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Thyroid storm — ABEM Board MCQ

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HardRenal/Metabolic emergenciesThyroid stormABEM Board

A 39-year-old woman with untreated Graves disease arrives with fever, agitation, and vomiting. Triage acuity is ESI 1; T 104.0 F, BP 176/82 mm Hg, HR 168/min irregular, RR 30/min. She has tremor, exophthalmos, and pulmonary edema. Which of the following is the most appropriate next step in management?

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Correct answer: A — Give beta-blocker, thionamide, iodine after thionamide, steroids, and supportive cooling

Thyroid storm is treated with supportive care plus beta blockade, thionamide, iodine after hormone synthesis blockade, and glucocorticoids.

Reference: American Thyroid Association thyrotoxicosis guidance