F00574 020 g001

F00574 020 g001



Blood pressure „

Hypertension in Cushings a and Conns syndromes. ^ phaeochromocyloma Hypotension in adrenal insufficiency


@ Hcad

Eyes

Graves' dtóease Diplopia

Visual field defect (see opposite)

Hair

Aiopecia Frontal baldmg


Pulse

Atrial łibrfllation Sinus tachycardia Bradycardia

Skin

Hair distnbution A. Dry/greasy Pigmentation/pallor Bruising Vitiligo Striae Thickness


Facial features Hypoihyroid Hirsutism Acromegaiy Cushings Mentai State Lethargy Depression Confusion Libido


A Prognathism in acromegaiy


Nock

Voice

Hoarse, e.g. hypothyroid Viriiised

Thyroid gland (see opposite)

Goitre

Nodules


Vitiiigo in organ-specilic A autoimmune disease


Hands


Patmar erythema a Tremor ^


Acromegaiy Carpai tunnei syndrome


Pigmentation of creases A due to high ACTH leveis in Addison s disease


Acromegalic hands. Notę soft A tissue enlargement causing spade-like’ changes


Height and weight Q


A Multinodular goitre


Brcasts

Galactorrhoea

Gynaecomastia


Body fat

Central obesity in


Cushing s syndrome and h h(


growth normone deficiency


Boncs

Fragility fractures (e.g. of vertebrae, neck of femur or distal radius)


Genitalia

Virilisation

Pubertal development Testicular volume


Legs

Proximal myopathy Myxoedema


Obsorvation


•    Most examination in endocrinology is by observation

•    Astute observation can often yield spot' diagnosis of endocrine disorders

•    The emphasis of examination varies depending on which gland or hormone is thought to be involved


A Pretibial myxoedema in Graves’ disease


© Elsevier. Boon et al.: Davidson’s Principles and Practice of Medicine 20e - m>/w.studentconsult.com



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