Thyroid history and examination Flashcards
What are the symptoms of hyperthyroidism?
Weight loss despite increased appetite Increased frequency of defecation/diarrhoea Muscle weakness Anxious/irritable/emotionally labile Decreased concentration Hear intolerance Increased sweating Fine hair and hair loss Clubbing (thyroid acropachy) Onycholysis Tachycardia Palpitations AF Amenorrhoea Fertility problems
What are the symptoms of hypothyroidism?
Increased body weight despite decreased appetite Hoarse voice Constipation Decreased energy Slower movements and muscle weakness Lethargy Depression Decreased concentration Cold intolerance Dry, flaky skin Coarse thinning hair Brittle nails Bradycardia Menorrhagia Fertility problems
What should you ask about in a past medical history?
Previous thyroid disease, surgery or treatment
What should you ask about in a drug history?
Thyroxine
Lithium
Amiodarone
Glucocorticoids
What should you ask about in a social history?
Smoking
Alcohol
Diet
Effect on AODL
What should you ask about in a family history?
Familial thyroid disease
What are the steps of a thyroid examination?
Inspection Palpation Percussion Auscultation Special tests
What should you inspect?
General appearance Hands Forearm Eyes Neck Tongue
What should you look for in their general appearance?
Build Inappropriate clothing Restlessness Confusion Quality of skin and hair
What do you look for in the hands?
Temperature Sweating Palmar erythema Clubbing Brittle nails Onycholysis Tremor Pulse
What do you look for in the forearms?
Muscle wasting
What do you look for in the eyes?
Exophthalmos Chemosis Bloodshot eyes Periorbital/lid oedema Lid retraction Lid lag Eye movements Visual acuity and fundoscopy
What do you look for in the neck?
Masses
Swallowing
Sticking out tongue
What do you look for in the tongue?
Lingual thyroid
What do you palpate?
Trachea for tracheal deviation
Anterior neck
Cervical lymph nodes
