Thyroid Storm: A Case of Graves' Disease and Chest Infection
A branching clinical case simulation for a patient presenting with fever, palpitations, agitation, and vomiting. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 5hard20 min6 stages
- Patient
- 32 years, female
- Presenting complaint
- Fever, palpitations, agitation, and vomiting
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are the resident in a district general hospital's emergency department. A 32-year-old woman, Sarah, is brought in by ambulance with a 4-day history of productive cough, fever, and vomiting. She is agitated and trying to remove her clothes. Her observations are: Pulse 150, BP 104/62, RR 28, SpO2 94% on room air, temp 39.8°C. She is known to have Graves' disease but has not taken her medication for 2 months.
What this case teaches
Recognise thyroid storm as a clinical diagnosis; give beta-blockade, antithyroid drug, and iodine in the correct order; treat the precipitant; support the circulation.
How the case unfolds
- 1History: Focused QuestionsHistory
- 2Examination: Key FindingsExamination
- 3Investigations: Immediate OrderInvestigations
- 4Diagnosis: Recognise Thyroid StormDiagnosis
- 5Treatment: Drug SequenceTreatment
- 6Monitoring: First 24 HoursMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.