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Review Question - QID 212694

Congenital Hypothyroidism (Cretinism) Introduction Insufficient iodine intake or defect in T4/thyroid formation leading to fetal hypothyroidism QID: 212694 (M1.OMB.19.1)
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QID 212694 (Type "212694" in App Search)
A 6-month-old boy is brought to the emergency department after his mother found him to be lethargic. He was born at home with no prenatal care and has no documented medical history. On presentation, he is found to have shorter stature and increased weight compared to normal infants as well as coarse facial features. Physical exam reveals a large protruding tongue and an umbilical hernia. The patient otherwise appears normal. Laboratory tests confirm the diagnosis, and the patient is started on appropriate treatment. The physician counsels the parents that despite initiation of treatment, the boy may have lasting mental retardation. Which of the following is most likely associated with the cause of this patient's disorder?
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