Clinical Pearls

The Hypothyroidism Revolution

Hypothyroidism Food List

Get Instant Access

The most common forms of both hyper- and hypothyroidism are autoimmune: Graves disease causing hyperthyroidism and Hashimoto thyroiditis causing hypothyroidism. Hyperfunctioning ("hot") thyroid nodules are rarely malignant. Hypofunctioning ("cold") nodules >1 cm in diameter should be biopsied.

Thyroid disease is more common in women than men.

REFERENCES

Davis A. Shahla N. A practical guide to thyroid disease in women. Female patient

(Primary care ed). 2005;30(9):38-47. Rakel RE. Essentials of family practice. Philadelphia: WB Saunders. 1993. Singer PA. Cooper DS. Levy EG. et al: Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA 1995:273:808. South-Paul JE. Maiheny SC. Lewis EL (eds.). Current diagnosis and treatment in family medicine. New York: McGraw-Hill. 2(X)4.

A 25-year-old gravida,, para, woman at 39 weeks estimated gestational age presents to the labor and delivery triage unit stating that her "bag of water has broken." She reports having had a large gush of clear fluid followed by a constant leakage of fluid from her vagina. She subsequently started having uterine contractions approximately every 4 minutes. She has had an uncomplicated prenatal course with good prenatal care since 8 weeks' gestation. Her prenatal records are available for review in the triage unit. Her first pregnancy resulted in the full-term delivery of a 7 lb 8 oz. healthy boy.

In the triage unit, she is placed on an external fetal monitor. Her blood pressure is 110/70 mm Hg. her pulse is 90 beats/min. and her temperature is 98.7°F. Her general examination is normal. Her abdomen is gravid, with a fundal height of 38 cm. The fetus has a cephalic presentation by Leopold maneuvers and an estimated fetal weight of 8 lb.

♦ What signs and tests could confirm the presence of rupture of membranes?

♦ On the fetal monitoring strip shown (Fig. 16-1), what is the approximate baseline fetal heart rate? How often is she having uterine contractions?

^ Her prenatal records reveal that she had a positive group B

streptococcus (GBS) vaginal culture at 36 weeks' gestation. What therapy should be instituted at this time?

Figure 16-1. Fetal heart rate monitoring.

Was this article helpful?

0 0
Reducing Blood Pressure Naturally

Reducing Blood Pressure Naturally

Do You Suffer From High Blood Pressure? Do You Feel Like This Silent Killer Might Be Stalking You? Have you been diagnosed or pre-hypertension and hypertension? Then JOIN THE CROWD Nearly 1 in 3 adults in the United States suffer from High Blood Pressure and only 1 in 3 adults are actually aware that they have it.

Get My Free Ebook


Post a comment