A 45-year-old man on ICU develops thyroid storm with Burch-Wartofsky score more than 45. What is the correct treatment order?...

Question

A 45-year-old man on ICU develops thyroid storm with Burch-Wartofsky score more than 45. What is the correct treatment order?

Accepted Answer

IV beta-blocker (propranolol or esmolol) first, then thionamide (PTU or carbimazole), then iodine at least 1 hour AFTER the thionamide, then IV hydrocortisone - the order matters because iodine given before the thionamide would be used as substrate for more hormone production

Answer

Iodine first then beta-blocker

Answer

Iodine first then PTU

Answer

Surgery immediately

Answer

Thyroid hormone replacement

uk-fficm MCQ (SBA): Thyroid Storm

A 45-year-old man on ICU develops thyroid storm with Burch-Wartofsky score more than 45. What is the correct treatment order?