Difference between revisions of "Hyperthyroidism"

(Created page with "==Background== Precipitants: -infc -surg -trauma -dka -hypoglycemia -palpation of gland -withdrawal of meds ==DDX== Grave's Disease - exophthalmos, increased meta...")
 
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==Background==
 
==Background==
 
+
===Precipitants===
 
+
#infc
Precipitants:
+
#surg
 
+
#trauma
-infc
+
#dka
 
+
#hypoglycemia
-surg
+
#palpation of gland
 
+
#withdrawal of meds
-trauma
 
 
 
-dka
 
 
 
-hypoglycemia
 
 
 
-palpation of gland
 
 
 
-withdrawal of meds
 
 
 
 
  
 
==DDX==
 
==DDX==
 
+
===Grave's Disease===
 
+
#exophthalmos, increased metabolism, pretib myxedema
Grave's Disease
+
#ab stim tsh receptor
 
+
#decreased tsh conc
- exophthalmos, increased metabolism, pretib myxedema
+
#increased radioactive iodine uptake RAI
 
+
#tx first with propylthiouracil or methimazole, then either albation, surg or more meds. Meds I organfication of I2
- ab stim tsh receptor
 
 
 
- decreased tsh conc
 
 
 
- increased radioactive iodine uptake RAI
 
 
 
- tx first with propylthiouracil or methimazole, then either albation, surg or more meds. Meds I organfication of I2
 
 
 
 
  
 
==Treatment==
 
==Treatment==
 
+
#If no CHF, hydrate with D5NS
 
+
#Prograffin 3 gms qd (stops conversion and release)
1) If no CHF, hydrate with D5NS
+
#Propranolol 1-2 mg IV up to 0.1 mg/kg q 1- 2 h. or 40- 80 mg q6h. for conv & betablock. not if chf or brochospasm
 
+
#Iodide 30 ggts KI/d in divided doses or 0.5- 1.0 gm KaI in 1L ns q 12h. or sski 5 ggts q 6h. (stops release from gland)
2) Prograffin 3 gms qd (stops conversion and release)
+
#Dexamethasone 2mg q6 or hydrocortisone 100mg iv qh (stops conversion)
 
+
#Dopamine if hypotensive
3) Propranolol 1-2 mg IV up to 0.1 mg/kg q 1- 2 h. or 40- 80 mg q6h. for conv & betablock. not if chf or brochospasm
 
 
 
4) Iodide 30 ggts KI/d in divided doses or 0.5- 1.0 gm KaI in 1L ns q 12h. or sski 5 ggts q 6h. (stops release from gland)
 
 
 
5) Dexamethasone 2mg q6 or hydrocortisone 100mg iv qh (stops conversion)
 
 
 
6) Dopamine if hypotensive
 
 
 
 
  
 
==See Also==
 
==See Also==
 
 
 
Endo: Thyroid Storm
 
Endo: Thyroid Storm
  
 
Endo: Thyroid (General)
 
Endo: Thyroid (General)
 
 
  
 
==Source ==
 
==Source ==
 
 
 
6/06 MISTRY
 
6/06 MISTRY
 
 
 
  
 
[[Category:Endo]]
 
[[Category:Endo]]

Revision as of 05:30, 13 March 2011

Background

Precipitants

  1. infc
  2. surg
  3. trauma
  4. dka
  5. hypoglycemia
  6. palpation of gland
  7. withdrawal of meds

DDX

Grave's Disease

  1. exophthalmos, increased metabolism, pretib myxedema
  2. ab stim tsh receptor
  3. decreased tsh conc
  4. increased radioactive iodine uptake RAI
  5. tx first with propylthiouracil or methimazole, then either albation, surg or more meds. Meds I organfication of I2

Treatment

  1. If no CHF, hydrate with D5NS
  2. Prograffin 3 gms qd (stops conversion and release)
  3. Propranolol 1-2 mg IV up to 0.1 mg/kg q 1- 2 h. or 40- 80 mg q6h. for conv & betablock. not if chf or brochospasm
  4. Iodide 30 ggts KI/d in divided doses or 0.5- 1.0 gm KaI in 1L ns q 12h. or sski 5 ggts q 6h. (stops release from gland)
  5. Dexamethasone 2mg q6 or hydrocortisone 100mg iv qh (stops conversion)
  6. Dopamine if hypotensive

See Also

Endo: Thyroid Storm

Endo: Thyroid (General)

Source

6/06 MISTRY