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76 Cards in this Set

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A sensory deficit following this pattern is also known as [ ... ] neuropathy.

A sensory deficit following this pattern is also known as [ ... ] neuropathy.

stocking glove sensory neuropathy

Stocking glove sensory neuropathy is associated with what endocrinologic condition?

Diabetes mellitus, specifically, poor glucose control in patients with Diabetes.

This patient likely suffered from a stocking glove sensory deficit and developed [...] on the bottom of their feet.

This patient likely suffered from a stocking glove sensory deficit and developed [...] on the bottom of their feet.

(diabetic) foot ulcers

This patient has developed [...], a deformity of load bearing joints that arises due to the sensory deficits associated with diabetes (or other neuropathic conditions.)

This patient has developed [...], a deformity of load bearing joints that arises due to the sensory deficits associated with diabetes (or other neuropathic conditions.)

Charcot joints

What is this skin-finding known as, and what specific condition is it associated with?

What is this skin-finding known as, and what specific condition is it associated with?

Acanthosis nigricans


Associated with insulin resistance (type II Diabetes mellitus)

Name this pre-tibial lesion that usually begins with a well-circumscribed plaque with a waxy center and telangiectasia. What disease is it associated with in rare cases (<1%)?

Name this pre-tibial lesion that usually begins with a well-circumscribed plaque with a waxy center and telangiectasia. What disease is it associated with in rare cases (<1%)?

Necrobiosis lipoidica diabeticorum


Found in less than 1% of diabetics.

A fundoscopic exam with these findings would indicate what diagnosis?

A fundoscopic exam with these findings would indicate what diagnosis?

Diabetic retinopathy




Findings include microaneurysms and intraretinal microhemorrhages (flame hemorrhages).




Dot and blot pattern

These lesions are also associated with Diabetic retinopathy. What are they called?

These lesions are also associated with Diabetic retinopathy. What are they called?

cotton wool spots

What fundoscopic changes are associated with diabetes?

microvascular complications may produce:


microaneurysms and intraretinal microhemorrhages (dot and blot changes), cotton wool spots, flame hemorrhages, and vessel proliferation.

Diabetes alone will NOT produce which eye finding?

papilledema

Oral hyperpigmentation is associated with...

Oral hyperpigmentation is associated with...

Addison's disease aka Adrenal hypofunction

What is this finding, and what would it suggest?

What is this finding, and what would it suggest?

Hyper pigmentation of scars from Addison's disease, or Adrenal hypofunction.

A patient, appearing like the one in the image, presents to your clinic with general weakness (asthenia), low blood pressure, and massive weight loss. What endocrine disorder may they be suffering from?

A patient, appearing like the one in the image, presents to your clinic with general weakness (asthenia), low blood pressure, and massive weight loss. What endocrine disorder may they be suffering from?

Addison's disease (adrenal hypo function)

What is this finding? What endocrine disorder may it be associated with?

What is this finding? What endocrine disorder may it be associated with?

Hirsutism from Adrenal hypo function, aka Addison's disease

What psychiatric symptoms are associated with Addison's disease?

depression, schizophrenia, and bipolar disorder

A patient with massive weight loss, low blood pressure, and enhanced senses like smell, taste, and hearing is likely experiencing?

Addison's disease

What Basic Metabolic Panel findings are consistent with Addison's disease?

High potassium (K+), low sodium (Na+), low glucose

This patient presents to your clinic complaining of amennorhea. What diagnosis is likely? What symptoms do they display that affirm your diagnosis?

This patient presents to your clinic complaining of amennorhea. What diagnosis is likely? What symptoms do they display that affirm your diagnosis?

Cushing's disease (adrenal excess)




Visible on this patient:


Hirsutism (sideburn hair appearing)


Moon facies


striae present (arrow)


obesity

What symptom does this patient prominently display? What condition is this symptoms associated with?

What symptom does this patient prominently display? What condition is this symptoms associated with?

Buffalo hump-Cushing's disease

This patient presents to your clinic complaining of weight gain and headaches. Based on his appearance, what do you suspect he has? Name the symptoms he's displaying, plus other symptoms that are common with his disorder.

This patient presents to your clinic complaining of weight gain and headaches. Based on his appearance, what do you suspect he has? Name the symptoms he's displaying, plus other symptoms that are common with his disorder.

Cushing's disease


Patient has: weight gain, headaches, central obesity, gynecomastia, abdominal striae, thin limbs, easy bruising.




Other symptoms common with Cushing's: Hypertension, psychiatric symptoms like anxiety and mania, increased infections, muscle weakness, peripheral edema, decreased libido, glucose intolerance (with or without diabetes.)

This patient's appearance is consistent with...

This patient's appearance is consistent with...

Acromegaly:


enlarged mandible and frontal bone prominence

This patient complains that her wedding ring no longer fits. You suspect?

This patient complains that her wedding ring no longer fits. You suspect?

Acromegaly

This patient presents to your clinic complaining that his rings no longer fit. Name his symptom that is on display in this image and the associated condition he has.

This patient presents to your clinic complaining that his rings no longer fit. Name his symptom that is on display in this image and the associated condition he has.

Macroglossia


Acromegaly (also associated with hypothyroidism)

A patient presents to your clinic. He is 6'8'', has a large forehead and limbs. Visual testing yields these results. Name this visual field abnormality and diagnose this patient. Why does he have these visual deficits?

A patient presents to your clinic. He is 6'8'', has a large forehead and limbs. Visual testing yields these results. Name this visual field abnormality and diagnose this patient. Why does he have these visual deficits?

bitemporal hemianopsia


Acromegaly


A pituitary tumor is compressing his optic chiasm.

What is a common endocrine comorbidity associated with acromegaly?

Diabetes mellitus

What is the leading cause of death of patients with acromegaly?

Congestive heart failure

Diagnosis and confirmatory findings present

Diagnosis and confirmatory findings present

Hypothyroidism


Loss of lateral eyebrows and periorbital edema

Diagnosis and associated findings

Diagnosis and associated findings

Hypothyroidism


Non pitting edema of the face.


Coarse hair.



Symptoms and associated endocrine condition

Symptoms and associated endocrine condition

alopecia


Hypothyroidism

This patient presents to the clinic. In addition to the finding in the image, he also has bradycardia, deep tendon reflexes with a slow relaxation phase, and an apathetic affect. He complains that the room is cold despite it being 75 degrees. Wha...

This patient presents to the clinic. In addition to the finding in the image, he also has bradycardia, deep tendon reflexes with a slow relaxation phase, and an apathetic affect. He complains that the room is cold despite it being 75 degrees. What is the diagnosis? What symptoms is he displaying?

Hypothyroidism


Macroglossia (also associated with Acromegaly)

The following symptoms are associated with [...]




Coarse, dry hair and skin


Moderate weight gain and muscle pain (myalgia)


Bradycardia


Cold intolerance


Constipation


Deep tendon reflexes with slow relaxation phase


macroglossia


apathy

Hypothyroidism

Myxedema

Hypo metabolic state due to thyroid hormone insufficiency. Symptoms and exam findings consistent with hypothyroidism.

Deep tendon reflexes with a slow relaxation phase are also called [...]

Woltman sign

Name this finding and the associated condition

Name this finding and the associated condition

non-pitting pretibial myxedema


Graves disease

This patient was asked to quickly gaze up and then rapidly down. Name this finding and the associated condition

This patient was asked to quickly gaze up and then rapidly down. Name this finding and the associated condition

Lid lag


Hyperthyroidism

Name this finding and the associated condition

Name this finding and the associated condition

proptosis


Graves disease

Name this finding and the associated condition

Name this finding and the associated condition

Oncyolysis


Hyperthyroidism

Name this finding and its associated pathology (endocrine)

Name this finding and its associated pathology (endocrine)

pitting leg edema, a result of high-output heart failure in association with Hyperthyroidism

The following symptoms are seen in association with [...]




Lid lag


fine resting tremor (action tremor)


Smooth, velvety skin


Heat intolerance


Diarrhea and weight loss


Oncyolysis


Tachycardia


High-output heart failure (leg edema, increased JVD, S3)


Rapid deep tendon reflexes

Hyperthyroidism


(thyrotoxicosis)

A skin finding like this one may be associated with...

A skin finding like this one may be associated with...

Zebra rash associated with glucoagonoma

Sign and associated condition(s)

Sign and associated condition(s)

Pemberton's sign.


Facial plethora produced by raising both arms. Can be seen in large thyroid goiters that extend into the thoracic inlet. Also seen with SVC syndrome.

Symptom and associated conditions.

Symptom and associated conditions.

Goiter.


Can be hypo or hyperthyroidism. Have to differentiate with other symptoms or labs

This patient is not pregnant. What condition is likely causing this symptom? What other symptoms may you expect in this or other patients (males or females?)

This patient is not pregnant. What condition is likely causing this symptom? What other symptoms may you expect in this or other patients (males or females?)

Prolactinoma


Infertility, impotence, decreased libido, visual field deficits (mass effect)

Non functional adenomas of the pituitary would produce what symptoms? What is a potential risk of this condition?

visual field cuts (mass effect), compression of other structures.




possibility of spontaneous infarct or hemorrhage

MEN 1 syndrome

Autosomal dominant.


Any 2 of these 3 conditions: Hyperparathyroidism, anterior pituitary tumor, enters-pancreatic tumors (insulinoma)

Finding and associated disease

Finding and associated disease

Peau d'orange (orange peel). Dimpled, firm breast due to lymphatic invasion of inflammatory breast carcinoma

Finding and associated disease

Finding and associated disease

nipple retraction, common in breast malignancy but could be caused by benign mass

Finding and disease

Finding and disease

Paget's disease of the breast.


eczematous change of the nipple due to underlying invasive carcinoma.

How to palpate the thyroid

Visual inspection during swallowing.
Anterior palpation with right hand.
Bimanual palpation from behind (shown)

Visual inspection during swallowing.


Anterior palpation with right hand.


Bimanual palpation from behind (shown)

Differential diagnosis for a pituitary mass

Pituitary adenoma


Craniopharyngioma


Meningioma


Basilar artery aneurysm


Nerve sheath tumors (cranial nerves)

test of choice to diagnose a growth hormone tumor (acromegaly)

IGF-1

Differential diagnosis for galactorrhea

chronic nipple stimulation


high prolactin level


hypo and hyperthyroidism


chronic renal failure


medications: antipsychotics, narcotics, others

struma ovarii

extra-thyroidal tissue in an ovarian teratoma.


Clinical clues: clinical hyperthyroidism, normal thyroid exam, pelvic exam and imaging.

Kussmaul's respirations

deep respirations associated with type 1 diabetes mellitus.

thyrotoxicosis factitia

All the findings of thyrotoxicosis but no clinical findings of Graves' disease and a normal thyroid gland by examination.




Exogenous hormone administration.

Answer: lid lag

Answer: lid lag

Answer: loss of both lateral visual fields

Answer: loss of both lateral visual fields

Answer: cotton wool spots

Answer: cotton wool spots

Answer: order a serum glucose level

Answer: order a serum glucose level

Answer: glycosylated hemoglobin

Answer: glycosylated hemoglobin

answer: substernal thyroid gland extension

answer: substernal thyroid gland extension

answer: serum IGF-1

answer: serum IGF-1

answer: cold intolerance

answer: cold intolerance

answer: impressive abdominal striae

answer: impressive abdominal striae

answer: extra-thyroidal tissue producing hyperthyroidism

answer: extra-thyroidal tissue producing hyperthyroidism

answer: arterial pH of 7.15

answer: arterial pH of 7.15

answer: inflammatory breast carcinoma

answer: inflammatory breast carcinoma

answer: type 2 diabetes mellitus

answer: type 2 diabetes mellitus

Answer: Deep tendon reflexes showing delayed relaxation

Answer: Deep tendon reflexes showing delayed relaxation

Answer: hypertension

Answer: hypertension

answer: Hashimoto's thyroiditis

answer: Hashimoto's thyroiditis

Answer: inability to remove wedding ring

Answer: inability to remove wedding ring

Answer: sensory neuropathy in a stocking-glove distribution

Answer: sensory neuropathy in a stocking-glove distribution

answer: constipation and slow relaxation of deep tendon reflexes

answer: constipation and slow relaxation of deep tendon reflexes

Answer: Low 24-hour radioiodine therapy

Answer: Low 24-hour radioiodine therapy

Answer: prolactinoma

Answer: prolactinoma