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Internal Medicine
Pericardial effusion and ascites occasionally occur
Memory impairment
Psychosis may develop with long-standing hypothyroidism and may be precipitated by
thyroid hormone replacement
Physical examination
Thickened, puffy features is due to accumulation of mucinous mucoplysaccharide-rich
material in tissues .This is known and myxedema
Yellowish dry skin
Nonpitting edema
A delay in return phase of Achilles and other deep tendon reflexes is a specific finding.
Loss of the lateral portion of the eyebrows ( madarosis )
Effect of hypothyroidism on organ systems
Cardiovascular system : Decrease in cardiac output ,Pericardial effusion
Respiratory system : Hypoventilation ,Plural effusion
Gastrointestinal tract : Constipation
Nervous system: Decreased mental function , Psychiatric changes ( e.g. psychosis ,
depression )
Blood: Normocytic normochromic anemia.
Cretinism: is sever hypothyroidism beginning in infancy infants may have
Hypotonia, umbilical hernia,
Delayed mental and physical development, and mental retardation may result if
hypothyroidism goes untreated in the first few years of life.
Shot limbs and a large head , with a bread flat nose , widely set eyes , and a large
tongue characterize this form of dwarfism
Other signs and symptoms typical of adult patients may also be seen
Diagnostic workup:
Thyroid function tests:
1. Serum TSH level: