Thyroid case presentation

- Thianeshwar.I.S
Final yr 3r unit
• Santhanamary, 54 years old female housewife
from keelamudiman came with
• c/o swelling in the front of neck for 1 month
• HOPI:
• The patient was apparently normal before 1
month and then she noticed a swelling on the
left side of the neck which is
• Insidious in onset
• Gradual in progression
• Not associated with pain

• H/o excess sweating

• H/o loss of weight inspite of good appetite
• H/o insomnia
• H/o heat intolerance
• H/o loss of hair
• No H/o dyspnea
• No H/o dysphagia
• No H/o hoarseness of voice
• No H/o syncope
• No H/o tremor
• No H/o palpitation
• No H/o dyspnea on exertion
• No H/o eye pain
• No H/o ankle edema
• No H/o constipation
• No H/o cold intolerance
• No H/o bony pain
• No H/o cough with hemoptysis
• No H/o jaundice
PAST HISTORY:
H/o DM for past 15 years, on medication
Not a k/c of HT, TB, epilepsy, BA
No H/o previous surgeries
No H/o irradiation

PERSONAL HISTORY:
N bowel and bladder habits
Altered sleep pattern
Not a smoker ,alcoholic
• FAMILY HISTORY:
• Not relevant
• GENERAL EXAMINATION:
• Consious , oriented
• Moderately built & nourished
• Pallor present
• No cyanosis, clubbing, icterus, pedal edema &
generalised lymphadenopathy
• Vitals
• BP : 120/ 80 Hg
• RR: 16/min
• PR: 74/min
• Temp afebrile
• Eye signs not present
• No tremor
• No delayed ankle reflex
• Local Examination:
• Inspection:
• On sitting position
• Single swelling in the front of the neck 3*2 cm, oval in
shape.
• Skin over the swelling normal
• Swelling moves with deglutition
• Does not move with protusion of tongue
• Lower border is seen
• Trachea appears to be in midline
• No visible pulsations
• No scars & sinuses , dilated veins

• Palpation
• No warmth or tenderness felt
• Inspectory finding are confirmed
• Consistency – firm
• Surface - smooth
• Lower border is palpable
• Swelling is mobile
• Extent : medially 1cm from the midline, laterally
2cm from ant. Border of SCM, below 2cm from the
clavicle
• Carotid arty. Pulsations felt
• Percussion : resonance over the sternum
• Ascultation: no bruit heard
• No lymphnode enlargement
• Other systems:
• Cvs – s1 s2 normaly heard
• Rs- no vesicular breath sounds heard
• Cns-no focal neurological deficit
• Abdomen- soft, no organomegaly
• Diagnosis:
A case of toxic, non –malignant, solitary
nodular goitre without complications.