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; Obesity |
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
(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,
hyperosmolar (hyperglycemic) state · hypothermia from environmental exposure
· masses—thyroid, adrenal, and pituitary (benign and malignant or metastatic
tumors) · metabolic syndrome · multiple endocrine neoplasias · neck
lymphadenitis · pre-diabetes · puberty, delayed or precocious · salivary gland
neoplasms · sepsis · sialadenitis · stature abnormalities – unusual shortness
(eg, dwarfism due to achondroplasia or ateliosis), excessive height (eg, 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
abnormalities of serum parathyroid hormone levels · abnormalities of thyroid
function tests (eg, TSH, free or total T4 or T3) · computed tomography imaging ·
electrolyte disturbances (eg, hyper/hypocalcemia, hyper/hypokalemia,
pseudohyperkalemia, hyper/hyponatremia, pseudohyponatremia), hyper/
hypophosphatemia, hyper/hypomagnesemia, hyper/hypochloremia) · growth
hormone deficiency · hemoglobin A1c · hyper/hypoglycemia · magnetic
resonance imaging · nuclear medicine imaging · radiography · sonography ·
thyroid peroxidase antibodies · urine microalbumin/creatinine