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Endo. Disorders
Presentation of Disorders of the Endocrine System
| Clinical Presentation | Endocrine Abnormality |
|---|---|
| Signs of hyponatremia - brain oedema, nausea, vomiting, loss of consciousness, headache, seizure | SIADH |
| Polyuria, polydypsia, nocturia, signs of hypernatremia (irritability, restlessness, seizures), visual field defects, muscle twitching | Diabetes Insipidus |
| Weight loss, increased appetite, diarrhoea, intolerance to heat, sweating,palpitations,amenorrhoea, agitation, nervousness | Hyperthyroidism |
| Weight gain,decreased appetite, hoarse voive, decreased hearing, constipation, intolerance to cold, hair loss, carpal tunnel syndrome, hypercholesterolaemia, intellectual and motor slowing, muscle cramps, menorrhoragia. | Hypothyroidism |
| Truncal obesity, facial plethora, buffalo hump, hirsutism and acne, hypertension, oedema, proximal muscle weakness, skin striae and ecchymoses, polyuria, polydipsia, amenorrhoea, pigmentation | Hypercortisolism - Cushing's syndrome |
| Pigmentation, vitligo, lethargy, weight loss, anorexia, nausea, diarrhoea, nocturia, mental changes, seizures, postural hypotension | Hypoadrenalism - Addison's disease |
| Hypertension, hypokalaemia and hypernatremia | Hyperaldosteronism due to an adrenal adenoma- Conn's syndrome |
| Sympathetic nervous system overactivity - anxiety, panic attacks, hypertension, palpitations, tremor, sweating, headache. | Phaeochromocytoma |
| High cortisol, low ACTH | Adrenal origin, Cushing's syndrome |
| Suppression at 2mg of dexamethasone | Normal individual |
| High cortisol, high ACTH and suppression at 8mg of dexamethasone | Cushing's disease - pituitary adenoma |
| High cortisol, high ACTH and is not suppressed at 8mg of dexamethasone | Ectopic origin, Cushing's syndrome |
| Low cortisol and synathcen does not increase it significantly | Addison's disease |
| In patients with diabetes insipidus, administering ADH will increase the urine osmolality. | Central cause of diabetes insipidus |
| Injected insulin does not cause an increase in ACTH and GH. | Hypopituitism |
| Administration of glucose causes an increase in growth hormone | Acromegaly |
| Administration of glucose causes a decrease in growth hormone. | Normal individual |
| Low cortisol and low ACTH | Damaged pituitary |
| Low cortisol and high ACTH | Non-responsive adrenal gland |
| High cortisol and high ACTH | Over-active pituitary |
| High cortisol and low ACTH | Autonomous adrenal gland |
| High total T4 concentration, normal TSH and normal free T4 | An increase in thyroxine binding globulin due to pregnancy, oestrogen treatment or the oral contraceptive pill |
| The inability to form IGF-1, resulting in short stature and high levels of GH | Laron dwarfism |
| An insulin receptor defect | Leprechaunism |
| Low TSH with high T4 | Hyperthyroidism |
| High TSH with low T4 | Hypothyroidism |
| Increase in size of the adrenal gland, ambiguous genitalia, aldosterone crisis. | Congenital Adrenal Hyperplasia - deficiency in action of 21alpha-hydroxylase |
| Cushingoid signs and symptoms with a palpable abdominal mass | Adrenal carcinoma |
| Cushingoid signs/symptoms with an absence of the Cushingoig body habitus, more prominent oedema and hypertension and marked muscle weakness | Ectopic ACTH production (eg. small cell carcinoma of the lung) |
| Hyperpigmentation and Cushingoid appearance | Extra-adrenal tumour producing ACTH |
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