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Presenter-Tanmoy Mandal & Rajat Kar 
Chairperson- Prof S.P. Chowdhury
 WEIGHT GAIN-Hypothyroid 
PCOS 
Cushing syndrome 
Insulinoma 
Patients on insulin 
therapy 
 WEIGHT LOSS 
Hyperthyroid 
DM 
Adrenal failure 
Thyroiditis 
Zollinger Ellison 
Syndrome 
Pheochromocytoma
 INCREASED 
APPETITE-DM 
Frohlich syndrome 
Laurence moon 
biedl syndrome 
Insulinoma 
 DECREASED 
APPETITE-Adrenal 
failure 
Hypothyroid 
Drugs-dexamphetamine 
Cushing 
syndrome
 OBESITY- 
 Cushing syndrome 
 Syndrome X 
 Sleep apnea syndrome 
 Laurence moon biedl syndrome 
 Frohlich syndrome 
 Prader willi syndrome
 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
 VOMITING- 
 DKA 
 Adrenal failure 
 Hypercalcemia 
 Amyloidosis 
 Porphyria 
 Hyperparathyroid 
 DM 
 Vit A toxicity 
 Acute zinc toxicity 
 Galactosemia 
 DI 
 Congenital adrenal hyperplasia 
 Fructose intolerance 
 MELAS
 PAIN ABDOMEN- 
 Hypercalcemia 
 DKA 
 Adrenal crisis 
 Hyperparathyroid 
 Acute intermittent porphyria 
 Carcinoid 
 Zollinger Ellison Syndrome 
 Ovarian Hyperstimulation syndrome 
 C1 esterase deficiency 
 Myxedema
 POLYDIPSIA- 
 Central DI 
 Nephrogenic DI 
 Primary polydipsia 
 DM 
 Drugs 
 Hypercalcemia 
 POLYURIA- 
 Central DI 
 Nephrogenic DI 
 DM 
 Drugs 
 Cushing syndrome 
 Hypercalcemia 
 Alcohol 
 Caffeine
 HYPERHIDROSIS- 
 Hyperthyroid 
 Hypogonadism 
 Pheochromocytoma 
 Acromegaly 
 Mitochondrial 
diseases 
 Menopause 
 Obesity 
 HYPOHIDROSIS- 
 Hypothyroid 
 DM 
 Amyloidosis 
 Laron syndrome 
 Alcoholics 
 GH receptor 
deficiency 
 Fabry disease 
 Ectodermal dysplasia
 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
 HYPERSOMNIA- 
 Hypothyroid 
 Pickwickian 
syndrome 
 Prader willi syndrome 
 Narcolepsy 
 Niemann pick 
disease type C 
 Sleep deprivation 
syndrome 
 INSOMNIA- 
 Graves disease 
 Cushing syndrome 
 Alcohol 
 Caffeine
 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
 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
 GYNAECOMASTIA- 
 Klinefelter 
syndrome 
 Hypopituitarism 
 Drugs 
 Hypogonadism 
 Hyperthyroid 
 Aging 
 Adrenal tumors 
 Prolactinoma 
 BREAST ATROPHY- 
 Aging 
 PCOS 
 Menopause 
 HRT
 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
 ERECTILE 
DYSFUNCTION- 
 Hyperthyroid 
 Hypothyroid 
 Hypogonadism 
 Hemochromatosis 
 DM 
 Obesity 
 Hypercholesterolemia 
 Syndrome X 
 LOSS OF LIBIDO- 
 Hypothyroid 
 DM 
 Menopause 
 Hyperprolactinemia 
 Adrenal insufficiency 
 Drugs-SSRI
 LACTATIONAL 
FAILURE- 
 Sheehan syndrome 
 Drugs-metoclopramide 
 GALACTORRHEA- 
 Hypothyroid 
 Hyperprolactinemia 
 Pituitary adenoma 
 Drugs-antipsychotics, 
antidepressants 
 Male hypogonadism 
 CKD
 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
 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
 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
 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
 FLUSHING- 
 Carcinoid 
 Pheochromocytoma 
 Post menopausal 
 Hyperthyroid 
 Mastocytosis 
 Alcohol 
 Vit B3 excess 
 POSTURAL 
DIZZINESS- 
 Adrenal failure 
 DM 
 Hypoglycemia 
 Hyperthyroid 
 Hypothyroid 
 Hyperventilation 
syndrome
 HOARSENESS OF 
VOICE- 
 Hypothyroid 
 Goitre 
 Hashimoto 
thyroiditis 
 Acromegaly 
 Adrenocortical 
carcinoma 
 PROPTOSIS- 
 Graves disease 
 Cushing syndrome 
 Pheochromocytoma 
 Hypothyroidism 
 Acromegaly
 TREMORS- 
 Hyperthyroid 
 Hypercalcemia 
 Hyperparathyroid 
 FAHR Syndrome 
 Hypomagnesemia 
 Thiamine def 
 Hypoglycemia 
 Alcohol withdrawal 
 DEAFNESS- 
 Hypothyroid 
 Pendred syndrome 
 Alport syndrome 
 Usher syndrome 
 Drugs-aminoglycosides
 SEIZURES- 
 Hypoglycemia 
 Hypercalcemia 
 Hypocalcemia 
 Hypomagnesemia 
 VISUAL 
DISTURBANCE- 
 DM 
 Pituitary adenoma 
 Prolactinoma 
 Galactosemia 
 Hypothyroid 
 Zinc def. 
 Vit A def. 
 Storage diseases
 HEADACHE- 
 Pituitary adenoma 
 Nelson syndrome 
 Hypothyroid 
 Hypercalcemia 
 PARAESTHESIA- 
 DM 
 Cushing syndrome 
 Hypothyroid 
 Carcinoid syndrome 
 Myxedema 
 GH excess 
 Vit B 12 def
 Lithium 
 Amiodarone 
 Iodine supplements 
 Diuretics 
 Steroid 
 Vitamin A, D 
 Heparin 
 Anticonvulsant
 Onset of menses 
 Cycle 
 Duration 
 Flow 
 Dysmenorrhea 
 Menopause
 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
 PRIMARY- 
 Mullerian agenesis 
 Turner syndrome 
 Septo optic 
dysplasia 
 Kallmann syndrome 
 Swyer james 
syndrome 
 SECONDARY- 
 Hypothyroid 
 Hyperthyroid 
 Cushing syndrome 
 DM 
 PCOS
 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
History taking and clinical examination of endocrine system

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History taking and clinical examination of endocrine system

  • 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