The thyroid gland examination or thyroid status examination involves both a peripheral examination of the patient as well as the examination of their thyroid gland. It is important to know signs and symptoms of hypothyroid and hyperthyroid disease. The ability to assess these in a systematic and slick manner is an important skill to learn for your OSCE exams.
Wash your hands using the Ayliffe technique
Introduce yourself and give your name and grade
“Hi, my name is John Smith and I am a 4th year medical student”
Clarify patients identity by confirming name and asking for their DOB
Explain what examination you are performing and what it involves
“I have been asked to perform a thyroid examination on you today. This involves having a look at your hands and face, and having a feel of your neck”
“Would this be ok with you?”
Ask if they would like a chaperone
“The exam involves you having to remove your upper garment during part of the exam. Would you like a chaperone for this?”
Lie the patient at 45 degrees and leave them covered
Inspect the patient from the end of the bed and look for the following:
Inspect the hands and check for stigmata of chronic GI disease
Check the patient's pulse and resp rate. Time for 15 seconds and multiply by 4.
Next, inspect their eyes and mouth for the following.
Check for pretibial myxoedema (seen in hyperthyroidism).
Ask the patient to remove their upper garment if this blocks the view of the neck. Inspect the neck more closely and look for the following:
Explain to the patient you will be standing behind them to feel their neck. Palpate for a mass and note the following
Percuss down the sternum to hear for any dullness (this may signify a retrosternal goitre)
Auscultate the neck to hear for any bruits ‐ turbulent blood flow through the thyroid gland.
Let the patient know you have finished examining them and thank them for their time. Be courteous and offer them help to get redressed.
“That’s the end of the exam. Thank you for your time. Would you like any help getting dressed?”
Explain to the examiner what tests and investigations you would perform