Thyroid Crisis (Final Exam) Flashcards
(15 cards)
What is a thyroid strom?
Overwhelming release of thyroid hormones that exerts an intense stimulus on the metabolism
Thyroid crisis is life threatening condition most commonly precipitated by
Surgery
Trauma
Infection
TC: Risk Factors
Long standing hyperthyroidism (GRAVES)
Acute event (surgery-trauma-infection)
Irregular use or discontinuation of antithyroid drugs
TC: Clinical Manifestations
-Fever (Very high)
-Tachycardia (above 140)
-Cardiac arrhythmias (Atrial)
-N/V
-Agitation
-Tremoring
-Psychosis
-Stupor / Coma
-Hypotension
Treatment of thyroid storm
Beta blocker
Thionamide
Iodine solution
Glucocorticoids
Bile acid sequestrants
TC: Beta Blocker
Control symptoms and signs induced by increased adrenergic tone
Give q 6 hours
TC: Thionamide
Block new hormone synthesis supressess conversion of T4 to T3
Give q 4 hours
TC: Iodine solution
Block the release of thyroid hormone
TC: Glucocorticoids
Reduce T4 to T3 conversion, promote vasomotor stability, and treat adrenal insufficiency
Given q 8 hours
TC: Bile Acid Sequestrants
Decrease enterohepatic circulation (circulation of liver and bile) and recycling of thyroid hormones
Give q g hrs
Myxedema Coma
Severe hypothyroidism leading to decreased mental status - hypothermia - slowing of functions
Is myxedema coma common?
It is uncommon r/t the ability of it to be found early is disease stage
Myxedema Coma: Risk Factor
Hypothyroidism
-Long standing and severe forms
-Stressor events in poorly controlled patients
-Sedative drugs (OPIOIDS)
MC: Clinical Manifestations
Decreased mental status (coma)
Hypothermia
Hypotension
Bradycardia
Hyponatremia
Hypoglycemia
Hypoventilation
MC: Treatment
Thyroid hormone replacement
(levothyroxine+liothyronine)
Glucocorticoids
Supportive measures
(ICU-Vent-etc)
