@ClevelandClinic Hospital Medicine Grand Rounds - Dr. Mario Skugor - “Thyroid Disorders in the Hospital” #meded
If there are acute or severe chronic diseases - can cause the “Non-thyroidal illness” also know as “Sick euthyroid syndrome (SES)” - order a Reverse T3 (rT3) - in true hypothyroidism it will be LOW! In SES will be NORMAL! #meded
Hyperthyroidism approach - leverging radioactive iodine scan to differentiate causes.
Graves - will give diffuse and nice uptake.
Thyroiditis - will not show good uptake.
More on hyperthyroidism approach! #meded
Thyroid storm - a highly lethal disease. #meded
Thyroid storm treatment.
- Methimazole
- Steroids
- Betablockers
- Plasmapheresis
- Dialysis
Hypothyroidism - how to start thyroid hormone.
Weight based dose.
Myxedema coma - approach and treatment.
- iv thyroxine
- enteral liothyronine (T3) rarely used
- steroids
- treat the cause
Drug-induced thyroid disorders.
Amiodarone-induced thyroid hyperthyroidism
Lithium and thyroid disease
Iodine contrast agents and thyroid disorders.
Drugs that LOWER TSH
Drugs that INCREASE TSH
Anti-cancer drugs and thyroid disorders
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