Hx and Exam for endocrine patient Flashcards
List the symptoms associated with parathyroid-related hypocalcemia
- Neuropsych: seizures, dementia, anxiety, depression, exprapyramidal symptoms (Parkinsonism most common) papilledema
- Neuromuscular: paresthesias around mouth and fingers/toes, muscle stiffness, myalgias and spasms
- CV: CHF, hypotension, prolongation of QT interval
- Autonomic: Biliary colic, bronchospasm, diaphoressi
- Other: cataracts, dry course skin, hypopigmentation, eczema, steatorrhea
What is Chovstek sign?
A test you can do for hypocalcemia. It’s the twitching of the facial muscles in response to tapping over the area of the facial nerve.
What is Trousseau’s sign?
Carpopedal spasm caused by inflating the blood-pressure cuff to a level above systolic pressure for 3 minutes.
What are signs and symptoms parathyroid related hypercalcemia?
- CNS: Lethargy, weakness, confusion, coma
- Renal: polyuria, dehydration, nocturia, renal stones, renal failure
- GI; constipation, nausea, anorexia, gastric ulcer, pancreatitis
- Cardiac: syncope from arrythmias.
What are some causes of hypothyroidism?
Hypothyroidism associated with high TSH, Low T3 and T4.
Causes:
- Hashimoto’s thyroiditis - autoimmune (most common cause)
- Medication (ie. Li)
- Pregnancy (during or after) - can recur with subsequent pregnancies
- Treatment for hyperthyroidism
- Thyroidectomy
What are some symptoms of hypothyroidism?
- Constipation
- depression
- fatigue
- pale, dry skin
- sensitivity to cold
- elevated cholesterol levels
- dry, brittle nails and hair
- weight gain
What are some causes of hyperthyroidism?
- Graves disease
- toxic nodular or multinodular goiter
- thyroiditis
- excessive consumption of iodine or meds (like amiodarone) that contain iodine
- Pregnancy or first year after birth
What are some symptoms of hyperthyroidism?
- Fatigue or muscle weakness
- hand tremors
- mood swings
- nervousness or anxiety
- rapid heart rate
- heart palpitations or irregular heart heat
- skin dryness
- trouble sleeping
- weight loss
- increased frequency of bowel movement
- light or missing periods
- irritability
- thinning of hair
- heat intolerance
What is Addison’s Disease? What are the causes?
A form of adrenal insufficiency.
Primary cause: (accounts for 90% of cases)
- autoimmune
-due to TB
-chronic infections, surgical removal, cancer
secondary cause:
- lack of ACTH
- suddenly stopping exogenous glucocorticoids (like prednisone)
- surgical removal of ACTH-producing tumors from pituitary
- Pituitary gland suddenly stops producing ACTH (as in cancerous processes)
What are some symptoms of addison’s disease?
- chronic worsening fatigue and muscle weakness
- weight loss, loss of appetite
- N/V/D in about 50% of cases
- skin darkening, esp on scars, skin folds, pressure points, mucus membranes
- salty food craving
- hypotension
- irritability
- hypoglycemia (uncommon in adults)
- menstrual irregularities
What is Addisonian crisis?
Acute adrenal insufficiency.
usually appears at times of stress (illness, surgery etc)
-sudden penetrating pain of back, extremities, vomiting, diarrhea
-if left untreated can lead to death
What are some symptoms of Cushing syndrome?
- fatigue and sleeping problems
- HA
- backaches
- swelling
- irritability
- repeated infections and poorly healing wounds
- acne
- hair loss
What are some signs of Cushing syndrome?
- a round (moon shaped) and/or red face
- purplish streaks across the skin (striae)
- unsual build up of fatty tissue between the shoulder blades (buffalo hump)
- unusual build up of fatty tissue in abd area with thin arms and legs
- easy bruising
- excess facial/body hair growth in women
What are some symptoms of DM
- urinating often
- feeling very thirsty
- feeling very hungry - even though you are eating
- extreme fatigue
- blurry vision
- cuts/bruises that are slow to heal
- weight loss-even though you are eating more (Type I)
- tingling pain, or numbess in hands/feet (type II)
