Thyroid Flashcards
Hyperthyroid symptoms
nocturnal diarrhoea, heat intolerance, tremor, accelerated weight loss despite good appetite, worsening mood symptoms, anxiety, panic attacks with palpitations. difficulty swallowing, weight loss, heat intolerance, difficulty sleeping, tremor, increased frequency of defecation, proximal muscles weakness, palpitations, irritability, worsening anxiety, gynaecomastia, reduced libido and sexual dysfunction. Also inquires into symptoms of thyroid associated opthalmopathy: (grittiness, increased tear production, swelling, visual loss, double vision) and asks screening questions relating to other physical systems – GIT, CVS, RS and CNS. Seeks to establish effect of symptoms on function. May also clarify the evolution of psychiatric symptoms an
Examination
organized and systematic physical examination focussed on the Thyroid: any errors or omissions are minor and do not materially adversely impact on the examination outcome. Inspection of thyroid, observation of swallowing; Examines the neck for thyroid swelling, tenderness, bruit through inspection, palpation, (+/- auscultation). Examines patient for eye signs (e.g. exophthalmoses, proptosis or lid lag). Checks related areas including skin (moist/dry, hair loss); hands (tremor, temperature, nail signs); reflexes (hypo/ hyperreflexia); limbs (muscle bulk/wasting, proximal weakness /pretibial myxoedema); pulse (bradycardia/ tachycardia, arrhythmia), CVS (CCF, systolic flow murmur, BP); gynaecomastia.
Causes of hyperthyroidism
Graves’ disease. [The differential diagnosis includes: solitary toxic nodule / adenoma (Plummer’s disease), toxic multi-nodular goitre and thyroiditis (viral or autoimmune )
