USMLE Internal Medicine Review 10 03 Hypothyroidism

USMLE Internal Medicine Review 10 03 Hypothyroidism

On these “Gold Standard Internal Medicine Facts” pages you will find Free:

  • USMLE Audio Review files from our “Gold Standard USMLE Reviews”
  • Transcriptions of those files
  • And videos (as they become available)

The idea is that you can review for the USMLE online by:

  • Listening to the Audio
  • Following along with the transcription
  • Or by watching the video (if available)

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Let’s start our USMLE Review with Hypothyroidism and Hyperthyroidism from the Gold Standard USMLE Foundations of Medicine Audio Review program.

 

Play USMLE Audio MP3 10 03 Hypothyroidism Below

 

Begin 10 03 Hypothyroidism Transcription

Moving now for a closer look at hypothyroidism. This is a clinical syndrome resulting from a deficiency of thyroid hormones in term resulting in a generalized slowing down of a metabolic processes.

What is one general result of thyroidism in infants and children? Please also give a possible serious permanent consequence.

  • Hypothyroidism in infants and children can cause marked slowing of growth and development, with possible mental retardation or other permanent serious consequences. Adult onset hypothyroidism causes a general slowing down of the organism by deposition of mucopolysaccharides in intracellular spaces, especially in skin and muscle.

What is a more modern term for mucopolysaccharides? Go ahead and pause the tape.

  • A more modern term for mucopolysaccharides is glycosaminoglycans, since all the six known classes of mucopolysaccharides have been shown to contain large amounts of D-glucosamine and D-galactosamine.

Adult onset hypothyroidism often produces a clinical picture of what edematous condition of subcutaneous tissue?

  • Myxedema.

Pause the tape and name some general signs and symptoms of myxedema.

  • Myxedema is generally characterized by things like dryness and lose of hair, hoarseness, increased fluid in body cavities such as the pericardial sac, muscle weakness, slow mentation, somnolence and subnormal body temperature. One classification system groups the etiologies of hypothyroidism into four categories.

Primary hypothyroidism which is what? (Essentially in two words)

  • Thyroid failure.

Secondary hypothyroidism in which hypothyroidism is generally secondary to what condition?

  • Secondary to pituitary TSH deficit.

Tertiary hypothyroidism usually due to what deficiency?

  • Hypothalamic deficiency of TRH (Thyrotropin-releasing hormone).

What does TSH stand for?

  • Thyroid-Stimulating Hormone.

And an etiology of hypothyroidism referring to peripheral resistance to the action of what? 

  • Peripheral resistance to the action of thyroid hormones.

Student doctor please pause the tape and repeat some general signs and symptoms of myxedema, the characteristics of adult onset hypothyroidism, followed by four etiologies of hypothyroidism.

  • Adult onset hypothyroidism often produces a clinical picture of myxedema, often characterized by dryness and loss of hair, hoarseness, increased fluid in body cavities such as the pericardial sac, muscle weakness, slow mentation, somnolence and subnormal body temperature.
  • One classification system groups the etiologies of hypothyroidism into four categories. Primary hypothyroidism which is essentially thyroid failure, hypothyroidism secondary to pituitary TSH deficit, tertiary hypothyroidism due to hypothalamic deficiency of TRH (thyrotropin-releasing hormone), and hypothyroidism cause by peripheral resistance to the action of thyroid hormones.
  • The incidence of the various causes of hypothyroidism in any given region will vary according to geographical and environmental factors like dietary iodide and goitrogen intake, genetic characteristics and age distribution of the population.

What type of geographical terrain is most conducive to goiter?

  • Goiter most often occurs endemically in mountainous regions.

And what are two examples of highly goitrogenic food stuffs?

  • Cabbage and rapeseed, among others.

****END OF TRANSCRIPTION****

 

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