Myedema Coma Flashcards
What is Myxedema coma?
Occurs when the body compensatory response to hypothyroidism are overwhelmed by a precipitating factor such as infection
Myxedema coma is an extreme manifestation of?
( is rare, but potentially lethal condition )
Hypothyroidism
Notes
Patients with hypothyroidism may exhibit a number of physiologic alterations to compensate for the lack of thyroid hormone such as multiple organ abnormalities and progressive mental deterioration !!!
Even with early detection an appropriate treatment, mortality ranges from 30-60 percent
Who is at risk?
4x higher in which gender?
80% of cases occur in which gender? ^
What age and older?
90% occur during which season?
Also those who fail to take thyroid ____ during hospitalization
Women
Women
60+
Winter months
Thyroid replacement therapy
What are symptoms of myxedema coma? (7)
F, C, WG, CI, DV, CH, DPS
Fatigue
Consifpation
Weight gain
Cold intolerance
Deep voice
Coarse hair
Dry; pale, cool skin
Cardinal manifestations of myxedema coma is a deterioration of the patients mental status (6)
LBT. TI, SB, AR, CM, PB60
Low body temperature & BP
Triggering infection
Shallow/slow breathing
Absent or slow reflects
Changes in mental state
Pulse below 60bpm
What is the diagnosis?
Notes
Macroglossia, Ptosis, periobital edema, coarse sparse hair
Non putting edema of lower extremities
Myxedematous face
; which is generalized puffiness
Labs ? (3)
What are we looking at
Thyroid hormone levels
Electrolyte levels
CPK , creatine kinase levels
What are the main things we see in our thyroid levels?
Serum levels of T4 ^ or down ?
T3 up or down ?
TSH up or down ?
Low
Low
Up
What is the treatment ? (4)
ICU
Hypovolemia & electrolyte correction
Mechanical ventilation may be necessary
Treated with IV thyroid hormone
( IV thyroid hormone replacement )