thyroid storm Flashcards
thyroid storm aka?
Thyrotoxic crisis
is this emergency?
yes
T4 levels?
↑↑↑T4
Triggers for thyroid storm?
Thyroid surgery
Trauma
Infection
Acute iodine load
how might one get acute iodine load?
CT contrast media
skin symptoms?
-2
Hyperthermic
sweating
heart symptoms/signs?
-3
arrhythmias, tachycardic, HTN
GI symptoms?
-3
N&V,
diarrhoea
vomiting
what can happen to skin colour?
jaundice
brain symptoms
-5
headache confused agitated irritable anxious
category of diagnosis?
clinical
if you suspect thyroid storm clinically what should you do?
do not wait for blood results, start treatment ASAP.
HTN can cause what complication in thyroid storm?
how might you see this on CXR?
HF
CXR - see pulm oedema
pt suspected of thyroid storm.
supportive Mx?
-2
IV fluids
give O2
pt suspected of thyroid storm.
hyperthermia Mx?
ice packs and cooling blanket
pt suspected of thyroid storm.
drug to treat SNS symptoms?
-1
propranolol
pt suspected of thyroid storm.
drugs to bring down the high T4 and T3?
-2
group of these drugs?
methimazole or propylthiouracil
Anti-thyroid drugs
Methimazole moa?
inhibits thyroperoxidase > so I- not made to I
Propylthiouracil moa?
blocks iodination of thyroglobulin
what do you give to to stop T4 converting to T3?
give Lugol’s iodine
Lugol’s iodine, how does it work (through what effect)?
high I ingestion actually lowers thyroid hormone levels via Wolff-Chaikoff effect
which glucocorticoid do you give in thyroid storm?
how does this steroid help in thyroid storm?
dexamethasone
blocks conversion of T4 to T3
do you get fever in thyroid storm?
yes
prognosis?
if untreated, very fatal
CXR findings?
big heart from heart failure and pulm oedema
ECG findings?
arrhythmias
most common arrhythmia in thyroid storm?
AF
TFT results?
↑T3 ↑T4 ↓TSH
iodine uptake in thyroid storm, increased or decreased?
increased
LFT results? abnormal or normal?
abnormal
