Thyroid Disorders Pedia Flashcards
T or F. Mental retardation in congenital hypothyroidism is preventable.
True
What are the classical features of congenital hypothyroidism?
- Progressive jaundice
- Inactive defecation
- Umbilical hernia
- Hypotonia
- Skin: Dry and rough
- Pallor, coldness, edema, hypothermia
- “Rough facial features” : flat nasal bridge, enlarged tongue
- Open fontanels
- Delayed overall development
- Bradycardia
- Narrow Pulse Pressure
- Hypothermia
What are the involved genes in primary CH?
TTF-2, NKX2.1, NKX2.5 PAX-9
Most common cause of congenital hypothyroidism
Primary Hypothyroidism - 80-95% of cases
What is the size of an open fontanel?
> 1cm
Most common type of thyroid dysgenesis abroad?
Thyroid ectopia
Most common type of thyroid dysgenesis locally?
Athyreosis
Gene affected in abnormalities of thyroid hormone transport
Monocarboxylase transporter 8 (passage of T3 in neurons)
Safest anti-thyroid for pregnant women
PTU
How many years do you have to treat a case of transient hypothyroidism before you can confirm that it is transient?
3 years then stop medication then observe for 4-6 weeks
transcription factors involved in pituitary
development or function
HESX1, LHX3, LHX4, PIT1, PROP1 gene mutations
When is newborn screening done in a newborn?
after 48 hours
cut-off value for TSH
> 40 mU/mL
Pitfall of using TSH as the screening test
miss those infants with central hypothyroidism
What is the standard treatment for CH?
Levothyroxine for first 2 weeks.
What is the WHO classification of the goiter if it is noticeable on neck hyperextension?
1B
T or F. CH can be diagnosed early based on history and PE.
False. Majority appear normal at birth
6-month old boy was brought to the OPD for developmental delay. The patient was born full term via Normal Spontaneous Vaginal Delivery, uncomplicated. He did not undergo newborn screening. If congenital hypothyroidism was considered, which would be the best test to request?
a. Free T4
b. Free T4 and TSH
c. Thyroid scan
d. Bone aging
B. Free T4 and TSH
A hyperthyroid 12-year old girl has been on Methimazole for the past 2 years. The mother noted that the gland has increased in size. What would be the next best thing to do?
a. Refer to surgery for thyroidectomy
b. Do thyroid function tests
c. Discontinue medication
d. Increase dose of medication
B. Do thyroid function test
Swipe right or swipe left?
Swipe right na lang tapos pag pangit unmatch na lang hahahaha
