Patient Presentations Related to the Endocrine and Neuroendocrine Systems and Metabolism
Patient presentations span all ages and gender identities, reflecting patients from diverse backgrounds, cultures, and abilities and their reasons for presenting to osteopathic physicians in varied clinical settings.
| 3.1 Variations of Weight and Stature | |
| 3.2 Endocrine and Neck Masses | |
| 3.3 Hypothermia and Hyperthermia | |
| 3.4 Polyuria, Polydipsia, Polyphagia; Diabetes | |
| 3.5 Physical Exam Findings Related to the Endocrine and Neuroendocrine Systems and Metabolism | |
| 3.6 Laboratory and Diagnostic Testing Related to the Endocrine and Neuroendocrine Systems and Metabolism |
Clinical presentations in this category may include, but are not limited to, the following conditions or situations prompting patients to present for osteopathic medical care:
| Adrenal masses | adrenal cortex tumor • hyperaldosteronism • neuroblastoma |
| Amino acid metabolism disorders | homocystinuria • maple syrup urine disease • phenylketonuria • tyrosinemia • urea cycle disorders |
| Autoimmune endocrine disorders | Addison disease • Cushing syndrome • Graves disease • Hashimoto thyroiditis • type 1 diabetes (including hyperosmolar hyperglycemic state, ketoacidosis, neuropathy, retinopathy) |
| Carbohydrate metabolism disorders | galactosemia • glycogen storage diseases • hereditary fructose intolerance |
| Cardiometabolic disorders | hyperinsulinemia • metabolic syndrome • type 2 diabetes |
| Hereditary cancer syndromes | familial adenomatous polyposis • Li-Fraumeni syndrome • Lynch syndrome • multiple endocrine neoplasia • von Hippel-Lindau disease |
| Hypothalamic pituitary disorders | craniopharyngioma • diabetes insipidus • hypopituitarism • pituitary tumor • prolactinoma • syndrome of inappropriate antidiuretic hormone secretion |
| Inborn errors of metabolism | Gaucher disease • mitochondrial disorders • Niemann-Pick disease • Tay-Sachs disease |
| Lipid metabolism disorders | dyslipidemia • familial hypercholesterolemia • hyperlipidemia |
| Neuroendocrine tumors | carcinoid syndrome • carcinoid tumors • medullary thyroid cancer • pheochromocytoma |
| Nutritional disorders | kwashiorkor • protein-calorie malnutrition • vitamin deficiency |
| Ovarian dysfunction | polycystic ovary syndrome • primary ovarian failure |
| Pancreatic disorders | hypoglycemia • Zollinger-Ellison syndrome |
| Parathyroid disorders | hyperparathyroidism • hypoparathyroidism • parathyroid cancer |
| Salivary gland disorders | sialadenitis • salivary gland neoplasms |
| Stature-based abnormalities | gigantism • short stature |
| Temperature regulation | fever in immunocompromised patients • fever of undetermined etiology • heat exhaustion • heat stroke • hypothermia from environmental exposure |
| Testicular disorders | 5-α reductase deficiency • hypogonadism |
| Thyroid disorders | hyperthyroidism (including thyrotoxic crisis) • hypothyroidism (including myxedema crisis) • medullary carcinoma • papillary carcinoma • thyroid adenoma • thyroid cancer • thyroid nodule • thyroiditis • thyromegaly |
| Weight variations | excessive weight gain • obesity |
CONSTITUTIONAL SIGNS AND SYMPTOMS
- anorexia
- chills
- fatigue
- fever
- generalized weakness
- jaundice
- malaise
- night sweats
- unintentional weight loss
PHYSICAL EXAM FINDINGS AND EVALUATIONS
- acanthosis nigricans
- acromegaly
- adipose distribution
- Chvostek sign
- exophthalmos
- galactorrhea
- gynecomastia
- hirsutism
- hyper/hyporeflexia
- lid lag
- lymphadenopathy
- macroglossia
- pallor
- peripheral neuropathy findings
- retinopathy
- striae
- tender points
- thyromegaly
- tremors
- Trousseau sign
- viscerosomatic/
somatovisceral reflexes
LABORATORY AND DIAGNOSTIC TESTING
- autoantibody testing
- CT scanning
- DXA scanning
- electrolyte levels
- fine-needle aspiration
- glucose testing
- hemoglobin A1c testing
- hormone assays
- monofilament testing
- MRI
- nuclear medicine imaging
- radiography
- ultrasonography
- urine testing