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History of Pituitary Disease, Thyroid Examination, Thyroid History,…

- - - - TSH
        
        Hypothyroidism
        
        Hyperthyroidism
      - ACTH
        
        Targets adrenal cortex
        
        Cortisol
        
        Deficiency
        
        Acute
        
        Fatigue
        
        Hypotension
        
        Nausea/vomiting
        
        Weight loss
        
        Chronic
        
        Same as Addisons Disease (but NO excess pigmentation since ACTH low [secondary adrenal sufficiency, Addisons is primary])
        
        6 more items...
        
        Excess
        
        Cushing's Disease
        
        Weight gain
        
        2 more items...
        
        Hypertension
        
        Proximal muscle weakness
        
        Thin skin
        
        1 more item...
      - LH and FSH (gonadotropins)
        
        Deficiency
        
        Women
        
        Infertility
        
        Osteoporosis
        
        Changes in menstruation
        
        Men
        
        Testicular atrophy
        
        Infertility
        
        Decrease in body hair
        
        Change in shaving frequency
        
        Osteoporosis
        
        Mood changes
      - GH
        
        Deficiency
        
        Loss of muscle mass
        
        Increased fat (esp. central)
        
        Asthenia
        
        Fatigue
        
        Loss of strength
        
        Excess
        
        Acromegaly
        
        Skin thickening
        
        Skin tags
        
        Excessive sweating
        
        Deepened voice
        
        Enlarged hands/feet
        
        Hypertension
        
        Enlarged facial features (jaw, chin, tongue)
        
        Headaches
        
        Daytime sleepiness
        
        Snoring
      - PRL
        
        Deficiency
        
        Failure to lactate (women)
        
        Excess
        
        Symptoms of oestrogen or testosterone deficiency (because prolactin inhibits GnRH release)
        
        Women
        
        Galactorrhoea
        
        Amenorrhea
        
        Men
        
        Production of breast milk
        
        Gynecomastia
  - - - Vision changes
    - - Eye movement issues
- - - - Hypothyroidism
  - - - Bilateral?
  - - - Grave's Ophthalmopathy
        
        Grave's Disease
  - - - Restricted movement
  - - - Upper lid doesn't follow eye down or delayed
- - - - Thyrotoxicosis (hyperthyroidism)
- - - - Bruit positive suggests Graves Disease
- - - - Hyperthyroidism
  - - - Grave's Disease
- - - - Restlessness
      - Irritability
  - - - Lifting
      - Climbing stairs
  - - - Can lead to
        
        Atrial fibrillation
  - - - Grave's disease
- - - - Lethargy
      - Depression
        
        Low mood
        
        Irritability
      - Somnolence
    - - Decreased appetite
      - Constipation
    - - Ask how much and over what period if so
    - - Hair loss
    - - Myalgia
    - - Oedema
      - Dyspnoea
    - - Numbness or pain in hands
- - - - Hyperpigmentation
- - - - Virilisation
        
        Deepening of voice
        
        Acne
        
        Clitoral enlargement
        
        Frontal balding
      - Hirsutism
    - - Often unnoticed
- - - - Hypertension
      - Increased urination/thirst
      - Increased Na+
        
        Decreased K+
        
        Muscle weakness/cramping
- - - - Headache
      - Episodic anxiety
      - Palpitations
      - "Impending sense of doom"