By David G. Ferriman

ISBN-10: 0723602050

ISBN-13: 9780723602057

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3. After hypophysectomy. 4. Adrenal haemorrhage was described as a clinical entity named the Waterhouse-Friderichsen syndrome. Doubt is now cast upon the supposed adrenal failure as plasma hydroxycorticosteroids have been found normal on a few occasions when they have been measured. Adrenal haemorrhage should be considered in any severe toxaemia 58 T H E ADRENAL GLANDS—ADRENAL CORTEX Acute Adrenal Failure—Crisis, continued. accompanied by haemorrhagic tendencies, especially meningococcal septicaemia.

Cardiac muscle is affected by myxoedematous change and indirectly by grossly atheromatous coronary arteries. Larger doses of T3 may precipitate acute cardiac failure and death. HYPERTHYROIDISM 35 3. Oral thyroxine 0*1 mg. is given daily from onset. This will exert its full effect in about 1 week, when T3 can be discontinued. 4. Blood-volume is restored by intravenous infusion of dextrose and low molecular weight dextran solutions. 5. Intravenous hydrocortisone—initial dose 100 mg. 8-hourly. 6. Antibiotics as prophylaxis against pneumonia.

The so-called 'lateral aberrant thyroid ' is almost invariably a local lymph-node metastasis. 5. Distant métastases with bony changes or radiological changes in a chest X-ray. 6. A stony hard, fixed irregular thyroid. — 1. Thyroid cancer may arise de novo, or develop in pre-existing non-toxic nodular goitre. 2. From 1 : 5 to 1 : 10 solitary nodules are malignant. The incidence is even higher if attention is focused on 'cold' nodules (nodules which fail to take up iodine). 3. Multinodular goitres are rarely malignant in women, though they may occasionally be so in men.

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A Synopsis of Endocrinology and Metabolism by David G. Ferriman

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