SIADH (syndrome of inappropriate ADH secretion)
1) A 56-year-old man complaining that he noticed that his
shoes were becoming tight. On examination he has prominent supra orbital
ridges and his jaw looked prominent.
There was malocclusion of the teeth. His hands looked
large and the skin over the back of the hands was thickened. There was wasting
of the muscles of the thenar eminence.
2) A patient is referred for investigation of
hypertension. On examination she has central obesity and thins arms and legs.
She is hirsute .She has an oily skin and acne. There are purple striae on her
abdominal wall. She has evidence of proximal muscle weakness.
3) A 56-year-old female is referred for investigation of
a complaint of feeling weak and lethargic. He blood pressure is low and there
is a postural drop in blood pressure. On examination there is generalised
pigmentation of the skin with more marked pigmentation in the skin creases, in
the buccal mucosa and the nipples.
4) A 30-year-old female has been referred for
investigation of loss of weight. On examination she is thin her skin is
sweaty; she has a fine tremor and tachycardia.
5) A 55-year-old female is referred for investigation of
lack of energy. On examination she is overweight, her skin is coarse, dry and
cold. There is diffuse loss of hair over her scalp. Her pulse rate is slow.