Triads/tetrads for syndromes

Question 1

Pituitary hormones

Answer 1

Question 2

Hypothyroidism:

Answer 2

tiredness + husky voice + cold intolerance physical slowing + mental slowing + facial puffiness

Question 3

Hyperthyroidism:

Answer 3

anxiety + weight loss + muscle weakness sweaty hands + loose frequent bowel motions + palpitations

Question 4

Addison disease:

Answer 4

fatigue/weakness + anorexia & nausea + dizziness ± skin discolouration

± abdominal pain, weight loss, loose bowels (diarrhoea)

Question 5

Cushing disease:

Answer 5

plethoric moon face + thin extremities + muscle weakness hirsutism + abdominal striae + hypertension

Question 6

Primary hyperaldosteronism (Conn Syndrome):

Answer 6

usually asymptomatic—any symptoms are features of hypokalaemia, e.g. weakness, paraesthesia, cramps

Question 7

Phaeochromocytoma:

Answer 7

headache + palpitations + sweating + anxiety

Question 8

Congenital adrenal hyperplasia:

Answer 8

sexual ambiguity + clitoral hypertrophy + virulisation + salt losing state

Question 9

Acromegaly:

Answer 9

nasal problems + fitting problems (shoes, gloves, rings) + weakness + sweating

Question 10

Hypopituitarism:

Answer 10

(female) amenorrhoea + loss of axillary and pubic hair + breast atrophy, (male) reduced libido + impotence + loss of body hair

Question 11

Diabetes insipidus:

Answer 11

weakness + polyuria + polydipsia (intense craving for ice water)

Question 12

Hyperprolactinaemia:

Answer 12

symptoms common to both sexes—reduced libido + subfertility + galactorrhoea

+ females—amenorrhoea/oligomenorrhoea

+ males—ED, reduced facial hair

Question 13

Hyperparathyroidism

Answer 13

Classic mnemonic: bones, moans, stones, abdominal groans

Due to hypercalcaemia

Question 14

Hypercalcaemia:

Answer 14

weakness + constipation + polyuria

Question 15

Hypoparathyroidism:

Answer 15

neuromuscular excitability + tetany + neuropsychiatric features, e.g. confusion

Due to hypocalcaemia

Question 16

Diabetes mellitus:

Answer 16

fatigue & tiredness + polydipsia + polyuria + weight loss (indicates type 1)

Question 17

Adrenal tumours:

Answer 17

RULE: tumours >4 cm (on imaging) require thorough assessment as malignant tumours are large.

Excision is usually advisable.