Wednesday, March 14, 2018

Burch-Wartofsky Point Scale (BWPS) for Thyrotoxicosis

Q: All of the following are parts of diagnostic criteria for thyroid storm except?

A) Thermoregulatory dysfunction Temperature

B) Central nervous system effects
C) Gastrointestinal-hepatic dysfunction
D) Thrombocytopenia
E) Cardiovascular dysfunction

Answer: D

 Diagnostic criteria for thyroid storm popularly known as Burch-Wartofsky Point Scale (BWPS) for Thyrotoxicosis consist of following six components
  1. Thermoregulatory dysfunction 
  2. Central nervous system effects 
  3. Gastrointestinal-hepatic dysfunction 
  4. Cardiovascular dysfunction 
  5. Heart failure
  6. Precipitant history
A score of
  • 45 or more is highly suggestive of thyroid storm, 
  • 25 to 44 supports the diagnosis, and 
  • below 25 makes thyroid storm unlikely.

An online calculator can be seen here


Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am 1993; 22:263.

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