Screening the Endocrine System

Question 1

endocrine system screening checklist

Answer 1

 General health (fatigue, unexplained weight change, weakness)
 Psychologic, cognitive (personality changes, memory loss, irritability)
 Gastrointestinal (nausea, vomiting, anorexia, dysphagia, diarrhea, constipation)
 Urogenital (impotence, intermittent urine stream, straining to void)
 Musculoskeletal (muscle weakness, cramps, arthralgias, stiffness, bone pain)
 Sensory (paresthesia, numbness)
 Dermatologic (foot ulcerations, edema, dry skin, impaired wound healing)
 Miscellaneous (temperature intolerance, visual changes, increased bruising,
orthostatic hypotension, increased thirst)

Question 2

Pituitary Gland: diabetes insipidus

Answer 2

lack of secretion of vasopressin (ADH)

Question 3

Signs and symptoms of diabetes insipidus

Answer 3

• polyuria, polydipsia
• dehydration
• fatigue
• irritability
• increased serum sodium
• decreased urine specific gravity

Question 4

Pituitary Gland: Acromegaly

Answer 4

hypersecretion of growth hormone, most often due to a tumor in the pituitary gland

Question 5

signs and symptoms of acromegaly

Answer 5

• bony enlargement
• amenorrhea
• diabetes melitus
• profuse sweating, or diaphoresis
• hypertension
• CTS, hand pain, and stiffness
• back pain (thoraco-lumbar)

Question 6

Adrenal gland: Addison’s Disease

Answer 6

hyposecretion by adrenal glands, due to autoimmune response or tumor, treated with cortisol/hormone replacement

Question 7

signs and symptoms of Addison’s disease

Answer 7

• dark pigmentation of skin
• hypotension
• progressive fatigue
• hyperkalemia
• GI disturbance
• arthralgias, myalgias
• tendon calcification
• hypoglycemia

Question 8

Adrenal gland: cushings disease

Answer 8

• hypersecretion of cortisol by adrenal glands, due to tumor, excessive corticosteroids, or pituitary dysfunction

Question 9

signs and symptoms of cushings disease

Answer 9

• weight gain
• fatty deposits, especially in the midsection and face (moon shaped) and between the shoulders and upper back (buffalo hump)
• thinning skin that bruises easily
• skin injuries that are slow to heal
• fatigue
• muscle weakness

Question 10

Thyroid Gland: hyperthyroidism/Graves disease

Answer 10

hyperfunction = too much thyroid hormone

Question 11

signs and symptoms of hyperthyroidism/Graves disease

Answer 11

 Elevation in body metabolism
 Three major signs common in adult > 70
Tachycardia, fatigue, weight loss
 Signs common in adults < 50
Tachycardia, hyperactive reflexes, increased sweating,
heat intolerance, fatigue, tremor, nervousness, polydipsia,
weakness, increased appetite, dyspnea, and weight loss
 Other common signs/sxs
Periarthritis (shoulder especially)
Proximal muscle weakness and atrophy
Higher incidence of myasthenia gravis

Question 12

thyroid gland: hypothyroidism

Answer 12

hypofuntion = insufficient thyroid hormone

Question 13

signs and symptoms of hypothyroidism

Answer 13

 Generalized depression in body metabolism
 Constipation
 Depression
 Dry hair and hair loss
 Dry skin
 Fatigue
 Greater sensitivity to cold
 Slow heart rate
 Swelling of the thyroid gland (goiter)
 Unexplained weight gain or difficulty losing weight
 Carpal tunnel syndrome

Question 14

Pancreas: diabetes melitus

Answer 14

deficient or defective insulin

Question 15

long term sequela of DM

Answer 15

 State of hyperglycemia
 Disruption in metabolism of carbohydrates, fats, and proteins
 Small vessel disease
 Large vessel vascular complications
 Neuropathies

Question 16

Sings and symptoms of DM

Answer 16

 Polyuria, polydipsia, polyphagia
 Neuropathy, numbness/tingling, feet/hands
 Blurred vision, irritability
 Hand stiffness
 Glycosuria, ketonuria
 Fatigue and weakness
 Slow healing

Question 17

Exercise related complications of DM

Answer 17

 Must be planned, executed with caution
 Monitor glucose before, during, and after exercise
Blood glucose > 250 mg/dl – postpone session
Blood glucose < 100 mg/dl - Give 10-15 g carbohydrate snack
 Retinopathy & nephropathy
Avoid high intensity exercise
 Avoid insulin injection to active extremities within 1 hour of exercise