Hatch - HPI Flashcards
Vocab term for:
Onset of androgen-dependent body changes such as growth of axillary and pubic hair, body odor, and acne.
Adrenarche
Vocab term for: Pertaining toperipheralbody parts, such as toes and fingers
acral
Vocab term for: skin tag.
Common in geriatrics. If seen in younger, consider Cushing’s.
acrochordon
Vocab term for: Abnormal growth of the hands, feet, and face.
Overproduction of Growth Hormone (GH)
Acromegaly
Acanthosis nigricans is related to: (2)
Insulin resistance (elevated insulin states) Obesity (usually associated with Cushing's)
Acanthosis nigricans is present where on the body?
Most notable sign is dark patches of skin with a thick, velvety texture.
Patches may appear on the armpits, groin, neck, elbows, knees, knuckles, or skin folds.
Lips, palms, and soles of the feet may also be affected.
Women who have missed at least three menstrual periods in a row have _____.
amenorrhea
MCC of amenorrhea
pregnancy
Other causes of amenorrhea
inability to regulate hormones
Girls who haven’t begun menstruation by age 15, have ____.
amenorrhea
Discharge of milk-like substance from the breast.
Not associated with breastfeeding after pregnancy.
Galactorrhea
Term reserved for describing prominence of eyes secondary to thyroid disease
Exophthalmosis
Hyperthyroidism (Grave’s Dz) eye condition term
VERY common in females
Exophthalmosis
Abnormal protrusion of the eyeball or eyeballs
Exophthalmosis
Abnormal protrusion or displacement of an eye or other body part due to all other causes
Proptosis
Condition of male-pattern hair growth in women.
Hirsutism
Results in excessive amounts of stiff and pigmented hair on body areas where men typically grow hair —
face, chest and back.
Hirsutism
Abnormal hair growth that often is caused from excess male hormones called androgens, primarily testosterone.
Hirsutism
Onset of menstruation.
menarche
Onset of puberty at an abnormally early age
Usually before the age of:
8 in girls
9 in boys.
Precocious puberty
Appearance of sexual hair.
Pubarche
Developmental stage during which secondary sexual characteristics appear.
Puberty
irregular areas of skin that look like bands, stripes, or lines.
A result of rapid growth or weight gain.
Striae
Onset of female breast development.
Thelarche
Biological development of sex differences
Virilization
Changes that make a male body different from a female body.
Virilization
________ changesare produced by androgens.
Virilization
Hashimoto’s thydoiditis puts a patient at greater risk for development of…
other endocrine disorders such as adrenal, testicular, or ovarian failure
Bottom line of endocrine HPI:
may harbor more than one endocrinopathy, so don’t overlook the the history and physical exam
Hypogonadal male has a _____ voice
high pitched
androgenized female may have a ____ voice than expected
deeper
Amenorrhea + galactorrhea + elevated prolactin =
pituitary tumor
Amenorrhea + galactorrhea =
generally benign etiology –> consider the prolactin though!
when evaluating the endocrine system of the pituitary gland through HPI, consider..
the hormones secreted by the pituitary gland
pt presents with red cheeks, moon face, and hirsutism… you think…
What are those s/sx’s?
Cushing’s from high levels of cortisol
Next think: adrenal glands or pituitary?
S/Sx’s: Hypertension, increased weight gain, facial flushing from vascular problems, distribution of fat around face/neck, decreased energy
If male presents with normal body habitus, hx of normal erections, adequate libido, you can assume…
you can exclude hypogonadism
Male presents with a full beard, fathered children, you can know that the patient does not have…
a primary hypogonadal process
Patient presents with amenorrhea, you need to ask about what four things?
- thelarche (breast development)
- pubarche (onset of sexual hair)
- adrenarche (onset of body changes)
- menarche (onset of menses)
When considering acromegaly, also check the size of…
also compare what?
tight fitting rings
increased hat size
increased shoe size
compare old versus new photographs
Recent viral illness presenting with trouble swallowing and tender thyroid means…
thyroiditis
Sx of:
over activity, nervousness, jitteriness, and temp. intolerances
suggests what in the younger patients
hyperthryoidism
Sx of:
depression, fatigue, mild weight gain, or difficulty loosing weight
suggests what in the younger patients
hypothyroidism
Increased thirst, increased urination, noctural frequency, weight loss or increased appetite
DB!
What type of DB has a more acute presentation and has blurry vision, frequent infections, non-healing ulcers, numb or painful extremities?
T1DB
Pt presents with recurring vaginal candidiasis or recurrent UTI’s deserve a ____ workup
Diabetic evaluation/workup
tall, thin, long arms, legs, fingers, and toes
flexible joints and scoliosis
marfan’s
extra copy of X in genetic makeup
kleinfelter’s
low testosterone, reduced muscle mass, facial and body hair, breast enlargement, longer legs, short torsos
kleinfelter’s
enlarged hands, feet, overall bony growth
acromegaly
palmer erythema
hyperthyroid
HTN can suggest
cushing’s
hypotension can suggest
addison’s
Trousseau’s (BP cuff on arm one) and/or Chvostek’s sign (tap the zygomatic arch) indciates
hypocalcemia = hyperparathyroid
axillary hair loss
hypopituitary
supraclavicular fat pad
cushing’s
