Introduction – Hypothyroidism

by Carlo Raj, MD

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    In this discussion, we will take a look at hypothyroidism. Generally speaking, a patient walking through the door will have decreased basal metabolic rate, tired fatigued, constipated, gaining weight without necessarily consumption of too much food. Hypothyroidism defined by insufficient circulating thyroid hormone levels for normal cellular functioning, extremely common especially in women due to Hashimoto, a chronic lymphocytic type of thyroiditis. At this juncture, you should be able to integrate your complete picture of Hashimoto to the point where initially you may have in a female is experience-is experiencing Hashitoxicosis. Some point in time, with that lymphocytic infiltration may result in hypothyroidism primary type. Your patient with hypothyroidism will have puffy face, puffy hands; eye, periorbital region will be puffy. Differentiate this from Graves’ disease. This is not exophthalmos; mixed edema in all parts of the body. There is no pathognomonic sign or symptoms for hypothyroidism. Typical patient is lethargic, fatigued, multi… mild constipation, cold intolerance, dry skin, dulled facial expression, puffiness of the face, around the eyes, coarse hair. The complexion is going to be yellow because of decreased conversion or decreased metabolism of carotene. Do not confuse this with jaundice; this is vitamin A that is not being properly metabolized due-due to decreased T3, T4. Loss of lateral eyebrows and that’s an interesting symptom, isn’t it? There will be delayed DTR or delayed relaxation of deep tendon reflexes, growth failure in children because of lack of long bone growth, think of that child; it may have cretinism, yellowing of the skin, why? Because of increased carotene accumulation, short stature, extreme, extremely low IQ, galactorrhea, a decrease in T… a decrease in T3, T4 result in increase in TRH and TSH, thus resulting in hyperprolactinemia and galactorrhea. Hypercholesterolemia, especially LDL, type 2 hyperlipidemia, why? Because if you have...

    About the Lecture

    The lecture Introduction – Hypothyroidism by Carlo Raj, MD is from the course Thyroid Gland Disorders.

    Included Quiz Questions

    1. Chronic lymphocytic thyroiditis
    2. Pituitary adenoma
    3. Silent thyroiditis
    4. Grave's disease
    5. Iatrogenic causes
    1. Orbital bulging
    2. Weight gain
    3. Fatigue
    4. Constipation
    5. "Puffy," yellow face
    1. Hyperventilation
    2. Delayed relaxation of deep tendon reflexes
    3. Stunted growth (children)
    4. Intolerance to cold
    5. Pleural effusion
    1. A marked increased in T3 and T4 leads to thyroid mediated underproduction of thyroid hormone
    2. Loss of thyroid tissue
    3. Granulomatous destruction of thyroid
    4. Decreased iodine stores lead to inability to synthesize new thyroid hormone
    5. Most treatments for hyperthyroidism lead to hypothyroidism
    1. Pituitary; hypothalamus
    2. Pituitary; liver
    3. Hypothalamus; liver
    4. Hypothalamus; pituitary
    5. Liver; adrenal glands

    Author of lecture Introduction – Hypothyroidism

     Carlo Raj, MD

    Carlo Raj, MD

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