Snapshot A six-week-old male presents with lethargy and hypotonia. On physical exam, he is jaundiced and has a large protruding tongue. Introduction Insufficient iodine intake or defect in T4/thyroid formation leading to fetal hypothyroidism T4 is crucial during first two years of life for normal brain development Cretinism refers to untreated congenital hypothyroidism leads to congenital defects and physical abnormalities Presentation Symptoms severe mental retardation increased weight and short stature coarse facial features large protuding tounge umbilical hernia Evaluation Labs decreased T4 elevated TSH Treatment Treat with levothyroxine replacement Prognosis, Prevention, and Complications Prevention by newborn screening by law
QUESTIONS 1 of 3 1 2 3 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.EC.15.72) A obstetrician is working in a developing country to help promote maternal health and fetal well being. While there, he delivers a baby who he suspects has congenital hypothyroidism, most likely caused by inadequate maternal iodine intake. Which of the following signs and symptoms would NOT be expected to be observed in this child? Tested Concept QID: 106518 Type & Select Correct Answer 1 Hypotonia 0% (0/88) 2 Diarrhea 57% (50/88) 3 Umbilical hernia 14% (12/88) 4 Mild jaundice 16% (14/88) 5 Macroglossia 12% (11/88) M 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review tested concept (M1.EC.14.0) A 10-week-old female infant born at home presents to the pediatrician because her mother is worried that "she sleeps too much, always feels cold, and does not have bowel movements very frequently." On physical exam, the child has hypotonia, slight to mild jaundice, and the following features (Figure A & B). Which of the following lab findings would be seen in this patient? Tested Concept QID: 106982 FIGURES: A B Type & Select Correct Answer 1 Decreased total & free T4, increased TSH 90% (28/31) 2 Increased total & free T4, decreased TSH 0% (0/31) 3 Inhibitory anti-TSH receptor antibodies 0% (0/31) 4 Stimulatory anti-TSH receptor antibodies 3% (1/31) 5 Decreased total T4 & T3, normal TSH, increased reverse T3 3% (1/31) M 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review tested concept