Fine hand tremor , better demonstrated by placing a sheet of paper on the dorsum of both hands held straight, may be an important sign of disease.
If a patient is anxious, sweaty, tachycardic, and there is goiter, then thyroid function should be assessed to rule out thyrotoxicosis.
If the above features are there, in addition to cold hands, absence of goiter, and normal thyroid function, then anxiety disorder is likely.
If there is tachycardia, no features of anxiety, and normal thyroid function, then history of sympathomimetic medications intake should be sought.
If there are features of anxiety, irritability, and history of alcoholism, alcohol withdrawal should be suspected.
If a patient is anxious, sweaty, tachycardic, and there is goiter, then thyroid function should be assessed to rule out thyrotoxicosis.
If the above features are there, in addition to cold hands, absence of goiter, and normal thyroid function, then anxiety disorder is likely.
If there is tachycardia, no features of anxiety, and normal thyroid function, then history of sympathomimetic medications intake should be sought.
If there are features of anxiety, irritability, and history of alcoholism, alcohol withdrawal should be suspected.
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