Emergency Department Minute Quiz: 52-Year-Old Female with Throat Tightness

October 20, 2020
Brady Pregerson, MD

Check out this Emergency Department Minute Quiz from Brady Pregerson, MD. Can you determine the correct diagnosis?

Background:

A 52-year-old female presents to the emergency department for dyspnea and a feeling that she is being choked, especially when she bends her neck forward. She denies fever, sore throat, chest pain, voice change or other complaints.

Vital Signs & Physical Exam:

Vital signs are normal except for pulse of 52. Physical exam is otherwise normal except for that her thyroid gland feels a bit enlarged.

Initial Diagnostic Testing:

EKG: Normal

Labs: Normal except sodium 131

Imaging: CT of the neck was ordered.

What is the most likely diagnosis?

Thyroid nodule

SIADH

Anxiety

Abscess