Embed Size (px)
DESCRIPTION
Approaches for some commonly encountered endocrinological problems & their presentation
Citation preview
Presenter-Tanmoy Mandal & Rajat Kar
Chairperson- Prof S.P. Chowdhury
WEIGHT GAIN-Hypothyroid
PCOS
Cushing syndrome
Insulinoma
Patients on insulin therapy
WEIGHT LOSS
Hyperthyroid
DM
Adrenal failure Thyroiditis
Zollinger Ellison Syndrome
Pheochromocytoma
INCREASED APPETITE-
DM Frohlich syndrome
Laurence moon biedl syndrome
Insulinoma
DECREASED APPETITE-
Adrenal failure Hypothyroid Drugs-dexamphetamine
Cushing syndrome
OBESITY-
Cushing syndrome
Syndrome X
Sleep apnea syndrome
Laurence moon biedl syndrome
Frohlich syndrome
Prader willi syndrome
DIARRHEAHyperthyroid
HyperparathyroidDMWDHA SyndromeCarcinoid syndromeAdrenal failureZollinger ellison
syndrome
KwashiorkorVIPOMA
CONSTIPATION Hypothyroid
Hypokalemia DM Porphyria Amyloidosis Pheochromocytoma Vit D excess
Hypercalcemia Visceral myopathy
VOMITING- DKA Adrenal failure Hypercalcemia Amyloidosis Porphyria Hyperparathyroid DM Vit A toxicity Acute zinc toxicity Galactosemia DI Congenital adrenal hyperplasia Fructose intolerance MELAS
PAIN ABDOMEN-
Hypercalcemia
DKA
Adrenal crisis
Hyperparathyroid
Acute intermittent porphyria
Carcinoid
Zollinger Ellison Syndrome
Ovarian Hyperstimulation syndrome
C1 esterase deficiency
Myxedema
POLYDIPSIA-
Central DI
Nephrogenic DI
Primary polydipsia
DM
Drugs
Hypercalcemia
POLYURIA-
Central DI
Nephrogenic DI
DM
Drugs
Cushing syndrome
Hypercalcemia
Alcohol
Caffeine
HYPERHIDROSIS-
Hyperthyroid
Hypogonadism
Pheochromocytoma
Acromegaly
Mitochondrial diseases
Menopause
Obesity
HYPOHIDROSIS-
Hypothyroid
DM
Amyloidosis
Laron syndrome
Alcoholics
GH receptor deficiency
Fabry disease
Ectodermal dysplasia
HEAT INTOLERANCE-
Hyperthyroid Hypothalamic
tumors Drugs- atropine,
belladona Post menopausal
syndrome Graves disease
COLD INTOLERANCE-
Hypothyroid Adrenal failure Hypopituitarism Anorexia nervosa Hypothalamic
tumors Hashimoto
thyroiditis
HYPERSOMNIA-
Hypothyroid
Pickwickiansyndrome
Prader willi syndrome
Narcolepsy
Niemann pick disease type C
Sleep deprivation syndrome
INSOMNIA-
Graves disease
Cushing syndrome
Alcohol
Caffeine
PRECOCIOUS PUBERTY-
Congenital adrenal hyperplasia
Adrenal tumors Hypothalamic
hamartoma Mc Cune Albright
syndrome Angelman syndrome Exogenous hormones
DELAYED PUBERTY- Hypothyroid Constitutional Hypopituitarism Turner syndrome Klinefelter syndrome Prader willi syndrome Kallmann syndrome Cushing syndrome Androgen
insensitivity syndrome
HIRSUITISM- PCOS
Cushing syndrome Congenital adrenal
hyperplasia Ovarian tumors
Acromegaly Porphyria cutanea
tarda Drugs- Danazol,
phenytoin, minoxidil
DECREASED BODY HAIR-
Hypogonadotrophichypogonadism
Klinefelter syndrome Panhypopituitarism Kwashiorkor
Zinc deficiency Iron deficiency
GYNAECOMASTIA- Klinefelter
syndrome Hypopituitarism Drugs Hypogonadism Hyperthyroid Aging Adrenal tumors Prolactinoma
BREAST ATROPHY- Aging PCOS Menopause HRT
SHORT STATURE-
Growth hormone deficiency
Kwashiorkor
Turner’s syndrome
Achondroplasia
Hypothyroidism
Rickets
Osteogenesisimperfecta
Prader willi syndrome
Malnutrition
TALL STATURE-
Acromegaly
Marfan syndrome
Fragile X syndrome
Androgen insensitivity syndrome
Sotos syndrome
Mc-Cune Albright syndrome
Klinefelter syndrome
Homocystinuria
Hyperthyroid
ERECTILE DYSFUNCTION-
Hyperthyroid
Hypothyroid
Hypogonadism
Hemochromatosis
DM
Obesity
Hypercholesterolemia
Syndrome X
LOSS OF LIBIDO-
Hypothyroid
DM
Menopause
Hyperprolactinemia
Adrenal insufficiency
Drugs-SSRI
LACTATIONAL FAILURE-
Sheehan syndrome
Drugs-metoclopramide
GALACTORRHEA-
Hypothyroid
Hyperprolactinemia
Pituitary adenoma
Drugs-antipsychotics, antidepressants
Male hypogonadism
CKD
RECURRENT FRACTURE-
Cushing syndrome Osteoporosis Hypogonadism Hyperthyroid RTA-2 Rickets Osteogenesis
imperfecta Hyperparathyroid Osteopetrosis
BONE PAIN- Hypercalcemia Rickets Hyperparathyroid Paget disease of
bone Osteomalacia Gaucher’s disease Acromegaly
POOR SCHOLASTIC PERFORMANCE-
Hypothyroid
Type 1 DM
Lead poisoning
Down’s syndrome
Fragile X syndrome
Klinefeltersyndrome
FAILURE TO THRIVE-
Down’s syndrome
Inborn errors of metabolism
Cystic fibrosis
Hyperthyroid
Juvenile DM
HYPERPIGMENTATION-
Adrenal failure Hemochromatosis Drugs- minocycline Cushing disease Porphyria Nelson syndrome Graves disease Mercury poisoning
VITILIGO- Hyperthyroid Pernicious anemia PGA syndrome Drugs Adrenal failure
AMBIGUOUS GENITALIA-
21 alpha hydroxylase def
3 beta hydroxylase def
5 alpha reductase def
11 beta hydroxylase def
Androgen receptor defect
Drug induced
DECREASED TESTICULAR VOLUME-
Klinefelter syndrome Hemochromatosis Congenital adrenal
hyperplasia Cushing syndrome Hyperprolactinemia Kallman syndrome Laurence moon biedl
syndrome Alcohol
FLUSHING-
Carcinoid
Pheochromocytoma
Post menopausal
Hyperthyroid
Mastocytosis
Alcohol
Vit B3 excess
POSTURAL DIZZINESS-
Adrenal failure
DM
Hypoglycemia
Hyperthyroid
Hypothyroid
Hyperventilation syndrome
HOARSENESS OF VOICE-
Hypothyroid
Goitre
Hashimoto thyroiditis
Acromegaly
Adrenocorticalcarcinoma
PROPTOSIS-
Graves disease
Cushing syndrome
Pheochromocytoma
Hypothyroidism
Acromegaly
TREMORS-
Hyperthyroid
Hypercalcemia
Hyperparathyroid
FAHR Syndrome
Hypomagnesemia
Thiamine def
Hypoglycemia
Alcohol withdrawal
DEAFNESS-
Hypothyroid
Pendred syndrome
Alport syndrome
Usher syndrome
Drugs-aminoglycosides
SEIZURES- Hypoglycemia Hypercalcemia Hypocalcemia Hypomagnesemia
VISUAL DISTURBANCE-
DM Pituitary adenoma Prolactinoma Galactosemia Hypothyroid Zinc def. Vit A def. Storage diseases
HEADACHE-
Pituitary adenoma
Nelson syndrome
Hypothyroid
Hypercalcemia
PARAESTHESIA-
DM
Cushing syndrome
Hypothyroid
Carcinoid syndrome
Myxedema
GH excess
Vit B 12 def
Lithium
Amiodarone
Iodine supplements
Diuretics
Steroid
Vitamin A, D
Heparin
Anticonvulsant
Onset of menses
Cycle
Duration
Flow
Dysmenorrhea
Menopause
AMENORRHEA-
Hypothyroid
Hyperthyroid
Sheehan syndrome
Hyperprolactinemia
Hemochromatosis
PCOS
Turner syndrome
Congenital adrenal hyperplasia
Androgen insensitivity syndrome
OLIGOMENORRHEA-
PCOS
Hyperprolactinemia
Anorexia nervosa
Bulimia nervosa
Drugs- antipsychotics
Thyrotoxicosis
Prader willi syndrome
PRIMARY-
Mullerian agenesis
Turner syndrome
Septo optic dysplasia
Kallmann syndrome
Swyer jamessyndrome
SECONDARY-
Hypothyroid
Hyperthyroid
Cushing syndrome
DM
PCOS
Number of children Last child birth Vaginal delivery/ LSCS Emergency / planned delivery Prolonged third stage of labour Gestational diabetes History of large baby Postpartum complication History of severe blood loss postpartum Lactational failure History of infertility Use of drugs for pregnancy
