Thyroid in pregnancy:
B-HCG stimulate thyroid hormone production leading to elevated T4 and suppressed TSH in early pregnancy
Transient , subclinical hyperthyroid state
Total T4 increases due to higher thyroxine -binding globulin
While Free T4 levels rise only slightly .
Thyroid nodule evaluation:
Patient with thyroid nodule , normal TSH and no significant risk factor (Family Hx or Radiation)
Should undergo FNA (gold standard) for further evaluation
Note:
(Early biopsy can prevent delays in the diagnosis of thyroid cancer )
Amiodarone-induced hypothyroidism
Fatigue , lethargy , high TSH
Cont amiodarone medication for life threatening condition (Arrhythmia )
And initiate levothyroxine
Carefully monitor life threatening !
emergency tracheostomy should not be performed in the ED / bc its a formal operative procedure best done in controlled environment like the operating room
Case of sever fascial trauma , brisk bleeding upper airway associated with noisy breathing >
Note :
Nasotracheal or orotracheal intubation difficulty cuz obstructive the view of cords
(Cricothyroidotomy ) in ED