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THYROID HX. AND EXAM

Name; Esther KudjoAge; 34yrsSex ; femaleOccupation ;Hair dresser

Religion ; Christian[Catholic]Residence ;Obuasi Brahabebome

!; Anterior nec s!ellin"#3yrs

H !; $atient !as !ell until 3yrs a"o !hen she noticed a small s!ellin" in the anterioras%ect of her nec !hiles dressin"& 'he re%orted to Obuasi "o()t hos%ital !here she !as"i(en some medications un no!n to her but he condition did not im%ro(e& 'he reali*ed thatthe s!ellin" !as increasin" in si*e and is no! associated !ith breathlessness+dys%ha"ia butno hoaseness of (oice& 'he decided to re%ort to ath for e,%ert mana"ement&

OD"$al%itations-%edal s!ellin"#.iarrhoae-/ncreased a%%etite-0ei"ht loss-Oli"omenorrhoea-/ncreased s!eatin"-Cou"h#Chest %ain#Headaches#1e(er-

MSHChronic medical illnesses#[tb+htn+dm+e%ile%sy+ asthma+scd]#(e2#ray of nec #$re(ious hos%ital admissions#'ur"ical o%eration#Haemotransfusion#

D#ug $xon" term medications#

Herbal %re%arations#o no!n dru" aller"ies

%amil& $x1amily h, of anterior nec s!ellin"#Chronic medical illnesses

Social $x5arried !ith 6 children+ li(e at obuasi !ith family& 'he is a hair dresser&'he eats a lot ofcabba"e& 'he neither drin s alcohol nor smo es ci"arettes&

S'MMARY / %resent a 34yr old !oman !ho %resented !ith a 3yr history of anterior nec s!ellin" !ithassociated %ressure and to,ic sym%toms&

/m%ressions

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7ra(es d,8 .iffuse to,ic "oitre 9o,ic multinodular "oitre 9o,ic nodule 9o,ic thyroid adenoma Early sta"e of hashimoto thyroiditisOthers#thyroid ca #%retracheal lym%h node #sublin"ual dermoid cyst #thyro"lossal cyst #"oitre

O(EAncious loo in" !oman+ !ho is underdressed for the !eather& 'he is thin& ot %ale+anicteric+ afebrile and !ell hydrated&9rachea is de(iated to the ri"ht& 9here is an anteriornec s!ellin" that mo(es u% !ith s!allo!in" but not !ith %rotrusion of the ton"ue& /tmeasures 4cm:3cm+ smooth surface+ non tender+ !ell defined ed"es+ firm consistency+notattached to underlyin" structures+s in o(er it mobile+ no differencial !armth+not fluctuant&

o cer(ical lym%h nodes %al%able&

Hands are s!eaty and !arm+ no di"ital clubbin"& 1ine tremors of out hands$ulse

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9b Carbima*ole =Dm" tid[