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Thyroid Exam

Introduction

Greetings
Hand wash
Verify the patient's identity
Explanation of the examination
Obtain consent
Expose patient's neck and upper sternum
Position patient sitting on a chair

General Inspection

Assess weight
Observe behavior
Note clothing (heat/cold intolerance)
Listen for hoarse voice

Hand Examination

Check for thyroid acropachy
Look for onycholysis
Assess for palmar erythema
Test for peripheral tremor
Check radial pulse

Face Examination

Assess skin condition
Check eyebrows for loss

Eye Examination

Check for lid retraction
Look for exophthalmos
Assess eye movements
Test for lid lag

Thyroid Examination

Inspect neck for masses or scars
Ask patient to swallow and observe movement
Palpate thyroid gland

Assess size, shape, consistency, and nodules

Palpate trachea for deviation
Percuss upper sternum for retrosternal extension
Auscultate thyroid gland for bruit
Palpate cervical lymph nodes

Additional Tests

Check reflexes (biceps and knee jerk)
Look for pretibial myxoedema
Test for proximal myopathy

Conclusion

Summarize findings
Suggest further tests if needed

Consider thyroid function tests, ultrasound

Exam Progress

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