General |
Brain (neurologic/psychiatric) |
Head and neck |
– Weakness, fatigue, lethargy – Dizziness, syncope – Weight fluctuations: marked weight loss or gain – Arrested linear growth – Cold intolerance – Sweating/hot flashes |
– Poor concentration and memory – Altered cognition – Insomnia – Features of depression, anxiety, obsessive-compulsive disorder – Social withdrawal – Irritability |
– Dental enamel erosion and caries – Parotid enlargement (from self-induced vomiting) – Oral trauma and lacerations – Dry, cracked lips and tongue |
Cardiac and pulmonary |
Gastrointestinal |
Endocrine |
– Dysrhythmias – Palpitations – Chest pain – Shortness of breath – Edema – Dizziness – Orthostatic heart rate and blood pressure changes – Delayed capillary refill – Acrocyanosis |
– Constipation or diarrhea – Gastroesophageal reflux – Abdominal discomfort/bloating – Delayed gastric emptying, early satiety – Hemorrhoids, prolapse – Hematemesis |
– Amenorrhea or irregular menses – Delayed pubertal development – In diabetes, poor glucose control and possible diabetic ketoacidosis – Infertility |
Renal/metabolic |
Dermatologic |
Musculoskeletal |
– Renal calculi – Edema – Dehydration – Incontinence |
– Dry skin – Carotenoderma – Hair loss or thinning – Brittle nails – Lanugo – Poor wound healing – Russell sign: calluses on the knuckles or dorsum of the hand due to self-induced vomiting |
– Decreased bone mineral density/osteoporosis, risk of bone fractures – Fatigue – Muscle weakness – Cramps |