By Pauline Camacho
This compact but whole consultant to the analysis and remedy of endocrine and metabolic problems combines the benefits of a brief textual content ebook with these of an atlas, and gives thorough dialogue of every sickness supported by means of a wealth of pictures. each one subject is roofed via a consultant contributor. whereas reflecting the good advances in biochemical and radiological research, the authors emphasize that analysis of many endocrine stipulations nonetheless is dependent upon the medical acumen of physicians.
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Extra resources for Clinical Endocrinology and Metabolism (Color Handbook Series)
Up to half of patients will present with local or distant disease; the favored sites of spread being cervical lymph nodes, then mediastinum, lung, liver, and bone. Some patients may present with pain from local invasion. The overall clinical behavior is more aggressive than the differentiated thyroid cancers above, but less aggressive than anaplastic cancer. Thyroid cancer 35 Anaplastic thyroid cancer Anaplastic thyroid cancer is an uncommon entity, accounting for less than 2% of thyroid cancers, but causing the most deaths.
Physical findings include proximal thigh weakness and atrophy. Those with thoracic polyradiculopathy may present with severe pain in a band-like distribution about the chest or abdomen. Cranial mononeuropathies can affect the oculomotor, trochlear, and abducens nerves, leading to ophthalmoplegia. Patients with diabetic ophthalmoplegia present with unilateral pain, ptosis, and diplopia. Peripheral mononeuropathies may produce effects in the median, ulnar, radial, and peroneal nerves. This has an acute onset and may result in symptoms such as foot drop.
Hypersensitivity reactions, lipohypertrophy, lipoatrophy, nodule formation, and cellulitus may be seen in patients administered insulin. The use of sufonylureas may lead to the development of a wide variety of skin manifestations. Thiazolidindiones, metformin, and alpha-glucosidase inhibitors have not been associated with significant cutaneous manifestations. ETIOLOGY Please refer to pathophysiology. PATHOPHYSIOLOGY Lipohypertrophy likely results from localized effects of insulin. Insulin in high concentration leads to the inhibition of lipolysis locally.