Bradycardia | Cold extremities/acrocyanosis/weak peripheral pulses/reduced capillary refill time |
Orthostatic changes in pulse or blood pressure | |
Hypothermia | |
Dull, thinning hair | Muscular weakness and peripheral neuropathy* |
Sunken cheeks, sallow skin | |
Lanugo hair | Cutting/self-harm |
Signs of malnutrition, angular stomatitis, pallor | Callous on third finger (Russell's sign) |
Atrophic breasts | |
Pitting oedema in peripheries | Dental erosion |
Carotenaemia (yellowing of palms) | Parotidomegaly |
Infection | Signs of vomiting |
Thyroid (for differential diagnosis) | Signs of substance abuse |
* The SUSS test: Sit up: The patient is asked to sit up from lying supine on a flat surface without using the hands, if possible. Squat: The patient is asked to squat and to rise without using the hands, if possible. Rating: 0 completely unable to rise; 1 able to rise only with use of hands; 2 able to rise with noticeable difficulty; 3 able to rise without difficulty.