Page 38 - Master Blueprint 2018 - 2019
P. 38

CLINICAL               3        PATIENT PRESENTATIONS RELATED TO THE
          PRESENTATION
                                          ENDOCRINE SYSTEM AND METABOLISM




             Patient presentations span all relevant age                              The Guide to clinical presentations in this category may
             categories, special populations, and varied                              include, but is not limited to, the following ways in which
             clinical settings.                                                       patients present for osteopathic medical care:


                                                                                      anesthesia-related complications • bariatric surgery • congenital neck masses
                                                                                      (eg, branchial cleft abnormalities) • diabetes mellitus • diabetic ketoacidosis •
                                                                                      dysmorphic features and genetic syndrome stigmata • endocrine disorders,
                                                                                      specific, such as Cushing, Addison, Hashimoto, or Graves’ disease, poly cystic
                                                                                      ovary syndrome • fever in immunocompromised host • fever of undetermined
                                                                                      etiology • fluid and electrolyte management in hospitalized patient • gestational
                                                                                      hyperglycemia • heat exhaustion, heat stroke • hyper/hypoglycemia • hyper/
                                                                                      hypothermia from acute illness (viral, bacterial, parasitic) • hyperglycemic crisis,
             3.1     ABNORMALITIES OF WEIGHT AND STATURE; OBESITY
                                                                                      hyperosmolar (hyperglycemic) state • hypothermia from environmental exposure
             3.2     ENDOCRINE AND NECK MASSES                                        • masses– thyroid, adrenal, and pituitary (benign and malignant or metastatic
                                                                                      tumors) • metabolic syndrome • multiple endocrine neoplasias • neck
             3.3     HYPOTHERMIA AND HYPERTHERMIA
                                                                                      lymphadenitis • pre-diabetes • puberty, delayed or precocious • salivary gland
             3.4     POLYURIA, POLYDIPSIA, POLYPHAGIA; DIABETES MELLITUS
                                                                                      neoplasms • sepsis • sialadenitis • stature abnormalities – unusual shortness
             3.5     PHYSICAL EXAM FINDINGS RELATED TO THE ENDOCRINE                  (eg, dwarfism due to achondroplasia or ateliosis), excessive height (eg, gigantism
                  SYSTEM AND METABOLISM
                                                                                      due to Marfan syndrome) • thyroglossal duct and/or dermoid cysts • weight
             3.6     LABORATORY TEST FINDINGS AND DIAGNOSTIC IMAGING
                  RELATED TO THE ENDOCRINE SYSTEM AND METABOLISM                      abnormalities – involuntary weight loss, excessive weight gain, obesity



                                                                                      CONSTITUTIONAL SIGNS AND SYMPTOMS
                                                                                      fatigue  • fever, generalized weakness  • involuntary weight loss  • malaise  •
                                                                                      night sweats  • pallor


                                                                                      PHYSICAL EXAM FINDINGS
                                                                                      acromegaly  • adipose distribution  • Chvostek sign  • exophthalmos  • hyper/
                                                                                      hyporeflexia  • lid lag  • lymphadenopathy, neck  • macroglossia  •  


        COMLEX-USA MASTER BLUEPRINT                                                                DIMENSION 2     CLINICAL PRESENTATION 3     PAGE 37
   33   34   35   36   37   38   39   40   41   42   43