Okay, welcome. My name is Devine. This is episode 431 of the Devine Intervention

podcasts. In today's podcast we're going to be continuing the rapid review

series for the USMELA Step 2C, Step 3 exams, this is going to be Series 89.

Let's begin.

What if they give you a question about a 39-year-old female?

They tell you that for the past five weeks she has been having a lot of anxiety and she feels like she's been having a lot of palpitations, so hard has been racing.

And then they see on physical exam, you know, she has increased the tendon reflexes.

She has a blood pressure of 160 over 85 and a heart

radius 125 beats per minute And then they also tell you that an EKG is obtained and it shows an irregular

interval. What should you be thinking about here? I really hope you're saying

define this person has hyperthyroidism and what's going to be the most likely cause?

It's going to be Graves Disease. Graves' disease.

So what are the key facts of this case

that tell us that this is hyperthyroidism?

First things first, the person's heart rate is really high.

Remember, thyroid hormone basically increases the number of beta-one receptors that you

please on the surfaces of your cardiac myocytes. When that happens, you're going to stimulate the heart more.

So your cardiac output is going to go up, your heart rate is going to go up because there's an increased

speed of conduction down the EV node.

And also because your cardiac output is going up, your systolic blood pressure goes up as well.

Now, what are the EKG findings? You see an irregular interval. Well, that tells you that that's E-Fib. Remember E-Fib is the most common

arrhythmia found in people that have hyper-thyroidism. In E-Fib, your curious complexes are going to be narrow because it's an E tranerythmia.

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