Toxic multinodular goiter physical examination: Difference between revisions
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===Extremities=== | ===Extremities=== | ||
* Tremor | * Tremor-high frequency and low amplitude and can involve the face and head as well as the extremities. | ||
* Myopathy | * Myopathy | ||
* Muscle weakness with or without atrophy and myalgias | * Muscle weakness with or without atrophy and myalgias. | ||
* Proximal and distal weakness. | |||
* Deep tendon reflexes are usually normal or increased, | |||
* Paresthesias, due to coexisting polyneuropathy | |||
=== Bone === | === Bone === | ||
Revision as of 18:42, 9 October 2017
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Toxic multinodular goiter Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Physical Examination
Appearance of the Patient
- Patients with thyroid adenoma are usually well-appearing.
- Tachycardia may be present.
Skin
- Flushing
- Diaphoresis
- Smooth skin
- Onycholysis and nail softening
- Hyperpigmentation
- Thinning of the hair
Neck
- Thyromegaly with solitary, non-tender thyroid nodules.
- Soft, smooth, and mobile nodules.
- Lymphadenopathy
HEENT
- Lid lag occurs in all patients with hyperthyroidism due to sympathetic overactivity.
Lungs
- Shortness of breath on exertion
- Hypoxemia
- Hypercapnia
- Tracheal compression from a large goiter.
- Pulmonary hypertension.
Heart
- Tachycardia with wide pulse pressure.
- Systolic hypertension
- Congestive heart failure
- Dilated cardiomyopathy
- Atrial fibrillation
Abdomen
- Weight loss
- Increased appetite
- Anorexia in older hyperthyroid patients.
- Dysphagia
- Cholestiatosis
Genitourinary
- Increased urinary frequency and nocturia
- Enuresis is common in children.
- Gynecomastia
- Reduced libido
- Erectile dysfunction.
Neuromuscular
- Psychosis, agitation, and depression.
- Anxiety, restlessness, irritability, and emotional lability.
- Insomnia
- Cognitive impairments such as confusion, poor orientation and immediate recall, amnesia, and constructional difficulties.
- Peripheral neuropathy
- Carpal tunnel syndrome
Extremities
- Tremor-high frequency and low amplitude and can involve the face and head as well as the extremities.
- Myopathy
- Muscle weakness with or without atrophy and myalgias.
- Proximal and distal weakness.
- Deep tendon reflexes are usually normal or increased,
- Paresthesias, due to coexisting polyneuropathy
Bone
- Bone resorption due to increased bone turn over
- The loss in cortical bone density is greater than that of trabecular bone.
- Osteoporosis and an increased fracture