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  • Enlarged thyroid

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  • 240.9 Goiter, unspecified
  • 241.0 Nontoxic uninodular goiter
  • 241.1 Nontoxic multinodular goiter
  • 241.9 Unspecified nontoxic nodular goiter
  • 242 Thyrotoxicosis with or without goiter
  • 242.0 Toxic diffuse goiter
  • 242.00 Toxic diffuse goiter without mention of thyrotoxic crisis or storm
  • 242.01 Toxic diffuse goiter with mention of thyrotoxic crisis or storm
  • 242.1 Toxic uninodular goiter
  • 242.10 Toxic uninodular goiter without mention of thyrotoxic crisis or storm
  • 242.11 Toxic uninodular goiter with mention of thyrotoxic crisis or storm
  • 242.2 Toxic multinodular goiter
  • 242.20 Toxic multinodular goiter without mention of thyrotoxic crisis or storm
  • 242.21 Toxic multinodular goiter with mention of thyrotoxic crisis or storm
  • 242.3 Toxic nodular goiter unspecified type
  • 242.30 Toxic nodular goiter, unspecified type, without mention of thyrotoxic crisis or storm
  • 242.31 Toxic nodular goiter, unspecified type, with mention of thyrotoxic crisis or storm
  • 242.40 Thyrotoxicosis from ectopic thyroid nodule without mention of thyrotoxic crisis or storm

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  • E01.1 Iodine-deficiency related multinodular (endemic) goiter
  • E01.2 Iodine-deficiency related (endemic) goiter, unspecified
  • E03.0 Congenital hypothyroidism with diffuse goiter
  • E03.1 Congenital hypothyroidism without goiter
  • E04 Other nontoxic goiter
  • E04.0 Nontoxic diffuse goiter
  • E04.2 Nontoxic multinodular goiter
  • E04.8 Other specified nontoxic goiter
  • E04.9 Nontoxic goiter, unspecified
  • E05.00 Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm
  • E05.0 Thyrotoxicosis with diffuse goiter
  • E05.2 Thyrotoxicosis with toxic multinodular goiter
  • E07.1 Dyshormogenetic goiter
  • P72.0 Neonatal goiter, not elsewhere classified

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Description

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  • Enlarged thyroid gland, can result in decreased production of thyroid hormone
  • Prolonged elevation of thyroid stimulating hormone (TSH)
  • Weight gain or loss
  • May range from single or small nodules to significant enlargement
  • Multinodular goiter4
  • Enlargement can limit neck mobility and swallowing

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Essentials of Diagnosis

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  • Fatigue
  • Decreased activity tolerance
  • Sensitivity to cold
  • Abnormal thyroid function tests
  • Thyroid enlargment

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive diagnostic testing, inability to afford testing and medications, noncompliance with medication regimen
  • May cause pathology in multiple organ systems
    • GI: liver
    • Cardiovascular: heart, peripheral circulation, blood pressure
    • Integumentary
  • May result in secondary problems indicating need for PT intervention: aerobic capacity and muscle endurance impairment, sarcopenia, weakness, musculoskeletal problems, neuromuscular problems, weight gain
  • Hyperlipidemia
  • Can result in hyperthyroid

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Demographics

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  • Can occur in anyone throughout lifespan, beginning at birth (1 in 4,000 infants affected)
  • Estimated 5 million people affected in the U.S., and an equal number undiagnosed
  • Higher incidence in women and people aged 60 years and older

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Signs and Symptoms

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  • Nausea
  • Vomiting
  • Diarrhea
  • Coughing
  • Sweating
  • Shaking agitation
  • Hoarseness
  • Dizziness with arms overhead
  • Difficulty swallowing
  • Sensitivity to cold
  • Slowed or rapid heart rate
  • Constipation
  • Joint or muscle pain
  • Paleness
  • ...

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