Thyroid

ID

cc: hypofunction, hyperfunction or neck mass

HPI:

• Local symptoms:

  • Neck pain

  • Dysphagia

  • Hoarse voice

• Evaluation of thyroid hyper/hypo-function

  • Energy

    • Hypo - tired

    • Hyper - "tired and wired"

  • Sleep

    • Hypo - increased, but still tired

    • Hyper - insomnia, difficult falling asleep, broken sleep

  • Bowel movements

    • Hypo - constipation

    • Hyper - more frequent, diarrhea

  • Weight

    • Hypo - gain

    • Hyper - loss

  • Appetite

    • Hypo - may be decreased

    • Hyper - increased appetite, still weigh loss

  • Temperature intolerance

    • Hypo - cold intolerance

    • Hyper - heat intolerance

  • Neurological

    • Hypo - difficulty with concentration/memory, slowed speech and motor activity, carpal tunnel

    • Hyper - tremors

  • MSK

    • Hypo - muscle weakness

    • Hyper - muscle weakness

  • Menstrual cycles

    • Hypo - Heavy menses

    • Hyper - Less frequent / absent menses

  • Mood

    • Hypo - Depressed mood

    • Hyper - Irritable, anxious

  • Hair

    • Hypo - hair loss, coarse and sparse dry hair

    • Hyper - hair thinning and loss, more oily

  • Skin

    • Hypo - dry/rough skin, edema (facial, peripheral)

    • Hyper - moist skin

  • Cardiac

    • Hypo - bradycardia

    • Hyper - tachycardia, palpitations

  • Eyes

    • Hyper (Graves'): diplopia, eye pain, blurry vision, stare, gritty feeling

• Risk factors

  • Family history

    • Thyroid disease, autoimmune disease, malignancy

  • Radioactive iodine treatment

  • Radiation exposure

  • Iodine deficiency

    • Not using iodinated salt, not from Canada

  • Iodine excess

    • Medications, CT contrast

  • History of autoimmune / endocrine disease

  • Pregnancy / post-partum

  • Viral infection / flu

Medications

• Thyroid replacement (Levothyroxine)

• Anti-thyroid medications

• Amiodarone

• CT contrast

Allergies

Past Medical History

• Thyroid disease

• Pregnancy

• Radioactive iodine treatment

• Previous thyroid surgeries

• Previous radiation exposure

Habits

• Smoking

Social history

FIFE