Emergency-Endocrine

Emergency-Endocrine - THYROID GLAND DYSFUNCTION Thyroid...

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Unformatted text preview: THYROID GLAND DYSFUNCTION Thyroid Gland Dysfunction Presents es: Wm - underproduetion of thyroid hermene I Cretinleln - eeeure in infants and children as a result of thyroid hermene eleflelenelir in fetal life - Myxdenln - occurs in adults as a result nl’ thyroid homnne deficiency - nenpittlng, gelatinous, mueineue infiltrates beneath the skin Thyroid Gland Dysfunction W (Grave's mm»; - h tened th id :1 acthri and :Tgué'pmduflm offltlgmid Ilfll'gIflIl (T4 and *my lead to "thyroid storm" (thyroid crisis) 1* hlgh mortality rate - hypermetaholhm - high fever ' CV, neumloglc and GI dysfunan Thyroid Gland Dysfunction Goals in Mnnngeent Physical Examinatinn W5! ' thick tangle, thick edemtous skin with puffy hands Ind face ' skin is (Ir)r (smtlngis usually absent) whwheartrm - patient may appear slow mm *- nemns with minim! a; slight tremor - Int-Hull! “P with marked tnnhvcnrdla Thyroid Gland Dysfunction Dental Therapy Cnnsideraflons mum: -mmgeininnrmalminner W *dentalmshould notukeplacelnmere hyperhncflon (may lead to thyroid stnrln) Thyroid Gland Dysfunction Deutnl Therapy Consider-aliens flmthmlsl - CNS depressents (bfll'bitllfltfi, nineties, ensiolyfles] should be used only with extreme caution - increased incidence of CV disease *- dentel use should be witheld until medical muslfltaflon or definitive care ls mmplislled Thyroid Gland Dysfunction Thyroid Storm ' hmrrefla - profuse muting, NW, abdominal pains - tachycardia and atrial fibrillation * more agitation leading to psychotic behaflor Thyroid Gland Dysfunction Myxedemn Cum - hypothermia * brldycardla - hypotenslon - loss of consciousness _Unconscious Patient with Historfiof H othymidism of ype yrmdlsm office. Ithmnrelflkelythatthlspaflenthaslost madman due to fear . In this nituatinn. the usual steps of mannfiunl of the uncuminus patient will pmduce II rap I! return {if aluminum. _Unconscious Patient with HIStO of Hy othyrpidism or ypert yroldlsm MW 1} Terminate the dental procedure 2) Position the patient - supine with a tl lees Huh 3' 3) BLS 4] Summon medical assistance 5) Establish W line 6] Administer 02 ‘7) Definitive management Definitive Management of Hyperthyrmdism - trnnzport to ER - large doses of propylthiourlcil (anflthmid drug) - administer prnprnnnlol to block nth-energie- mediated effects of thyroid hormnnn * administer large doses of glncncnrflcnids tn pment mnrnnce of acute adrenal insufficiency * cnld packs - nlnnltor hydration and Electrolytes Definitive Mana ement of Hypothyrm ism *tumporttoER *Idministerhrgedumofthyrold humane fur Milly! *mn-ecflonofhypoihelmla ...
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Emergency-Endocrine - THYROID GLAND DYSFUNCTION Thyroid...

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