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Probably in part due to early age presentation, but I hear you
FA2019 p518 - process of elim for other spinal cord lesions
also just an FYI, her achilles reflex symptom is called Woltman Sign and can be seen in many cases of hypothyroidism
got the right answer but does anyone know why a lingual thyroid would cause hypothyroidism instead of hyperthyroidism? because I know patients who have a lingual thyroid removed are at risk of hypothyroidism
Probably not scientifically accurate, but the body is like, hey, lingual thyroid, you're in the wrong place, you don't get to grow! Hypothyroidism ensues. Plus I don't think you'd be able to swallow if you had a normal-sized thyroid literally inside your throat.
@ruready4this, she probably has hypothyroidism because her lingual thyroid isn't functioning enough like a normal sized thyroid. The question mentioned no palpable thyroid gland, as in the lingual thyroid is doing all of the work due to an absent thyroid gland in the neck. This is actually the reason why patients who have a lingual thyroid removed are at risk for hypothyroidism- once you remove it, you have zero tissue producing thyroxine.
Is there a situation where you would pick fibromuscular dysplasia over atherosclerosis if given both options? Thanks for your help!
Atherosclerosis affects PROXIMAL 1/3 of renal artery
Fibromuscular dysplasia affects DISTAL 2/3 of renal artery
Why is there ↓ size in both kidneys? This threw me off
@gonyyong : Maybe because narrowed renal a. d/t atherosclerosis led to renal hypoperfusion and decrease in size?
Fibromuscular dysplasia occurs in young females according to Sattar Pg 67, 2018.
Normally you will see Fibromuscular dysplasia in a young female 18-35 with high or resistant hypertension. She is older has a history type II DM predispose you to vascular disease and normal to moderate elevation in BP
@gonyyong there's bilateral renal artery stenosis. The decrease in size of both kidneys should be from atrophy due to lack of renal blood flow.
1 year ago, she did not present any physical or Lab abnormalities. This means she must not suffer fibromuscular dysplasia, otherwise she must have presented renal abnormalities for a long long time, or even before DM-2.