Endocrinology & Metabolism M1 CuRE preclerkship Carmen Hurd, Course leader February 6, 2014

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Composite Clinical Presentations CP4* UGME Sept 2012 DRAFTV6 HEALTH CONDITIONS

SYMPTOMS & SIGNS 34 hemoptysis ABNORMAL LABS 99 ADHD spectrum

1 abdominal mass 35 Hirsutism *** 66 acidosis 100 adrenal disorders ***

2 abd pain: acute & chronic 36 hoarse voice 67 alkalosis 101 arthritis 3 allergic reactions 37 impotence 68 hemoglobin disorders 102 CVD 4 anxiety 38 incontinence 69 calcium/phopshate/magnesium *** 103 cirrhosis 5 ascites 39 jaundice 70 cardiac markers/EKG 104 CNS infections 6 blunt trauma 40 joint pain-acute & chronic 71 coagulation abnormalities 105 Diabetes ***

7 burns 41 low back pain 72 creatinine:acute & chronic 106 Drug OD 8 bleeding 42 lymphadenopathy 73 CXR abnormalities 107 eating disorders 9 cardiac murmurs 43 neck mass/thyroid *** 74 lipid abnormality *** 108 fungal infections

10 chest pain 44 pain syndrome 75 leukocyte disorders 109 HIV/AIDS 11 constipation 45 palpitations 76 liver enzymes/function 110 hypertension 12 cough- acute & chronic 46 pruritus 77 potassium abnormalities 111 infertiltiy 13 cyanosis 47 red eye 78 platelet disorders 112 kidney disease-chronic 14 delirium 48 paralysis 79 pulmonary function tests 113 lung disease-chronic 15 dementia 49 pelvic pain/mass 80 sodium abnormalities 114 malnutrition 16 diarrhea- acute & chronic 50 seizures 81 urinalysis abnormalities 115 menses/menopause ** 17 diplopia 51 skin growths FACTORS EFFECTING HEALTH 116 mood disorders 18 dysphagia 52 skin rashes 82 adverse drug reactions 117 multiple sclerosis 19 dyspnea-acute & chronic 53 sleep disorders 83 chronic disease 118 Osteoporosis ** 20 dysuria/UTI 54 somnolence 84 Contraception 119 pediatric emergencies 21 ear pain 55 sore throat 85 Culture 120 palliative care 22 edema 56 syncope 86 WHO Determinants of Health 121 pituitary disorders ** 23 extremity pain-acute&chronic 57 tendon rupture 87 developmental pediatric delay 122 pregnancy/complications 24 eye trauma 58 testicular swelling/pain/mass 88 Disabilities 123 psychosis 25 fever 59 tinnitus 89 neglect/abusive relationship or behavior 124 suicidal behavior 26 fatigue 60 vomiting 90 educational level 125 shock/resuscitation 27 foot ulcers *** 61 vision loss acute&chronic 91 elderly/frail 126 sports injuries 28 fracture/dislocation 62 weakness 92 environmental health 127 STI 29 GI bleed 63 wheezing- acute & chronic 93 infectious epidemic/prevention 128 suicidal behavior 30 head injury 64 UT obstruction symptoms-lower 94 food and water security 129 systemic autoimmune disorders 31 headache 65 vertigo/dizziness 95 body weight disturbances *** 130 surgical infections 32 hearing loss weight loss, polyuria, polydipsia, hypertension 96 substance abuse/addiction/alcoholism 131 TB 33 hematuria 97 poverty 132 Thyroid disorders **

98 smoking 133 Venous thrombosis Missing: Growth and puberty, sexual differentiation

Endo & Metabolism M1: Objectives 1. Describe hormone physiology, including regulatory mechanisms 2. Describe both normal and abnormal growth and pubertal development 3. Describe the hypothalamic and pituitary axis, with an emphasis on anatomy,

imaging, and pituitary hormone secretion, action and regulation 4. Describe male and female reproductive physiology including anatomy of the

specified organs, hormone secretion and regulation, the menstrual cycle, and spermatogenesis

5. Describe normal glucose metabolism. 6. Understand the definition of, risk factors for, and health consequences of obesity in

adults and children 7. Describe the risk factors, pathophysiology, epidemiology, and diagnosis of type 1

and type 2 diabetes 8. List the principles of diabetes self-management 9. Describe insulin pharmacokinetics 10. Describe the physiology of lipid metabolism 11. Describe common lipid disorders, and the mechanism of common lipid-lowering

medications 12. Describe the anatomy and physiology of the thyroid and adrenal glands, and of

their respective hormones 13. Describe bone physiology and calcium metabolism 14. Identify the basic anatomy and normal histology of endocrine glands

Mid Term to cover first half of course, 50% of final grade Final exam to cover second half of course, 50% of final grade

Endo & Metabolism M1: Clinical Reasoning • 3-4 cases:

• Hypotension (due to addison’s disease) • Amenorrhea (due to a prolactin-secreting tumor) • Hypertriglyceridemia • ?

Endo & Metabolism M2: Objectives

Course Description: • Endocrinology and Metabolism M2 exposes students to clinical aspects of

endocrinology, diabetes, and lipids. The first half of the course will focus on the pituitary, adrenal, and thyroid glands and reproductive endocrinology. The second half will focus on bone/calcium, diabetes and lipids.

Course Objectives: By the end of Endocrinology and Metabolism M2, the student will be able to: • Describe the epidemiology of common endocrine and metabolic disorders. • Explain the importance of prevention and screening, particularly for obesity and

diabetes. • Develop a differential diagnosis and investigational approach to endocrine and

metabolic disorders. • Interpret investigations to help diagnose endocrine and metabolic disorders. • Identify common presentations for common endocrine and metabolic disorders. • Understand management principles of endocrine and metabolic disorders. •

Topic outline