February Week 2 (by Dr Nigra)

Foley TP. Hypothyroidism. Pediatr. Rev. 2004;25:94-100.

Counts. Varma. Hypothyroidism in Children. PIR. 2009.

1. Which screening tests are recommended for patients who have a high risk of developing hypothyroidism?
A. serum TSH
B. thyroid antibodies
C. Free T4
D. All of the above
2. What should you do if a baby’s newborn screen shows an elevated TSH?
A. Send confirmatory labs and begin treatment the same day.
B. Send confirmatory labs and begin treatment if they are positive for hypothyroidism.
C. Begin treatment.
D. Repeat the newborn screen.  
3. You are on call at Arlington on a Saturday and some parents bring their baby in for a “clinic visit”.  The baby is now 1 week old, born at 42 1/7 WGA via c-section for failure to progress, weighing 4.5 kg.  The mother says the baby is not feeding well.  Which physical exam finding is associated with congenital hypothyroidism in the first 2 post-natal weeks?
A. large anterior and posterior fontanelles
B. coarse facial features
C. muscular pseudohypertrophy
D. myxedema