Carolinas Case CONFEREnce - Dr. Beverly

​Case 1:

• Excess iodine exposure can lead to the Jod Basedow effect:
• In presence of excess iodine, patient’s have autonomous production of thyroid hormone independent of normal regulatory functions

 

• Average iodine intake for an average adult is 150ucg.
  
• Iodine load in 1 CT scan averages 370mg/ml.
  
• Each scan loads with 100-120ml.
  
• Can affect patients will underlying thyroid disease

• Treatment in the ED focuses on symptomatic care, adrenergic receptor blockade, blocking thyroid hormone synthesis, inhibiting hormone release and decreasing peripheral conversion

 
 
Case 2:

• Postural orthostatic tachycardia syndrome is defined by excessive increase in heart rate (greater than 30bpm) when supine to standing in the absence of other overt orthostatic symptoms

 

• Treatment focuses on preventing hypovolemia and treating excessive sympathetic tone. 

 


Case 3:

• Cerebellar strokes present with vague symptoms and are hard to diagnose. 

 

• Pitfalls in ED diagnosis include failure to recognize risk factors in young patients and failure to understand that there is a spectrum of disease. 

 

• Consider inpatient hospitalization for patients at higher risk. 

 

• Do not delay consultation if you are worried. 

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