general endocrine screen hx

Question 1

overview of subsections to consider (7)

Answer 1

1 - gi questions
2 - sexual
3 - hair and skin
4 - CNS questions
5 - water homeostasis
6 - specific PMHx
7 - specific FHx

other than that just the standard SHx and DHx

Question 2

1 - gi questions

Answer 2

changes in :
1 - appetite and weight (up +down in thyrotoxicosis / bad DM, both up in cushing’s, both down in adrenal insuff/ GI disease, weight up in hypothyroid )

2 - bowel habit (hyperthy = diarrhoea, hypothy and hypercalcaemia = constipate)

Question 3

2 - sexual qs

Answer 3

1 - menstrual and obstetric hx (amenorrhoea)

2 - impotence (vasculopathy, neuropathy, side effects of drugs)

Question 4

3 - hair and skin

Answer 4

1 - excessive sweating (hyperthyroid, phaeo, hypogly, acromegaly)

2 - change in hair distrib (hirsutism and temporal recession in women = androgen excess e.g. PCOS, cushings) (paucity in men = hypogonad) (loss of axilla and pubic hair = adrenal insuff in women, hypo pit in men)

3 - skin changes - dry and pale in hypothy. acanthosis nigricans (pigmented papillomas) = cushings, PCOS diabetes. glucocorticoid excess = stria and bruises. too much ACTH causes hyper pigmentation of creases e.g. in cushings or primary hypoadrenalism.

4 - neck lump - (goitre or nodes)

Question 5

4 - CNS questions

Answer 5

1 - lethargy - hypothy, addisons, DM but lots of others too.

2 - headache or visual changes - pituitary adenoma causing bitemporal hemianopia.

3 - mental and emotional status- many possible causes causing depression (DM, bushings, hypothy, delerium, dementia (hypothy), anxiety (hyperthy, phaeo, hypopara).

Question 6

5 - water homeostasis

Answer 6

1 - polyuria and polydipsia - DM, diabetes insipidus, hypercal. or primary polydipsia is psychogenic.

Question 7

6 - specific PMHx

Answer 7

1 - thyroid disease,
2 - HTN
3 - diabetes
4 - pituitary disease
5 - TB

the presence of one disorder increases the likelihood of another.
Tb can cause primary adrenal failure.
HTN may have an end cause.

Question 8

7 - specific FHx

Answer 8

1 - thyroid, DM, pituitary tumour, phaeo, pancreatic tumour.

familial predisposition to autoimmune endocrine disorders or to endocrine cancers.