NBOME
COMLEX-USA MASTER BLUEPRINT

3. Patient Presentations Related to the Endocrine System and Metabolism

Patient presentations span all relevant age categories, special populations, and varied clinical settings.

3.1Abnormalities of Weight and Stature; Obesity
3.2Endocrine and Neck Masses
3.3Hypothermia and Hyperthermia
3.4Polyuria, Polydipsia, Polyphagia; Diabetes Mellitus
3.5Physical Exam Findings Related to the Endocrine System And Metabolism
3.6Laboratory 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

Contents
^