Neonatal

Question 1

Features of congenital hypothyroidism:

Answer 1

• Prolonged neonatal jaundice
• Constipation
• Quiet baby
• Enlarged fontanelle
• Respiratory distress during feeding
• Absence of epiphyses on xray of limb

Late features:

• Lethargy
• Slow movement
• Hypotonia
• Hoarse cry
• Dry skin
• Macroglossia
• Umbilical hernia
• Delayed developmental milestone

Question 2

Investigation for congenital hypothyroidism?

Answer 2

Cord blood same (TSH, T4)

Question 3

Management of congenital hypothyroidism

Answer 3

1. Aim: To restore euthyroid state
2. Life-long L-thyroxine tablet
3. Follow up:

• Regular monitoring T4 and TSH level
• Ensure compliance
• Monitor growth and development
• Rule out transient hypothyroidism (at 3 years old)