L&K - 6 year Internal exam

Polyuria, polydipsia, polyphagia, weight loss, blurry vision, fatigue; may present with DKA.

Polyuria, polydipsia, polyphagia, weight loss, blurry vision, fatigue; may present with DKA.

Often insidious: polyuria, polydipsia, polyphagia, fatigue, blurred vision, poor wound healing; may present with hyperosmolar hyperglycemic state.

Neurogenic/autonomic: tremor, sweating, anxiety, palpitations, hunger; neuroglycopenic: confusion, seizures, focal deficits, somnolence, coma. Symptoms often at BG <2.8 mmol/L.

Heat intolerance, weight loss with increased appetite, palpitations, tremor, anxiety, diarrhea, oligomenorrhea, exophthalmos (in Graves), goiter with bruit.

Fatigue, cold intolerance, weight gain, constipation, bradycardia, dry skin, hair loss, impaired memory; myxedema in severe cases and risk of myxedema coma.

Fatigue, weight loss, anorexia, hyperpigmentation, salt craving, hypotension, GI symptoms, hyperkalemia and hyponatremia.

Central obesity, moon facies, purple striae, thin fragile skin, proximal muscle weakness, hypertension, glucose intolerance, mood changes.

Thyrotoxic phase (transient hyperthyroid symptoms) followed by hypothyroid phase then recovery; De Quervain painful goiter with jaw pain and fever; postpartum subtype is painless.

Often asymptomatic; may have nephrolithiasis, bone pain, constipation, polyuria, polydipsia, depression, weakness. Signs of hypercalcemia.

Hyperprolactinemia: galactorrhea, oligomenorrhea/amenorrhea and infertility in women; decreased libido, erectile dysfunction, gynecomastia in men; macroadenomas cause headaches and bitemporal hemianopsia.

Symmetric inflammatory polyarthritis (MCPs, PIPs, wrists), morning stiffness >30 min, fatigue, rheumatoid nodules, systemic features (fever, weight loss).

Acute monoarthritis (classically podagra), severe pain, erythema, swelling often at night; chronic gout → tophi, joint destruction and nephrolithiasis. [page 14–15]

Asymmetric oligoarthritis or symmetric polyarthritis, dactylitis, enthesitis, nail pitting, associated psoriasis with scaly plaques.

Inflammatory back pain in young adults (<45): morning stiffness improving with activity, reduced spinal mobility, possible peripheral arthritis, enthesitis and kyphosis; extra‑articular uveitis.

Multisystem manifestations: malar rash, photosensitivity, arthritis, serositis, renal involvement (nephritis), hematologic abnormalities, neurologic symptoms and constitutional features.

Systemic features (fever, weight loss) with ischemic symptoms: new headache, jaw claudication, visual loss in GCA; limb claudication, pulselessness, BP asymmetry in Takayasu.

ENT involvement (sinusitis, nasal ulceration, saddle nose), pulmonary nodules/cavitation, hemoptysis, and rapidly progressive glomerulonephritis causing hematuria/RPGN.

Skin thickening and tightening (sclerodactyly), Raynaud phenomenon, telangiectasia, esophageal dysmotility, pulmonary fibrosis and PAH, renal crisis with malignant hypertension.

Proximal symmetric muscle weakness (difficulty rising from chair, combing hair), myalgias, dysphagia; dermatomyositis has skin findings (Gottron papules, heliotrope rash, shawl sign).

Heavy proteinuria (>3.5 g/day), hypoalbuminemia, hyperlipidemia, edema (periorbital → anasarca), increased infection and thrombotic risk.

Hematuria (cola‑colored urine), RBC casts, moderate proteinuria (1–3 g/day), hypertension, edema, oliguria and azotemia.

Rapid loss of renal function over days–weeks with nephritic features: hematuria, RBC casts, oliguria and often edema and hypertension.

Often episodic gross hematuria concurrent with or shortly after URTI or GI infection; may have proteinuria and progressive renal dysfunction in some.

Occurs 1–6 weeks after group A strep infection: hematuria, edema, hypertension, oliguria; may be asymptomatic in many.

Nephrotic syndrome with large proteinuria, hypoalbuminemia, edema; systemic signs may include macroglossia, restrictive cardiomyopathy, hepatosplenomegaly.

Early microalbuminuria progressing to overt proteinuria, hypertension, declining GFR, and features of CKD; associated diabetic retinopathy.

Nephrotic syndrome—massive proteinuria, hypoalbuminemia, edema—most common in children.

Can present nephritic or nephrotic: hematuria, proteinuria, hypertension, edema; may progress to CKD.

Nephrotic syndrome (edema, heavy proteinuria) often in adults; may progress to ESRD.

Oliguria or anuria, fluid overload, uremic symptoms (nausea, confusion, pericarditis), or asymptomatic lab abnormalities.

Often asymptomatic early; later uremic symptoms (fatigue, pruritus, anorexia), edema, hypertension, anemia, bone mineral disease.

Indicated for ESRD symptoms: uremia, fluid overload, refractory hyperkalemia, severe acidosis, encephalopathy.

Flank pain, hematuria, recurrent UTIs, nephrolithiasis, palpable/enlarged kidneys, progressive CKD; extrarenal cysts (liver) and Berry aneurysms.

Renal colic: severe flank pain radiating to groin, nausea/vomiting, hematuria; may cause obstruction and infection.

Cystitis: dysuria, frequency, urgency, suprapubic pain; pyelonephritis: fever, flank pain, nausea/vomiting, CVA tenderness.

Fatigue, pallor, brittle nails, koilonychia, pica, glossitis; signs of anemia and possible GI blood loss.

Megaloblastic anemia (macrocytosis), glossitis, pallor, neurological symptoms (paresthesias, ataxia, cognitive impairment).

Megaloblastic anemia similar to B12 deficiency (macrocytic), glossitis, GI symptoms; neurologic signs are typically absent.