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Spot Diagnosis - Congenital

Discussion in 'Spot Diagnosis' started by neo_star, Jan 1, 2013.

  1. neo_star

    neo_star Moderator

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    congenital_zpse59f262c.jpg

    Hint: In utero exposure to Methimazole and Carbimazole is a risk factor
     

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  2. neo_star

    neo_star Moderator

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    Ans : Aplasia Cutis Congenita

    The image I posted is healed..most of us would easily recognise the lesion, earlier in it's course ( ex. image posted below )

    [​IMG]

    (-:
     

  3. neo_star

    neo_star Moderator

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    Related self assesment question

    [FONT=&amp]A 37-year-old G3P2 presents to your office for her first OB visit at 10 weeks gestation. She has a history of Graves disease and has been maintained on propylthiouracil (PTU) as treatment for her hyperthyroidism. She is currently euthyroid but asks you if her condition poses any problems for the pregnancy. Which of the following statements should be included in your counseling session with the patient?
    [/FONT]
    [FONT=&amp]A. She may need to discontinue the use of the thionamide drug because it is commonly associated with leukopenia.[/FONT]
    [FONT=&amp]B. Infants born to mothers on PTU who are euthyroid may develop a goiter and be clinically hypothyroid.[/FONT]
    [FONT=&amp]C. Propylthiouracil does not cross the placenta.[/FONT]
    [FONT=&amp]D. Pregnant hyperthyroid women, even when appropriately treated, have an increased risk of developing preeclampsia.[/FONT]
    [FONT=&amp]E. Thyroid storm is a common complication in pregnant women with Graves disease.[/FONT]

    [FONT=&amp]EXPLANATION:
    [/FONT]
    [FONT=&amp]Hyperthyroidism in pregnancy is treated with thionamides, namely, propylthiouracil (PTU) and methimazole. These medications block thyroid hormone synthesis. Both cross the placenta, and fetal hypothyroidism and goiter have been associated with maternal thionamide treatment for Graves disease. Transient leukopenia occurs in about 10% of patients taking thionamide drugs, but does not necessitate stopping the medication. Women who remain hyperthyroid despite therapy have a higher incidence of preeclampsia and heart failure. Thyroid storm occurs only rarely in untreated women with Graves disease. This emergent medical condition involves thyrotoxicosis, which is characterized by fever, tachycardia, altered mental status, vomiting, diarrhea, and cardiac arrhythmia. The treatment of thyroid storm involves administering multiple medications to suppress thyroid function.

    [/FONT]
    [FONT=&amp]The answer is B.[/FONT]
     

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