Emergency Department Management of Patients With Thyroid Emergencies (Pharmacology CME)

Enlarge Image
Delivery Method:	Online
$99.00 ADD TO CART OR SUBSCRIBE AND SAVE Back To Store

Publication Date: June 2024 (Volume 27, Number 6)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 06/01/2028.

Specialty CME Credits:Included as part of the 4 credits, this CME activity is eligible for 1 Pharmacology CME credit, subject to your state and institutional approval.

Authors

Peer Reviewers

Abstract

Patients experiencing thyroid emergencies can present with a wide array of clinical presentations and comorbid conditions, so a systematic strategy to identify key historical and physical examination features can help guide the emergency clinician in recognizing these infrequent conditions. This issue review the most up-to-date evidence for diagnosing and managing decompensated hypothyroidism and thyroid storm in adult, pediatric, and pregnant patients.

Case Presentations

A 67-year-old woman presents to the emergency department by EMS with altered mental status…

• According to EMS, a family member found her at home, without heat, with an outdoor ambient temperature of 36°F. She was in a confused mental state.
• On EMS arrival, the patient was noted to be obtunded, with a temperature of 31.6°C, heart rate of 43 beats/min, blood pressure of 78/45 mm Hg, and respiratory rate of 15 breaths/min.
• In the ED, you note the patient to be cold and minimally responsive.
• Review of her medical record shows she currently takes lisinopril, atorvastatin, levothyroxine, and citalopram. Because the differential diagnosis for this patient is so broad, you wonder whether her medication list provides any clues…

A 34-year-old woman presents to the emergency department with heart palpitations…

• The patient states that her heart palpitations began 2 hours ago, and that for the past 2 weeks, she has felt anxious and has been experiencing nausea and diarrhea.
• Her vital signs are: temperature, 38.3°C; heart rate, 148 beats/min; blood pressure, 157/62 mm Hg; and respiratory rate, 25 breaths/min. Her weight is 52 kg.
• Her physical examination is notable for moderate distress, an irregularly irregular heart rhythm, clear lung sounds, a painless enlarged mass over the neck, and mild suprapubic and left costovertebral angle tenderness. She appears to be very thin for her height.
• You consider whether her anxiety, nausea, diarrhea, and palpitations are being driven by a more complex underlying process…

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.