Definition

  • Q. Define hypothyroidism?
  • Q. What are primary and secondary hypothyroidism?
  • Q. What is myxedema?
    • Q. What is Hoffman’s syndrome?
  • Q. What is Pendred’s syndrome?
  • Q. What is subclinical hypothyroidism (borderline hypothyroidism or compensated euthyroidism)?
  • Q. What is Hashimoto’s thyroiditis?

Epidemiology

  • Q

Etiology and Pathophysiology

  • Q. What are the causes of hypothyroidism?
  • Q. What are the common causes of primary hypothyroidism?
  • Q. What is the most common cause of primary hypothyroidism?
  • Q. What are the common causes of transient hypothyroidism?
  • Q. What are the causes of goitrous hypothyroidism?
  • Q. If there is goiter with hypothyroidism, what is the likely cause?
  • Q. What are the causes of nongoitrous hypothyroidism?
  • Q. Why hypothyroidism in Graves’ disease?
  • Q. What is the difference between myxedema and hypothyroidism?
  • Q. Why nonpitting edema in myxedema?
  • Anemia in hypothyroidism
    • Q. What are the types of anemia in hypothyroidism?
    • Q. What are the causes of anemia in hypothyroidism?

Clinical manifestations

  • Q. What are the common presentations of hypothyroidism?
  • Q. What are the neurological features in hypothyroidism?
  • Q. What are the cardiovascular problems in myxedema?

Examinations

  • Q. What are the common findings on examination?
    • Q. What bedside physical sign will you see in myxedema?
    • Q. How slow relaxation is best elicited in the ankle? Why slow relaxation?

Investigations

  • Q. What investigations fo you suggest in hypothyroidism?
  • Q. Which biochemical investigations would you suggest to diagnose hypothyroidism? Why not serum T3?
    • Q. What are the expected findings in primary hypothyroidism?
    • Q. What are the expected findings in secondary hypothyroidism?
  • Q. If single investigation is asked for hypothyroidism, which one? / Tell one single investigation to diagnose hypothyroidism.
  • Q. How to interpret thyroid function test results? h22
  • Q. What are the biochemical abnormalities (other than thyroid hormones) in hypothyroidism?
  • Q. What are the ECG findings in hypothyroidism?
  • Q. How to investigaet a case of secondary hypothyroidism?
  • Q. How to investigate hypothyroidism in pregnancy?
  • Hashimoto’s thyroiditis
    • Q. What is the radio-iodine uptake in Hashimoto’s thyroiditis?
    • Q. What are the histological findings in Hashimoto’s thyroiditis?

Diagnosis

  • Q. What is the difference between primary and secondary hypothyroidism?
  • Q. What questions will you ask if you suspect hypothyroidism?
  • Q. One disease can be diagnosed by over telephone, which is the disease?
  • Q. Ask one question to a patient of hypothyroidism and what 2 clues can you get from the patient’s answer?
  • A middle-aged women presented with constipation, hoarseness of voice and cold intolerance. What is your probable diagnosis? h4
  • Q. What are your differential diagnoses?
    • Q. Why not this is nephrotic syndrome?
    • Q. Why not Cushing’s syndrome?

Treatment

  • Q. How will you treat the patient?
  • Q. What is the protocol of giving thyroxine?
    • Q. In which conditions initial small dose (25 μg) is used?
    • Q. Why thyroxine should be started in low dose?
    • Q. How long will you continue the treatment?
  • Q. What is the aim of treatment?
  • Q. In hypothyroidism, if there is no response after thyroxine therapy, what are the possibilities?
  • Q. Tell the follow up of hypothyroid patient during treatment.
  • Q. What are the clinical criteria of remission of hypothyroidism?
  • Special conditions
    • Q. If the patient has ischemic heart disease with hypothyroidism, how to treat?
    • Q. How to treat an elderly patient with hypothyroidism?
    • Q. Tell the treatment of hypothyroidism in pregnancy.

Complications

  • Q. What will happen if inadequate replacement is given during pregnancy?
  • Q. What is myxedema coma? What are the mechanisms? How to treat?
  • Q. What is myxdema madness?
  • Q. What is sick euthyroid syndrome?
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