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 398 150 000-450 000/mm3

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 g/dL

Arterial Blood GasArterial 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

Clarity clear

Color colorless

Glucose negative negative mg/dL

Bilirubin negative negative

Ketones negative negative mg/dL

Sp. grav. 1.015 1.003-1.040

Blood negative negative

pH 6.5 5.0-8.0

Protein negative negative mg/dL

Urobilinogen 0.1 0.2 EU/dL

Nitrites negative negative

Leukocytes negative negative

Urinalysis