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18 Cards in this Set
- Front
- Back
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18 yo G2P1 at 35 weeks gestation with + hx of Graves disease
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under treatment with oral PTU
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has been feeling tachycardic and like her heart is pounding
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has nervousness, sweating etc.
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BP is 150/110
Hr 140 |
low grade fever
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Thyroid is tender and enlarged. What is the dx?
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thyroid storm
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What is the treatment for thyroid storm?
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B blockers, steroids and PTU
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most common cause of hyperthyroidism in the US
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Graves
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signs of Graves
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exophthalmos
non tender goiter uniformly enlarged thyroid |
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What is the hallmark of thyroid storm vs simple hyperthyroidism
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you get unstable vitals
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So again what are we gonna do for this lady?
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propanolol for her severe tachycardia and htn
steroids and additional PTU |
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What about in a non-pregannt patient?
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it's exactly the same except that you can also use potassium iodide in these patients.
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How would you interpret a high WBC in these patients?
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they may also have BONE MARROW APLASIA
no bueno |
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2 most commonly used drugs for hyperthyroidism
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PTU and methimazole
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What is the difference between the two?
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PTU has some peripheral conversion inhbition as well so it has a dual effect
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do we use PTU or MMZ more often in pregnant patients?
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PTU
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Why use PTU if it has peripheral effects as well?
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because methimazole can cause aplasia cutis
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What are some sequellae of thyroidectomy?
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hypothyroidism
hypoparathyroidism vocal cord paralysis |
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Where should these ptients be managed with thyroid storm>
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the ICU
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What can you do if the fetus appears to devleop hypOthyroidism?
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you can give intra-amniotic injections of T4/T3
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