EMQs in Clinical Medicine.pdf - Peshawar Medical College

212 Metabolic and endocrine disturbances
The aim of Box 3 is to summarize some distinctive features of endocrine
disease that commonly appear in EMQs.
Box 3 Endocrine disturbance [78]
Symptoms to look out for in questions:
• Heat intolerance, weight loss,
diarrhoea, anxiety
• Cold intolerance, weight gain, depression,
constipation, dementia, depression
• Change in facial appearance, visual
problems
• Weight gain, hirsutism, menstrual
problems, depression
On examination:
• Buccal/palmar crease hyperpigmentation,
postural hypotension
• ‘Moon-shaped’ face, centripetal obesity,
proximal myopathy, purple striae,
hypertension, diabetes mellitus
• Macroglossia, spade-like hands and feet
• Bradycardia, dry thin hair, goitre, loss of
outer third of eyebrow, slowly relaxing
reflexes
• Tachycardia, goitre, atrial fibrillation, lid lag
Hyperthyroidism
Hypothyroidism
Acromegaly
Cushing’s syndrome
Addison’s disease
Cushing’s disease
Acromegaly
Hypothyroidism
Hyperthyroidism