Thyroid exam

Question 1

Intro

Answer 1

Wash hands, intro (check for hoarse voice - hypo) and ask for chaperone and pain

Question 2

Inspection of hands

Answer 2

Temperature, sweating, palmar erythema, clubbing, brittle nails and onycholysis

Question 3

Pulses signs

Answer 3

Brady - hypo
Tachy - hyper
AF

Question 4

Inspection of forearms

Answer 4

muscle wasting

Question 5

Eye inspection

Answer 5

Exopthalmos (Graves) - look from all sides
Lid lag (hyper) - stright line down quickly
Eye movement (double vision) - H
Pull eyelids
Visual acuity and fundoscopy
Chemosis, conjuctival inpsection,
Lid retraction + hyper

Question 6

Palpation of neck

Answer 6

Cervical lymph nodes

Thyroid from behind

Ask to stick out tongue and look at back

Ask to swallow water and inspect and feel

Check for central trachea

Question 7

Auscultation

Answer 7

of thyroid to check for bruit using bell

Question 8

Extra tests

Answer 8

ask patient to stand from chair with arms crossed to check for proximal muscle weakness

Check shins for pretibial myxoedema

Question 9

Reflexes

Answer 9

Check for ankle reflexes

Question 10

Present for thyroid exam

Answer 10

Today I completed a thryoid exam on patient X. They appeared comfortable at rest and there were no obvious signs of thyroid pathology, their pulse was XX bpm, on palpation and auscultation everything appeared normal. To complete my exam I would order a TSH, T3 and T4 blood test and would do a full history and fundoscopy, ECG if irregular pulse