Paper II
2023 January (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Treatment of thyrotoxic crisis.

Q104 marksShort Answers

Answer

  • Propranolol (high-dose) — rapid control of adrenergic symptoms (tachycardia, tremor, agitation); also blocks peripheral T4-to-T3 conversion at high doses.
  • Propylthiouracil — blocks new hormone synthesis and additionally inhibits peripheral T4-to-T3 conversion.
  • Iodide solution (given after starting the thioamide) — Wolff-Chaikoff effect, rapidly blocks hormone release.
  • Corticosteroids (Hydrocortisone) — inhibit peripheral T4-to-T3 conversion and cover possible relative adrenal insufficiency.
  • Supportive care — cooling measures, IV fluids, treatment of the precipitating cause.

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