Podcast # 428: Severe Hypothyroidism

Podcast # 428: Severe Hypothyroidism

Author: Gretchen Hinson, MD

Educational Pearls:

  • Clinical manifestations of severe hypothyroidism may include:
    • Pale, cool, diaphoretic skin
    • Myxedema is the non-pitting edema seen in hypothyroidism
    • Hypothermia, heart failure, hypotension and shock
    • Shortness of breath
    • Cholestasis, constipation
    • Encephalopathy and coma

Mortality is 30-50%

Specific treatment includes thyroid hormone (T3, T4, or both) and glucocorticoids (for potential adrenal insufficiency)

References:

Kwaku MP, Burman KD. Myxedema coma. J Intensive Care Med. 2007 Jul-Aug;22(4):224-31. Review. PubMed PMID: 17712058.

Ono Y, Ono S, Yasunaga H, Matsui H, Fushimi K, Tanaka Y. Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan. J Epidemiol. 2017 Mar;27(3):117-122. doi: 10.1016/j.je.2016.04.002. Epub 2017 Jan 5. PubMed PMID: 28142035; PubMed Central PMCID: PMC5350620.

Lee CH, Wira CR. Severe angioedema in myxedema coma: a difficult airway in a rare endocrine emergency. Am J Emerg Med. 2009 Oct;27(8):1021.e1-2. doi: 10.1016/j.ajem.2008.12.027. PubMed PMID: 19857436.

Summarized by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1145)

EMSAC 2024

EMSAC 2024

Contributors: Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano From military-inspired trauma protocols to behavioral health alternatives and cardiac ...

26 Heinä 202511min

Episode 966: Acetaminophen Toxicity

Episode 966: Acetaminophen Toxicity

Contributor: Jorge Chalit-Hernandez, OMS4 Educational Pearls: What is the toxic dose of acetaminophen? 7.5 grams, in an adult. The safe daily limit is 4 grams in an adult with a normally functioning...

21 Heinä 20253min

Episode 965: Oxygen Administration in Trauma Patients

Episode 965: Oxygen Administration in Trauma Patients

Contributor: Aaron Lessen, MD Educational Pearls: Many trauma patients are placed on oxygen via non-rebreather A large, multicenter, controlled trial evaluated the outcomes of oxygen administration i...

14 Heinä 20252min

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Contributor: Aaron Lessen, MD Educational Pearls: Prehospital seizures are typically managed with intramuscular midazolam (Versed) Seizures theoretically involve the NMDA pathway, and ketamine is a p...

7 Heinä 20254min

Episode 963: Antihypertensives and Emergency Room Considerations

Episode 963: Antihypertensives and Emergency Room Considerations

Contributor: Alec Coston, MD Educational Pearls: For patients presenting to the emergency room with hypertension, clinicians should determine if it is isolated and uncomplicated, or involves comorbidi...

30 Kesä 20254min

Episode 962: HEART Score

Episode 962: HEART Score

Contributor: Taylor Lynch, MD Educational Pearls: How do we risk-stratify chest-pain patients? One option is the HEART score This score predicts a patient's 6-week risk of a major adverse cardiac ev...

23 Kesä 20254min

Episode 961: Cell Phone Sign

Episode 961: Cell Phone Sign

Contributor: Aaron Lessen, MD Educational Pearls: A prospective study at the Mayo Clinic Rochester was conducted to examine whether patients actively using their phones on initial assessment in the E...

16 Kesä 20251min

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Contributor: Travis Barlock MD Educational Pearls Frank's sign is a curious physical exam finding first described in the literature in 1973 Bilateral earlobe creases are recognized as a marker of co...

9 Kesä 20251min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
rss-sosiopodi
radio-antro
filocast-filosofian-perusteet
rss-ammamafia
utelias-mieli
mielipaivakirja
rss-bios-podcast
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita