Thyroid

Question 1

Congenital hypothyroidism causes?

Answer 1

Delayed recognition> 3 months will cause mental deficiency
Causes-
Mal descent of the thyroid and throid dysgenesis
Dyshormogenesis
Iodine deficiency

Question 2

Clinical features of congenital hypothyroidism?

Answer 2

Identify by heel prick test in 3-5 days of life

Failure to thrive
Feeding problem 
Constipation
Prolonged jaundice 
Pale mottled cold dry skin
Coarse facies
Large tongue
Hoarse cry
Goiter
Umbilical hernia
Delayed development

Question 3

Clinical features of acquired hypothyroidism?

Answer 3

Adult features

Question 4

Ix , Tx and how to devide adequate tx or not?

Answer 4

Ix -5
Congenital Mx- 1 acquired mx- 2
Adequacy-4

Question 5

Hyperthyroidism?

Answer 5

Maily due to graves

Tx-

1. carbamazepine, PTU (beware of agranulocytosis)
2. beta blockers
3. medical tx for 2 years,eye signs wont resolve
4. when stopped 40-75% relapse
5. sx
6. radioiodine
7. follow up throxine replacement

Question 6

Neonatal hyperthyroidism?

Answer 6

TSIg transferring from mothers with graves disease
Tx required since fatal but spontaneously resolve with time

Complications- 
Tachy 
Sweating 
Irritability 
Poor weight gain 
Failure to thrive 

Mx- mx cardiac arrhythmia