1. Presenting complaint
2. Alimentary changes
3. Integumental changes
4. Nervous changes
5. Rheumatoid changes
6. Urogenital changes
7. Past medical, surgical history
8. Family, social, drug history

Presenting complaint

• SOCRATES

Alimentary changes

• Weight loss (thyrotoxicosis, DM) vs. gain (Cushing's, hypothalamic dz).
• Wasting.
• Appetite: loss (Addison's) vs. increased (thyrotoxicosis).
• Diarrhea (hyperthyroid, Addison's)
• Constipation (hypothyroidism, hypercalcemia).
• Polydipsia [excess drinking] (DM, renal dz, hypercalcemia).

Integumental changes

• Pigmentation (hypopituitarism, Cushing's, acromegaly, Addison's). See Skin Colors Reference.
• Dryness (hypothyroidism, hypoparathyroidism).
• Sweating (hyperthyroidism, pheochromocytoma, arcomegaly).
• Overgrowth (acromegaly).

Nervous changes

• Nervousness, irritability (thyrotoxicosis).
• Fatigue (hypothyroid, DM, Addison's, acromegaly).
• Headaches (hypoglycemia).
• Seizures (hypoglycemia).
• Visual loss (acromegaly, DM).

Rheumatoid changes

• Shorter stature.
• Gigantism (Marfan's, Kleinfelter's, growth hormone).
• Hand, skull bony growth (acromegaly).

Urogenital changes

• Polyuria (DM, DI, polydipsia).
• Menstrual changes (polycystic ovary, pituitary dz).
• Impotence (hyperprolactinemia, hypogonadism, acromegaly).

Past medical, surgical history

• Congenital problems.
• Goiter, thyroid problems.
• Thyroidectomy.
• Thyroid surgery, radiation.
• Parathyroid, pituitary surgery.

Family history

• Condition in a family member (Marfan's, DM).

Social history

• Smoking: ever smoked, how many per day, for how long, type [cigarette, pipe, chew] (DM).
• Occupation (stress).
• Who is with you there at home [often chronic dz].

Drug history

• HRT.
• Thyroid drugs.
• Diabetic drugs.
• Prostate dz drugs.
• Steroids.

Endocrine Exam »