Thyroid Examination

Question 1

Thyroid Status Question

Answer 1

Menstrual cycle
Skin - dry, oily
Weight - loss, gain
Appetite - increased, decreased
Bowels - changes
Temperature - hot, cold
Energy
Mood
Palpitations

Question 2

General Inspection

Answer 2

Agitated
Dressed appropriately
Obvious goitre
BMI
Medications etc

Question 3

Hands and Arms

Answer 3

Temperature
Colour
Dry - hypothyroid
Sweaty - hyperthyroid
Thyroid acropachy - graves disease
Oncholysis
Palmar Erythema - hyperthyroidism
Fine Tremor - hyperthyroid
Pulse - fast (hyper), slow (hypo), irregular (thyrotoxicosis)
Chicken wings - proximal myopathy

Question 4

Face

Answer 4

Dry skin - hypo
Sweating - hyper
Loss of outer third of eyebrow - hypo
Exophthalmos - graves
Proptosis
Lid retraction
Periorbital oedema
H test - graves
Lid lag - graves
Peaches and cream complexion

Question 5

Neck Inspection

Answer 5

Masses - normal thyroid shouldn't be visible
Goitre
Scars
Lymph nodes
Swallow water
Stick out tongue

Question 6

Neck Examination

Answer 6

Feel the thyroid - symmetry, size, consistency, nodular
Stick out tongue
Swallow water
Lymph node examination
Percuss for retrosternal goitre
Auscultate thyroid for bruits
Tracheal deviation

Question 7

Other

Answer 7

Reflexes
Pretibial myxoedema
Proximal myopathy of the lower limbs (stand up arms crossed)

Question 8

Further Examinations

Answer 8

TFTs - TSH and T4
ECG - if irregular pu;se
Further imaging - USS