NERVOUSNESS

DD:

Panic Attack

Hyperthyroidism

Pheaochromocytoma

Menopause

Drugs

Coffee

History:

Tell me more?
First time?
How frequently?
Any particular reason or ppt factors?/ worried/mood
Affecting your life? How?

• Any weather preferences? Appetite? Weight? Bowel motion? Periods? Hors mess of voice? Neck lump? Vision change/ FEVER (Thyroiditis)/ Breathing/ Swallowing

• Tremors/ shakiness of your hands
• Episodic sweating/ headache/ Nausea & vomiting
• Heart racing/ chest pain/ ever checked BP earlier
• Sleep/ mood/ anxious 
• 5 P Menstrual irregularities/ hot flush/ mood swings

PMH- CVD, thyroid, CA

Family Hx- CA

Alcohol, coffee, medications 

Social history: stress

Physical examination:

GA BMI

Vital signs PR- regular BP

Thyroid ( neck ex, eye signs, peripheral edema, proximal myopathy - when relevant)

Hand - moisture, tremor

CVS, RS, ABD

Neurological ex - cerebellum signs, Hyperthyroidism- brisk reflex

UDS BSL ECG