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