50.有關甲狀腺風暴（thyroid storm）的治療，下列何者正確？
(A)須先給與iodide，至少一小時後再使用thioamides
(B)須使用高劑量注射劑型的thioamides
(C)類固醇會惡化甲狀腺風暴，應避免使用
(D)使用propranolol可改善心跳過快，抑制周邊的T4轉為T3

●A beta blocker to control the symptoms and signs induced by increased adrenergic tone
●A thionamide to block new hormone synthesis
●An iodine solution to block the release of thyroid hormone
●An iodinated radiocontrast agent (if available) to inhibit the peripheral conversion of T4 to T3
●Glucocorticoids to reduce T4-to-T3 conversion, promote vasomotor stability, possibly reduce the autoimmune process in Graves' disease, and possibly treat an associated relative adrenal insufficiency
●Bile acid sequestrants may also be of benefit in severe cases to decrease enterohepatic recycling of thyroid hormones
 immediate treatment with a beta blocker (propranolol in a dose to achieve adequate control of heart rate, typically 60 to 80 mg orally every four to six hours, with appropriate adjustment for heart rate and blood pressure) and either propylthiouracil (PTU) 200 mg every four hours or methimazole (20 mg orally every four to six hours).
PTU is favored over methimazole because of PTU's effect to decrease T4-to-T3 conversion.
One hour after the first dose of thionamide is taken, we administer iodine (saturated solution of potassium iodide, 5 drops orally every six hours or Lugol's solution, 10 drops every eight hours).

ref: uptodate Thyroid storm