On these “Gold Standard Internal Medicine Facts” pages you will find Free:
- USMLE Audio Review files from our “Gold Standard USMLE Reviews”
- Transcriptions of those files
- And videos (as they become available)
The idea is that you can review for the USMLE online by:
- Listening to the Audio
- Following along with the transcription
- Or by watching the video (if available)
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Let’s start our USMLE Review with Hypothyroidism and Hyperthyroidism from the Gold Standard USMLE Foundations of Medicine Audio Review program.
Play USMLE Audio MP3 12 04 Allergic Reactions, Side Effects Below
Begin 12 04 Allergic Reactions, Side Effects Transcription
What is an allergic reaction to antithyroid drugs experienced by about 5% of patients; It is treated with antihistamines and unless serious is not an indication to stop the medicine?
And which sudden blood condition is an allergic reaction to antithyroid drugs experienced by about 0.5% of patients and requiring immediate discontinuation of therapy?
- This complication is usually signal by a sore throat and fever. Agranulocytosis.
Where does this condition get its name and what are its chief manifestations? Go ahead and pause the tape.
- Agranulocytosis involves a severe decrease in granulocytes, a type of white blood cell, and results in fever, severe fatigue, and bleeding sores at the rectum, vagina, and mouth.
If there is a agranulocytic reaction to antithyroid drugs, immediate antibiotic therapy is indicated, along with change to an alternative therapy for the Graves’ disease.
What is usually the therapy of choice?
We’ll name 4 other rare side effects whose presence requires immediate stoppage of antithyroid drug therapy.
First, large circumscribed areas of sudden onset subcutaneous edema seen mainly in young women and typically disappearing within 24 hours?
- That’s Angioedema or Angioneurotic edema.
Second, severe pain in a joint not of an inflammatory nature?
- Acute Arthralgia.
Third, a yellowish staining produced by inspissated bile or bile plugs in small biliary passages in the liver?
- Cholestatic Jaundice.
And fourth, what type of toxicity usually caused by protrusion of a part of the liver through the abdominal wall or the diaphragm?
- Hepatocellular toxicity.
Student doctor please pause the tape and summarize allergic reactions to antithyroid drugs. Please include rash and agranulocytosis, along with four rarer side effects which require immediate discontinuation of therapy.
- Rash is an allergic reaction to antithyroid drugs experienced by about 5% of patients. It is treated with antihistamines and unless serious, is not an indication to stop the medication. Agranulocytosis is an allergic reaction experienced by about 0.5% of antithyroid drug patients and requires immediate discontinuation of therapy. It involves a severe decrease in granulocytes, a type of white blood cell. And it is usually signaled by sore throat and fever, and results in fever, severe fatigue, and bleeding sores at the rectum, vagina and mouth. In the case of an agranulocytic reaction immediate antibiotic therapy is indicated along with an alternative therapy for the Graves’ disease, usually radioactive iodine. Other rare side effects whose presence requires immediate stoppage of the antithyroid drug therapy include angioedema, acute arthralgia, Cholestatic Jaundice, and Hepatocellular toxicity.
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