What is involved in the initial screening process?
The initial screening process includes: thorough physical exam, complete blood count and serum chemistry, total T4 value, and urinalysis. A urine protein:creatinine ratio is performed when overt proteinuria is identified. A microalbuminuria test is performed if urine protein is negative. A free T4 may be run to confirm the diagnosis of hyperthyroidism if the total T4 is only marginally elevated or is within the high end of the normal range. The remainder of the screening process includes: survey thoracic radiographs, indirect blood pressure (usually via Doppler manometry) and a baseline electrocardiogram. Further cardiac evaluation (echocardiography) is not performed, unless there is suspicion or evidence of cardiac disease determined during this initial screening process.
