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  • Diffuse thyrotoxic goiter

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  • 242.0 Toxic diffuse goiter
  • PT diagnoses codes that may be secondary to thyroid disorders.
    • 315.4 Developmental coordination disorder
    • 709.2 Scar conditions and fibrosis of the skin
    • 719.70 Difficulty in walking involving joint site unspecified
    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
    • 728.89 Other disorders of muscle, ligament, and fascia
    • 729.9 Other and unspecified disorders of soft tissue
    • 781.2 Abnormality of gait
    • 782.3 Edema
    • 786.0 Dyspnea and respiratory abnormalities
    • 786.05 Shortness of breath

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  • E05 Thyrotoxicosis (hyperthyroidism)
  • E05.0 Thyrotoxicosis with diffuse goiter

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Description

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Essentials of Diagnosis

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  • Diagnosis is made by the symptoms
  • Thyroid hormone test
  • Onset of symptoms is often insidious
  • Symptoms build over a period of time, which can delay diagnosis

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing
  • May cause pathology in multiple organ systems
    • GI: liver
    • Cardiovascular: heart, peripheral circulation, blood pressure
    • Integumentary
  • May result in secondary problems
    • Aerobic capacity and muscle endurance impairment
    • Sarcopenia
    • Weakness/impaired muscle performance
    • Musculoskeletal problems
    • Neuromuscular problems
    • Weight gain indicating the need for PT intervention, depending on severity

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Demographics

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  • Higher incidence in young women: 5 to 10 times more common
  • Most common form of hyperthyroidism in children
  • Presents during early adolescence
  • Less common in blacks
  • Gender: females at greater risk

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Signs and Symptoms

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  • PTs may treat conditions caused by hyperthyroid or treat patients with hyperthyroid for other pathologies that are unrelated
    • Graves’ ophthalmopathy: red or swollen eyes, bulging or protruding eyeballs, impaired vision, inflammation, light sensitivity
    • Eye irritation
    • Double vision
    • Enlarged thyroid
    • Fatigue
    • Weight loss
    • Bulging of eyes
    • Pretibial myxedema (PTM)
    • Possible goiter
    • Tachycardia
    • Cardiac: atrial fibrillation, arrhythmias, palpitations
    • Racing/rapid pulse
    • High blood pressure
    • Hyperactivitiy
    • Difficulty concentrating and focusing
    • Heat intolerance
    • Sweating, clammy skin
    • Confusion, disorientation
    • Diuresis
    • Muscle Weakness
    • Tremors
    • Neck pain
    • Unexplained weight loss with inability to gain weight
    • Difficulty swallowing
    • Change in voice
    • Heart disease
    • Dyspnea, shortness of breath with exertion
    • Airway obstruction
    • Increased appetite
    • Menstrual disturbance, irregularity
    • Increased bowel frequency
    • Breast development in men
    • Clammy skin
    • Diarrhea
    • Hair loss
    • Hand tremor
    • Itching
    • Nausea and vomiting
    • Skin blushing or flushing
    • Difficulty sleeping
    • Osteoporosis
    • Nervousness/anxiety

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Functional Implications

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  • Severe symptoms such as immediacy of need to urinate, increased volume of urine, and increase in bowel frequency may be disabling and result in inability or reluctance to leave home
  • Vision impairment
  • Inability to ...

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