Question

Which one of the following features may NOT be seen in hypothyroidism?

• A. Cold intolerance
• B. Deafness
• C. Pericardial effusion
• D. Pretibial myxoedema

Hint:

Pretibial myxoedema belongs to Graves' disease, a hyperthyroid condition.

Answer 1

The Correct Option is D

Step 1: Understanding the Question.
We need to find the one listed feature that does not actually belong to hypothyroidism.

Step 2: Key Concept.
Hypothyroidism slows down the body's metabolism, so most of its features come from that slowdown, such as feeling cold, fluid building up in tissues, and slowed nerve or organ function. Pretibial myxoedema, on the other hand, is a specific autoimmune skin change linked to Graves' disease, which is a form of hyperthyroidism, not hypothyroidism.

Step 3: Detailed Explanation.
Cold intolerance is one of the most classic hypothyroid symptoms, since a slow metabolism produces less body heat. Deafness, specifically a sensorineural type, can happen in hypothyroidism because of myxoedematous swelling around the structures of the inner ear, and it is also a feature of congenital hypothyroidism such as in Pendred syndrome. Pericardial effusion is a well known complication of hypothyroidism, part of what is called myxoedema heart, where fluid rich in protein collects around the heart. Pretibial myxoedema, despite sharing the word myxoedema, is caused by TSH receptor antibodies acting on skin fibroblasts over the shins, and it is seen in Graves' disease, which is a hyperthyroid condition, not in hypothyroidism.

Step 4: Final Answer.
Pretibial myxoedema is a feature of Graves' hyperthyroidism, not hypothyroidism, so it is the one that may NOT be seen in hypothyroidism.