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NBME 20 Answers

nbme20/Block 3/Question#24

A 2-month-old girl is brought to the emergency ...

Thyroid function tests

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submitted by hayayah(505),

Patient has congenital hypothyroidism (cretinism). Findings: pot belly, pale, puffy-faced, umbilical hernia, macroglossia, hypotonia, poor brain development (MC cause of treatable mental retardation), large anterior fontanelles.

whossayin  how can you differentiate the symptoms of cretinism from Down syndrome? +  
step1soon  @whossayin Down Syndrome: upslanting palpebral fissures, atlantoaxial instability, bent little finger, congenital heart disease, displacement of the tongue, excess skin on the back of the neck, flaccid muscles, hearing loss, immune deficiency, low-set ears, mouth breathing, obesity, obstructive sleep apnea, polycythemia, seborrheic dermatitis, single line on palm, thickening of the skin of the palms and soles, thyroid disease, or vision disorder +  

 +2  upvote downvote
submitted by dickass(22),

...migrant workers ...has not received routine medical care ==> she was not screened for hypothyroidism