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Thyroid storm — SCE Acute Medicine MCQ

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HardAcute Renal and Metabolic EmergenciesThyroid stormSCE Acute Medicine

A patient with untreated Graves disease has fever 40°C, delirium, atrial fibrillation and acute heart failure. Which diagnosis and treatment framing is correct?

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Correct answer: C — Give multimodal thyroid-storm treatment and organ support

The best answer is “Give multimodal thyroid-storm treatment and organ support”. This is correct because decompensated thermoregulatory, neurological and cardiovascular dysfunction defines the emergency clinically. Beta-blockade is tailored to haemodynamics, a thionamide blocks synthesis, iodine follows it, and corticosteroid reduces conversion and treats relative adrenal insufficiency. Outpatient or definitive radioiodine strategies are inappropriate during instability.

Reference: Society for Endocrinology emergency guidance: acute hyperthyroidism: https://pmc.ncbi.nlm.nih.gov/articles/PMC5657262/