° Pa we a Pee . : he ayeres Sh ST e ee Pa ng) a a re a ae he aw t 2 ’ * a eee he ; - —- = at, oe - ne 7” WOMPITAL OF THE MEDICAL RESEARCH CINTER, BROOKHAVEN NATIONAL LABOLATORT rrr : a Se ee Uririk 2208 . UFION, NEW YOMK 1973 ere) 05-45-4082 peal nod Aree Code 516 VAphont 44262 -- + da al ee ” aan E RTS PET ren ee « A moe a ‘ 5 ae ‘ ie erik oes c 7 : hs aha = DISCHARGE SUMMARY amie ADMITTED: June 16, 1973 s June 2, 197) , Phie 54 year old Marshallese wousa who had t been exposed to a alight amount of fallouc in 1954 was brought to the United States and admitted to this hospital for evaluation of thyroid modularity and physical status for possible thyrold surgery. 4 > HLILSTORY: i£ 3 t Examination, this past March revealed 2 rather hard masses in the right lobe of the thyroid, These had not been noted on previous examinations. Wo lymph nodes vere palpated and she has always appeared euthyroid, Her T-4 level sn Merch wee 3.7 pga. She vas accidentally expored in 1954 to abour 14 rad of gaeimm cadiation and an estimated dose of 22 rade to the thyroid from fallout while she was living on Utirik Island, She showed no affects to this slight exposure, Following her initial exam ination she was not again examined until 1969 at which time she was found to have blood pressure readings of 200-220/100-110 and « systolic murmer was noted. Also reported wae an umblii{cal hernia and a possible fibroid of the uterus, Her only complaints have been headaches, chronic joint pains, particularly of the right arm. FAAMINATION : This intelligent, alert, somewhat obese Marshallese lady appeared to be healchy and euthyroid, The thyroid findings were as described above for the March examination, Ocher findings included inversion of the nipple of the right breast; enlargement of the heart with « harsh systolic murmur, heard best over the aorta and PMI areas; blood pressure 180/86 with no evidence of decompensation; EKG was within normal linits; tenderness around the umbilicus though the hernia was not actually palpated; Pelvic examination revealed 3 small areas of hyperplasia of the cervix. AND DATA: The thyroid scan showed a poovly 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 yec in. Serum was non-reactive for antithyroid globulin antibodies. X-Ray of the chest showed moderate cardiomegaly and arteriosclerocais. The lunge were clear, Zhe hemogram was normal except for an ESR of 40 (high values are noted in the Marshallese), Serology was negative. Serum proceina negacive, and electrolytes generally normal. Urine was negative and liver and kidney function tests normal. HOSPITAL COURSE: Ducing her 8-day hospital stay, she Temained generally a_symptomatic except for some palin and stiffness in her right arm which waa relieved with aspirin, Her appetice was good and she was completely ambulatory. Her blocd pressure remained normal after the slight elevation noted on admission, She was discharged on June 10th for travel to Cleveland. ba 720A - 126 - a!