Anterior
Pituitary disorders
·
Growth retardation / excess
·
Thyroid, adrenal, and gonadal
dysfunction
Posterior
pituitary disorders
·
Arginine deficiency
·
Oxytocin deficiency
·
Vasopressin
(ADH) deficiency: diabetes insipidus presenting as polydipsia and polyuria
Causes
of pituitary disorders
·
Congenital hormone deficiency
·
Infection
·
Vascular Immunological
·
Neoplastic
·
Traumatic
·
Infiltration
·
Radiation damage
Hypopituitarism
·
Presents as hypothyroidism and hypo
parathyroidism
Acromegaly
·
Cause: pituitary tumor causing GH excess
·
Symptoms: change in appearance, increased size of hands and feet,
headaches, excessive sweating, visual deterioration, tiredness, weight gain,
amenorrhea, galacotrhhea, impotence/poor libido, deep voice, goiter,
breathlessness, pain/tingling in the hands, polyuria/polydipsia, muscle
weakness
·
Signs: prominent supra orbital ridge, prognathism, large toungue,
spade-like feet and hands, thick greasy skin, visual field defects,
galactorhea, hypertension, edema, heart failure, arthropathy, proximal
myopathy, glycosuria
Galactorrhea
·
Galactorrhoea
and secondary hypogonadism are signs of hyperprolactinaemia.
·
Patients
with a prolactinoma can sometimes demonstrate bilateral galactorrhoea during
the clinical examination.
HISTORY
OF ADRENAL CONDITIONS (SCORING SHEET)
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1
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2
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3
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4
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1.0 DEMOGRAPHIC
INFO
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Name
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Age
and date of birth
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Residential
address
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Occupation
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2.0 HISTORY
OF PRESENTING COMPLAINT(s)
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Complaint
#1: Onset, course, location (site), radiation, severity, time of day,
duration, diurnal variation, character, aggravating factors (food, cough etc ),
relieving factors, associated symptoms
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Complaint
#2:
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Complaint
#3:
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Complaint
#4:
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What
does the patient think is going on?
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Treatments
already given
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Effect:
work, daily life, sports,
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3.0 PAST
MEDICAL / SURGICAL HISTORY
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Chronic
illnesses like HT, DM, Cardiac
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Hospitalizations
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Surgeries
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4.0
ALLERGY HISTORY
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Reactions
to medications: type and drug
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Food
allergies
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Environmental
allergies
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5.0
MEDICATION HISTORY
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List
of current medications doses and why: prescribed or OTC?
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List
of chronic medications
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Medicine
stopped
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Herbal
or complimentary medications
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6.0 FAMILY HISTORY
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Parents:
age, height, weight, health status, consanguinity, region of origin
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Siblings:
names, nicknames, age, height, weight, health status
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Significant
problems maternal & paternal
sides: arthritis, DM, HT, renal disease, anemia, headache, TB
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Diseases
that run in the family
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Specific
question about illnesses resembling presenting complaint: thyroid disease,
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7.0
SOCIAL HISTORY
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Type
of housing, location (city vs rural), how many people in house
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Education,
occupation, income, religion and culture, smoking
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Health
insurance
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Contact
with animals
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8.0
RISK FACTORS
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9.0
REVIEW OF SYSTEMS (If not covered in presenting complaints and PMH)
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Skin:
skin rash, pigmentation, bruising
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CVS
and RES: chest pain, cough (hemoptysis), dypnea (orthopnea, nocturnal
dyspnea), cyanosis, palpitations, ankle swelling,
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Hematological:
pallor, jaundice, bone pain, bruises, epsitaxis
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GIT:
Vomiting, nausea, dyspepsia, dysphagia, abd pain, diarhoea / constipation,
Bowel habits, feeding, weight loss / gain, rectal bleeding
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Urinary
tract: dysuria, enuresis, frequency., nocturia, hematuria, incontinence,
urethral discharge
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Genital:
menstruation (regularity, length, volume), impotence,
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CNS:
irritability, drowsiness, collapse / blackout, abnormal movements (seizures), headache,
numbness, dizziness and loss of balance, vision, hearing, headache
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Musculoskeletal:
joint swelling, joint pain, skin rash, movement restrictions, muscle wasting,
spasms,
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