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Regulatory: Thyroid storm - Coggle Diagram
Regulatory: Thyroid storm
Risks
untreated hyperthyroidism or interruption in medical regimen
thyroid surgeries or heavy manipulation of the thyroid gland during surgery
Grave's disease
contrast dyes
pathology/etiology
TS occurs from excessive release of t3/t4 from the thyroid gland often caused by untreated/undertreated grave's disease/hyperthyroidism. It is often precipitated by increased stress, infection and DKA. Alternatively excessive manipulation of the thyroid can also cause TS.
T3/T4 regulates the body's metabolism. When excessive amounts are released cellular metabolism drastically increases resulting in depletion of the bodies energy reserves (causing weakness) and hyperthermia (causing dehydration/diaphoresis). The increased metabolism also increases O2 demands throughout the body causing air dyspnea/air hunger. Excessive amounts also stimulates the SNS leading to extreme tachycardia eventually causing high-output heart failure and dysrhythmias. As perfusion, oxygenation and bodily reserves fail, coupled with hyperthermia, cell death occurs resulting in organ failure and death.
Treatment
cooling measures
treatment of underlying factors (infection, DKA, hyperthyroidism)
Pharm: admin of thionamides, iodine compounds, beta-blockers, glucocorticoids, antipyretics
Fluid replacement
labs/diagnostics
t3/t4 and TSH levels
metabolic panel, CDC, LFT, creatinine/BUN
blood glucose
radioactive iodine uptake test
S&S
complications
Death
organ damage
Heart failure
S&S hyperthyroid: heat intolerance, diaphoresis, weakness
GI: N&V, diarrhea
CNS: agitation/irritability, delirium, coma
hyperthermia
CV: tachycardia, dysrhythmias, HTN
dyspnea