Cretinism : Definition, Causes, Symptoms, Clinical Features, Treatment And MCQs for NEET, GPAT, CSIR NET JRF

“A cretin is a child with severe hypothyroidism present at birth or developing within first two years of postnatal life.’’

1.] The word ‘’cretin’’ is derived from a French meaning ‘’Christ – like.’’

2.] It is a disease in which during the developmental of the child, if the proper treatment is not given, then the child is both mentally and physically retarded.

CAUSES OF CRETINISM :-

The causes of congenital hypothyroidism are as follows :

• Developmental anomalies e.g. thyroid agenesis and ectopic thyroid.
• Genetic defect in thyroid hormone synthesis e.g. defect in iodine trapping, oxidation, iodination, coupling and thyroglobulin synthesis.
• Fetal exposure to iodides and anti thyroid drugs.
• Endemic cretinism in regions with endemic goiter due to the dietary lack of iodine.

SYMPTOMS OF CRETINISM :-

Signs and symptoms of cretinism are as follows :

• There will be increase in metabolism which will lead to decrease in weight gain.
• Child can suffer from stunted growth.
• Person may suffer from fatigue and lethary.
• Person will have thickened facial features.
• Child will have abnormal bone growth.
• Mental retardation will occur in child.
• Yellowing of the skin i.e; Jaundice.
• Swelling of the neck from an enlarged thyroid gland (goiter)

CLINICAL FEATURES :-

• The clinical feature manifestation usually become evident within a few weeks to month of birth.
• The presenting feature of a cretin are : slow to thrive, poor feeding, dry scaly skin, constipation, hoarse cry and bradycardia.
• The clinical picture of a fully developed cretinism emerges is characterized by impaired skeletal growth and consequent dwarfism, round face, narrow forehead, big protuberant tongue and protuberant abdomen.
• Characteristic laboratory findings include rise in TSH level and fall in T3 and T4 level.

TREATMENT OF CRETINISM :-

• Patient suffering from cretinism are given the synthetic version of thyroid hormone called levothyroxine as it compensate the decreased secretion of thyroid hormone. In case of children this thyroid hormone pills are difficult to swallow, so in such cases the pills are crushed and are given to them in milk form.
• Soy protein and concentrated iron formula can interfere with the absorption of thyroid hormone.

MULTIPLE CHOICE QUESTIONS :-

1.] Cretinism is due to abnormal secretion of ?

a. Thyroid stimulating hormone

b. Thyroxine

c. Calcitonin

d. Parathormone

2.] Hypothyroidism in children causes ?

a. Myxoedema

b. Cretinism

c. Goiter

d. Diabetes mellitus

3.] In which of the following condition child is both mentally and physically retarded ?

a. Myxoedema

b. Hypothyroidism

c. Cretinism

d. None of the above

4.] The word ‘’cretin’’ is derived from which language ?

a. Latin

b. German

c. French

d. All of the above

5.] In cretinism child suffer from severe ?

a. Hyperthyroidism

b. Hypothyroidism

c. Grave’s disease

d. None of the above

6.] Endemic cretinism is caused due to ?

a. Lack of iodine

b. Lack of sodium

c. Lack of K+

d. Lack of O2

7.] Fetal exposure to iodides and anti thyroid drug causes ?

a. Myxoedema

b. Grave’s disease

c. Cretinism

d. None of the above

8.] Following are the symptoms of cretinism ?

a. Swelling near the navel

b. Swelling of the neck

c. Stunted growth

d. None of the above

9.] ‘’Levothyroxine’’ is used in the treatment of ?

a. Myxoedema

b. Cretinism

c. Hashimoto’s disease

d. Grave’s disease

10.] Which of the following can interfere with the absorption of thyroid hormone ?

a. Soy protein and concentrated K+ formula

b. Albumin protein and concentrated Fe formula

c. Soy protein and concentrated Fe formula

d. None of the above

SOLUTIONS :-

1.] (b) Thyroxine

2.] (b) Cretinism

3.] (c) Cretinism

4.] (c) French

5.] (b) Hypothyroidism

6.] (a) Lack of iodine

7.] (c) Cretinism

8.] (d)

9.] (b) Cretinism

10.] (c) Soy protein and concentrated Fe formula

For More Standard and Quality Question Bank you can Join Our Test Series Programme for GPAT, NIPER JEE, Pharmacist Recruitment Exam, Drug Inspector Recruitment Exams, PhD Entrance Exam for Pharmacy

List of Successful GPATINDIAN CANDIDATES

REFERENCES :-

1.] Textbook Of Pathology By Harsh Mohan; 7th edition; Page no. 794.

2.] Robbin’s Basic Pathology; 5th edition; Page no. 1125.