Endocrine—Overview of Conditions

TRIADS/TETRADS FOR SYNDROMES RELATED TO PITUITARY HORMONES

Thyroid

Hypothyroidism: tiredness + husky voice + cold intolerance physical slowing + mental slowing + facial puffiness

Hyperthyroidism: anxiety + weight loss + muscle weakness sweaty hands + loose frequent bowel motions + palpitations

Adrenal

Addison disease: fatigue/weakness + anorexia & nausea + dizziness ± skin discolouration ± abdominal pain, weight loss, loose bowels (diarrhoea)

Cushing disease: plethoric moon face + thin extremities + muscle weakness hirsutism + abdominal striae + hypertension

Primary hyperaldosteronism (Conn syndrome): usually asymptomatic—any symptoms are features of hypokalaemia, e.g. weakness, paraesthesia, cramps

Phaeochromocytoma: headache + palpitations + sweating + anxiety

Congenital adrenal hyperplasia: sexual ambiguity + clitoral hypertrophy + virulisation + salt losing state

Pituitary

Acromegaly: nasal problems + fitting problems (shoes, gloves, rings) + weakness + sweating

Hypopituitarism: (female) amenorrhoea + loss of axillary and pubic hair + breast atrophy, (male) reduced libido + impotence + loss of body hair

Diabetes insipidus: weakness + polyuria + polydipsia (intense craving for ice water)

Hyperprolactinaemia: symptoms common to both sexes—reduced libido + subfertility + galactorrhoea + females—amenorrhoea/oligomenorrhoea + males—ED, reduced facial hair

Other endocrine related

Hyperparathyroidism

Classic mnemonic: bones, moans, stones, abdominal groans

Due to hypercalcaemia

Hypercalcaemia: weakness + constipation + polyuria

Hypoparathyroidism: neuromuscular excitability + tetany + neuropsychiatric features, e.g. confusion

Due to hypocalcaemia

Diabetes mellitus: fatigue & tiredness + polydipsia + polyuria + weight loss (indicates type 1)

Adrenal tumours: RULE: tumours >4 cm (on imaging) require thorough assessment as malignant tumours are large. Excision is usually advisable.