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Aree Code 516 VAphont 44262
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DISCHARGE SUMMARY
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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.
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HLILSTORY:
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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
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