Thyroid examination/Endocrine

Question 1

Endocrine differentials: Tiredness (4)

Answer 1

Hypothyroidism

Hyperthyroidism

DM

Hypopituitarism

Question 2

Endocrine differentials: weight gain (3)

Answer 2

Hypothyroidism

PCOS

Cushing’s syndrome (excessive ACTH - stimulates adrenal cortex - high levels of cortisol)

Question 3

Endocrine differentials: weight loss (4)

Answer 3

Hyperthyroidism

DM

adrenal insuff.

Question 4

Endocrine differentials: Diarrhoea (3)

Answer 4

Hyperthyroidism

gastrin-producing tumour

carcinoid

Question 5

Endocrine differentials: diffuse neck swelling (3)

Answer 5

Simple goitre

Grave’s disease (autoimmune hyperthyroidism)

Hashimoto’s thyroiditis (autoimmune, destroys thyroid gland, hypothyroidism)

Question 6

Endocrine differentials: polyuria and polydipsia (4)

Answer 6

DM

Diabetes insipidus (Anti-diuretic hormone not working correctly)

Hyperparathyroidism (overactive parathyroid gland - increase PTH secretion, blood calcium rises)

Conn’s syndrome (too much aldosterone - increases blood presure)

Question 7

Endocrine differentials: Hirsutism (4)

Answer 7

Unwanted male pattern hair growth

Idiopathic

PCOS

Congenital adrenal hyperplasia

Cushing’s syndrome

Question 8

Endocrine differentials: ‘Funny turns’ or spells (3)

Answer 8

Hypoglycaemia

Phaeochromocytoma (tumour of adrenal gland - too much epinephrine and norepinephrine)

neuroendocrine tumour

Question 9

Endocrine differentials: Sweating (4)

Answer 9

Hyperthyroidism

hypogonadism

acromegaly

phaeochromocytoma

Question 10

Endocrine differentials: Flushing (2)

Answer 10

Hypogonadism (especially menopause)

Carcinoid syndrome (paraneoplastic syndrome compremising of S+S that occur 2ndary to Tumors eg. diarrhoea and flushing)

Question 11

Endocrine differentials: Resistant hypertension (4)

Answer 11

Conn’s syndrome (too much aldosterone)

Cushing’s syndrome (Excessive ACTH-Cortisol)

Phaeochromocytoma (Tumour of adrenal glands - too much adrenaline/noradrenaline)

Acromegaly (increased GH)

Question 12

Endocrine differentials: Amenorrhoea/ oligomenorrhoea (3)

Answer 12

(no periods/ infrequent periods)

PCOS

Hyperprolactinemia (high prolactin)

thyroid dysfunction

Question 13

Endocrine differentials: Erectile dysfunction (4)

Answer 13

Primary or secondary hypogonadism

DM

non-endocrine systemic disease

medication-induced eg beta-blocker, opiates

Question 14

Endocrine differentials: Muscle weakness (4)

Answer 14

Cushing’s syndrome (raised ATH - high cortisol)

Hyperthyroidism

Hyperparathyroidism

Osteomalacia (softening of bones)

Question 15

Endocrine differentials: Bone fragility and fractures (4)

Answer 15

Hypogonadism

hyperthyroidism

Cushing’s syndrome

Primary hyperparathyroidism

Question 16

Signs and symptoms of Hyperthyroidism (9+)

Answer 16

Fatigue, poor sleep

Tremor, heat intolerance, XS sweating

Pruritus (itch)

Onycholysis (loosening of nail from nail bed)

Hair loss

irritable, anxiety, emotional lability

dyspnoea, palpitations, ankle swelling

weight loss, diarrhoea

Proximal muscle weakness

Oligomenorrhoea or amenorrhoea

eye symptoms: grittiness, tearing, eyelid swelling, blurred vision)