Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:54

802 Hypothermia Hypothyroidism

follow-up

During Treatment

■Monitor core temperature continuously

■Monitor for electrolyte abnormalities and hypoglycemia

■Goal for rewarming is 0.5–2.0◦C/h

complications and prognosis

■Assess for frostbite and other cold injuries

■Prognosis good if rewarming achieved

■Neurologic deficits can be long-standing, but degree of deficit NOT

predicted by degree of hypothermia

Hypothyroidism.....................................

LAWRENCE CRAPO MD, PhD

history & physical

History

■Thyroid surgery

■Family history of thyroid disease

■I-131 treatment

■Therapeutic irradiation of the neck or thorax (mantle)

■Iodine excess: amiodarone, contrast, kelp, cough syrup

■Medications: lithium

■Iodine deficiency

■Pregnancy: recent, complicated

Signs & Symptoms

■Weight gain, cold intolerance, tiredness, fatigue, depression

■Neck enlargement

■Dry, puffy, yellowish skin

■Thin, brittle hair; alopecia

■Constipation, abdominal pain

■Sluggish, tiredness

■Bradycardia, hypothermia

■Delayed deep tendon reflexes, proximal muscle weakness, myalgias,

cramps

■Puffiness of face and extremities

■Goiter