endocrine Flashcards
general metabolic symptoms
Lethargy
Poor appetite
Vomiting
Jaundice
Underdevelopment (size, weight)
Weight loss
Seizures
Coma
Odour changes to breath, sweat, saliva
Cushings syndrome signs and symptoms
symptoms result from high levels of cortisol
Moon face
buffalo hump
muscle wasting
stretch marks
weight gain
easy bruising
skin and bone thinning
low libido
menstrual changes
hirsutism
Addisons disease signs and symptoms
bronzing of the skin
changes in body hair distribution
gi disturbances
weakness
hypoglycemia
postural hypertension
weight loss
adrenal crisis:
profound fatigue
dehydration
vascular collapse low bp
lower serum Na
increased serum K
Hyperparathyroidism signs and symptoms
70-80% asymptomatic (primary)
Physical examination may be normal
Symptom severity varies with developmental rapidity, and level of hypercalcaemia
stones, bones, abdominal moans, and psychic groans
loss of appetite
nausea
vomiting
constipation
muscle weakness
aches and pains in bones and joints
fatigue depression confusion
renal stones increase thirst increased urination
(Typically)
Tachycardia
tremor
hyperreflexia
anxiety
irritability
emotional liability
panic attacks
Heat intolerance
sweating
increased appetite yet weight loss
Grave’s disease signs and symptoms
Opthalmopathy signs
Blurred vision, photophobia, lacrimation, double vision, deep orbital pressure
Periosteal new bone formation may mimic finger clubbing (as well as in other skeletal areas)
Pretibial myxoedema (immune related deposition of mucopolysaccharides in pretibial skin)
Hypothyroidism signs and symptoms
Usually
Fatigue, lethargy, weakness, constipation, weight gain, cold intolerance, muscle weakness, slow speech, poor memory
Skin is dry, coarse and thick, with non-pitting oedema in the eyelids and hands (myxoedema)
Hair: brittle and coarse, loss of outer 3rd of eyebrows
Facies: dulled expression, slowed speach
Palpable thyroid gland (depends on cause)
Bradycardia
Delayed relaxation phase of reflexes, cerebellar ataxia, hearing impairment, poor memory, dementia, peripheral neuropathy and paresthesia
MSK: carpal tunnel, stiffness, weakness
“Slow in thought, speech and deed”
Paget’s Disease sings and symptoms
Physical presentation
Many lesions are asymptomatic
Skeletal Px (M/C hip and pelvis)
Leg bowing, pathological Fx
Increased heat of extremity
Skull and vertebral enlargement
Neurological impairment, vision, hearing loss, radicular Px and cord compression
Secondary OA due to e.g. abnormal loading
Heart failure (compression, shunting) – rarely seen, only in severe cases
Diabetes Mellitus signs and symptoms
slow wound healing
constant hunger
frequent urination
blurred vision
fungal infection and itchy skin
unexplained weight loss
numbness of the hands and feet
Clinical presentation
May be normal in early stages
Symptoms of hyperglycaemia
Polyuria, thirst, blurred vision
Diabetic retinopathy
Non-proliferative
Proliferative
Cataracts
Glaucoma
Peripheral neuropathy
Mononeuropathies involving CN III, IV and V, as well as intercostal and femoral nerves, are common
Neuropathy – physical exam
Decreased pinprick, light sensation and pain sensations
Decreased vibration sense
Loss of proprioception
Motor disturbances
Decreased reflexes, weakness, atrophy
Unable to pick up objects, turn page in a book – affects ability to self care
Neuropathy – physical exam
Decreased pinprick, light sensation and pain sensations
Decreased vibration sense
Loss of proprioception
Motor disturbances
Decreased reflexes, weakness, atrophy
Unable to pick up objects, turn page in a book – affects ability to self care
Nephropathy
Pedal oedema
Pallor
Weakness
Foot ulcers
Arthropathy (Charcot’s joints)
Bone/joint deformity d/t repeated traumas (2o to neuropathy)
Diabetes Insipidus signs and symptoms
Excessive thirst: People with diabetes insipidus often have an intense and unquenchable thirst.
Increased urine output: The condition causes the body to produce large amounts of urine, often up to several liters per day.
Diluted urine: The urine produced in diabetes insipidus is often very pale and diluted due to the body’s inability to concentrate urine.
Dehydration: Despite the increased thirst, people with diabetes insipidus may still become dehydrated due to the large amount of water lost in their urine.
Dry skin and mucous membranes: The condition can cause dryness of the skin, mouth, and eyes due to dehydration.
Fatigue and weakness: Dehydration can also lead to fatigue and weakness.
Headaches: Some people with diabetes insipidus may experience headaches, particularly if they become dehydrated.
Irritability and confusion: Dehydration and electrolyte imbalances caused by diabetes insipidus can sometimes lead to irritability and confusion.
Leads to polydipsia and polyuria
Can also be caused by lithium (used to treat bipolar) and other nephrogenic causes
Gian cell (Granulomatous) arteritis signs and symptoms
jaw px fatigue or discomfort during chewing or speaking
pain relief on discontinuation of jaw movement
sever temporal head aches
scalp tenderness
unexplained fever
visual impairment
Headache
Tenderness of scalp
Polymyalgia syndrome
Visual disturbance
Intermittent claudication of jaw and tongue on mastication
Tender vessels
Rheumatoid Arthritis signs and symptoms
Early morning stiffness lasting more than 30 minutes
Insidious onset (often what distinguishes inflammatory from mechanical)
Pain improves with exercise but not at rest
SI joint pain usually presenting as tenderness over alternating buttocks
Night pain
Back pain lasting more than 3 months, which can be intermittent
Sjogren’s Syndrome signs and symptoms
Dry mouth and lips
Erythema of the tongue and mucosa
Dry eyes, conjunctivitis and irregularity of the corneal light reflex
Salivary gland enlargement and dysfunction
Difficulty chewing and swallowing
Associated conditions (RA, SLE)
Juvenile Idiopathic Arthritis (JIA) signs and symptoms
Signs & Symptoms
Arthritis present for at least 6 weeks – mandatory for the diagnosis of JVA / JIA.
Insidious or abrupt onset
Morning stiffness
Arthralgia during the day
Child complains of joint pain, or uses joints abnormally
History of school absence and / or not wanting to participate in PE
Fevers which occurs 1-2x a day at roughly the same time
May have psoriasis or a subtle dermatological manifestation
Psoriatic Arthritis signs and symptoms
1 in 5 patients with psoriasis have psoriatic arthritis
Findings on exam:
Enthesopathy or enthesitis – Achilles & plantar Fascia
Dactylitis
Skin lesions – scaly silvery plaques
Nail Lesions – Beau’s lines, leukonychia, onycholosis, subungual hyperkeratinosis etc.
Synovitis
Gout signs and symptoms
Presentation
“Gouty attacks”
80% initially monoarticular
Over long periods, become polyarticular
Intense pain over affects joint
Initial attacks 1st metatarsophalangeal joint (podagra)
May be accompanied by fever, chills & malaise.
Long term gout – uncontrolled hyperuricemia (chronic arthritis & tophi)
