Endocrine HPI/PE Flashcards
What is adrenarche?
Onset of androgen-dependent body changes such as growth of axillary and pubic hair, body, body odor, and acne
What is acral?
Pertaining to peripheral body parts such of fingers and toes
What is Acrochordon?
Skin tags
What is acanthosis nigricans?
- Common skin pigmentation
- thick velvety texture
- patches appear on armpits, groin, neck, elbow, knees, knuckles, or skin fold
What is acanthosis nigricans related to?
- Insulin resistance (elevated insulin states)
- Obesity
- Acromegaly
What age is considered amenorrhea? and how many missed periods qualifies a pt for amenorrhea?
- Girls who haven’t begun menstruation by age 15
- At least 3 missed periods
What are the causes for amenorrhea?
- Pregnancy
- inability to regulate hormones
What is exopthalmosis?
- Prominence of the eyes secondary to thyroid disease
- Hyperthyroidism (Graves dz)
What is proptosis?
- Abnormal protrusion or displacement of an eye or other body parts due to all other causes
What is hirsutism? and what is it caused by?
- Male pattern hair growth in women, on face chest and back
- Caused by: excess male hormones called androgens, primarily testosterone
When is menarche?
Onset of menstruation
What is precocious puberty? and what are the ages for girls and boys?
Early onset of puberty
- 8 in girls
- 9 in boys
What is pubarche?
Appearance of sexual hair
What is puberty?
Developmental stages during which secondary sexual characteristics appear
What is Thelarche?
Onset of female breast development
What is virilization?
- Biological development of sex differences
- Changes that make a male body diff from female body
- These changes are produced by androgens
What is the challenge when completing an HPI for an endocrine problem?
- a pt may harbor more than one endocrinopathy which could be overlooked if subtle historical and clinical cues are over looked
- don’t be in a hurry w/ your hx
What does male development require?
Normal function of hypothalamic - testicular axis.
Amenorrhea is an important clue in the breakdown of what?
Hypothalamic - pituitary - ovarian axis
What is the diagnosis of too much growth hormones in an adult pt?
Acromegaly
Amenorrhea + galactorrhea w/ elevated prolactin levels suggest what?
Pituitary tumor
What are the steps of HPI?
- Hx
- PE
- Labs
- radiologic imaging
What are complaints of an older pt with hyperthyroidism?
- Fatigue
- weight loss
- constipation
What are complaints of an younger pt with hyperthyroidism?
- Overactivity
- Nervousness
- Jitteriness
- Temperature intolerance
What are sxs of hypothyroidism?
- Depression
- Fatigue
- Mild weight gain or difficulty loosing weight
What would indicate thyroiditis?
Recent viral illness presenting w/ trouble swallowing and tender thyroid
A female pt presenting with recurrent vaginal candidiasis or pt with recurrent UTI should be evaluated for what?
Diabetic evolution/work-up
Describe the onset of type 2 DM?
Gradually slower onset of sxs
What is the onset of type 1 DM and sxs?
Acute onset
- blurred vision
- Frequent infections
- Non-healing ulcers
- Numb or painful extremities
What are alimentary changes?
Changes to nutrition, digestion and absorption
Weight loss is d/t what?
- Thyrotoxicosis
- DM
Weight gain is d/t what?
- Cushings
- Hypothalamic dz
Appetite loss is d/t what?
Addisons
Appetite increase is d/t what?
Thyrotoxicosis
Diarrhea is d/t what?
- Hyperthyroidism
- Addisons
Constipation is d/t what?
- Hyperthyroidism
- Hypercalcemia
Polydipsia is d/t what?
- DM
- Renal dz
- Hypercalcemia
Pigmentation changes are d/t what?
- Hypopituitarism
- Cushings
- Addisons
Dryness is d/t what?
- Hypothyroidism
- Hypoparathyroidism
Sweating is d/t what?
- Hyperthyroidism
- Pheochromocytoma
- Acromegaly
Overgrowth is d/t what?
Acromegaly
Nervousness, irritability is d/t what?
Thyrotoxicosis
Fatigue is d/t what?
- Hypothyroid
- DM
- Addison’s
- Acromegaly
HA is d/t what?
Hypoglycemia
Seizures is d/t what?
Hypoglycemia
Visual loss is d/t what?
- Acromegaly
- DM
What are some causes of Rheumatoid changes?
- Short stature or Gigantism
- Marfans
- Kleinfelters
- Acromegaly
What is polyuria d/t?
- DM
- DI
- Polydipsia
What is menstrual changes d/t?
- Polycystic ovary
- Pituitary dz
What is impotence d/t?
- Hyperprolactinemia
- Hypogonadism
- Acromegaly
What drug hx should be asked for endocrine HPI?
- Hormone Replacement Therapy (HRT)
- Thyroid drugs.
- Diabetic drugs.
- Prostate dz drugs.
- Steroids.
Penguinoid habitus is associated with what?
Klinefelters
Tremors or Palmer erythema is a sign of what?
Hyperthyroid
Pigmentation of palmar crease is a sign of what?
Addison’s
4th, 5th metacarpals shortened is a sign of what?
Pseudohypoparathryoid
Decreased quantities of hair, perioral and periorbital wrinkling is a sign of what
Hypogonadism.
Females with excessive hair, acne, male-pattern balding, central scalp hair loss is a sign of what?
Androgen excess.
Hypertension is a sign of what?
Cushing’s
Hypotension is a sign of what?
Addisons
A positive Trousseau’s and / or Chvostek’s sign is sign of what?
- Hypocalcemia
- Hyperparathyroidism (elevated secretion of parathyroid hormone PTH)
Muscle weakness is a sign of what?
- Hypothyroid
- Cushing‘s
Axillary hair loss is a sign of what?
Hypopituitary
Skin tags are a sign of what?
Acromegaly
Moon face, Acne, oily skin is a sign of what?
Cushings
Hirsutism on face is a sign of what?
Panhypopituitary
Chin enlargement is a sign of what?
Acromegaly
Exophthalmos is a sign of what?
Hyperthyroidism
Occular fundus findings: cotton wool spots is a sign of what?
- DM
- Acromegaly
Buccal pigmentation is a sign of what?
Addisons
Tongue enlargement is a sign of what?
Acromegaly
A “buffalo hump”, palpate supraclavicular fat pads, striae, disproportionate abdominal fat is a sign of what?
Cushings
When doing a PE of the thyroid you are inspecting for what?
A Goiter
Pigmented nipples is a sign of what?
Addisons
Loss, gain of chest hair is a sign of what?
Hypogonadism
Male gynecomastia is a sign of what?
Cushings
Reduced female breast size is a sign of what?
Panhypopituitary
During PE you inspect the genitalia for what?
- Atrophy
- Virilization
During PE you inspect the legs for what?
- Peripheral neuropathy (DM).
- Dry and brittle nails
- Toenails and foot showing same symptoms asfingernails and hands.