination and Pap smear Pelvic/Vaginal Ultrasound Mammogram if 50 years or over Hormone Therapy |
Breast examination |
If sexually active: Vaginal examination and Pap smear Mammogram if 50 years or over |
|
Breast examination Pap smear Vaginal ultrasound |
| Thyroid function |
TSH/Free T4 Thyroid antibodies |
TSH Free T4 if TSH abnormal Treat hypothyroidism |
|
|
TSH, FreeT4 Thyroid antibodies |
| Hearing and ears |
Audiology |
|
|
Audiology 2 yearly Or 3-5 yearly if normal audiology initially |
|
| G-I disease |
LFTs Endomysial and transglutaminase antibodies Transdermal HT if abnormal LFTs |
LFTs Referral to hepatologist if progressive elevations in LFTs |
LFTs Endomysial and transglutaminase antibodies |
|
LFTs Endomysial and transglutaminase antibodies |
| Obesity, glucose tolerance |
Waist circumference Fasting glucose and lipids Consider oGTT Low fat diet Exercise |
Waist circumference Fasting glucose and lipids Low fat diet Exercise |
|
|
Fasting glucose oGTT as per gestational diabetes screen |
| Bones |
se Calcium, Phosphate, albumin, PTH, 25 hydroxy vitamin D Plain XR if indicated DEXA (hip, spine and total body-to assess fat mass) Calcium supplement: 1000- 1200 mg/day Vitamin D 400 IU/ day Exercise |
25 hydroxy Vitamin D |
DEXA if osteopaenia on initial examination |
DEXA if normal BMD initially |
|
| Lymphoedema Webbing |
Support stocking and physiotherapy |
|
|
|
|
| Vision (Squint, ptosis) |
Opthalmology review |
|
Opthalmology review |
|
|
| Dental |
Dental review |
Dental review |
|
|
|
| Psycho-social and education |
Assessment of overall function Referral to Support groups and psychologist Vocational guidance Education re fertility |
|
|
|
Counselling re fertility options/ risks. Referral to Fertility specialist |
