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Pediatric Problem Solving – Case 10
A 5-month-old girl presented with history of constipation and delayed developmental milestones. She had prolonged physiological jaundice. On exam, she is hypoactive, has an open mouth with large tongue. Other systemic examinations are within normal.
What is the next step in management?
A 5-month-old girl presented with history of constipation and delayed developmental milestones. She had prolonged physiological jaundice. On exam, she is hypoactive, has an open mouth with large tongue. Other systemic examinations are within normal.
What is the next step in management?
A) Checking T4 and TSH
B ) Checking serum bilirubin
C ) Doing CT scan of head
D ) Follow up after 4 weeks Explanation of the case:
Explaination of the case
key points:
Constipation, delayed developmental milestones, being hypoactive open mouth with large tongue, prolonged physiological jaundice = hypothyroidism
Choice (A): the right choice
Points with: manifestations of hypothyroidism. In any case, u've to investigate for treatable causes first.
Choice (B): there's no use of checking bilirubin + it is physiological.
Choice ( C ): there's no use of CT scan, even if there was brain damage, it's not treatable
Choice (D): the condition cant be delayed
key points:
Constipation, delayed developmental milestones, being hypoactive open mouth with large tongue, prolonged physiological jaundice = hypothyroidism
Choice (A): the right choice
Points with: manifestations of hypothyroidism. In any case, u've to investigate for treatable causes first.
Choice (B): there's no use of checking bilirubin + it is physiological.
Choice ( C ): there's no use of CT scan, even if there was brain damage, it's not treatable
Choice (D): the condition cant be delayed
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