Glândulas

O médico é obrigado a considerar algo mais do que um órgão doente, além do homem como um todo - ele precisa ver o homem em seu mundo.
Harvey Cushing (1869-1939)


Propedêutica


Sintomas

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Dx Diferenciais

Polidipsia 
  • Diabetes mellitus
  • Diabetes insipidus
  • Hypercalcemia
  • Psychogenic polydipsia (associated with schizophrenia)
  • Sjögren's syndrome
  • Anticholinergics
  • Primary hyperaldosteronism
Poliúria 
  • Osmotic diuresis: diabetes mellitus, mannitol infusion, radiocontrast media, high-protein tube feeds
  • Drugs: diuretics, lithium, caffeine
  • Diabetes insipidus
  • Hypercalcemia, eg, hyperparathyroidism
  • Psychogenic polydipsia (eg, schizophrenia)
  • Excess IV fluids
  • Chronic renal failure (early)
  • Diuretic phase of acute tubular necrosis (ATN)
  • Hypokalemia
  • Post-transurethral resection of the prostate
  • Cushing’s syndrome
  • Primary hyperaldosteronism
  • Inability to concentrate urine: sickle cell trait or disease, chronic pyelonephritis, amyloidosis
  • Anxiety
Polifagia 
  • Diabetes
  • Hipertireoidismo
  • Cushing
  • Insulinoma
  • Ansiedade
  • Obesidade
  • Psiquiátrico
  • Má absorção
  • Fístula intestinal
  • By Pass intestinal
peso 
  • Increased caloric intake
  • Fluid retention: congestive heart failure (CHF), cirrhosis, nephrotic syndrome
  • Cushing’s syndrome, eg, exogenous corticosteroids (central obesity)
  • Hypothyroidism (edema and fat accumulation)
  • Alcoholism (via hypercortisolism)
  • Menopause (decreased metabolic rate)
  • Polycystic ovary syndrome
  • Syndrome X (obesity, diabetes, and hypertension)
  • Insulinoma (hypoglycemia causing overeating)
  • Insulin or thiazolidinedione therapy (worsen obesity)
  • Other drugs, eg, antipsychotics, antidepressants
  • Pregnancy
  • Growth hormone deficiency
  • Hypothalamic disorders
  • Congenital leptin deficiency (morbid obesity)
  • Defects in ?-MSH (melanocortin 4) receptor (morbid obesity)
  • Genetic syndromes of obesity and mental retardation: Prader-Willi syndrome (hypotonia, hypogonadism); Laurence-Moon-Bardet-Biedl syndrome (polydactyly, renal anomalies, retinitis pigmentosa, hypogonadism); Cohen’s syndrome (microcephaly, hypotonia, short stature, ocular anomalies, neutropenia); Biemond syndrome (diabetes mellitus, polydactyly, coloboma, facial anomalies, hypogonadism)