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diagnosis differential endocrinology amenorrhea dermatology generalized gynecology hypothyroid obgyn primary pruritus systemic acth adrenal dyslipidemia gynecomastia hyperlipidemia insufficiency lipidprofiles myopathy
Approach to Thyroid Function Tests in the Evaluation of Hyperthyroidism • Low TSH, Low normal T4
Approach to Thyroid Function ... normal T4 → Possibly ... • Low TSH, normal ... T3 → Central (secondary ... #algorithm #diagnosis
Laboratory Evaluation of Patients for Thyroid Disease Hyperthyroidism: • Graves disease - TSH low; free T4
Thyroid Disease Hyperthyroidism ... in some cases, T3 ... normal; T3 low; ... disease course #hypothyroid ... #hyperthyroid #
Pruritus - Generalized Differential Diagnosis Algorithm - Systemic and Primary Causes == Primary Skin Lesions == Macules /
Systemic and Primary Causes ... Mellitus Liver Function ... /uremia TSH & T4 ... Pruritus #primary #secondary ... #causes
Abnormal Lipid Profiles - Differential Diagnosis Algorithm Increased Cholesterol and Triglycerides - Genetic Causes
Abnormal Lipid Profiles ... Differential Diagnosis Algorithm ... Diabetes • Hypothyroidism ... Hypothyroid ... #Dyslipidemia #Abnormal
Pruritus - No Primary Skin Lesion - Differential Diagnosis Algorithm Blood Glucose: • Diabetes Mellitus Liver Function Tests/Enzymes:
Mellitus Liver Function ... /uremia TSH & T4 ... : • Hypothyroidism ... #Pruritus #secondary ... #causes
Hypothyroid Myopathy Very common (up to 80% ) in patients with hypothyroidism Pathophysiology: • T4 deficiency leads to
Hypothyroid Myopathy ... patients with hypothyroidism ... Pathophysiology: • T4 ... deficiency leads to abnormal ... impairs musde function
Gynecomastia - Differential Diagnosis Algorithm No Testicular Mass on Ultrasound • Adrenal Neoplasm • Increased Extraglomerular Aromatase
Tumor Increased T4 ... Decreased TSH • Hyperthyroidism ... T4 and TSH • ... • Non-Tumor Secondary ... #causes #endocrinology
Causes of Secondary Amenorrhea - Differential Diagnosis Algorithm Absence of menses for more than 3 cycles or
Causes of Secondary ... FSH, Low estrogen ... : • Functional ... compression) • Hypothyroidism ... #Causes #OBGyn
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Insufficiency Diagnosis Algorithm ... unclear (often the case ... this indicates normal ... adrenal function ... primary AI - Low
Causes of Primary Amenorrhea - Differential Diagnosis Algorithm No onset of menarche by age 16 with secondary
by age 16 with secondary ... age 14 without secondary ... Etiology - High FSH, Low ... Hypothalamic: • Functional ... Hyperprolactinemia • Hypothyroidism
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