Endocrinology

Question 1

Hypothyroidisms (Sx, Ix, Mx)

Answer 1

Hypothyroidism Symptoms
- dry skin
- hoarse cry
- constipation
- puffy face, prominent tongue
- listless, failure to thrive
- umbilical hernia (Neonate)
- hypothermia or heat intolerance
- bradycardia
- Jaundice in neonate
- goiter

Causes
- Neonate: agenesis/ectopic/dyshormonogenesis vs manternal Abs
- children: neck radiation, syndrome (T21/Williams/Turner), Autoimmun (hashimotos TPO [thyroid peroxidase] ab or Thyroglobulin Ab)

Hypothyroidism Investigations
- TFTs (expect high TSH if agenesis/ectopic/dyshormonogenesis)
- neonate: US or nuclear med scan ?ectopic vs agenesis

Management
- Levethyroxine
- need to repeat TFTs 6 weekly and can then spread out to 3-6monthly, when more stable and older

Question 2

Hyperthyroidism