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Thyroid
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Diabetes
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Adrenal
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Pituitary
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Past History
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Weight loss/gain
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Polyuria, polydipsia
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Fatigue, dizziness
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Headache, vision
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Endocrine/autoimmune disorders
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Heat/cold intolerance
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Fatigue
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Pigmentation
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Libido/fertility
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Surgeries, radiation
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Palpitations, tremor
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Infections
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Nausea, salt craving
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Galactorrhea
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|
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Neck swelling
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Neuropathy, vision
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Growth changes
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Hair/skin/mood changes
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General Inspection
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Vitals
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Hands/Arms
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Face & Neck
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Chest
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Abdomen
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Legs
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Neuro
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Body habitus
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BP (± orthostatic)
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Tremor
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Eye signs (lid lag, exophthalmos)
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Gynecomastia
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Central obesity
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Myopathy
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Visual fields
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Skin/hair/voice
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HR
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Palmar erythema
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Eye signs (lid lag, exophthalmos)
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Hair distribution
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Striae
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Reflexes
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CN exam (pituitary)
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Scars, pigmentation, striae
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Blood glucose
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Myopathy
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Thyroid: inspect, palpate, auscultate
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Masses
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Neuropathy
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Temp
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Reflexes
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Edema
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Skin changes
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Thyroid
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Hypo-/Hyperthyroidism, Nodules, Goiter, Thyroiditis
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Adrenal
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Addison’s, Cushing’s, Conn’s (Hyperaldosteronism), Pheochromocytoma
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Pituitary
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Prolactinoma, Acromegaly, Hypopituitarism, Diabetes Insipidus
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Pancreas
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Diabetes Mellitus (Type 1 & 2), Hypoglycemia
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Gonadal
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PCOS, Hypogonadism, Menstrual disorders
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📉 Hypo
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📈 Hyper
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Weight Gain
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Weight Loss
|
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Fatigue
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Sweating/Palpitations
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Cold Intolerance
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Anxiety, Tremors
|
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Constipation
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Diarrhea
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Depression
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Heat Intolerance
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Amenorrhea
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Irregular Periods
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Symptom
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Possible Differential
|
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Weight loss
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Hyperthyroid, diabetes, Addison’s, cancer
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Weight gain
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Hypothyroid, Cushing’s, insulin therapy
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Amenorrhea
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PCOS, prolactinoma, hypothalamic causes
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Polyuria/polydipsia
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Diabetes mellitus, diabetes insipidus, hypercalcemia
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Fatigue
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Hypothyroid, Addison’s, diabetes, anemia
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Hormone excess/deficiency
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Primary/secondary gland problem
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Mass effects (compression, vision)
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Systemic effects (metabolic, menstrual, growth)
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Timeline (acute, chronic, fluctuating
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Lab
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Indication
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TSH + Free T4
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Thyroid function (hypo/hyper)
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Cortisol ± ACTH
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Adrenal function (Addison’s/Cushing’s)
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OGTT + HbA1c
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Glucose tolerance & diabetes control
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Prolactin
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Pituitary tumors, galactorrhea, amenorrhea
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PTH + Calcium
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Hyper-/Hypoparathyroidism
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LH/FSH + Sex hormones
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Gonadal axis function
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Insulin/C-peptide
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Differentiating type 1/2 diabetes, insulinomas
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Syndrome
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Key Features
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Cushing's
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Central obesity, moon face, purple striae, HTN, glucose intolerance
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Addison’s
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Hyperpigmentation, fatigue, hypotension, salt craving, weight loss
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Graves'
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Hyperthyroid + eye signs (exophthalmos, lid lag), diffuse goiter
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Hypothyroid
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Cold intolerance, dry skin, weight gain, fatigue, slow reflexes
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Acromegaly
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Enlarged hands/feet, coarse features, diabetes, spacing of teeth
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Prolactinoma
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Galactorrhea, amenorrhea, reduced libido, visual changes
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PCOS
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Irregular menses, hirsutism, acne, insulin resistance, obesity
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Glucose (pin prick)
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Visual field via confrontation
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Thyroid exam (palpate, swallow, auscultate)
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Visual signs (Cushingoid features, tremor, myxedema)
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Diabetic foot exam (vibration, pinprick, monofilament)
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