Endocrine Medical Screening Flashcards
What do endocrine and metabolic disorder symptoms often mimic?
non-MSK conditions
Signs and symptoms of endocrine system involvement:
PAIN
-moves around
-no pattern or confusing pattern
-arthralgias
-myalgias
-muscle cramps
-cold/heat intolerance
-neuropathies
-skin/hair changes
-gastrointestinal issues
-genitourinary
-psychological
Hypothyroidism vs Hyperthyroidism
Hypothyroid:
- Fatigue
– Mental fogginess
– Dry Skin/brittle nails
– Cold intolerance
– Arthralgia/myalgia
– Depression
– Weight gain/difficulty
losing weight
– Hoarseness
– Slow reflex relaxation
Hyperthyroid:
– Nervousness
– Tachycardia/Palpitations
– Fatigue
– Heat intolerance
– Weight Loss
– Diarrhea
– Proximal mm weakness
– Muscle cramping
Pituitary: general screening, non-MSK type symptoms, CVP
GENERAL SCREENING:
-poor appetite, nausea, fatigue, increased thirst, mood disturbance
-widely variable: growth delays to changes in libido
NON-MSK type symptoms
-decreased muscle mass/strength, increased body fat, OP, dizziness
CVP: hypotension
What populations are at greater risk for Type 2 diabetes?
Native Americans, Latino Americans, Native Hawaiians, Pacific Islanders
Diabetes Mellitus screening:
-polyuria
-polydipsia
-polyphagia (type 1)
-weight loss (type 1)
-fatigue and weakness
-blurred vision, infections, delayed healing
-numbness, tingling, irritability
-hyperglycemia
-glycosuria - glucose in urine
Typical symptoms with parathyroid dysfunction:
HYPO-low serum calcium
-tingling or burning (paresthesia) in the lips, fingertips, toes
-muscle aches or cramps in your legs, feet, abdomen, or face
-muscle spasms, particularly around your mouth, but also in your hands, arms, and throat
-fatigue or weakness
HYPER- elevated blood calcium (usually benign tumor causes this)
-moans, groans, stones, and bones, with psychic overtones
-chronic fatigue, lack of interest in doing things, depression, can’t concentrate, osteoporosis/osteopenia, bone pain, difficulty sleeping
What are the 4 elements of metabolic syndrome?
“insulin resistance syndrome”
-central obesity
-increased triglycerides and reduced HDL chol (good cholesterol)
-hypertension
-glucose intolerance
LIFESTYLE MODIFICATION:
-achieve and maintain a weight reduction through diet and moderate-intensity PA
T scores for osteoporosis:
– Normal = -1.0 or above standard deviations
– Osteopenia = -1.0 to 2.5 standard deviations
– Osteoporosis = -2.5 or less
– Severe osteoporosis = -2.5 or less w/ one or more fragility fractures
Disorders that can increase the risk of osteoporosis:
eating disorders
IBS/celiac disease
smoking
COPD
RA, other autoimmune connective tissue disorders (medications, inactivity)
Lupus (meds, disease)
Diabetes Mellitus
Multiple myeloma
Vitamin D deficiency
Liver diseases
Asthma (medications)
Breast CA (estrogen drop meds or surgery)
Hyperthyroidism
Education to provide pts with OP?
-rationale and specific exercise recommendations
-intake and dosage of calcium and vitamin D
-effects of smoking and alcohol use on bone health, especially for those at risk
-inform those with fragility about the risk of additional fractures
-understand general risks and benefits of medications —> refer to PCP if concerns are present
What is the Z-score for OP?
-compares bone density to the average bone density of people your own age and gender
Relative risk vs Absolute risk :
Absolute Risk: risk of developing the disease over a time period
ex: you have a 1 in 10 risk of developing a certain disease in your life
ex: FRAX (absolute risk)
Relative Risk: used to compare the risk in two different groups of people
-ex: risk of developing heart disease in smokers vs non-smokers
ex: BMD (relative risk)
When is medication recommended by the FRAX?
-when absolute risk is > 20%
–> medications that inhibit osteoclasts or stimulate osteoblasts
INHIBIT OSTEOCLASTS:
-antiresorptive meds
STIMULATE OSTEOBLASTS:
-recombinant human parathyroid hormone (can take for a max of 2 years
Forteo- can lead to spontaneous femur fractures if taken for long periods
Good impact options to improve BMD in ppl with OP:
-pickleball or tennis
-hiking
-calisthenics
-jumping rope
-jumping jacks
