Def Etiology Symptoms Physical exam Lab/instrumental Complication

Hyperthroidism-  Family predisposition  Rapid weight loss  Reduced weight  Decreased cholesterol Thyrotoxic crisis
Classification  Female sex  Sweating  Muscle waste and and increased Thyrotoxic
 Stress  Increased HR with decreased muscle triglycerides cardiomyopathy
 Infection premature beads or strength  Slightly increased Toxic hepatitis
 Toxic multinodular goiter arrythmia  Possible subfebrile glucose
 Secondary-TSH producing  Systolic arterial hypertension temp  Increased FT3
adenoma  Weakness  + signs of Grefe  Decreased TSH and
 Fatigue  Bilateral TTH
 Easy tiredness exophthalmos with  Ultrasound of thyroid
 Sexual impotence in men- hyperthyroid stare gland
loss of hair  Thyroid gland is  Low levels of calcium
 Menstrual disturbances enlarged with in secondary, high in
 In some cases secondary tenderness during primary
diabetes mellitus palpitation  ECG
Hypothroidism  Autoimmune-  Fatigue  Obesity  Increased cholesterol Pericarditis
 Reduced intake of iodine  Exhausation  Loss of scalp hair, and low blood glucose Ischemic Heart disease
Primary  Infections  Weight gain axillary hair, pubic  Increased TSH and Myxedema coma
Secondary  Total or partial resection  Bradycardia hair TTH
of gland  Amenorrhea  Macroglossia  Decreased FT3 and
 Drugs- amiodarone,  Decreased libido  Low HR and systolic FT4
interferon alpha  Coarse voice BP  Ultrasound-
 Idiopathic  Bradycardia  Periorbital puffiness  Fine needle aspiration
Predisposition  Bradypsychia biopsy
Female sex, family predis, endemic  Bradylalia- slowness  Secondary- MRI of
region with lack pf iodide in speech pituitary gland
 Edema  ECG bradycardia with
low QRS complexes
Hyperadrenocortism- Primary  Fatigue  Obesity affecting  increased blood sugar
increased synthesis of  Hyperplasia or tumours  Proximal muscle weakness the body while the and WBC
cortisol due to hyperplasia of the cortex of  Weight gain often with limbs are thin  decreased potassium
or tumours suprarenal gland edema  Moon shaped face  possible elevated liver
Secondary  Elevated systolic and  Buffalo hump enzymes
 Adenoma of the frontal diastolic BP  Purple striae over  Increased levels of
part of pituitary gland  Hyperacidity abdomen, buttocks cortisol rhythm
 Prolonged treatment with  Pain in bones due to lower back, upper  Acth is decreased
 corticosteroids (bronchial osteoporosis thighs primary hypercortism
asthma, connective tissue  Secondary diabetes mellitus  acanthosis  CT scan
and other types of  Menstrual irregularities nigricans-axilla  PET scan and MRI
autoimmune)  Decreased libido in men and  MRI
 Ectopic ACTH- due to women  ECG with hypertrophy
bronchial or other tumour of LV with ST-T
secreting similar ACTH changes
substances
Hypoadrenocortism- Primary  Excessive weakness  Hyperpigmentation  Increased K+
decreased synthesis of  Due to atrophy of the  Easy tiredness – face, breasts,  Low sodium
secretion of corticosteroids cortex and the suprarenal  Vertigo elbows, lines of the  Low BP glucose
gland caused by  Drowsiness palms and  Reduced level of
infections, autoimmune  Low bP gum(increased cortisol and
disease, amyloidosis  Orthostatism secretion of aldosterone with
Secondary  Nausea melanocyte increased ACTH
 Due to tumours or  Abdominal pain stimulation  CT
postpartum ischemic  Loss of appetite and weight hormone)  MRI
infarction of pituitary  Reduced fat and
gland muscle tissue
 Menstrual
disturbances
GOUT  Crystallisation of uric acid-  A red, hot, tender, swollen  Obsese  Synovial fluid analysis-
Form of inflammatory occur because of genetic, joint  Skin looks red and  Blood test-
arthritis characterised by diet or decreased  MTP joint at base of toe is shiny hyperuricemia, blood
recurrent attacks of a red, excretion of urate most often affected  Tophi may appear plasma level
tender, hot, swollen joint  Diet- consumption of  Can affect ankle, knees , around joints, pinna >420micromols, 360 in
alcohol, fructose wrist and elbow of ear females
sweetened drink, meat  Fever  RF
and seafood  Fatigue  ANA
 PRPS- mutation  Malaise  Ultrasound- to detect
 Medical condition= Gout  Hyperuricemia urate crystal in a joint
frequently occurs in  Limited range of motion  X-ray- joint X-ray can
combo with other medial be used in ruling out
problem, metabolic other causes of joints
syndrome, kidney  CT/MRI
failure,hemolytic
 anaemia
 Medication- diuretics
 Obesity and diabetes= risk
factor
Rheumatoid arthritis Cause is unknown, it is an  Swollen, tender and warm  Persistent  RF is increased about • Eyes = episcleritis or
autoimmune disease-some genetic joints-MCPA, PIP, MTP symmetric 80% of people with RA scleritis. More
and environmental factors  Joint stiffness-usually worse polyarthritis that  APCA common is the indirect
in morning and after affects hands and  Antinuclear B- effect of
Etiology inactivity feet  Blood- sedimentation keratoconjunctivitis
 Rheumatoid nodule in skin  Pain upon walking rate, CRP, kidney sicca, which is a
 Genetic predisposition-  Fatigue  Ulnar deviation function dryness of eyes and
family history of RA- HLA-  Fever  Buttonhole  X-ray- decreased bone mouth caused by
DR1 and HLADR4  Local osteoporosis around deformity density, bone erosion, lymphocyte infiltration
 Environmental- Smoking, inflamed joints  Swan neck narrowing of joint of lacrimal and salivary
silica exposure, infections  Periodontitis and tooth loss deformity space glands.
 Obesity  Pericarditis  Ultrasound MRI
 F sex  Carpal tunnel syndrome • Heart = endocarditis,
pericarditis, L ventricle
failure,

• Renal amyloidosis as
a consequence of
untreated chronic
inflammation

• Joint damage, joint

DMARD

ANTIFLARES

Ankylosing spondylitis- type  Idiopathic  Chronic dull pain in the  Schober test-  CRP Vertebral fractures
of arthritis where there is  Combination of genetic lower back or gluteal region measure degree of  Sedimentation rate
long term inflammation of and environmental factors  Pain often severe at rest may lumbar forward  HLAB27 Ag test
the joints of the spine. >90 of those affecting improve during physical flexion as the  Increase ESR
have HLA-B27 activity patients bends over  X-ray
 Worse at nigh w morning as though touching  MRI
stiffness toes  Ultrasound
 Loss of spinal mobility  Gaenslen test-
 Loss of chest expansion w/a patient supine, hip
limitation of ant. Flexion, joint is maximally
lat.flexion and extension of flexed on one side
lumbar spine and the opposite
 Fatigue hip is extended
 Fever  Chin brown
 Malaise measurement- AS
 Enthesitis- achilles often have necks
tendonitis, plantar fasciitis that angle forward
sharply as the spine
stiffens
 Chest expansion-
compromised
Autoimmune connective SLE is presumably caused by  Systemic- low grade fever,  Cyanosis(secondary  ANA test +
disorders genetic susceptibility coupled w/an photosensitivity to resp compl)  Blood work-
environmental trigger which  Mouth and nose- ulcers  Butterfly rash hematological
Systemic lupus results in defects in immune  Face- butterfly rash  Rash over body disorder- leukopenia,
erythematosus system  Fatigue  lymphopenia
 Loss of appetite  Urine serology-
Environmental One of the factors associated with  Joint pain- arthritis protein in urine
tiggergenetic factor SLE is vit D def  Discord rash-scar  MRI scan
immune system cant clear  Pleuritis, pericarditis
effectively nuclear Risk factors- smoking, direct  Kidney disorder
antigen immune sunlight, F sex, black Asian and  Blood disorder-anemia
response desposition in ethnicity, medication  Neurological disorder
tissues