Thyroid Storm**** Flashcards

1
Q

What is another name for this?

A

Hyperthyroid crisis

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2
Q

What triggers it?

A

Illness (e.g. infection)
Surgery
Trauma

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3
Q

S+S:

Think about severe manifestations of hyperthyroidism

A

Fever

CV - tachycardia, AF, HF

D&V - acute abdomen

Confusion - coma

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4
Q

Management:

(1) IV fluids:
- Why are fluids given?
- What can be done for vomiting? - not antiemetics

(2) What bloods should be taken?

(3) Propranolol is given if are no CI’s and the cardiac output is okay.
- Why should it not be given to those with asthma/poor cardiac output?
- What can be given instead?

A

To replace fluid loss due to D&V

NG tube

T3, T4 and TSH
—–
It has caused cardiac arrest in a thyroid storm

Short-acting beta-blockers - IV esmolol

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5
Q

Management:

(4) What other cardiac drug may be used to control the HR quickly?

(5) Antithyroid drugs are used:
- Which drugs are used?
- Route?

(6) Steroids (Hydrocortisone/dexamethasone):
- Why are steroids prescribed?

Extras:

  • Why may bile acid sequestrants (e.g. cholestyramine) given?
  • What drug can be given to reduce a fever?
A

Digoxin - high dose

Propylthiouracil - 1st line
Carbimazole

NGT - not IV

====
They prevent the peripheral conversion of T4 to T3 - remember T3 is stronger even though it is produced less by the gland but mainly by peripheral conversion
====
Prevents T4 and T3 reabsorption in the gut

Paracetamol - tepid sponging can also be used

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