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NBOME

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 massesadrenal cortex tumor • hyperaldosteronism • neuroblastoma
Amino acid metabolism disordershomocystinuria • maple syrup urine disease • phenylketonuria • tyrosinemia • urea cycle disorders
Autoimmune endocrine disordersAddison disease • Cushing syndrome • Graves disease • Hashimoto thyroiditis • type 1 diabetes (including hyperosmolar hyperglycemic state, ketoacidosis, neuropathy, retinopathy)
Carbohydrate metabolism disordersgalactosemia • glycogen storage diseases • hereditary fructose intolerance
Cardiometabolic disordershyperinsulinemia • metabolic syndrome • type 2 diabetes
Hereditary cancer syndromesfamilial adenomatous polyposis • Li-Fraumeni syndrome • Lynch syndrome • multiple endocrine neoplasia • von Hippel-Lindau disease
Hypothalamic pituitary disorderscraniopharyngioma • diabetes insipidus • hypopituitarism • pituitary tumor • prolactinoma • syndrome of inappropriate antidiuretic hormone secretion
Inborn errors of metabolismGaucher disease • mitochondrial disorders • Niemann-Pick disease • Tay-Sachs disease
Lipid metabolism disordersdyslipidemia • familial hypercholesterolemia • hyperlipidemia
Neuroendocrine tumorscarcinoid syndrome • carcinoid tumors • medullary thyroid cancer • pheochromocytoma
Nutritional disorderskwashiorkor • protein-calorie malnutrition • vitamin deficiency
Ovarian dysfunctionpolycystic ovary syndrome • primary ovarian failure
Pancreatic disordershypoglycemia • Zollinger-Ellison syndrome
Parathyroid disordershyperparathyroidism • hypoparathyroidism • parathyroid cancer
Salivary gland disorderssialadenitis • salivary gland neoplasms
Stature-based abnormalitiesgigantism • short stature
Temperature regulationfever in immunocompromised patients • fever of undetermined etiology • heat exhaustion • heat stroke • hypothermia from environmental exposure
Testicular disorders5-α reductase deficiency • hypogonadism
Thyroid disordershyperthyroidism (including thyrotoxic crisis) • hypothyroidism (including myxedema crisis) • medullary carcinoma • papillary carcinoma • thyroid adenoma • thyroid cancer • thyroid nodule • thyroiditis • thyromegaly
Weight variationsexcessive 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