Hypothyroidism

Question 1

Cretinism

Answer 1

Hypothyroidism in children and neonates. Leads to mental retardation, short stature, enlarged tongue, coarse facial features.
Can be due to maternal hypothyroidism during pregnancy or due to an iodine deficiency

Question 2

Myxedema

Answer 2

Occurs in hypothyroidism in older children and adults.
Characterized by clinical myxedema in larynx and tongue, decreased basal metabolic rate, decreased sympathetic activity, muscle weakness, cold intolerance, decreased sweating, bradycardia and decreased cardiac output, oligomenorrhea, constipation, non-pitting edema, goiter, congestive cardiac failure or pericardiac effusion

Question 3

Diagnosis of hypothyroidism

Answer 3

Administration of TSH - in primary T4 will still be decreased, while in secondary both TSH and T4 will be low

Question 4

Causes of hypothyroidism

Answer 4

iodine deficiency, Hashimoto thyroiditis, drugs, surgical removal, radio ablation

Question 5

Primary hypothyroidism

Answer 5

Examples:
Rendel's thyroiditis
Hashimoto thyroiditis
Iodine deficiency
Post-thyroidectomy
Drug induced
Subacute (deQuervain) granulomatous inflammation

Question 6

Secondary hypothyroidism

Answer 6

Associated with Turners, Downs, cystic fibrosis

Question 7

Treatment

Answer 7

Levothyroxine (T4)