endocrinology: pictorial quiz

ENDOCRINOLOGICENDOCRINOLOGICAL PICTORIAL AL PICTORIAL

QUIZQUIZ

• PROF. DR. G. SUNDARAMURTHY’S PROF. DR. G. SUNDARAMURTHY’S UNITUNIT

• DR. P. VANJINATHANDR. P. VANJINATHAN

A 40 Years old male patient A 40 Years old male patient presented with complaints of presented with complaints of generalized weakness,pain over the generalized weakness,pain over the both wrists tightening of the ring & both wrists tightening of the ring & increased thickness of the tongue increased thickness of the tongue and size of the hand and feetand size of the hand and feet

what is the diagnosis ?what is the diagnosis ?

ACROMEGALYACROMEGALY

Frontal BossingFrontal BossingIncreased hand & foot sizeIncreased hand & foot sizeMandibular Enlargement – PrognathismMandibular Enlargement – PrognathismIncreased Heel Pad ThicknessIncreased Heel Pad ThicknessLarge Fleshy noseLarge Fleshy noseGeneralized Visceromegaly -Generalized Visceromegaly -

Cardiomegaly,MacroglossiaCardiomegaly,Macroglossia

38 Years old woman presented with 38 Years old woman presented with complaints of gaining weight, growth complaints of gaining weight, growth of facial hair, amenorrhoea , recently of facial hair, amenorrhoea , recently diagnosed to have elevated Blood diagnosed to have elevated Blood Pressure with easy bruising.Pressure with easy bruising.

What is the diagonsis ?What is the diagonsis ?

Cushing’s SyndromeCushing’s SyndromeWeakness of proximal musclesWeakness of proximal musclesPurplish striaePurplish striaeOsteoporosisOsteoporosisMoon facies, buffalo torsoMoon facies, buffalo torsoHypertension, EdemaHypertension, EdemaAcne, Hirsuitism, Oligo/AmenorrhoeaAcne, Hirsuitism, Oligo/AmenorrhoeaInsomnia, frank psychosisInsomnia, frank psychosis

32 years old woman presented with complaints of loss of weight, tremors, increased sweating ,palpitations,loss of hair in eye brows.

What is the diagnosis ?

Grave’s diseaseGrave’s disease

40 years old male presented with easy fatiguability, weight loss, anorexia, increased pigmentation over palms and dorsum of feet.

What is the diagnosis ?

ADDISON’S DISEASEADDISON’S DISEASE

• Mineralocorticoid deficiency –Mineralocorticoid deficiency –

Hyponatremia, Hyperkalemia , Hyponatremia, Hyperkalemia , AcidosisAcidosis

• Glucorticoid deficiency –Glucorticoid deficiency –

Hypoglycemia, Hypoglycemia,

Impaired energy mobilizationImpaired energy mobilization

• Increased ACTH – HyperpigmentationIncreased ACTH – Hyperpigmentation

PSEUDOHYPOPARATHYROIDISPSEUDOHYPOPARATHYROIDISMM

• Hereditary disorderHereditary disorder

• Symptom and Signs of Hypoparathyroidism Symptom and Signs of Hypoparathyroidism despite an increased PTH leveldespite an increased PTH level

• Due to end organ resistance to PTHDue to end organ resistance to PTH

• Hyperplasia of parathyroid glandsHyperplasia of parathyroid glands

• Short stature, Round face, BrachydactylyShort stature, Round face, Brachydactyly

• Short 4Short 4thth and 5 and 5thth metacarpals and metacarpals and metatarsalsmetatarsals

NECCROBIOSIS LIPOIDICA NECCROBIOSIS LIPOIDICA DIABETICORUMDIABETICORUM

Rare disorderRare disorder Young women with Type 1 DM, Young women with Type 1 DM,

Neuropathy, RetinopathyNeuropathy, Retinopathy Begins in pretibial region as an Begins in pretibial region as an

erythematous plaque or papules that erythematous plaque or papules that gradually enlarge, darken & develop gradually enlarge, darken & develop irregular margins with atrophic centres & irregular margins with atrophic centres & central ulcerationcentral ulceration

PainfulPainful

Diabetic DermopathyDiabetic Dermopathy

• Pigmented pretibial papules/diabetic Pigmented pretibial papules/diabetic skin spotsskin spots

• Elderly male, T2 DMElderly male, T2 DM

• Shin of legs, Minor mechanical Shin of legs, Minor mechanical traumatrauma

• As an erythematours area As an erythematours area Area of Area of circular hyper pigmentationcircular hyper pigmentation

DIABETIC DIABETIC AMYOTROPHYAMYOTROPHY

Disabling illnessDisabling illnessMiddle age or laterMiddle age or laterWeakness followed by wasting of Weakness followed by wasting of

pelvifemoral muscles - U/L or B/L, pelvifemoral muscles - U/L or B/L, associated with painassociated with pain

Concomitant distilled predominantly Concomitant distilled predominantly sensory neuropathysensory neuropathy

Inv - Electro diagnostics studiesInv - Electro diagnostics studies

CHARCOT’S JOINTCHARCOT’S JOINTa complication of diabetic neuropathya complication of diabetic neuropathyAffects both type 1 and type 2 DM patientsAffects both type 1 and type 2 DM patientsIn long standing diabetics and neuropathy In long standing diabetics and neuropathy

is always present and quite severeis always present and quite severeFoot becomes very swollen and warm to Foot becomes very swollen and warm to

touchtouchBones in the foot are weakened and Bones in the foot are weakened and

fractured without a major traumafractured without a major traumaLeads to severe deformities, intractable Leads to severe deformities, intractable

ulceration ulceration culminating in the need for culminating in the need for amputationamputation