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12 Cards in this Set
- Front
- Back
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How can a thyroid storm present?
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Exaggeration of hyperthyroidism
Tachycardia CHF Extreme fever Vomiting Diarrhoea Hepatic failure with jaundice and confusion Vascular collapse - hypotension, cardiac arrhythmia, death |
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What is the aetiology behind a thyroid storm?
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Often precipitated by infection, trauma, or surgery in a hyperthyroid patient
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How do you treat thyroid storm?
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Similar to hyperthyroidism just higher doses
propylthiouracil or carbimazole - oral or rectal Lugol's solution (K iodide) - oral - blocks TH release Control tachycardia with proprnaolol, esmolol, metorolol. |
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What is myxedema coma?
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severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to slowing of function in multiple organs
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What are the triggers of myxedema coma?
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trauma, sepsis, cold exposure, MI, stress, narcotics or hypnotics
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How does someone with myxedema coma present?
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hypothermia
bradycardia hyponatramia - impairment in free water excretion due to inappropriate excess casopressin secretion or impaired renal function hypoglycaemia hypoventilation unresponsiveness Hung reflexes |
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How do you manage myxedema coma?
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ABCs
Steroids - possibility of concomitant adrenal insufficiency 1. liothyronine 2. L-thyroxine Supportive measures |
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What medications cause thyrotoxicosis?
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Amiodorone (can be severe)
Lithium (hyper or hypo) Thyroxine OD Iodine OD (e.g. from seaweed additive to soy milk) |
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What disease is 'pretty much' the only cause of thyroid tenderness?
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Subacute thyroiditis
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Patient has all the clinical signs of Graves. What is imaging do you order to confirm the diagnosis?
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Technicium scan: tells you if there is diffuse, bilateral and increased uptake characteristic of Graves.
NOT ultrasound. U/S gives you an idea of thyroid anatomy (e.g. if there are nodules or cytsts) |
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Re. technicium uptake values:
What is normal uptake % What is Graves uptake % |
Normal = 5%
Graves = 18% |
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What causes solitary nodule?
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simple cyst/colloid nodule
follicular adenoma (benign) thyroid cancer subacute thyroditis Usually, a clinically palpable single nodule is a dominant nodule in a multinodular goitre (the other nodules are clinically inapparent). NB Multiple nodules very common |
