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Is it focal or diffuse? Focal masses in the thyroid include thyroglossal cyst, toxic adenoma, colloid cyst, Riedel's struma, nontoxic adenoma, and malignancies.
Is there movement with protrusion of the tongue? This is a typical finding ... DIAGNOSTIC WORKUP
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Is there fever? The presence of fever would suggest an infectious disease, such as tuberculosis, AIDS, brucellosis, and typhoid fever, but collagen diseases and neoplasms should not be forgotten.
Is there anorexia? The presence of ... DIAGNOSTIC WORKUP
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Unexplained, involuntary weight loss (defined as loss of 5% of baseline body weight over 6–12 months) is a common clinical presentation and is nearly always a sign of a serious medical or psychiatric illness. Numerous studies have independently associated unintentional weight... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Weight gain is a very common complaint in adult medicine and has a vast differential diagnosis. The key to diagnosis is often a good history and physical examination. It is important to quantify the degree and rapidity of weight gain by comparing old weights in the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The norm in infants and children is to gain weight, so weight loss in a pediatric patient (unless medically indicated) should demand evaluation. Acute weight loss, defined as loss of 3–5% of body mass in less than 30 days, signals illness and is often the result of the loss of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Chronic diarrhea (nonbloody, without weight loss) is defined as increased total daily stool output (greater than 10 g/kg/day), associated with increased stool water content; diarrhea is classified as chronic when it lasts longer than 2 weeks. Per liter, normal... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Diarrhea is considered chronic when it last longer than 14 days. Weight loss with diarrhea should always be concerning and deserves thorough investigation. Collectively the malabsorption syndromes are the most common etiologic factors.
... Workup and Diagnosis ... Treatment
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... As noted in Table 62, the diagnostic analysis of weight loss is best accomplished by applying physiology. Food and oxygen must be properly and regularly brought into the body (intake), properly absorbed and circulated to the cells, and properly used; the waste products must
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, thyroid tumors, and drugs. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Weight gain occurs when ingested calories exceed body requirements for energy, causing increased adipose tissue storage. It can also occur when fluid retention causes edema. When weight gain results from overeating, emotional factors — most... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Two groups of neonates are born weighing less than the normal minimum birth weight of 5½ lb (2,500 g) — those who are born prematurely (before 37 weeks’ gestation) and those who are small for gestational age (SGA). Premature neonates weigh... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Weight loss can reflect decreased food intake, decreased food absorption, increased metabolic requirements, or a combination of the three. Its causes include endocrine, neoplastic, GI, and psychiatric disorders; nutritional deficiencies; infections; and neurologic lesions that cause... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Ankylosing spondylitis
Bilateral lesions of the lateral hypothalamus (hypothalamic anorexia)
Decreased food intake/malnutrition
Abdominal angina
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... Thyroid Lesions
Adenoma (benign)
Atypical
Embryonal (trabecular)
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... Elevated Serum Thyroid-Stimulating Hormone
Primary hypothyroidism
Overt (low free T4)
Subclinical (normal free T4)
Assay... Suppressed Serum Thyroid-Stimulating Hormone
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... Cessation of cigarette smoking
Congenital disorders
Alström syndrome
Biemond syndrome
Blount disease
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... Inflammation of the thyroid gland occurs as autoimmune thyroiditis (long-term inflammatory disease), subacute granulomatous thyroiditis (self-limiting inflammation), Riedel’s thyroiditis (rare, invasive fibrotic process), and... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Papillary and follicular carcinomas are the most common types of thyroid cancer and are usually associated with a longer survival. Papillary carcinoma accounts for half of all thyroid cancers in adults; it's most common in young adult females and metastasizes... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, and thyroid tumors. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine. If no... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... Weight gain occurs when ingested calories exceed body requirements for energy, causing increased adipose tissue storage. It can also occur when fluid retention causes edema. When weight gain results from overeating, emotional factors—most commonly anxiety, guilt, and depression&mdash... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Two groups of neonates are born weighing less than the normal minimum birth weight of 5½ lb (2,500 g)—those who are born prematurely (before the 37th week of gestation) and those who are small for gestational age (SGA). The premature neonate weighs an appropriate amount for... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Weight loss can reflect decreased food intake, decreased food absorption, increased metabolic requirements, or a combination of the three. It may be caused by endocrine, neoplastic, GI, and psychiatric disorders; nutritional deficiencies; infections; or neurologic lesions... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... David B. Graham
Involuntary weight loss is a challenging problem, often surrounded with fears by both patient and physician of an occult malignancy. Although malignancy is an important cause of weight loss, extensive and... Approach. ... History: Initial data ... Basic physical examination ... Testing ... Diagnostic assessment. ... Pictures
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... Stephen F. Wheeler and David E. Bybee
Goiter, an enlarged thyroid gland, is the most common thyroid abnormality. Goiter is termed endemic if it occurs in more than 10% of a population. Endemic goiter most commonly results from dietary iodine... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Stephen F. Wheeler and David E. Bybee
Palpable nodules are present in 4% to 7% of adults. Prevalence is four to nine times greater in women than men. Approximately 5% of all solitary nodules are carcinomas.
Approach The evaluation of nodular... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
Neck Mass
❑ Inflammatory lymphadenopathy
❑ Parotid swelling/tumor
❑ Laryngeal cancer
&... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Hashimoto thyroiditis
❑ Multinodular goiter
❑ Follicular adenoma
❑ Thyroid cyst
❑... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Diabetes
❑ Depression
❑ Inadequate intake
❑ Drugs
❑ Hyperthyroidism ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Inflammation of the thyroid gland occurs as autoimmune thyroiditis (long-term inflammatory disease), postpartum thyroiditis, subacute granulomatous thyroiditis (self-limiting inflammation), Riedel’s thyroiditis (rare, invasive fibrotic process),... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Thyroid cancer occurs in all age groups, especially in persons who have had radiation treatment to the neck area. Papillary and follicular carcinomas are most common and are usually associated with prolonged survival.
Papillary... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, and thyroid tumors. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine.... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Weight gain occurs when ingested calories exceed body requirements for energy, causing increased adipose tissue storage. It can also occur when fluid retention causes edema. When weight gain results from overeating, emotional factors —... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Weight loss can reflect decreased food intake, decreased food absorption, increased metabolic requirements, or a combination of the three. Its causes include endocrine, neoplastic, GI, and psychiatric disorders; nutritional deficiencies; infections; and neurologic lesions that... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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...Impaired weight gain and linear growth arecommon problems in the pediatric population and can occur separatelyor together. Disorders that significantly affect weight gain alsomay affect linear growth. Principal Causes of Growth Deficiency: Weight and Height ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, thyroid tumors, and drugs. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Weight gain occurs when ingested calories exceed body requirements for energy, causing increased adipose tissue storage. It can also occur when fluid retention causes edema. When weight gain results from overeating, emotional factors—most commonly anxiety, guilt... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Two groups of neonates are born weighing less than the normal minimum birth weight of 51⁄2 lb (2,500 g)—those who are born prematurely (before 37 weeks' gestation) and those who are small for gestational age (SGA). Premature... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Weight loss can reflect decreased food intake, decreased food absorption, increased metabolic requirements, or a combination of the three. Its causes include endocrine, neoplastic, GI, and psychiatric disorders; nutritional deficiencies; infections; and neurologic lesions... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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As noted in Table 62, the diagnostic analysis of weight loss
is best accomplished by applying physiology. Food and oxygen must
be properly and regularly brought into the body (intake), properly absorbed
and circulated to the cells, and properly used... Pictures
... READ EXCERPTS »
While training for the Olympic games, track star Gail Devers began to suffer from a number of mysterious symptoms: weight loss, dry skin and fatigue....
Hyperthyroidism is a serious hormonal imbalance that can lead to weight loss, anxiety, diarrhea and other symptoms. Treatments are available, and in...
Sleep is necessary to feel refreshed, but now we know sleep actually impacts the way the body functions. Sleeping poorly can affect how often you get...