USMLE Internal Medicine Review 10 07 Hypothyroidism in Adults

USMLE Internal Medicine Review 10 07 Hypothyroidism in Adults

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  • USMLE Audio Review files from our “Gold Standard USMLE Reviews”
  • Transcriptions of those files
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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 07 Hypothyroidism in Adults Below

 

Begin 10 07 Hypothyroidism in Adults Transcription

What are six common features of hypothyroidism in adults? Please try to list them.

  • Common features of hypothyroidism in adults include alphabetically coldness, constipation, easy fatigability, menstrual irregularities, muscle cramps and weight gain.

And how about five common physical findings of the adult hypothyroid patient?

  • Physical findings include cool rough and dry skin, a hoarse husky voice, puffy face and hands, slow reflexes, and often a dull and apathetic faces.

What is it that may give the skin of the adult hypothyroid patient a yellowish hue?

  • Reduced conversion of keratin to vitamin A with resultant increased keratin blood levels can affect a yellowish hue to the skin.

Student doctor please pause the tape and repeat six common features and five common physical findings of the adult hypothyroid patient.

  • Common features of hypothyroidism in adults include coldness, constipation, easy fatigability, menstrual irregularities, muscle cramps and weight gain. Additional physical findings include cool rough and dry skin, a hoarse husky voice, puffy face and hands, slow reflexes, and often a dull and apathetic faces. Reduced conversion of keratin to vitamin A with resultant increased keratin blood levels can affect a yellowish hue to the skin.

Hypothyroidism in adults is manifested by which three cardiovascular signs? (Just list them please in any order)

  • Hypothyroidism is manifested by impaired muscular contraction, bradycardia, and diminished cardiac output.

ECG reveals low voltage of which three waves or complexes?

  • ECG reveals low voltage of P and T waves and QRS complexes. These normally improve with therapy.

Cardiac enlargement may occur in adult hypothyroidism often due to pericardial effusion which can be determined by echocardiography.

Cardiac enlargement may also be the result of what type of edema?

  • Interstitial edema.

Or it can be the result of what type of swelling?

  • Non-specific myofibrillary swelling.

Cardiac enlargement may also be the result of what location of dilation?

  • The result of left ventricular dilation.

Although cardiac output is reduced, which two cardiovascular conditions often associated with lowered cardiac output are rarely noted in the adult hypothyroid patient?

  • Congestive heart failure and pulmonary edema are rarely noted.

While there is controversy as to whether myxedema induces this condition, the condition is more common in patients with hypothyroidism, especially other patients.

What condition are we talking about?

  • Coronary artery disease.

And patients with which cardiac condition may actually be protected from ischemic stress to the heart?

  • Patients with angina pectoris.

Student doctor please pause the tape and summarize cardiovascular manifestations associated with adult hypothyroidism, please also include our remarks on ECG findings, cardiac enlargement, cardiac output, coronary artery disease, and angina pectoris.

  • Hypothyroidism in adults is manifested by impaired muscular contraction, bradycardia, and diminished cardiac output. ECG reveals low voltage of P and T waves and QRS complexes, which normally improve with therapy. Cardiac enlargement may occur in adult hypothyroidism often due to pericardial effusion and sometimes due to interstitial edema, non-specific myofibrillary swelling or left ventricular dilation. Although cardiac output is reduced in adult hypothyroid patient, congestive heart failure and pulmonary edema, often associated with lowered cardiac output are rarely noted.  While there is controversy as to whether myxedema induces coronary artery disease, CAD is more common in patients with hypothyroidism, especially other patients. Patients with angina pectoris may actually be protected from ischemic stress to the heart.

****END OF TRANSCRIPTION****

 

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