一位 40 歲控制不佳的甲狀腺機能亢進（葛瑞夫茲氏症）女性，今晨剛接受大型骨科創傷手術後在隔離病房。短短數分鐘內變得激動與譫妄。生命徵象：體溫 40.5°C、心跳 180/min、大量出汗。下列哪項病況可解釋此表現？
A 40-year-old female with poorly controlled hyperthyroidism (Graves' disease) is in isolation following major orthopedic trauma surgery this morning. Within minutes, she becomes agitated and delirious. Vital signs: temperature 40.5°C (105°F), heart rate 180/min, profuse diaphoresis. Which condition explains this presentation?
- AThyroid storm (thyrotoxic crisis) precipitated by surgical stress.✓ 正解由手術壓力誘發之甲狀腺風暴（甲狀腺毒性危機）
- BMalignant hyperthermia from an unrecognized brain tumor.由未察覺之腦腫瘤引起之惡性高熱
- CMyxedema coma with metabolic shutdown and hypothermia.伴有代謝停滯與低溫之黏液水腫昏迷
- DAddisonian crisis from cortisol depletion.由皮質醇耗竭引起之愛迪生氏危機
甲狀腺風暴（thyroid storm / thyrotoxic crisis）是控制不佳的甲狀腺機能亢進在重大壓力（手術、感染、創傷、生產）下急速釋放大量甲狀腺素的致命急症。 選項 A 正確：高燒、心搏過速、譫妄、大汗 = 甲狀腺風暴典型四聯徵。需立即治療：β-blocker（propranolol）控制心跳、PTU/methimazole 阻斷新合成、Lugol's iodine 阻止釋放、corticosteroid、降溫、IV 補液。 選項 B 錯誤：惡性高熱與麻醉藥相關，且無高代謝症狀組合。 選項 C 錯誤：黏液水腫昏迷反為低體溫、心搏過慢。 選項 D 錯誤：愛迪生氏危機特徵為低血壓、低血糖、低鈉、高鉀，非高熱與快心跳。
Thyroid storm (thyrotoxic crisis) is a life-threatening exacerbation of uncontrolled hyperthyroidism precipitated by major stress (surgery, infection, trauma, childbirth). B correct: Hyperthermia, tachycardia, delirium, and diaphoresis are the classic tetrad. Treatment: beta-blocker (propranolol) for HR, PTU/methimazole to block synthesis, Lugol's iodine to block release, corticosteroids, cooling, IV fluids. A incorrect: Malignant hyperthermia is anesthesia-induced, not this combination. C incorrect: Myxedema coma is hypothermia and bradycardia. D incorrect: Addisonian crisis features hypotension, hypoglycemia, hyponatremia, hyperkalemia.
「Thyroid Storm (甲狀腺風暴) = 壓力誘發大洩洪！ + 高燒40度以上 + HR心搏180狂跳 + 精神錯亂幻覺」。這套生死存亡的組合拳是跨國界所有護理師鑑定甲狀腺疾病死亡警訊的終點。與 Myxedema coma (失溫凍死) 形成最強反差背誦題。