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Endocrine Case

Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Oct 28, 2011.

  1. Egyptian Doctor

    Egyptian Doctor  Moderator Verified Doctor

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  2. david920801

    david920801 Well-Known Member

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    Hyperthyroidism
     


  3. aisyah

    aisyah Famous Member

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    exophthalmus in grave disease (hyperthyroidism)
     


  4. maruis

    maruis Moderator

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    exophthalmos or proptosis
     


  5. Rocket Queen

    Rocket Queen Super Moderator

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    Exophthalmus-Graves disease
     


  6. dr.bor

    dr.bor Famous Member

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    hyperthyroidism, Basedow's disease, Grave disease
     


  7. Heba Abd El Wahab

    Heba Abd El Wahab Well-Known Member

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    exophthalmus -gravies
     


  8. Egyptian Doctor

    Egyptian Doctor  Moderator Verified Doctor

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    Answer : Graves Disease
     


  9. neo_star

    neo_star Moderator

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    Related Self Assessment Question

    A 58-year-old man presents with tachycardia, fever, confusion, and vomi-ting. Work-up reveals markedly elevated (triiodothyronine) T3 and (thyroxine) T4 levels. He is diagnosed as having a thyroid storm. Which of the following is the most appropriate next step in the management of this patient?

    A. Emergent subtotal thyroidectomy
    B. Emergent total thyroidectomy
    C. Emergent hemodialysis
    D. Administration of fluid, antithyroid drugs, β-blockers, iodine solution, and steroids
    E. Emergent radiation therapy to the neck

    EXPLANATION:

    Thyroid storm can be associated with high mortality rates if it is not appropriately managed in an intensive care unit setting.

    Treatment includes rapid fluid replacement, antithyroid medication such as propylthiouracil (PTU), β-blockers, iodine solutions, and steroids.

    β-Blockers are given to reduce peripheral conversion of T4 to T3 and decrease the hyperthyroid symptoms.

    Lugol iodine helps to decrease iodine uptake and thyroid hormone secretion.

    PTU therapy blocks formation of new thyroid hormone and reduces peripheral conversion of T4 to T3.

    Corticosteroids block hepatic thyroid hormone conversion.

    The thyroid storm needs to be treated before undergoing any surgery.

    Radiation therapy and hemodialysis have no role in the treatment of thyroid storm.


    The answer is D.
     


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