Approaches for some commonly encountered endocrinological problems & their presentation

1. Presenter-Tanmoy Mandal & Rajat Kar
Chairperson- Prof S.P. Chowdhury

2.  WEIGHT GAIN-Hypothyroid
PCOS
Cushing syndrome
Insulinoma
Patients on insulin
therapy
 WEIGHT LOSS
Hyperthyroid
DM
Adrenal failure
Thyroiditis
Zollinger Ellison
Syndrome
Pheochromocytoma

3.  INCREASED
APPETITE-DM
Frohlich syndrome
Laurence moon
biedl syndrome
Insulinoma
 DECREASED
APPETITE-Adrenal
failure
Hypothyroid
Drugs-dexamphetamine
Cushing
syndrome

4.  OBESITY-
 Cushing syndrome
 Syndrome X
 Sleep apnea syndrome
 Laurence moon biedl syndrome
 Frohlich syndrome
 Prader willi syndrome

5.  DIARRHEA
Hyperthyroid
Hyperparathyroid
DM
WDHA Syndrome
Carcinoid syndrome
Adrenal failure
Zollinger ellison
syndrome
Kwashiorkor
VIPOMA
 CONSTIPATION
 Hypothyroid
 Hypokalemia
 DM
 Porphyria
 Amyloidosis
 Pheochromocytoma
 Vit D excess
 Hypercalcemia
 Visceral myopathy

6.  VOMITING-
 DKA
 Adrenal failure
 Hypercalcemia
 Amyloidosis
 Porphyria
 Hyperparathyroid
 DM
 Vit A toxicity
 Acute zinc toxicity
 Galactosemia
 DI
 Congenital adrenal hyperplasia
 Fructose intolerance
 MELAS

7.  PAIN ABDOMEN-
 Hypercalcemia
 DKA
 Adrenal crisis
 Hyperparathyroid
 Acute intermittent porphyria
 Carcinoid
 Zollinger Ellison Syndrome
 Ovarian Hyperstimulation syndrome
 C1 esterase deficiency
 Myxedema

8.  POLYDIPSIA-
 Central DI
 Nephrogenic DI
 Primary polydipsia
 DM
 Drugs
 Hypercalcemia
 POLYURIA-
 Central DI
 Nephrogenic DI
 DM
 Drugs
 Cushing syndrome
 Hypercalcemia
 Alcohol
 Caffeine

9.  HYPERHIDROSIS-
 Hyperthyroid
 Hypogonadism
 Pheochromocytoma
 Acromegaly
 Mitochondrial
diseases
 Menopause
 Obesity
 HYPOHIDROSIS-
 Hypothyroid
 DM
 Amyloidosis
 Laron syndrome
 Alcoholics
 GH receptor
deficiency
 Fabry disease
 Ectodermal dysplasia

10.  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

11.  HYPERSOMNIA-
 Hypothyroid
 Pickwickian
syndrome
 Prader willi syndrome
 Narcolepsy
 Niemann pick
disease type C
 Sleep deprivation
syndrome
 INSOMNIA-
 Graves disease
 Cushing syndrome
 Alcohol
 Caffeine

12.  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

13.  HIRSUITISM-
 PCOS
 Cushing syndrome
 Congenital adrenal
hyperplasia
 Ovarian tumors
 Acromegaly
 Porphyria cutanea
tarda
 Drugs- Danazol,
phenytoin, minoxidil
 DECREASED BODY
HAIR-
 Hypogonadotrophic
hypogonadism
 Klinefelter syndrome
 Panhypopituitarism
 Kwashiorkor
 Zinc deficiency
 Iron deficiency

14.  GYNAECOMASTIA-
 Klinefelter
syndrome
 Hypopituitarism
 Drugs
 Hypogonadism
 Hyperthyroid
 Aging
 Adrenal tumors
 Prolactinoma
 BREAST ATROPHY-
 Aging
 PCOS
 Menopause
 HRT

15.  SHORT STATURE-
 Growth hormone
deficiency
 Kwashiorkor
 Turner’s syndrome
 Achondroplasia
 Hypothyroidism
 Rickets
 Osteogenesis
imperfecta
 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

16.  ERECTILE
DYSFUNCTION-
 Hyperthyroid
 Hypothyroid
 Hypogonadism
 Hemochromatosis
 DM
 Obesity
 Hypercholesterolemia
 Syndrome X
 LOSS OF LIBIDO-
 Hypothyroid
 DM
 Menopause
 Hyperprolactinemia
 Adrenal insufficiency
 Drugs-SSRI

17.  LACTATIONAL
FAILURE-
 Sheehan syndrome
 Drugs-metoclopramide
 GALACTORRHEA-
 Hypothyroid
 Hyperprolactinemia
 Pituitary adenoma
 Drugs-antipsychotics,
antidepressants
 Male hypogonadism
 CKD

18.  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

19.  POOR SCHOLASTIC
PERFORMANCE-
 Hypothyroid
 Type 1 DM
 Lead poisoning
 Down’s syndrome
 Fragile X syndrome
 Klinefelter
syndrome
 FAILURE TO
THRIVE-
 Down’s syndrome
 Inborn errors of
metabolism
 Cystic fibrosis
 Hyperthyroid
 Juvenile DM

20.  HYPERPIGMENTATI
ON-
 Adrenal failure
 Hemochromatosis
 Drugs- minocycline
 Cushing disease
 Porphyria
 Nelson syndrome
 Graves disease
 Mercury poisoning
 VITILIGO-
 Hyperthyroid
 Pernicious anemia
 PGA syndrome
 Drugs
 Adrenal failure

21.  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

22.  FLUSHING-
 Carcinoid
 Pheochromocytoma
 Post menopausal
 Hyperthyroid
 Mastocytosis
 Alcohol
 Vit B3 excess
 POSTURAL
DIZZINESS-
 Adrenal failure
 DM
 Hypoglycemia
 Hyperthyroid
 Hypothyroid
 Hyperventilation
syndrome

23.  HOARSENESS OF
VOICE-
 Hypothyroid
 Goitre
 Hashimoto
thyroiditis
 Acromegaly
 Adrenocortical
carcinoma
 PROPTOSIS-
 Graves disease
 Cushing syndrome
 Pheochromocytoma
 Hypothyroidism
 Acromegaly

24.  TREMORS-
 Hyperthyroid
 Hypercalcemia
 Hyperparathyroid
 FAHR Syndrome
 Hypomagnesemia
 Thiamine def
 Hypoglycemia
 Alcohol withdrawal
 DEAFNESS-
 Hypothyroid
 Pendred syndrome
 Alport syndrome
 Usher syndrome
 Drugs-aminoglycosides

25.  SEIZURES-
 Hypoglycemia
 Hypercalcemia
 Hypocalcemia
 Hypomagnesemia
 VISUAL
DISTURBANCE-
 DM
 Pituitary adenoma
 Prolactinoma
 Galactosemia
 Hypothyroid
 Zinc def.
 Vit A def.
 Storage diseases

26.  HEADACHE-
 Pituitary adenoma
 Nelson syndrome
 Hypothyroid
 Hypercalcemia
 PARAESTHESIA-
 DM
 Cushing syndrome
 Hypothyroid
 Carcinoid syndrome
 Myxedema
 GH excess
 Vit B 12 def

27.  Lithium
 Amiodarone
 Iodine supplements
 Diuretics
 Steroid
 Vitamin A, D
 Heparin
 Anticonvulsant

28.  Onset of menses
 Cycle
 Duration
 Flow
 Dysmenorrhea
 Menopause

29.  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

30.  PRIMARY-
 Mullerian agenesis
 Turner syndrome
 Septo optic
dysplasia
 Kallmann syndrome
 Swyer james
syndrome
 SECONDARY-
 Hypothyroid
 Hyperthyroid
 Cushing syndrome
 DM
 PCOS

31.  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