Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of palpitations, heat intolerance, unintentional weight loss despite increased appetite, and increased frequency of bowel movements. Reports symptoms of anxiety, irritability, and insomnia. Onset of symptoms is gradual over [Number] months. No history of recent iodine contrast exposure or thyroid medication use.
Clinical Examination Findings
Vitals: Tachycardia noted (HR: [Value] bpm), BP [Value]/[Value] mmHg. HEENT: Diffuse thyroid enlargement (goiter) noted on palpation, non-tender, no discrete nodules. Presence of lid lag and exophthalmos. Cardiovascular: Hyperdynamic precordium, regular rhythm, S1/S2 normal, no murmurs. Neurological: Fine tremor of outstretched hands, hyperreflexia noted. Skin: Warm, moist, velvety texture.
Treatment Protocol
Initiate treatment with Methimazole [Dose] mg daily. Beta-blocker (Propranolol [Dose] mg) prescribed for symptomatic control of tachycardia and tremors. Patient advised to monitor for signs of agranulocytosis (fever, sore throat). Follow-up TSH, Free T4, and T3 levels in 4-6 weeks. Discussed definitive treatment options including Radioactive Iodine (RAI) therapy or thyroidectomy.