HOSPITAL OF THE BROOKHAVEN UPTON, Area Code Utirik 2208 NAME) MEDICAL RESEARCH CENTER, NATIONAL LABORATORY NEW YORK 11973 516 YAphank 4-6262 08-45-40R (UNIT NO.) DISCHARGE SUMMARY ADMITTED: June 2, 1973 DISCHARGED: June 10, 1973 This 54 year old Marshallese woman who had been exposed to a slight amount of fallout in 1954 was brought to the United States and admitted to this hospital for evaluation of thyroid nodularity and physical status for possible thyroid surgery. HISTORY: the thyroid. Examination, this past March revealed 2 rather hard masses in the right lobe of These had not been noted on previous examinations. palpated and she has always appeared euthyroid. No lymph nodes were Her T-4 level en (yernh was 3.7 mom. She was accidentally exposed in 1954 to about 14 rad of g&rimm radiation and an estimated dose of 22 rads to the thyroid from fallout while she was living on Utirik Island. She showed no affecte to this slight exposure. Following her initial exanr- ination she wae not again examined until 1969 at which time she was found to have blood pressure readings of 200-220/100-110 and a systolic murmer wag noted. Also reported wag an umbilical hernia and a possible fibroid of the uterus. Her only complaints have been headaches, chronic joint pains, particularly of the right arm. FHYSICALEXAMINATION : This intelligent, alert, somewhat obese . Marshallese lady appeared to be healthy and euthyroid. The thyroid findings were as described above for the March examination. Other findings included inversion of the nipple of the right breast; enlargement of the heart with a harsh systolic murmur, heard best over the acrta and PMI areas; blood pressure 180/86 with no evidence of decompensation; EKG was within normal limits; tenderness around the umbilicus though the hernia was not actually palpated; examination revealed 3 amall areas of hyperplasia of the cervix. AND DATA: Pelvic The thyroid scan showed a poorly function- ing nodule in the lower half of the right lobe. The radioactive fodine uptake was normal and the response to TSH stimulation was good. T-4 report is not yet in. Serum was non-reactive for antithyroid globufin antibodies. X-Ray of the chest showed moderate cardiomegaly and artertoaclerosis. The lungs were clear. The hemogram was normal except for an ESR of 40 (high values are noted in the Marshallese). electrolytes generally normal. normal. HOSPITALCOURSE: Serology was negative. Serum proteins negative, and Urine was negative and liver and kidney function tests During her 8-day hospital stay, she remained generally a_symptomatic except for some pain and stiffness in her right arm which was relieved with aspirin. Her appetite was good and she was completely ambulatory. Her blood pressure remained normal after the slight elevation noted on admission, She was discharged on June 10th for travel to Cleveland. ONL 720A - 126 -