23
Physical Examination
Findings Screening Tests Confirmatory Tests
Delayed ankle reflex;
periorbital edema; coarse
skin; cold skin; slow
movement; goiter
yroid- stimulating
hormone; free thyroxine
None
Lid lag ; fine tremor of
the outstretched hands;
warm, moist skin, goiter,
thyroid nodule
yroid- stimulating
hormone; free thyroxine
Radioactive iodine uptake
and scan
Skin stigmata of
neurofibromatosis
(café-au-lait spots;
neurofibromas);
orthostatic hypotension
24-h urinary fractionated
metanephrines or plasma
metanephrines under
standard conditions (supine
position with indwelling IV
cannula)
CT or MRI scan of
abdomen/pelvis, Ga-
DOTATATE PET/CT scan
BP higher in upper
extremities than in
lower extremities;
absent femoral pulses;
continuous murmur over
patient's back, chest,
or abdominal bruit;
le thoracotomy scar
(postoperative)
Echocardiogram oracic and abdominal
CT angiogram or magnetic
resonance arteriography
Central obesity,
"moon" face, dorsal and
supraclavicular fat pads,
wide (1 cm) violaceous
striae, hirsutism
Overnight 1-mg
dexamethasone suppression
test
24-h urinary free cortisol
excretion (preferably
multiple); midnight salivary
cortisol
Usually none Serum calcium Serum parathyroid hormone
