. Utirik 2208 NAME HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY UPTON, NEW YORK 11973 Area Code 516 YAphank 4~6252 08-45-40R (UNIT NOd DISCHARGE SUMMARY ADMITTED: June 2, 1973 DISCHARGED: June 10, 1973 This 54 year old Marshallese woman who had been exposed to a slight amounc of fallout in 1954 was brought to che United States and admitted to this hospital for evaluation of thyroid nodularity and physical status for possible thyroid surgery. HISTORY: Examination, this past March revealed 2 ° rather hard masses in the righe lobe of the thyroid. These had not been noted on previsus examinationa. No lymph nodes were palpated and she has always appeared euthyroid. Her T-4 level en (Merch was 3.7 mom. She was accidentally exposed in 1954 to about 14 rad of gearimecadiation and an eatimated dose of 22 rads to the thyroid from fallout while sne was living on Utirik Island. She showed no affects to this slight exposure. Following her initial examination she was 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 was noted. Also reported was an umbilical hernia and a possibie fibroid of the uterus. Her only complaints have been headaches, chronic joint pains, particularly of the right arm. EXAMINATION : and euthyroid. This intelligent, alert, somewhat obese Marshallese lady appeared to be healthy 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 aorta 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; Pelvic examination revealed 3 small areas of hyperplasia of the cervix. ANDDAT : The thyroid scan showed a poorly function- ing nodule in the lower half of the right lobe. The radioactive iodine uptake was normal and the response to TSH stimulation was good. T-4 report is noc yet in. Serum was non-reactive for antithyroid globusin antibodies. X-Ray of the chest showed moderate cardiomegaly and arteriosclerosis. 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 hospitai stay, she remained generally a_symptomatic excepc 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. for travel to Cleveland. tnt 7204 ~ 126 - She was discharged on June 10th