Thyroid Crisis: From 1 Different Sources
(thyroid storm) a life-threatening condition due to an acute and severe exacerbation of previously undiagnosed or inadequately treated *thyrotoxicosis. It often follows infections, childbirth, nonthyroid surgery, or trauma but can occur without an obvious cause. The presenting features are a fever, severe agitation, nausea and vomiting, diarrhoea, and abdominal pains. An accelerated heart rate and irregularity of the heart rhythm can cause heart failure, and psychotic episodes or coma can result. Blood tests will reveal hyperthyroidism and may also show altered liver function, high blood sugar, high calcium levels, a high white blood cell count, and often anaemia. Treatment is with intravenous fluids, oxygen, antithyroid drugs (such as *carbimazole or *propylthiouracil), high-dose iodide solution (see Lugol’s solution), high-dose steroids, and beta blockers. The patient must be cooled and given antipyretics, such as paracetamol. Any underlying cause must also be treated.
Crisis is a word used with several distinct meanings. (1) The traditional meaning is that of a rapid loss of fever and return to comparative health in certain acute diseases. For example, PNEUMONIA, if allowed to run its natural course, ends by a crisis usually on the eighth day, the temperature falling in 24 hours to normal, the pulse and breathing becoming slow and regular and the patient passing from a partly delirious state into natural sleep. In this sense of the word, the opposite of crisis is lysis: for example, in typhoid fever (see ENTERIC FEVER), where the patient slowly improves during a period of a week or more, without any sudden change. (2) A current use of the word crisis, and still more frequently of critical, is to signify a dangerous state of illness in which it is uncertain whether the sufferer will recover or not.... crisis
A rare disease that accounts for around 1 per cent of all cancers, cancer of the THYROID GLAND usually presents as an isolated hard nodule in the neck. The rate at which the nodule grows depends upon the patient’s age and type of cancer cell. Pain is not usually a feature, but the increasing size may result in the tumour pressing on vital structures in the neck – for example, the nerves controlling the LARYNX (resulting in hoarseness) and the PHARYNX (causing di?culty in swallowing). If more than one nodule is present, they are likely to be benign, not malignant. Treatment is by surgical removal after which the patient will need to take THYROXINE for the rest of his or her life. Radioactive iodine is usually given after surgery to destroy any residual cancerous cells. If treated early, the outlook is good.... thyroid cancer
A colloquial description of the feelings of anxiety and distress experienced by some individuals in early middle age. They realise that by 45 years of age they are no longer young, and men in particular try to turn the clock back by changing jobs, dressing trendily, taking up energetic or unusual sports or engaging in extramarital liaisons. Sometimes those in mid-life crises develop mild or even serious DEPRESSION. The feelings of anxiety and insecurity usually disappear with time but some people may bene?t from counselling.... mid-life crisis
The largest cartilage in the LARYNX and forms the prominence of the Adam’s apple in front of the neck.... thyroid cartilage
... thyroid gland, diseases of
The provision of immediate advice or help by a variety of agencies such as social services departments to people with acute personal or sociomedical problems.... crisis intervention
A group of blood tests used to evaluate the function of the thyroid gland and to detect or confirm any thyroid disorder. The thyroid hormones T3 and T4 are measured, as well as thyroid-stimulating hormone (TSH), the pituitary gland hormone that stimulates the thyroid gland.... thyroid-function tests
Techniques, such as radionuclide scanning and ultrasound scanning, that are used to provide information about the location, anatomy, and function of the thyroid gland.... thyroid scanning
an acute medical emergency due to a lack of corticosteroid production by the body, caused by disease of the adrenal glands or long-term suppression of production by steroid medication. It manifests as low blood pressure and collapse, biochemical abnormalities, hypoglycaemia, and (if untreated) coma and death. Treatment is with steroids, administered initially intravenously in high doses and later orally. In patients with poor adrenal function an Addisonian crisis is usually brought on by an acute illness, such as an infection. [T. Addison (1793–1860), British physician]... addisonian crisis
(CRHT) (in psychiatry) a multidisciplinary team in psychiatric services specialized in the treatment of severely mentally ill patients in their home environment. An additional remit of CRHTs is to try and avoid acute hospital admissions.... crisis resolution and home treatment team
acute obstruction of a kidney causing severe pain in the loins. The obstruction usually occurs at the junction of the renal pelvis and the ureter, causing the kidney to become distended with accumulated urine (see hydronephrosis). Sometimes the pelvis drains spontaneously, with relief of pain, but acute decompression of the kidney may be required with surgical relief of the obstruction (*pyeloplasty). [J. Dietl (1804–78), Polish physician]... dietl’s crisis
a rarely seen but well-documented alteration in the shape of the nails resembling *clubbing but unique to Graves’ disease (see thyrotoxicosis). It is often associated with formation of new bone seen on X-rays of the hands and wrists, which is said to resemble bubbles along the surface of the bones.... thyroid acropachy
autoantibodies directed against the cells of the thyroid gland, which serve as a marker of autoimmune thyroid disease. There are two main types: antibodies directed against the thyroid peroxidise (TPO) enzyme; and anti-thyroglobulin, directed against the thyroid colloid (see thyroid gland). The highest level of thyroid antibodies is found in *Hashimoto’s disease.... thyroid antibodies
an iodine-containing substance, synthesized and secreted by the thyroid gland, that is essential for normal metabolic processes and mental and physical development. There are two thyroid hormones, *triiodothyronine and *thyroxine, which are formed from *thyroglobulin. Lack of these hormones gives rise to *cretinism in infants and *myxoedema in adults. Excessive production of thyroid hormones gives rise to *thyrotoxicosis.... thyroid hormone
(TSH, thyrotrophin) a hormone, synthesized and secreted by the anterior pituitary gland under the control of *thyrotrophin-releasing hormone, that stimulates activity of the thyroid gland. Raised levels of TSH are found in primary *hypothyroidism. Normal or low TSH levels in the presence of a low serum thyroxine are found in secondary hypothyroidism and the *euthyroid sick syndrome.... thyroid-stimulating hormone
see thyroid crisis.... thyroid storm
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