Fast Five Quiz: How Much Do You Know About Hyperthyroidism?

Romesh Khardori, MD, PhD

Disclosures

May 08, 2017

Common signs of thyrotoxicosis include the following:

  • Tachycardia or atrial arrhythmia

  • Systolic hypertension with wide pulse pressure

  • Warm, moist, smooth skin

  • Lid lag

  • Stare

  • Hand tremor

  • Muscle weakness

  • Weight loss despite increased appetite (although a few patients may gain weight if excessive intake outstrips weight loss)

  • Reduction in menstrual flow or oligomenorrhea

If the thyroid is enlarged and painful, subacute painful or granulomatous thyroiditis is the likely diagnosis. However, degeneration or hemorrhage into a nodule and suppurative thyroiditis should also be considered.

Toxic multinodular goiters generally occur when the thyroid gland is enlarged to at least two to three times the normal size. The gland often is soft, but individual nodules occasionally can be palpated.

In rare instances, Graves disease affects the skin through deposition of glycosaminoglycans in the dermis of the lower leg. This causes nonpitting edema, which is usually associated with erythema and thickening of the skin, without pain or pruritus.

For more on the physical examination findings in hyperthyroidism and thyrotoxicosis, read here.

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