Rongelap unexposed 641 MOSPITAL OF Tel MEDICAL RESEARCH CENTER, MOCKHAYIN NATIONAL LABOLATORT peers 08-50-53 & UPTON, MEW YORK 11973 Aves Coda Sid VAphenh 4-62762 ADMITTED: SCHARCED!t 27 May 1974 ural NO] 3 June 1974 This 4l-year-old Marshallese woman was admitted co chis hospital for thyroid studies due surgery. to nodularity in the gland, and evaluacion for possible tHyrold MEDICAL HISTORY: In March 1974, during routine physical exaaination, the patient was found to have a firma nodule in the lower left pole of the thyroid gland and possibly another ciny nodule in che upper right lobe, The nodules were non-tender and no lymphadenopschy was noted, She appeared to be euthyroid, The patient is one of the unexposed people in the Rongelap compariosn pepulation. Since exams began in 1957 on chis group, her health has been generally good, but with an increasing tendency to obesity and a recent development of hypercension, Her weight increased from 145 lb in 1957 to 170 1b at presenc, The past few years she has had frequent headaches, and the BP has Lecome elevated to around 170-160/100-115, She has had sbout annual pregnanctes, rasulting in 9 healthy children, 2 miscarriages, and 1 child dying at the age of | year, Excepe for occasional joint pains and presence of worms in her stools, her history is otherwise negative generally, She has had no symptoms referable to kidney disease. PHYSICAL EXAMINATT ON: The patient is somewhat obcse 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. Her BP was 150-180/105-115, The heart and lunge appeared normal, as well as the peripheral vascular syster. FPunduscopic exam was generally negative except for slight increase in light reflex, The physical exam wag otherwise negative except for the presence of a cystocele and rectocele, LABORATORY & X-RAY DATA: No acans or thyrold 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 J)6 mg%, and triglycerides were 182 mgt. Creatinine clearance was alightly low, Aldosterone was $0 mg/ 24 hr. VMA was normal. The urine showed 20 mg albumin, but waa otherwise negative, Stool examinations cevealed the presence of whip worms and trichirus trichura, HOSPITAL COURSE: and alepc well, to 160/110, During her hospitalization, the patient remained asympromactic, and ate She was completely ambulatory, Her BP varied from 130/90 From the lab findings a diagnosis of mild essential hypertension el- - 136 + eed