OSCE 1: Endocrine Lab Flashcards
Describe how to examine a thyroid.
1) Have patient flex neck slightly to relax SCM
2) Place fingers of both hands on patient’s neck so
that index fingers lie just below cricoid cartilage.
3) Have patient swallow so thyroid rises up under finger pads.
4) Displace trachea to right and palpate right lobe.
Repeat for left lobe.
What are you examining for when palpating the thyroid?
Contour and symmetry
-nodules
If thyroid is enlarged, what can be heard over lateral lobes?
Bruit
-in patients w/ hyperthyroidism or toxic multinodular goiter
Patients with Grave’s disease will tend to have what type goiters?
Soft goiters
Patients with Hashimoto’s thyroiditis or malignancy will tend to have what type goiters?
Firm goiters
Patients with thyroiditis will tend to have what type goiters?
Tender
What other symptom is common in patients with Grave’s disease? (hyperthyroidism)
Exophthalmos/proptosis
-abnormal protrusion of eyeballs
What the two examinations to check for hypocalcemia?
Chvostek sign
Trousseau’s sign
Describe Chvostek sign.
Twitching of facial muscles in response to tapping over the facial nerve
Describe Trousseau’s sign.
Carpopedal spasm caused by ischemia from inflating the blood pressure cuff
What are some symptoms of patients with hypocalcemia?
Cataracts Dry coarse skin Hyperpigmentation Eczema Steatorrhea: presence of excess fat in feces
Describe a diabetic screening.
- Examine the feet for skin lesions/infection, etc.
- Pressure sensation using Monofilament testing
- Vibration sensation testing using a tuning fork
- Superficial pain sensation using pinprick/temperature sensation
- Bilateral DTRs of the ankle
- Bilateral pulses of LE
Describe a diabetic foot exam.
- Inspect feet for: ulcers, claw toes, amputations, ingrown toenails, calluses, wounds, etc
- Check pulses
- Monofilament testing for neuropathy screening
- Vibration/pinprick/ankle reflexes
What are normal fasting glucose levels?
<100 mg/dL
What are normal 2 hour postprandial glucose levels?
<140 mg/dL
