Endo Flashcards
Cases of hypocalcemia ( HighPTH)
• Metabo lic: Vitamin D deficiency, chronic kidney disease
• Inflammatory : Pancreatitis, sepsis
• Onco logy: Tumor lysis syndrome
• PTH resistance : Pseudo- hypoparathyroidism
Common clinical features of untreated acromegaly
Local tumor effect
Pituitary enlargeme nt, visual field defects, headache, cranial nerve defects
Common clinical features of untreated acromegaly
Musc uloskeletal/ Skin
Gigantism, malocd uded jaw, arthralgias/arthritis , proximal myopathy, hyperhidrosis, skin tags, carpal
tunnel syndrome
Common clinical features of untreated acromegaly
Cardiovascular
Cardiomyopathy , hypertension, heart failure, valvular disease (eg, mitral & aortic regurgitation)
Common clinical features of untreated acromegaly
Pulmonary/Gastrointestinal
Sleep apnea , narcolepsy, colon polyps/cancer, diverticulosis
Common clinical features of untreated acromegaly
Enlarged organs
Tongue, thyroid, sal ivary glands , liver, spleen, kidney, prostate
Common clinical features of untreated acromegaly
Endocrine
Galactorrhea, decreased libido, diabetes mellitus, hyperparathyroidism, hypertriglyceridemia
Acromegaly causes
concentric myocardial hypertrophy,
diastolic dysfunction,
left ventricular dilation,
and global hypokinesis
Necrolytic migratory erythema
gluca gonoma
serum glucagon level >500
Features of gluca gonoma
Clinical
presentation of gluca gonoma
Weight loss
Necrolytic migratory erythema: erythematous papules that coalesce to form large, indurated plaques with central clearing
Diabetes mellitus/hyperglycemia
Gastrointestinal symptom s (eg, diarrhea, anorexia , abdominal pain)
Symptoms of Milk alkali syndrome
… Nausea, vomiting , constipation
• Polyuria , polydipsia
• Neuropsychiatric symptoms
Excessive intake of calcium & absorbable alkali
Milk-alkali syndrome
Laboratory findings
Hypercalcemia
Metabolic alkalosis
Acute kidney injury
Suppressed PTH
Destruction of bilateral adrena l cortex
Primary insufficiency
Clinical features of primary adrenal insufficiency
• More severe symptoms • Hypo
• Hyperkalemia, hyponatremia • Hyperpigmentat ion
Differential diagnosis of myopathy
Glucocorticoid-induced
Polymyalgia rheumatica
Inflammatory myopathies
Statin-induced myopathy
Hypothyroid myopathy
This patient has painless muscle weakness associated with weight gain, bone loss, hypertension, and hirsutism , which is consistent with
hypercortisolism (Cushing syndrome )
Findings due to excess estrogen include
telangiectasias, palmar erythema, testicular atrophy, and gynecomastia (usually bilateral but can be unilateral).
