Hyperthyroidism: Difference between revisions
(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 | |||
#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 | |||
#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) | |||
#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) | |||
#Dexamethasone 2mg q6 or hydrocortisone 100mg iv qh (stops conversion) | |||
#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
- infc
- surg
- trauma
- dka
- hypoglycemia
- palpation of gland
- withdrawal of meds
DDX
Grave's Disease
- exophthalmos, increased metabolism, pretib myxedema
- 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
- If no CHF, hydrate with D5NS
- Prograffin 3 gms qd (stops conversion and release)
- 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)
- Dexamethasone 2mg q6 or hydrocortisone 100mg iv qh (stops conversion)
- Dopamine if hypotensive
See Also
Endo: Thyroid Storm
Endo: Thyroid (General)
Source
6/06 MISTRY