General

Dwarfism

Deficiency in growth hormone --> retardation of growth Delayed puberty

Hypothyroidism and adrenal insufficiency

Gigantism

Excessive secretion of growth hormone BEFORE puberty--> overgrowth of the entire body.

Increased height

Increased weight and delayed sexual development.

Agromegaly

Excessive secretion of growth hormone AFTER puberty -->

overgrowth of bone in face, head, hands, and feet but no change in height.

Internal organs also enlarge (e.g., cardiomegaly), and

metabolic disorders (e.g., diabetes mellitus)

Anorexia nervosa

This severe mental health disorder is characterized by severevand life-threatening WEIGHT LOSS. Behavior is characterized by fanatic concern about weight, aversion to food, distorted body image, starvation diets, frenetic

exercise patterns, intense fear of weight gain, and striving for perfection.

Endogenous obesity: Cushing syndrome

Either administration of adrenocorticotropin (ACTH) or

excessive production of ACTH by the pituitary stimulates the adrenal cortex to secrete excess cortisol. This causes Cushing syndrome, characterized by weight gain and edema with central trunk and cervical obesity (buffalo hump) and round, plethoric face (moon face). Excessive catabolism causes muscle wasting; weakness; thin arms and legs; reduced height; and thin, fragile skin with purple abdominal striae, bruising, and acne.

OLDCART

Onset

Location

Duration

Characteristics

Aggrevating factors

Relieving factors

Treatment

PQRSTU

Provocative or palliative

Quality or quantity

Region or radiation

Severity scale 1-10

Timing or onset

Understand patient's perception of problem

4 parts of general survey

1. Physical appearance (age, sex, LOC, skin color, facial features)

2. Body structure (stature, nutrition, symmetry, posture, position, contour, deformities)

3. Mobility (gait, ROM)

4. Behavior ( facial expression, mood, speech, dress, hygiene)

Assessment order

1. inspection (good lighting, adequate exposure, instruments)

2. palpation (fingertips, fingers + thumb, dorsa, base)

3. percussion (soft --> deep) (dull, tympanic, hollow, flat)

4. auscultation