How do you treat thyroid storm?
Response: We use iodine, IV steroids, IV methimazole, high doses of beta blockers.

Do you recommend prenatal screening with TSH for all women even without hx of thyroid disease?
Response: Yes, can help especially in women who are having difficulties conceiving.

For RAIU scan, are there any implications on patients / restrictions, once they take the radioactive iodine - i.e. limiting contact with family members?
Response: Not for the scan. The dose is extremely small, and it is a tracer (123 iodine) rather than a treatment (131 iodine). No restrictions needed.

In patients with recurrent thyroiditis, do they have increased risk of developing another cause of hyperthyroidism?
Response: No, they will just get recurrent subacute thyroiditis.

When someone gets ectopic heartbeats during a viral resp infection, could this be transient thyroiditis?
Response: Thyroid dysregulation takes 2-4 weeks to present itself post viral infection, therefore unlikely that symptoms during the viral infection would be caused by hyperthyroidism.

Every Graves d pt needs to see an opthalmologist?
Response: No, only if they have symptoms (most patients with Graves will not have Graves orbitopathy).

Why is PTU not first line treatment for Grave's?
Response: It has more adverse effect risk (agranulocytosis or hepatic dysfunction) than methimazole. However in pregnancy first trimester it has less risk of fetal malformation than methimazole.

Sub-clinical hypothyroid question: Pt could not get appt w her GP, so presented to me with TSH 16, normal T4. I found her ferritin was low, pt was not taking her Rx iron pills. So I altered her po iron to different form & referred to thryoid Dr on CRDS. However the form as a pre-requisite requests a TSH level and a thyroid scan - what is being checked for in the scan?
Response: Not sure why they would ask for a scan. Not helpful in hypothyroidism. But with a TSH above 10 you can start synthroid (even if normal T4).