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Questions and Answers
A newborn is suspected of congenital hypothyroidism following a routine neonatal screening. Which combination of symptoms would most strongly suggest this diagnosis?
A newborn is suspected of congenital hypothyroidism following a routine neonatal screening. Which combination of symptoms would most strongly suggest this diagnosis?
- Tachycardia, diarrhea and bulging fontanelles.
- Lethargy, constipation, and prolonged physiological jaundice. (correct)
- Hyperactivity, rapid weight gain, and excessive sweating.
- Jitteriness, frequent feedings, and warm, moist skin
An 8-year-old child presents with several symptoms suggestive of hypothyroidism. Which set of clinical manifestations would require further investigation?
An 8-year-old child presents with several symptoms suggestive of hypothyroidism. Which set of clinical manifestations would require further investigation?
- Increased appetite, accelerated growth, and early dentition.
- Tented skin turgor, sunken eyes, and delayed reflexes.
- Frequent urination, excessive thirst, and smooth, moist skin.
- Delayed dentition, short neck with fat, and rough, dry skin. (correct)
A 30-year-old woman reports fatigue, weight gain, and constipation. Physical examination reveals a low heart rate and dry skin. Which laboratory test is most important to confirm a diagnosis of hypothyroidism?
A 30-year-old woman reports fatigue, weight gain, and constipation. Physical examination reveals a low heart rate and dry skin. Which laboratory test is most important to confirm a diagnosis of hypothyroidism?
- Liver function tests (LFTs)
- Thyroid function tests (T3, T4, TSH) (correct)
- Electrolyte panel
- Complete blood count (CBC)
A 6-month-old infant is diagnosed with hypothyroidism. The physician prescribes levothyroxine (L-troxin). What is the appropriate starting dosage?
A 6-month-old infant is diagnosed with hypothyroidism. The physician prescribes levothyroxine (L-troxin). What is the appropriate starting dosage?
A child has been on levothyroxine for hypothyroidism for 3 months. What is the most appropriate next step in managing their treatment?
A child has been on levothyroxine for hypothyroidism for 3 months. What is the most appropriate next step in managing their treatment?
Flashcards
Neonatal Hypothyroidism Screening
Neonatal Hypothyroidism Screening
Screening newborns for hypothyroidism to enable early detection and treatment, preventing potential complications.
Neonatal Hypothyroidism Symptoms
Neonatal Hypothyroidism Symptoms
Anemia, lethargy, constipation, feeding difficulties, and a hoarse cry are typical in newborns with hypothyroidism.
Child Hypothyroidism Symptoms
Child Hypothyroidism Symptoms
Delayed dentition, short neck, and umbilical hernia present in children indicate possible hypothyroidism.
Late Hypothyroidism Symptoms
Late Hypothyroidism Symptoms
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Hypothyroidism Management
Hypothyroidism Management
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Study Notes
- Hypothyroidism can be acquired/late or congenital.
- Neonatal screening for all deliveries helps discover the S&S early for prompt treatment.
Clinical Picture
Neonatal S&S:
- Sleepiness
- Anemia
- Lethargy
- Hoarse cry
- Constipation
- Feeding difficulties
- Abdominal distension
- Cold, dry, rough, thick skin
- Prolonged physiological jaundice
Infant S&S:
- Wrinkled forehead
- Sparse eyebrows
- Low hairlines
- Puffy eyelids
- Large tongue
- Thick lips
- Cold
Child S&S:
- Widely open anterior fontanel
- Scanty, rough, dry scalp hair
- Rough, dry, thick, cold skin
- Delayed dentition
- Short neck with fat
- Short, broad hands
- Distended abdomen
- Umbilical hernia
- Hoarse voice
- Constipation
- Hypotonia
- Anemia
Late S&S:
- Fatigue
- Hair loss
- Depression
- Puffy face & lids
- Loss of eyebrows
- Doughy, deep voice
- Goiter & low heart rate
- Weight gain & constipation
- Dry, rough, pale, cold, bold skin
- Amenorrhea, infertility & decreased desire
Investigations
- T3, T4, TSH level tests
- Wrist X-ray
Management
- L-troxin tablet on empty stomach
- Neonate Dosage: 15 mcg/kg/day
- Infant Dosage: 10 mcg/kg/day
- Child Dosage: 5 mcg/kg/day
- Follow up monthly with TSH level tests
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