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    Toxic Multinodular Goiter Physical Examination

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    Angie Mandeoya
    Physical examination of a patient with toxic multinodular goiter may reveal signs and symptoms including thyromegaly with solitary nodules, tachycardia, lid lag, tremors, weight loss or increased appetite, anxiety or emotional lability, and flushing or diaphoresis of the skin. Additional findings can include hypertension, atrial fibrillation, shortness of breath, cognitive impairments, and neuromuscular symptoms such as tremors, weakness, or neuropathy. A thorough physical exam evaluates symptoms affecting multiple body systems that may arise from hyperthyroidism and the enlarged thyroid gland.

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    Toxic Multinodular Goiter Physical Examination

    Uploaded by

    Angie Mandeoya
    201 views2 pages
    Physical examination of a patient with toxic multinodular goiter may reveal signs and symptoms including thyromegaly with solitary nodules, tachycardia, lid lag, tremors, weight loss or increased appetite, anxiety or emotional lability, and flushing or diaphoresis of the skin. Additional findings can include hypertension, atrial fibrillation, shortness of breath, cognitive impairments, and neuromuscular symptoms such as tremors, weakness, or neuropathy. A thorough physical exam evaluates symptoms affecting multiple body systems that may arise from hyperthyroidism and the enlarged thyroid gland.

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    Toxic Multinodular Goiter Physical Examination

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    Physical examination of a patient with toxic multinodular goiter may reveal signs and symptoms including thyromegaly with solitary nodules, tachycardia, lid lag, tremors, weight loss or increased appetite, anxiety or emotional lability, and flushing or diaphoresis of the skin. Additional findings can include hypertension, atrial fibrillation, shortness of breath, cognitive impairments, and neuromuscular symptoms such as tremors, weakness, or neuropathy. A thorough physical exam evaluates symptoms affecting multiple body systems that may arise from hyperthyroidism and the enlarged thyroid gland.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    201 views2 pages

    Toxic Multinodular Goiter Physical Examination

    Uploaded by

    Angie Mandeoya
    Physical examination of a patient with toxic multinodular goiter may reveal signs and symptoms including thyromegaly with solitary nodules, tachycardia, lid lag, tremors, weight loss or increased appetite, anxiety or emotional lability, and flushing or diaphoresis of the skin. Additional findings can include hypertension, atrial fibrillation, shortness of breath, cognitive impairments, and neuromuscular symptoms such as tremors, weakness, or neuropathy. A thorough physical exam evaluates symptoms affecting multiple body systems that may arise from hyperthyroidism and the enlarged thyroid gland.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    Toxic multinodular goiter physical examination

    Overview
    The clinical features of toxic multinodular goiter includes flushing, diaphoresis, smooth
    skin, onycholysis, hyperpigmentation, thinning of the hair, thyromegaly,lymphadenopathy, lid
    lag, shortness of breath on exertion, hypoxemia, hypercapnia, tachycardia, atrial fibrillation, weight
    loss, increased appetite, anorexia, dysphagia, increased urinary
    frequency, enuresis, gynecomastia, reduced libido, erectile dysfunction, psychosis, agitation,
    and depression, anxiety, restlessness, irritability, and emotional lability. Some other features which
    may be seen are insomnia, confusion, poor orientation and immediate recall, amnesia, and
    constructional difficulties, peripheral neuropathy, carpal tunnel syndrome, tremors.

    Physical Examination
    Appearance of the Patient
    Physical examination is as follows:[1][2][3][3][4][5][6][7][3][4][5][8]

     Patients with thyroid adenoma are usually well-appearing.


    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
    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

     High and low frequency amplitude tremors which 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

     Osteoporosis and an increased fracture

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