Thyroid Storm**** Flashcards
What is another name for this?
Hyperthyroid crisis
What triggers it?
Illness (e.g. infection)
Surgery
Trauma
S+S:
Think about severe manifestations of hyperthyroidism
Fever
CV - tachycardia, AF, HF
D&V - acute abdomen
Confusion - coma
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?
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
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?
Digoxin - high dose
Propylthiouracil - 1st line
Carbimazole
NGT - not IV
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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
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Prevents T4 and T3 reabsorption in the gut
Paracetamol - tepid sponging can also be used