Associated history or physical finding	Suspected conditions	Actions to consider
Abdominal cramping, attacks of cyanotic flushing, edema, hypotension, watery diarrhea, wheezing	Carcinoid tumor	24-hour urine 5-hydroxyindoleacetic acid; certain foods may cause false-positive results; if elevated, the tumor must be localized using radiologic imaging
Anxiety, diarrhea, exophthalmos, heat intolerance, tachycardia, tremor	Hyperthyroidism	Thyroid-stimulating hormone
Cough, fever, high-risk sexual activity, history of exposure to tuberculosis, immunocompromise, intravenous drug use, Janeway lesions, new heart murmur, Osler nodes, splinter hemorrhages, travel, weight loss	Endocarditis HIV Tuberculosis	Complete blood count, purified protein derivative or interferon-gamma release assay, chest radiography, HIV test (CD4+ count if known to be HIV-positive), blood cultures to include HACEK organisms, echocardiography
Diabetes mellitus, episodic sweating	Hyper-/hypoglycemia	Test blood glucose during typical episode
Erectile dysfunction, low libido	Male hypogonadism	Early-morning total testosterone level
Excessive daytime sleepiness, Mallampati III or IV oropharynx, observed snoring or gasping during sleep, overweight	Obstructive sleep apnea	Sleep study
Firm lymphadenopathy without recent infection	Malignancy	Lymph node biopsy
Generalized sweating, headache, labile hypertension, paroxysms of palpitations	Pheochromocytoma	24-hour urine catecholamines or metanephrines, plasma; if elevated, the tumor must be localized using radiologic imaging
Heartburn, indigestion	Gastroesophageal reflux disease	Trial of proton pump inhibitor or histamine H2 blocker
Upper respiratory tract infection	Infectious mononucleosis	Complete blood count, heterophile antibodies (consider antiviral capsid antigen immune globulin M)
Women age 30s to 60s, menstrual changes, vasomotor symptoms	Perimenopause/menopause	Follicle-stimulating hormone (may be normal at early stage), treatment of vasomotor symptoms