Endocrine

Question 1

Change in body weight

Answer 1

Increased appetite + weight loss = Hyperthyroidism or DM uncontrolled

Weight gain = Hypothyroidism

Increased appetite + weight gain = Cushings?

Loss of appetite + weight loss = adrenal insufficiency/GI disease

Question 2

Voice changes

Answer 2

Hoarseness - Hypothyroidism

Question 3

Change in bowel habit

Answer 3

Increased frequency/diarrhoea - Hyperthyroidism

Constipation - hypothyroid

Question 4

Energy level

Answer 4

Increased (can be decreased), muscle weakness -hyperthyroidism

Decreased, low movements, muscle weakness - hypothyroidism

Question 5

Mood changes?

Answer 5

Irritable, anxious - hyperthyroidism

Lethargic, depressed - hypothyroidism

Both show decreased concentration

Question 6

Heat tolerance

Answer 6

Prefer cool environment, wears fewer clothes - hyperthyroidism

Prefers warm environment - wears extra clothes

Question 7

Skin changes

Answer 7

Sweaty - hyper thyroïdism

Dry, flaky skin - hypothyroidism

Question 8

Hair

Answer 8

Fine hair, hair loss - hyperthyroidism

Coarse thinning hair - hypothyroid

Question 9

Nails

Answer 9

Clubbing (thyroid acropatchy); nail coming off nail bed (onycholysis) - hyperthyroidism

Brittle nails - hypothyroidism

Question 10

Heart feels

Answer 10

Palpitations, tachycardia, AF - hyperthyroidism

Bradycardia - hypothyroidism

Question 11

Periods (females)

Answer 11

Infrequent - hyperthyroidism

Heavy, prolonged, irregular - hypothyroidism

Both have fertility problems

Question 12

Any surgery to thyroid or medical Rx to hyperthyroid?

Answer 12

Also ask about onset and duration of all. Symptoms

Question 13

DHx, SHx, FHx

Answer 13

Thyroxine? Amiodarone, lithium, sulphonylurea

Smoking, alcohol, DIET - enough iodine?? - effect on ADLs and life?

FHx thyroid stuff?