Enter
Greet the Examiner
Sanitize your hands
Introduce yourself to the examiner and Patient
Overweight, lots of clothes, look at hair (hair loss, loss of outer third of eyebrow), neck (is there a goitre), skin (dry, coarse), is the voice hoarse/deep or speech slow
feel (cool), puffy, pulse (brady), carpal tunnel signs (thenar eminence wasting, loss of sensation lateral 3 and a half fingers, positive Tinel’s and Phalen’s tests), nails (thyroid acropachy: hypothyroid post treatment of Grave’s disease),
Offer BP (Diastolic Hypertension)
observe for periorbital swelling. Look for exophthalmos+opthalmoplegia (hypothyroid post treatment of Grave’s disease)
Facial swelling, tongue enlargement,
Swallow and observe from front and side, stick out tongue, look for scars (don’t miss a thyroidectomy scar), palpate from behind and get patient to swallow, feel for lymphadenopathy, feel trachea, percuss sternum, auscultate over goitre. Is the swelling diffuse or nodular, tender or nontender.
Look at shins for rash/oedema. Ask to Stand from sitting (proximal myopathy).
Reflexes (slow to relax)
