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Is it bilateral or unilateral? Bilateral exophthalmos would suggest hyperthyroidism. Unilateral exophthalmos suggests orbital tumor, abscess, or aneurysm.
If it is bilateral, are there signs of hyperthyroidism? If ... DIAGNOSTIC WORKUP
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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 in ... DIAGNOSTIC WORKUP
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Proptosis, or exophthalmos, may be caused by inflammatory, infectious, neoplastic, traumatic, or vascular etiologies. Thyroid-associated orbitopathy is by far the most common cause of proptosis. Some may have a benign course, but others follow a fulminant course that threatens... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Proptosis is a finding that usually signals significant pathology. Regardless of duration of symptoms, a rapid evaluation is necessary to discover and treat malignancy or conditions that will result in visual loss.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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... The mnemonic VINDICATE is a useful and quick way to recall the causes of exophthalmos (for enophthalmos see the section on ptosis, page 441).
V—Vascular disorders include a carotid–cavernous fistula and cavernous
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Exophthalmos — the abnormal protrusion of one or both eyeballs — may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic... History and physical examination ... Medical causes ... Special considerations ... History and physical examination ... ... Special considerations ... Pictures
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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 the hormone thyroxine. If no infection is... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Thyrotoxicosis with high or normal radioactive iodine uptake
Abnormal thyroid stimulator
Human chorionic gonadotropin (HCG)
Gestational thyrotoxicosis
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... Diffuse Goiter
Euthyroid or hypothyroid
Cigarette smoking (thiocyanate)
Increased intrinsic growth potential
... Multinodular Goiter ... Nongoiter Neck Masses ... References
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... Exophthalmos (also called proptosis) is the unilateral or bilateral bulging or protrusion of the eyeballs or their apparent forward displacement (with lid retraction). The prognosis depends on the underlying cause.
Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Simple (or nontoxic) goiter is a thyroid gland enlargement that isn’t caused by inflammation or a neoplasm, and is commonly classified as endemic or sporadic. Endemic goiter usually results from inadequate dietary intake of iodine associated... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Hyperthyroidism (also known as Graves’ disease, Basedow’s disease, or thyrotoxicosis) is a metabolic imbalance that results from thyroid hormone overproduction. The most common form of hyperthyroidism is Graves’disease, which... 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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... Exophthalmos—the abnormal protrusion of one or both eyeballs—may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic tumors. This sign may occur suddenly or gradually, causing mild... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Stephen F. Wheeler and David E. Bybee
Thyrotoxicosis affects 1.9% of women and 0.16% of men. Approximately 15% of cases occur in persons aged more than 60 years. Graves’disease is more common in younger patients, whereas toxic... Approach ... History ... Physical examination (PE) ... Testing ... Diagnostic assessment
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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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... Differential Overview
Neck Mass
❑ Inflammatory lymphadenopathy
❑ Parotid swelling/tumor
❑ Laryngeal cancer
... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Grave disease
❑ Familial
❑ Orbital asymmetry
❑ Orbital cellulitis ... Diagnostic Approach ... Clinical Findings
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... Thyrotoxicosis is a metabolic imbalance that results from thyroid hormone overproduction or thyroid hormone overrelease from the gland. The most common form of thyrotoxicosis is Graves’disease, which increases thyroxine production, enlarges the... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Nontoxic or simple goiter — thyroid gland enlargement not caused by inflammation or a neoplasm — is commonly classified as endemic or sporadic.
Endemic goiter usually results from inadequate dietary intake of iodine associated with... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Exophthalmos — the abnormal protrusion of one or both eyeballs — may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic tumors. Also known as ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... 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 infection is present,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... 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 the hormone... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Exophthalmos—the abnormal protrusion of one or both eyeballs—may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic tumors. This sign may occur... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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The mnemonic VINDICATE is a useful and quick way to recall the
causes of exophthalmos (for enophthalmos, see the section on ptosis, page 369).
V—Vascular disorders include a carotid–cavernous fistula and
cavernous sinus... Pictures
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... Adda Grimberg, MD Goiter - BASICS Goiter - description Goiter is enlargement of the thyroid gland. Goiter - epidemiology The most common cause of pediatric goiter in the US is chronic ... Goiter - DIAGNOSIS ... Goiter - TREATMENT ... Goiter - FOLLOW UP ... Goiter - bibliography ... Goiter - CODES ... Goiter - FAQ
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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....
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