American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a symptom that may require the use of acetaminophen and cooling blankets during thyroid storm?

1. Hypotension

2. Hyperthermia

3. Bradycardia

4. Nausea

The correct answer is: Hyperthermia

Hyperthermia is a significant symptom of a thyroid storm, which is a life-threatening condition resulting from untreated or poorly controlled hyperthyroidism. During a thyroid storm, the body experiences a severe increase in metabolic rate, leading to excessive heat production. This hyperthermia can elevate body temperature to dangerously high levels, typically defined as a core temperature above 100.4°F (38°C), but often reaching 104°F (40°C) or higher. Acetaminophen is commonly used to reduce fever, and its antipyretic properties help in managing hyperthermia in patients experiencing a thyroid storm. Additionally, cooling blankets may be utilized to physically cool the patient down, assisting in rapid temperature reduction. Managing hyperthermia is crucial, as the elevated body temperature contributes to the overall metabolic derangement and can worsen the patient’s condition. Other symptoms like hypotension, bradycardia, and nausea are significant in the context of thyroid storm but are not primarily managed with acetaminophen and cooling measures used for hyperthermia. Hypotension may arise due to shock or heart failure related to the hypermetabolic state, bradycardia is typically not associated with the increased heart rates seen in thyroid storm, and while nausea is a