Endocrine Assessment

 

Emergency

 

Hx

Ex

Ix

Mx

 

Index

 

 

  

 

Endocrine History

 

HPI

PMH

 

Social

 

Family

 

 

  

Endocrine History of Presenting Illness (HPI)

 

-  Polydipsia: DM, SIADH, Diabetes Insipidus

-  Weight change

-  Decreased weight + polyphagia: hyperthyroidism, DM

-  Increased weight + polyphagia: Cushings syndrome, hypoglycaemia, hypothyroidism

-  Increased weight + anorexia: hypothyroidism

-  Change in bowel habit

-  Diarrhoea: hyperthyroidism, adrenal insufficiency

-  Constipation: hypothyroidism, hypercalcaemia

-  Galactorrhea: hyperprolactinaemia

-  Sexual dysfunction

-  Menstrual changes

-  Menstrual Hx

-  Diaphoresis: hyperthyroidism, Pheochromocytoma, Acromegaly, menopause

-  Change in hair distribution

-  Male w less: hypogonadism

-  Female w more: androgen excess

-  Skin changes

-  Pigmentation: Addisons disease, Acanothosis nigricans

-  Increased: Acromegaly, Cushings syndrome, adrenal insufficiency

 

 

 

  

Endocrine Past Medical History (PMH)

 

-  Meds

-  Amiodorone: hyperthyroidsm

-  Thyroxine: hypothyroidism

-  Insulin: DM (1, 2 or GDM)

-  DM

-  GDM: DM

-  Thyroidectomy: hypothyroidism, hypoparathyroidism

-  Radioactive iodine: hypothyroidism

-  HTN: Pheochromocytoma, Cushings syndrome, Conns syndrome

 

 

 

  

Endocrine Social & Personal History

 

-   

 

 

 

  

Endocrine Family History

 

-  Thyroid: Hashimotos, Graves disease

-  DM: Type 1 or Type 2

 

 

 

 

Endocrine Examination

 

General

 

Head

 

Thyroid Exam

Arm

 

Chest

Breast

Abdo

Leg

Testicle Exam

 

Sexual Development

 

 

 

  

General Endocrine Examination

 

-  Usually a targeted exam & not Ex as a system

-  Tremor

-  Agitation

-  Body habitus

 

 

 

  

Endocrine Head & Neck Exam

 

-  Yellow sclera (hypercarotenaemia): hyperthyroidsm

-  Lid retraction: hyperthyroidsm

-  Lid lag (von Graefes sign): hyperthyroidsm

-  Bilateral sensory deafness: congenital hypothyroidism

-  Chvosteks Sign: Hypoclacaemia

-  Exopthalmos, proptosis: Graves disease, pituitary tumour

 

 

Neck

-  Thyroid exam

 

 

 

  

Endocrine Upper Limb Exam

 

-  Onycholysis (Plummer nails): hyperthyroidsm

-  Hyper-reflexia: hyperthyroidsm

-  Hung up reflexes: hypothyroidism

-  Palmar erythema, warmth & sweating: hyperthyroidsm

-  Pulse

-  Tachycardia: hyperthyroidsm, pheochromocytoma

-  AF: hyperthyroidsm

-  Collapsing (increased CO): hyperthyroidsm

-  Tremor

-  Fine tremore evident w paper laid across backs of elevated hands: hyperthyroidsm

-  Proximal myopathy: hyperthy, +/- hypothyroidism (rare)

-  CTS: hypothyroidism

-  Yellow palms (Hypercarotenaemia): hypothyroidism

Trousseaus Sign: Hypoclacaemia

 

 

 

 

  

Endocrine Chest Exam

 

-  Gynaecomastia

-  Pericardial effusion: hypothyroidism

-  Pleural effusion: hypothyroidism

-  Breast exam

 

 

 

  

Endocrine Abdominal Exam

 

-  Striae: Cushings syndrome

-  Lipodystrophy: insulin injection sites 

 

 

 

  

Endocrine Lower Limb Exam

   

-  Peripheral oedema, ankle swelling: chronic liver disease

-  Pretibial myxoedema: hyperthyroidsm

-  Proximal myopathy: hyperthyroidsm

-  Hyper-reflexia: hyperthyroidsm

-  Hung up reflexes: hypothyroidism

  

 

 

 

Endocrine Investigations

 

Path

Imaging

Proc

Micro

 

 

 

 

Endocrine Management

 

General

Meds

Surgery

Proc