Please enable JavaScript.
Coggle requires JavaScript to display documents.
Thyrotoxicosis (Examination (Eyes (Non-specific
Lid-lag
Lid retraction…
Thyrotoxicosis
Examination
Completion
- Cardiovascular examination: risk of heart failure
- Examine the eyes for evidence of optic atrophy
- Observation chart
- Hx
Eyes
Non-specific
- Lid-lag
- Lid retraction (↑ tone of sup. tarsal muscle)
Graves’
- Soft tissue swelling and Chemosis
- Exophthalmos
- Ophthalmoplegia: esp. upgaze
- Exposure keratopathy
- Optic atrophy
-
Periphery
- Thyroid acropachy
- Palmer erythema
- Hot, sweaty palms
- Tachycardia or AF
- Pre-tibial myxoedema
- Proximal myopathy
Neck
- Smooth, diffuse goitre
- May have bruit
Mx
-
Radioiodine
CI: pregnancy, around children :red_cross:
SE
- May worsen thyroid eye disease
- Most pts. become hypothyroid
Thyroidectomy
SE
- Haematoma
- Recurrent laryngeal nerve injury
- Hypoparathyroidism
- Hypothyroidism
-
Viva
Hx
Symptoms of thyrotoxicosis
- Heat intolerance, sweating
- ↑ appetite, ↓wt.
- Diarrhoea
- Anxious, irritable
- Visual problems, eye pain
- Oligomenorrhoea
Triggers
- Child-birth
- Stress
- Infection
-
Ix
Bloods
-
-
-
Other: ↑ Ca, ↑ ESR, glucose (exclude DM)
-
Differential
- Graves’ [NB. Pts. w/ Graves’ are often hyperthyroid but may become eu- or hypo-thyroid]
- Thyrotoxic phase of a thyroiditis
- Simple colloid goitre