3. Patient Presentations Related to the Endocrine System and Metabolism
Patient presentations span all relevant age categories, special populations, and varied clinical settings.
| 3.1 | Abnormalities of Weight and Stature |
| 3.2 | Endocrine and Neck Masses |
| 3.3 | Hypothermia and Hyperthermia |
| 3.4 | Polyuria, Polydipsia, Polyphagia; Diabetes Mellitus |
| 3.5 | Physical Exam Findings Related to the Endocrine System And Metabolism |
| 3.6 | Laboratory Test Findings and Diagnostic Imaging Related to the Endocrine System And Metabolism |
The guide to clinical presentations in this category may include, but is not limited to, the following ways in which patients present for osteopathic medical care:
anesthesia-related complications • bariatric surgery • congenital neck masses (e.g., branchial cleft abnormalities) • diabetes mellitus, including diabetic ketoacidosis • dysmorphic features and genetic syndrome stigmata • endocrine disorders (e.g., Cushing syndrome, Addison disease, Hashimoto thyroiditis, Graves disease) • 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, hyperosmolar (hyperglycemic) state • hypothermia from environmental exposure • masses – thyroid, adrenal, and pituitary (benign and malignant or metastatic tumors) • metabolic syndrome • multiple endocrine neoplasia • neck lymphadenitis • pre-diabetes • puberty, delayed or precocious • salivary gland neoplasms • sepsis • sialadenitis • stature abnormalities including unusual shortness (e.g., dwarfism due to achondroplasia or ateliosis) and excessive height (e.g., gigantism due to Marfan syndrome) • thyroglossal duct and/or dermoid cysts • weight 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 • monofilament testing • myxedema • retinopathy • striae • thyromegaly and goiter • tremors • Trousseau sign
LABORATORY TEST FINDINGS AND DIAGNOSTIC IMAGING
CT scanning • electrolyte levels (e.g., calcium, potassium, sodium, phosphorus, magnesium, chloride) • glucose testing • growth hormone levels • hemoglobin A1c testing • magnetic resonance imaging • nuclear medicine imaging • radiography • serum parathyroid hormone levels • thyroid function tests (e.g., TSH, free or total T4 or T3) • thyroid peroxidase antibodies • ultrasonography • urine microalbumin/creatinine levels
