ENDOCRINE EMERGENCIES · MEMBERSHIP SURGERY

Thyroid storm — 32F, 3 weeks post-partum

12 decision points ~24 min Difficulty 5/5 Membership

Setting

You are the surgical registrar on-call at Korle Bu, cross-consulted by medicine on a woman referred from a district hospital. Thyroid function tests take 4 hours; point-of-care lactate, glucose, ECG immediately; endocrine and ICU are contactable overnight.

Patient

Mrs P, a 32-year-old market trader three weeks post-partum (uncomplicated vaginal delivery), presents agitated, confused, tremulous and febrile. Family report a 3-month history before pregnancy of weight loss and palpitations that were dismissed as anxiety. Vitals: BP 168/64, HR 168 atrial fibrillation, temperature 40.1°C, RR 32, SpO₂ 94%, GCS 12. Diffuse smooth goitre + exophthalmos. Diarrhoea twice this morning.

Reference stack

Bailey & Love 28e Ch 46 · Sabiston 21e Ch 37 · ATA 2016 Hyperthyroidism guidelines · Burch & Wartofsky 1993

Start cascade →

You'll be asked to decide what happens next at each step. There's no timer — take your time. The correct answer + evidence-anchored rationale is revealed after each choice.