Scenario 6.3 Thyroid Storm

Chest X-ray

ECG

CBC WBC 9.2 4000-12 000/mm3 HGB 11.1 11-15 g/dL HCT 34 30-43% PLT 398

BMP Glucose 145 65-100 mg/dL BUN 20 5-20 mg/dL Sodium 137 136-145 meq/L Potassium 3.3 3.5-5.5 meq/L Chloride 101 100-106 meq/L CO2 22 22-32 meq/L Creatinine 1.4 0.2-1.4 mg/dL

Cardiac Enzymes Creatine kinase 100 26-141 IU/L CK-MB 2.9 0.4-6.30 ng/ml Troponin I <0.01 Ref. range: Normal <0.06 ng/mL Borderline 0.06-0.78 Critical >0.78 A value of >0.78 is suggestive of acute MI

BNP Brain Natri. PE 15226 2.0-100 pg/mL

Thyroid Panel TSH 0.3 0.5-5.0 mIU/L T3 145 100-200 ng/dL T4 54 4.5-11.2 mg/dL

Arterial Blood Gas Arterial blood pH 7.46 7.35-7.45 Arterial PO2 210 60-70 mmHg Arterial CO2 28 35-45 mmHg Arterial HCO3 22 22-26 mmol/L Arterial % sat. 99% 96-100% Lactate 1.5 <2.0 mmol/dL

Urinalysis Clarity clear Color colorless Glucose negative negative mg/dL Bilirubin Ketones Sp. grav. 1.015 1.003-1.040 Blood pH 6.5 5.0-8.0 Protein Urobilinogen 0.1 0.2 EU/dL Nitrites Leukocytes Urinanalysis