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Flashcards in Thyroid Storm In Pregnancy Deck (9)
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Thyroid storm?

Thyrotoxicosis leading to
1. CNS dysfunction (coma/altered mental status)
2. Autonomic instability (hyperthermia, hypertension, hypertension)

1

Most common cause of thyrotoxicosis in US? Physical exam sign that is suggestive?

Most common cause of hyperthyroidism postpartum? Mechanism?

Graves Disease, diffusely enlarged goiter

Destructive lymphocytic thyroiditis; high corticosteroid levels and pregnancy suppress autoimmune antibodies, resulting in a flare postpartum

2

biologically active thyroxine hormone?

T3

3

Treatment of hyperthyroidism during pregnancy?

PTU > methimazole > radioactive iodine

(methimazole possibly associated with plasia cutis congenital – Skin/scalp defects)

4

Tx of thyroid storm?

1. PTU
2. Beta blockers to control tachycardia
3. Acetaminophen/cooling blankets for hyperthermia
4. Steroids to prevent conversion of T4 to T3

5

Antenatal treatment of maternal hyperthyroidism in pregnancy can result in? Management?

Failure to treat may result in?

Fetal hyper- or hypothyroidism. Maternal administration PTU or Intra-amniotic injection of thyroxine for fetal hyper- and hypothyroidism respectively

Non-immune hydrops and fetal demise

6

Effect of maternal subclinical hypothyroidism in children? Possible prevention?

Adverse neurological development/abnormal intelligence

Levothyroxine in the first trimester

7

Effect of pregnancy on thyroid hormones? Changes due to?

Increase in thyroid-binding globulin and total T4

No Change in free T4 or TSH

Estrogen

8

Antibodies seen in destructive lymphocytic thyroiditis?

Antimicrosomal and anti-peroxidase