Thyroid examination Flashcards

1
Q

A … will move upwards on tongue protrusion.

A

Thyroglossal cyst

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2
Q

What will a Graves’ goitre feel like (3)

A

Smooth, symmetrical, soft

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3
Q

What will a MNG feel like (3)

A

Nodular, asymmetrical, firm

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4
Q

A pulsatile mass is likely to be what

A

Carotid body tumour

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5
Q

A fluctuant mass is likely to be what

A

Lipoma

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6
Q

The thyroid gland moves … on swallowing

A

Upwards

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7
Q

Name 2 indications that the goitre may be retrosternal

A

1) Cannot get under when patient swallows

2) Dull percussion note from xiphisternum to suprasternal notch

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8
Q

An goitric bruit is essentially diagnostic of what

A

Graves’

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9
Q

When listening for a bruit you must ask the patient to what

A

Hold their breath

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10
Q

Describe Pemberton’s test

A

Arms above head, large retrosternal goitre blocks thoracic inlet.

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11
Q

In what 2 ways might Pemberton’s test clinically manifest as positive?

A
Facial plethora (obstructed venous return)
Stridor (tracheal compression)
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12
Q

How do you remember what to look for in the hands

A

The 4 PPPPs (+acropachy!)

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13
Q

What are the 4 Ps

A

Palmar erythema
Pulse
Paper (beta tremor)
Palms (temperature/sweat)

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14
Q

What pulses are associated with Hyperthyroidism (2)

A

AF

Tachycardia

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15
Q

What is the nail manifestation of Graves’

A

Acropachy

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16
Q

What are the 3 cardinal clinical manifestations of graves’

A

Eyes (exophthalmus + ophthalmoplegia)
Pretibal myxoedema
Acropachy

17
Q

Describe pretibial myxoedema

A

Brown oedematous swelling above lateral malleolus

18
Q

How would you clinically test for ophthalmoplegia

A

Double vision/pain when drawing an H

19
Q

Where would you look from for exophthalmous

A

Sides and directly above

20
Q

How would you check for exophthalmic goitre. Describe the test.

A

Lid lag (move finger quickly down when the pt is looking up)

21
Q

… may also be present in the calfs. It is due to lymphoedema.

A

Non-pitting oedema

22
Q

To finish this exam I would like to check.. and do these investigations (3)

A

Thyroid status
TFTs
USS
FNA (fine needle aspirate)