Med. Emergencies, THYRIOD emergencies (Altered Consciousness)

Thyroid gland shape and location

butterfly shape, anterior to trachea

the thyroid secretes the hormone ____

thyroxine

thyroxine regulates what 3 things

- metabolic rate

-growth rate

-Temperature

what is hyperthyroidism

too much thyroid hormone produced, causes by overactive thyroid

what is hypothyroidism

insufficient thyroid hormone production

what can cause hyothyroidism

- Hashimoto's disease (autoimmune destruction of thyroid gland

-thyroid surgery or radiation

- goiter (swelling/enlargement

congenital hypothyroidism

occurs during fetal development and affects growth and neurological development

what are the characteristics of hypothyroidism

- physical/mental sluggishness

-weight gain

-cold intolerance

-thickened tongue (macroglossia) and skin

-thickened, dry skin (myxedema)

-decreased perspiration

what are some characteristics of hyperthyroidism

-nervousness, irritability, and insomnia

-weight loss

-heat intolerance/excessive sweating

-warm, sweaty palms

-bulging eyes (exophthalmos)

what does euthyroid state mean

thyroid gland functioning normally, may have dysfunction but is being treated

Myxedema coma is due to severe ____

hypothyroidism

possible causes of myxedema coma

-undiagnosed hypothyroidism

-improper treatment of diagnosed hypothyroidism

-precipitating factors

signs and symptoms of Myxedema coma

- hypothermia

-severe hypotension

-mental disoretenation

Thyroid storm is due to severe _____

hyperthyroidism

signs and symptoms of thyroid storm

- high fever

-diaphoresis (severe sweating)

-tachycardia or atrial fibrillation

-anxiety

-delirium

-unconsciousness

thyroid storm may be precipitated by ___

stress

myxedema and thyroid storm are ___ and ___

rare. life threatening

what things should you check on medical history to prevent thyroid emergencies

- thyroid problems

-medications

-regular blood tests

unexplained weight gain is a symptom of ___

hypothyroidism

unexplained weight loss is a symptom of ___

hyperthyroidism

do NOT give patient with hypothyroidism ____

sedatives / CNS depressants, could result in extreme reaction

do NOT give patient with hypertyroidism ____

epinephrine, could cause thyroid storm

Cerebrovascular accident (CVA, Stroke, brain attack) definition

abnormal condition of the brain characterized by occlusion or hemorrhage of a blood vessel causing lack of oxygen to brain tissues

hemorrhage

great amount of blood loss in a short amount of time

aneurysm

abnormality of a blood vessel, usually and artery, caused most often by a defect or weakness in a wall of the vessel

thrombosis

clot that forms IN a vessel

embolism

foreign object, air, gas, or thrombosis that originates somewhere in the body and travels throughout body until it lodges

Ischemia

deficiency of blood supply usually to come part of the body due to functional obstruction or blockage

atherosclerosis

thickening/hardening of the artery walls which decreased blood flow and can lead to stroke

hypertension

abnormally high blood pressure of blood against artery walls

edema

localized or generalized swelling from retention of excessive fluid

hemiplegia

paralysis of one side of the body

Transient Ischemic attack

a brief episode of neurological dysfunction caused by focal brain or spinal cord ischemia without an acute infarction (death of brain tissue)

a TIA usually lasts ___minutes up to ___ hours

2-10 min, 24 hours

symptoms of a TIA (transient ischemic attack)

-dizziness

-speech defects

-pins and needles tingling or weakness

-confusion

-vision problems

a TIA is known as a ____ stroke

mini (warning sign of stroke)

a person that experiences a TIA is _____% more likely to have a stroke within 90 days

3-17.3%

Hemorrhagic CVA (cerebral hemorrhage)

death of neural tissue rustling from rupture of blood vessel in the brain

what type of CVA is most common in the dental setting and why

Hemorrhagic CVA; stress and anxiety

a Hemorrhagic CVA is often due to an abrupt change in ____

blood pressure

Hemorrhagic CVA account for ___% of all strokes

13

Ischemic CVA

death of neural tissue caused by blockage of a cerebral blood vessel resulting in

what are the 2 types of ischemic CVA

cerebral thrombosis, and cerebral embolism

cerebral thrombosis ischemic CVA account for ___% of all stokes

87

predisposing factors of CVA

-high BP

-high cholesterol/heart disease/smoking

-history of TIA or CVA

-diabetes

-oral contraceptive

-atrial fibrillation

do not treat within ___ months of a stroke/TIA

3

signs and symptoms of a CVA

-altered consciousness from yawning to coma

-unequal and dilated pupils

-vision changes

-impaired speech

-weakness, numbness, tingling on one side

-deviation of tongue

-sudden and severe headache

-elevated BP (systole >200)

3-6 months post TIA or stroke requires ____ clearance prior to treatment

physician

prevention of CVA

-through medical history

-do not treat within 3 moths of TIA/stroke

-take vital signs

-minimize stress

what is the single greatest risk factor for CVA

high blood pressure

what 4 things do stroke scales acess

1. ask patient to smile- look for weakness in one side

2. ask patient to hold out both arms with eyes closed - look for weakness in one arms

3. ask patient to repeat simple sentence while listening for difficulty in speech - listen for difficulty in speech

4. Time - 3 hour window

what does the acronym FAST stand for

F= face

A= arm

S= speech

T= time

how to position a patient suffering from a CVA

semi-upright with head elevated

when do you administer O2 for CVA emergency

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