USMLE Internal Medicine Review 10 09 Findings – Pulmonary Intestinal Peristalsis, Renal Function, Anemia

USMLE Internal Medicine Review 10 09 Findings – Pulmonary Intestinal Peristalsis, Renal Function, Anemia

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  • USMLE Audio Review files from our “Gold Standard USMLE Reviews”
  • Transcriptions of those files
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  • 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 09 Findings – P.I.P, Renal Function, Anemia Below

 

Begin 10 09 Findings – P.I.P, Renal Function, Anemia Transcription

When experienced by the hypothyroid patient, pernicious anemia is associated with parietal cell auto-antibodies and is often one of a spectrum of autoimmune diseases.

The spectrum also includes myxedema due to which chronic thyroid condition?

  • Myxedema due to chronic thyroiditis associated with thyroid auto-antibodies.

The autoimmune disease spectrum also includes diabetes mellitus, associated with what type of auto-antibodies?

  • Diabetes Mellitus associated with islet cell auto-antibodies.

And adrenal insufficiency associated with which type of auto-antibodies?

  • Adrenal insufficiency associated with adrenal auto-antibodies.

The association of primary hypothyroidism primary adrenal cortical insufficiency and insulin-dependent Diabetes Mellitus experienced together is referred to as what syndrome?(starts with capital S) The triad of primary hypothyroidism, primary adrenal cortical insufficiency, and insulin-dependent diabetes mellitus experienced together is referred to as Schmidt’s syndrome, to be distinguished from another Schmidt’s syndrome involving paralysis of a vocal cord.

Student doctor please pause the tape and summarize the spectrum of four autoimmune diseases along with their corresponding auto-antibodies which are sometimes experienced together by the hypothyroid patient. Please start with pernicious anemia.

  • Autoimmune diseases sometimes suffered as a group by the hypothyroid patient include pernicious anemia associated with parietal cell auto-antibodies, myxedema due to chronic thyroiditis associated with thyroid auto-antibodies, diabetes mellitus associated with islet cell auto-antibodies, and adrenal insufficiency associated with adrenal auto-antibodies.

Neuromuscularly, what are three signs or symptoms complained of by many adult hypothyroid patients? Just list them.

  • Adult hypothyroid patients often complain of muscle weakness, paresthesias, and severe muscle cramps.

And what are three central nervous system signs in the adult hypothyroid patient?

  • Adult hypothyroid patient’s central nervous system signs may include chronic fatigue, lethargy, and inability to concentrate. Whereas the clinical picture of fully developed myxedema is usually quite clear, signs and symptoms of mild hypothyroidism can be either subtle or evident.

Can hypothyroidism cause depressive symptoms?

  • Yes, hypothyroidism can cause severe depression and with emotional instability or even paranoid psychosis.

What is the mechanism whereby hypothyroidism may produce anovulatory cycles or infertility? Please pause the tape.

  • Hypothyroidism impairs the conversion of estrogen precursors to estrogens, resulting in altered FSH (follicle-stimulating hormones) and LH (luteinizing hormone) secretion and in anovulatory cycles or infertility. Severe menorrhagia may also be present.

Student doctor please pause the tape and summarize common neuromuscular and central nervous system symptoms of the adult hypothyroid patient and review the mechanism whereby hypothyroidism can cause anovulatory cycles or infertility.

  • Adult hypothyroid patients may suffer muscle weakness, paresthesias, severe muscle cramp, neuromuscular signs, and chronic fatigue, lethargy, and inability to concentrate CNS signs. Hypothyroidism can also cause severe depression with emotional instability or even paranoid psychosis.  Hypothyroidism impairs the conversion of estrogen precursors to estrogens, resulting in altered FSH (follicle-stimulating hormone) and LH (luteinizing hormone) secretion and also resulting in anovulatory cycles or infertility. Severe menorrhagia may also be present.

****END OF TRANSCRIPTION****

 

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