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Thyroid Storm & Subclinical Hyperthyroidism – Hyperthyroidism (Thyrotoxicosis)

by Carlo Raj, MD
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    Thyroid storm, what happens here? Let’s say that the colloid gets destroyed. When it does, it may then result in massive release of T3, T4 into circulation. Characterized by fever, sever tachy-. All that thyroid hormone sensitizing the heart and therefore, making it easier for catecholamines to work on beta-1 receptors to the point where the palpitations and arterial fibrillation might be taking place. There might be so much issue then which now you might then cause delirium or to the point of even coma. Quite dangerous – thyroid storm. Usually, precipitated by severe physiologic stress (childbirth, surgery), lots of stress in a patient with uncontrolled hyperthyroidism. Look for stresses in which the… results in massive release of T3, T4 into circulation. With the thyroid storm, you want to try to get in there as quickly as possible, because you’re worried about the patient becoming unconscious. Antithyroid drugs are the main therapy – should be started at least several hours prior to any, any iodine. PTU is preferred mainly due to, once again, its inhibition of conversion of T4 into T3. You’re worried about the palpitations, tachycardia and arterial fibrillation and therefore you’re thinking about giving beta blockade and “stress dose” of glucocorticoid coverage, because, remember, what is the precipitating event that is leading up to a thyroid storm? Extreme stress, such as childbirth. And therefore, during this stress, maybe it will be in the best interest of the patient to therefore supplement the patient with more glucocorticoid. Thyroid storm – potassium iodide is always considered. Supportive measures, fluid and electrolyte management, address underlying stress (such as infection, maybe the childbirth we were talking about earlier) and make sure that you monitor the underlying issue before you completely relieve the patient of any therapeutic management. Acetaminophen for that fever, not...

    About the Lecture

    The lecture Thyroid Storm & Subclinical Hyperthyroidism – Hyperthyroidism (Thyrotoxicosis) by Carlo Raj, MD is from the course Thyroid Gland Disorders.


    Included Quiz Questions

    1. Thyroid storm
    2. Infectious thyroiditis
    3. Silent thyroiditis
    4. Plummer's disease
    5. Grave's disease
    1. PTU
    2. RAI
    3. Amiodarone
    4. Aspirin
    5. FNA
    1. Functioning thyroid adenoma
    2. Head and neck radiation
    3. Nodular thyroid
    4. Thyroid storm
    5. Grave's disease
    1. Radioiodine uptake and scan
    2. Fine needle aspiration
    3. Blood cultures
    4. Glucocorticoid treatment
    5. Ultrasound
    1. Grave's disease
    2. Struma ovari
    3. Silent thyroiditis
    4. Subacute thyroiditis
    5. Iatrogenic thyroiditis

    Author of lecture Thyroid Storm & Subclinical Hyperthyroidism – Hyperthyroidism (Thyrotoxicosis)

     Carlo Raj, MD

    Carlo Raj, MD


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