thyroid storm

Question 1

thyroid storm aka?

Answer 1

Thyrotoxic crisis

Question 2

is this emergency?

Answer 2

yes

Question 3

T4 levels?

Answer 3

↑↑↑T4

Question 4

Triggers for thyroid storm?

Answer 4

Thyroid surgery
Trauma
Infection
Acute iodine load

Question 5

how might one get acute iodine load?

Answer 5

CT contrast media

Question 6

skin symptoms?

-2

Answer 6

Hyperthermic

sweating

Question 7

heart symptoms/signs?

-3

Answer 7

arrhythmias, tachycardic, HTN

Question 8

GI symptoms?

-3

Answer 8

N&V,
diarrhoea
vomiting

Question 9

what can happen to skin colour?

Answer 9

jaundice

Question 10

brain symptoms

-5

Answer 10

headache
confused
agitated
irritable
anxious

Question 11

category of diagnosis?

Answer 11

clinical

Question 12

if you suspect thyroid storm clinically what should you do?

Answer 12

do not wait for blood results, start treatment ASAP.

Question 13

HTN can cause what complication in thyroid storm?

how might you see this on CXR?

Answer 13

HF

CXR - see pulm oedema

Question 14

pt suspected of thyroid storm.

supportive Mx?
-2

Answer 14

IV fluids

give O2

Question 15

pt suspected of thyroid storm.

hyperthermia Mx?

Answer 15

ice packs and cooling blanket

Question 16

pt suspected of thyroid storm.

drug to treat SNS symptoms?
-1

Answer 16

propranolol

Question 17

pt suspected of thyroid storm.

drugs to bring down the high T4 and T3?
-2

group of these drugs?

Answer 17

methimazole or propylthiouracil

Anti-thyroid drugs

Question 18

Methimazole moa?

Answer 18

inhibits thyroperoxidase > so I- not made to I

Question 19

Propylthiouracil moa?

Answer 19

blocks iodination of thyroglobulin

Question 20

what do you give to to stop T4 converting to T3?

Answer 20

give Lugol’s iodine

Question 21

Lugol’s iodine, how does it work (through what effect)?

Answer 21

high I ingestion actually lowers thyroid hormone levels via Wolff-Chaikoff effect

Question 22

which glucocorticoid do you give in thyroid storm?

how does this steroid help in thyroid storm?

Answer 22

dexamethasone

blocks conversion of T4 to T3

Question 23

do you get fever in thyroid storm?

Answer 23

yes

Question 24

prognosis?

Answer 24

if untreated, very fatal

Question 25

CXR findings?

Answer 25

big heart from heart failure and pulm oedema

Question 26

ECG findings?

Answer 26

arrhythmias

Question 27

most common arrhythmia in thyroid storm?

Answer 27

AF

Question 28

TFT results?

Answer 28

↑T3 ↑T4 ↓TSH

Question 29

iodine uptake in thyroid storm, increased or decreased?

Answer 29

increased

Question 30

LFT results? abnormal or normal?

Answer 30

abnormal