Rongelap unexposed 841 HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY UPTON, NEW YORK 11973 Area Cade 516 YAphank 4-6262 — 08-50-53 R NT NO) CIRC 63 DISCHARGE SUMMARY ADMITTED: (NAME 27 May 1974 . DISCHARGED: 3 June 1974 This 4l-year-old Marshallese woman was admitted to this hospital fer thyroid studies due to nodularity in the gland, and evaluation for possible tHyroid gurgery. MEDICAL HISTORY: In March 1974, during routine physical examination, the patient was found to have a firm nodule in the lower left pole of the thyroid gland and possibly another tiny nodule in the upper right lobe, The nodules were non-tender and no lymphadenopathy was noted. She appeared to be euthyroid. The patient is one of the unexposed people in the Rongelap compariocsn population. Since exams began in 1957 on this group, her health has been generally good, but with an increasing tendency to obesity and a recent development of hypertension, Her weight increased from 145 lb in 1957 to 170 1b at present, The past few years she has had frequent headaches, and the BP has become elevated to around 170-180/100-115. She has had about annual pregnancies, resulting in 9 healthy children, 2 miscarriages, and 1 child dying at the age of 1 year, Except for occasional joint pains and presence of worms in her stools, her history is otherwise negative generally. disease, She has had no symptoms referable to kidney PHYSICAL EXAMINATION: The patient is somewhat obese and is 20-22 weeks pregnant, She appears euthyroid and generally in good health, Exam of the thyroid reveals a 1 cm nodule in the lower left lobe with a companion nodule also in the mid right lobe, The nodules were non-tender and no lymphadenopthy was noted. was 150-180/105-115. Her BP The heart and Lungs appeared normal, as well aa the peripheral vascular system. Funduscopic exam was generally negative except for slight increase in light reflex, The physical exam was otherwise negative except for the presence of a cystocele and rectocele, LABORATORY & X-RAY DATA: No scans or thyroid uptake studies were performed because of her pregnancy, X ray of the chest showed the heart to be top-normal in size, but otherwise negative, EKG was normal. Cholesterol was 336 mg, and triglycerides were 182 mg%. Creatinine clearance was slightly low. Aldosterone was 50 mg/ 24 hr. VMA was normal. The urine showed 20 mg albumin, but was otherwise negative, Stool examinations revealed the presence of whip worms and trichirus trichura. HOSPITAL COURSE: During her hospitalization, the patient remained asymptomatic, and ate and slept well. She was completely ambulatory, Her BP varied from 130/90 to 160/110. From the lab findings a diagnosis of mild essential hypertension -l- - 136 -