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Medicine Endocrinology c5f1a5de

Treatment of Thyroid crisis are all EXCEPT

A
Neomethimazole
B
Propranol
C
Iodine
D
Iodide
High-Yield Explanation
C i.e. (Iodine) (714 - CMDT- 09) (2237- H17th) (988 - 09)THYROTOXIC CRISIS OR THYROID STORM* Presents as life threatening exacerbation of hyperthyroidism* Fever, delirium, seizures, coma, vomiting, diarrhea and jaundice* Mortality rate due to cardiac failure, arrhythmia or hyperthermia* Precipitating factors, acute illness eg stroke, infections, trauma, diabetic ketoacidosis, surgery (especially on the thyroid) or radio iodine treatment of patients with partially or unteated hyperthyroidism of patients with partially or untreated hyperthyroidismTreatment(i) Large doses of prophylthiouracil** is the antithyroid drug of choice [methimazole orally every 6 hrs - (988- CMDT- 09)(ii) Stable iodide* given to block thyroid hormone synthesis (Pot. iodide or ipodate or iopanoic acid, sodium iodide)(iii) Propranol** - reduce tachycardia and other adrenergic manifestation(iv) Additional measure include - gluco corticoids, antibiotics, cooling, oxygen, IV fluids(v) LugoV iodine 10 drops 8hrly by mouth or sodium iodide (791 - Baily & Love 25th), (660 - S. Das 5th)* Definitive treatment with 131I or surgery is delayed until the patient is euthyroid (988- CMDT - 09)* Aspirin is avoided since displaces T4 from, TBG, raising FT4 serum levels

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