Thyroid: History

                                                                Thyroid: History

1.       Chief complaints

·         Swelling in front and sides of the neck

·         Hoarseness of voice

·         Difficulty in swallowing / breathing

·         Pain over the swelling

2.       History of Present Illness

·         Swelling

−        Duration

(A special feature of papillary and follicular carcinoma is their very slow growth. They may exist as a lump in the neck for many years before metastasizing. Thus the length of time that a lump has been present is no indication as to its underlying nature -Benign/Malignant) [Norman Browse]

−        Onset: Sudden or insidious

−        Site of onset: Front or side of the neck

−        Progress of the swelling

·         Pain:

−        Duration

−        Site

−        Character: Usually dull-aching

−        Radiation

−        Relieving and aggravating factors

3.       Pressure symptoms

·         Difficulty in swallowing

·         Difficulty in breathing

·         hoarseness of voice

4.       Any symptom of hyperthyroidism

·         Weight loss with increased appetite

·         diarrhea

·         Palpitation

·         Irritability on slight provocation

·         Insomnia

·         Bulging of eyes

·         Increased sweating

·         Heat intolerance

5.       Symptoms suggestive of hypothyroidism

·         Weakness/lethargy

·         Puffiness of face with pouting lips & dull expression

·         Menstrual problems

·         Constipation

·         Intolerance to cold

6.       Past History

·         Any history of irradiation in the neck

7.       Family History

·         Any history of thyroid disease in the family members (Autoimmune, Familial cancer, food habit)

8.       Treatment History

·         Levothyronine

·         Anti-thyroid drugs

·         Beta blockers

9.       Dietary history

·         Type of Salt (iodinated or not)

·         Excessive intake of Brassica family, sea fish (Anti-thyroid property)