What this deck covers
Congenital Hypothyroidism and Acquired Thyroid Disease in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.
Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.
The 18 cases, in order
- What the heel prick is for
- A high result in a well baby
- How much to begin with
- Why those weeks mattered
- A gland present but enlarged
- The antiseptic on the skin
- Two scans that disagree
- How the heel prick missed it
- Which one goes in first
- A firm goitre in a teenager
- Slowing down while gaining weight
- How often to repeat it
- A borderline result, no symptoms
- A slightly high number in a heavy child
- Odd results in a very ill child
- A whole village with the same neck
- How the dose is followed up
- Wound up and not sleeping
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: A raised TSH on a blood spot taken around day five, Repeat the blood spot in four weeks, 1 to 2 micrograms per kilogram each day, A risk of goitre and nothing more, An inherited block in making thyroid hormone, Permanent failure of the gland to develop, Iodine deficiency during the pregnancy, The screen measures TSH, Start both together at full replacement dose, Autoimmune thyroiditis, Coeliac disease, Only if symptoms develop, Recheck in three months rather than treating now, A thyroid scan and a needle biopsy.
Clinical pearls from this deck
- It is a TSH test, on day five, and that date is chosen to dodge the surge after birth.
- Sample, then treat. Waiting for the confirmation is the commonest avoidable delay there is.
- A newborn needs a bigger dose per kilo than an adult, and needs it at full strength now.
- Growth catches up. The brain does not. That is the whole argument for screening.
- A goitre at birth means the gland is there and cannot work, not that it is missing.
- An iodine load can shut a newborn thyroid down. Re-test at three years before saying lifelong.
Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.
More from this system: all Endocrinology Board Questions case decks · pediatric reference values.
