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OSCEs > Thyroid > Flashcards

Thyroid Flashcards

1
Q

How do you begin the examination?

A

Wash hands
Introduction
Identification
Consent

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2
Q

How should you position the patient?

A

Seated on a chair you can get around

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3
Q

What should you look for on general inspection?

A 
Voice (low pitched - hypo)
Build
Clothing (warm/cold?)
Restlessness
Confusion
Skin and hair quality
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4
Q

What thyroid signs do you look for in the hands?

A 
Temperature
Sweating
Palmar erythema
Clubbing
Brittle nails
Onycholosis
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5
Q

What do you palpate and look for in the hands?

A

Tremor (with paper)

Pulse

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6
Q

What do you look for in the forearms?

A

Muscle wasting

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7
Q

What signs do you look for in the eyes specific to graves?

A

Exopthalmos (bulging, inspect from above)
Chemosis (conjunctival oedema)
Bloodshot eyes
Eye movements in all directions (extraocular muscle myopathy)
Visual acuity

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8
Q

What eye signs are present for all types of hyperthyroidism?

A

Lid retraction

Lid lag

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9
Q

How do you test for lid lag?

A

Look up then down

Delayed downward movement of the upper eyelid

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10
Q

What do you inspect the neck for?

A

Masses

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11
Q

How do you assess if the mass is a thyroid mass?

A

Ask patient to swallow water

If the mass moves it is a thyroid mass

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12
Q

How do you assess if the mass is a thyroglossal cyst?

A

Ask patient to stick tongue out

If the mass moves upwards test is +ve

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13
Q

What do you inspect the back of the tongue for?

A

A lingual thyroid

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14
Q

What do you palpate from the front?

A

Trachea

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15
Q

What do you palpate for from behind?

A

A mass

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16
Q

What do you do determine if you find a mass?

A 
Size and site
Diffusely enlarged
Hard or soft
Smooth or nodular
Fixed to surrounding tissues
Can you feel above and below it?
Does it move on swallowing
Does it move when sticking tongue out?
17
Q

What else do you palpate in the neck?

A

Cervical lymph nodes

18
Q

What do you auscultate?

A

Over thyroid gland (breath held) for bruit

19
Q

What finishing pieces are there?

A

Proximal muscle weakness (stand from chair arms folded)
Ankle reflexes
Pretibial myxoedema

20
Q

What finding may you get when checking ankle reflexes?

A

Brisk slow relaxing in hypo

21
Q

How do you finish the exam?

A

Thank patient
Wash hands
Present

OSCEs (13 decks)

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