ACUTE NASOPHARYNGITIS

TONSILITIS

CROUP

OTHERS BRONCHITIS

BRONCHIOLITIS

PNEUMONIA

ASTHMA
Tracheoesophage • A tracheoesophageal fistula
al fistula (TEF) (TEF) is an abnormal
connection between these
two tubes. As a result,
swallowed liquids or food
can be aspirated (inhaled)
into your child's lungs.
Feeding into the stomach
directly can also lead to
reflux and aspiration of
stomach acid and food.
Definition

•A tracheoesophageal
fistula (TEF) is an
abnormal connection
between your esophagus
and trachea.
Incidence

•Tracheoesophageal fistula (TEF)

is a common congenital
anomaly of the respiratory tract,
with an incidence of
approximately 1 in 3500 to 1 in
4500 live births
Diaphragmatic hernia
Definition
A diaphragmatic hernia is a birth defect in
which there is an abnormal opening in the
diaphragm. The diaphragm is the muscle
between the chest and abdomen.
Congenital Diaphragmatic Hernia (CDH) is a
developmental defect of the diaphragm that
allows the abdominal contents to herniate into
the chest.
Incidence
Congenital diaphragmatic hernia (CDH) is a
rare condition occurring in
1-5/10,000 births.
It occurs in approximately 1/2500 live births
in Western Australia. Most defects are left
sided (80- 85%).
Types
Diaphragmatic
hernia

Boch dalek Central

Morgagni hernia
hernia tendon
Classification
CDH is commonly classified into:
1.Posterolateral (Boch dalek): most
common; 70-75%.
2.Anterior (Morgagni): 23-28%
3.Central tendon: 2-7%.
Cont….
• Boch dalek hernia: Boch dalek hernia forms either from
malformation of the diaphragm, or the intestines become locked
into the chest cavity during the construction of the diaphragm.
• Morgagni hernia: a defect on the anterior part of the diaphragm,
which allows abdominal organs to penetrate into the thoracic
cavity.
• Central tendon :The central tendon is an aponeurosis which
forms the top of the dome-shaped diaphragm. It blends with the
fibrous pericardium above, helping to maintain it in place. The
inferior vena cava passes through the central tendon at the level
of the 8th vertebra.
Causes
• In most cases, the cause of congenital
diaphragmatic hernia is not known.
• In some cases, CDH can be linked to a genetic
disorder or random gene changes called
mutations.
• In these cases, the baby may have more issues
at birth, such as problems with the heart, eyes,
arms and legs, or stomach and intestines.
Risk factors
Foetal gender
Maternal age beyond 40
Maternal Caucasian race
Maternal Smoking
Alcohol use during pregnancy
Birth weight.
Genetics
Medical conditions
Clinical manifestations
• Acute respiratory distress in new born
• Entry of air into the intestine leading to
further compression of lungs reducing
thoracic space.
• Dyspnea
• Cyanosis
• Scaphoid abdomen
• Impaired cardiac output
• Shock ,if severe
 Investigations
The following is a list of investigations to be done prior to surgery:
1. Chest x-ray to confirm CDH as other conditions such as eventration or
CCAM may mimic on antenatal scans. Occasionally CXR may not be able to
confirm the diagnosis then consider repeat CXR, ultrasound or chest CT.
2. Echocardiography to exclude congenital heart disease and to quantify
pulmonary hypertension.
3. Genetic testing: karyotype and micro-array. Selective testing may be
considered for phenotypical syndromes such as Cornelia de Lange,
Beckwith Weidemann.
4. Renal and head ultrasound to exclude any other associated anomalies.
Management
Goals of Management :
• Optimize ventilation and limit ventilator induced
lung injury.
• Achieve hemodynamic stability by limiting
pulmonary hypertension.
• Avoid fluid overload
Management
• Ultrasounds are scheduled regularly to monitor the baby’s growth and well-being. They are
also used to check the amount of amniotic fluid around the baby.
• Immediate Management :
1. Immediate intubation
2. Monitoring: Pre- and post ductal saturations aiming for post ductal SaO2 between 80%
and 95%
3. NGT insertion with frequent or continuous suction
4. IV access; umbilical line may also be used
5. Transfer to ICU
6. Invasive blood pressure monitoring
7. Sedation
8. Antimicrobials
9. Extracorporeal Membrane Oxygenation (ECMO)
10. Foetal endoluminal tracheal occlusion (FETO)
 Management

• Immediate respiratory assistance that includes:

Endo-tracheal intubation
Gastrointestinal decompression with a double lumen catheter to prevent further
respiratory compromise
• Fowler's position (that facilitates downward displacement of the abdominal content)
• Infants With mild respiratory distress: oxygen are administered by hood.
• Maintain acid-base balance which is vital in the man-agement and prevention of
pulmonary hypertension.
• Low ventilation and least mean airway pressure combined with rapid ventilatory rates
(80-120 breaths/min) to reduce the incidence of pulmonary leaks from Over inflation
the unaffected lung.
• Bag and mask ventilation is contraindicated (to prevent air entry to the stomach and
intestine that may further promote pulmonary function compensation).
• IV fluids.
• Transcutaneous oxygen pressure monitor or pulse oximeter reading
for oxygen saturation.
• Preoperative stabilization by opiates and paralyzing agents (like
pancuronium) and high-frequency ventilation. Also extracorporeal
membrane oxygenation(EMCO) is sometimes used.
• NaHCO, administration for combating acidosis
• Early surgical management (treatment involves returning the
abdominal organs to abdomen and repair the
• defect)
Extracorporeal Membrane
Oxygenation (ECMO)
• Extracorporeal membrane oxygenation (ECMO),
blood is pumped outside of the body to a heart-
lung machine. The machine removes carbon
dioxide and sends oxygen-rich blood back to the
body. Blood flows from the right side of the heart
to the heart-lung machine. It's then rewarmed and
sent back to the body.
Foetal endoluminal tracheal occlusion
(FETO)
• Fetoscopic endotracheal occlusion (FETO) is an experimental
procedure to reversibly block the trachea of the fetus with a
latex balloon. This procedure is used for fetuses diagnosed
with congenital diaphragmatic hernia and impaired lung
development.
Surgical management of
diaphragmatic hernia in children
•The goal of surgery is “to fix the
diaphragmatic hernia, restore
normal anatomy, and prevent
complications”.
 Preoperative Preparation

Stabilization: The child is stabilized in the intensive care

unit (ICU) to optimize respiratory and cardiovascular
function.
Mechanical ventilation: The child is intubated and
mechanically ventilated to support respiratory function.
Cardiovascular support: Inotropic agents and
vasopressors may be used to support cardiovascular
function.
Nutritional support: The child may receive nutritional
support through total parenteral nutrition (TPN) or enteral
nutrition.
Surgical Repair
Thoracotomy: A thoracotomy (incision in the chest) is performed to
access the diaphragm and hernia.
 Hernia reduction: The hernia is reduced, and the contents of the
hernia sac are returned to the abdominal cavity.
Diaphragmatic repair: The diaphragm is repaired using a patch or
primary closure.
Gastroesophageal reflux prevention: A fundoplication (wrapping the
stomach around the esophagus) may be performed to prevent
gastroesophageal reflux.
Surgical Approaches
• Open thoracotomy: A traditional open thoracotomy
approach may be used for larger hernias or more
complex repairs.
• Minimally invasive surgery: Minimally invasive surgery
(MIS) may be used for smaller hernias or less complex
repairs.
• Laparoscopic-assisted repair: A laparoscopic-assisted
repair may be used for hernias that require both
abdominal and thoracic access.
Postoperative Care
ICU care: The child is cared for in the ICU postoperatively to monitor
for respiratory and cardiovascular complications.
Mechanical ventilation: The child may require mechanical ventilation
postoperatively to support respiratory function.
Pain management: Pain management is critical postoperatively to
ensure the child's comfort and prevent complications.
Nutritional support: The child may require nutritional support
postoperatively to support healing and growth.
Complications
• Respiratory complications: Respiratory complications, such as
respiratory failure, may occur postoperatively.
• Cardiovascular complications: Cardiovascular complications, such as
cardiac arrest, may occur postoperatively.
• Infection: Infection is a risk postoperatively, and antibiotics may be
used to prevent infection.
• Hernia recurrence: Hernia recurrence is a risk, and long-term follow-
up is necessary to monitor for recurrence.
OTHERS
ACUTE
NASOPHARYNGITIS
Acute nasopharyngitis

•Acute nasopharyngitis, also

known as the common cold, is a
viral infection that affects the
upper respiratory tract,
particularly the nasopharynx.
Incidence
• More than 200 viruses can cause
nasopharyngitis, but the rhinovirus is the most
common one, as it accounts for 10–40% of
colds.
• The condition is highly contagious. People
can catch it through droplets from a person
with a cold that spread through touch or
inhalation.
Causes
• Rhinoviruses: These are the most common cause of the common
cold, and there are over 100 different strains.
• Coronaviruses: These viruses are also common causes of the
common cold, and some strains can cause more severe illnesses, such
as SARS and MERS.
• Adenoviruses: These viruses can cause a range of illnesses, including
the common cold, bronchitis, and pneumonia.
• Parainfluenza viruses: These viruses can cause the common cold, as
well as more severe illnesses, such as croup and pneumonia.
 Pathophysiology

Direct contact

Virus stays in the unhygienic hands for hours

Virus enters into Naso pharynx

Binds to ICAM-1( INTERCELLULAR ADHESION MOLECULE 1) protein[leukocytes]

Through unknown mechanism , triggers inflammatory response

Signs and symptoms

Clinical Manifestations

Fever

Dyspnea

Cough

Nasal inflammation

Retractions

Barrel-shaped chest

Shallow respirations

Viral pharyngitis (sneezing,

rhinorrhoea, and cough.)
• Fever. Fever is common, especially in young children; older
children have low-grade fevers, which appear early and suddenly.
• Dyspnea. The onset of dyspnea is abrupt, sometimes preceded
by a cough or nasal discharge.
• Cough. Symptoms include a dry and persistent cough.
• Nasal inflammation. Nasal inflammation may lead to obstruction
of passages, and continual wiping away of secretions causes skin
irritation to nares.
• Retractions. Suprasternal and substernal retractions are present.
• Barrel-shaped chest. The chest becomes barrel-shaped from
the trapped air.
• Shallow respirations. Respirations are 60 to 80 breaths per
minute.
• Viral pharyngitis is usually associated with sneezing, rhinorrhea,
and cough.
 Assessment and Diagnostic Findings

• Throat culture. A throat culture remains the standard for diagnosis, though
results can take as long as 48 hours; throat culture results are highly sensitive
and specific for group A beta-hemolytic streptococci (GABHS), but results can
vary according to technique, sampling, and culture media.
• Rapid testing. Most institutions and clinics have rapid testing, which is useful
when immediate therapy is desired; rapid testing can be highly reliable when
used in conjunction with throat cultures; several rapid diagnostic tests are
available; compared with throat culture, such tests are 70-90% sensitive and 95-
100% specific.
• Testing for viral causes. If Epstein-Barr virus (EBV) is considered, obtain a
complete blood count (CBC) to detect atypical cells in the white blood cell (WBC)
differential, along with a Monospot test (or another rapid heterophile antibody
test).
• Radiography. Imaging studies are usually not necessary unless a
retropharyngeal, parapharyngeal, or peritonsillar abscess is suspected; in such
Medical Management
Medical management of acute nasopharyngitis
in children focuses on relieving symptoms,
reducing the severity of the illness, and
preventing complications.
• Oxygen administration: Oxygen may be
administered in addition to the mist tent.
• Oral and IV fluids
Pharmacologic Management
• Symptomatic Relief:
1. Pain management: Acetaminophen (Tylenol) or ibuprofen (Advil or
Motrin) can help relieve headaches, fever, and throat pain.
2. Decongestants: Medications like pseudoephedrine (Sudafed) or
phenylephrine (Sudafed PE) can help reduce nasal congestion.
3. Cough suppressants: Cough medicines like dextromethorphan
(Robitussin) can help relieve coughing.
4. Saline nasal sprays: Saline nasal sprays can help moisturize the nasal
passages and loosen mucus.
 • Antiviral Medications:
Oseltamivir (Tamiflu): This medication can help shorten the duration
and severity of influenza A and B infections.
Zanamivir (Relenza): This medication can help treat influenza A and B
infections.
• Antibiotics
Drug
Dose Duration
Narrow-spectrum cephalosporin
Variable 10 days
(cephalexin, cefadroxil) (oral)*

20 mg/kg per day divided in 3

Clindamycin (oral) 10 days
doses (maximum 1.8 g/d)

12 mg/kg once daily (maximum

Azithromycin (oral) 5 days
500 mg)

15 mg/kg per day divided BID

Clarithromycin (oral) 10 days
(maximum 250 mg BID)
• Antipyretics
The oral dose of paracetamol for children aged 1 month to 18 years is: 15 mg/kg per
dose, to a maximum of 1 g per dose, every four to six hours
• Corticosteroids
Dexamethasone[single dose] (0.6 mg/kg, maximum 10 mg):faster onset of
pain relief and shorter suffering, especially in children.
• Antiviral Medications
Oseltamivir (Tamiflu): This medication can help shorten the duration and severity of influenza A and B
infections.
Zanamivir (Relenza): This medication can help treat influenza A and B infections.
• Supportive Care
 Fluids: Encourage children to drink plenty of fluids, such as water, clear broths, or
electrolyte-rich beverages like Pedialyte.
Rest: Encourage children to get plenty of rest to help their bodies recover. Humidifiers:
Using a humidifier can help add moisture to the air and relieve congestion.
Throat lozenges: Sucking on throat lozenges or cough drops can help soothe a sore
throat.
TONSILITIS
 Definition
An inflammation of the
tonsils, usually caused by an
infection by viruses or
bacteria.
 Risk factors
• Young age. Children are most commonly affected by
tonsillitis; the one caused by bacteria is most common in
children aged between 5 years to 15 years.
• Frequent exposure to germs. School-aged children are
in close contact with other students and frequently exposed
to viruses or bacteria that can cause tonsillitis.
 Symptoms
• Sore throat
• Red, swollen tonsils
• White or yellow patches or coating on the tonsils
• Fever
• Difficulty or pain with swallowing
• Tender, enlarged lymph nodes in the neck
• Bad breath
• Scratchy voice
• Stomach pain
• Headache
• Stiff neck
Diagnostic tests
• Medical History
• Physical Examination
• Throat Swab (Culture or Rapid Strep Test)
• Blood Tests
• Imaging Studies: CT scan
 Treatment
The treatment of tonsillitis varies depending on the underlying cause, whether it be viral or bacterial. Here are
some common techniques for managing tonsillitis:

• Viral Tonsillitis:

 Rest and Hydration: Proper rest helps the body recover, and staying well-hydrated is important for managing
symptoms.

 Pain Relief: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help relieve pain and
reduce fever.

 Throat Lozenges and Sprays: Throat lozenges or numbing throat sprays may provide temporary relief from
throat pain.

 Humidifier: Using a humidifier in the room can add moisture to the air and soothe the irritated throat.
• Bacterial Tonsillitis (Strep Throat):
Antibiotics: If the tonsillitis is caused by bacteria, particularly Group A
Streptococcus, tonsillitis antibiotics such as penicillin or amoxicillin are commonly
prescribed. It is important to finish the full course of antibiotics, even if symptoms
improve before completion.
Pain Relief: Over-the-counter pain relievers can be used to manage pain and
reduce fever.
• Severe or Recurrent Cases:
Corticosteroids: In some cases, especially when tonsillitis is associated with
swelling, a short course of corticosteroids may be prescribed to reduce
inflammation.
Tonsillectomy: In cases of chronic or severe tonsillitis that do not respond well to
other treatments, a surgical procedure to remove tonsils known as tonsillectomy
 Tonsillitis Home Remedy
 Warm Salt Gargle: Gargling with lukewarm salt water can help
soothe a sore throat and reduce inflammation.
 Fluids and Soft Foods: Consuming warm liquids, such as tea, and
eating soft foods like soups, yogurt, and mashed potatoes can be
easier on the throat.
 Avoid Irritants: Avoiding irritants like tobacco smoke and strong
odors can prevent further irritation to the throat.
 Complete Rest: Resting the body allows the immune system to
effectively prevent throat infection.
 Prevention
Regular  Hydration
Handwashing  Avoid Smoking and
Avoid Touching Face Second hand Smoke
Cover Mouth and  Manage Allergies
Nose  Proper Dental Hygiene
Avoid Contact with  Regular Exercise
Sick Individuals  Prompt Treatment of Sore
Maintain a Balanced Throat.
Diet  Regular Medical Check-
Sufficient Sleep ups
Introduction
• Charles Bendham coined the term "bronchitis" which means
"inflammation of the bronchial membrane" in 1808 from the word:

• Bronchia, which means "the bronchial tubes"

Itis, which means "inflammation"

• Bronchitis medical term breakdown: broncho + itis

Definition

•Bronchitis is an inflammation of
the bronchi, the airways in the
lungs and is typically caused by
a virus, but it can also be caused
by bacteria or a fungus.
Prevalence
• Bronchitis statistics in India and world: Here are some statistics on bronchitis in India
and the world:

• Bronchitis prevalence in India

In India, the prevalence of chronic bronchitis (CB) among adults over 35 is 3.49%.
According to findings from a study on respiratory symptoms, asthma, and chronic
bronchitis this rate is lower for women at 2.7% and higher for men at 4.29%.

• Bronchitis prevalence worldwide

Globally, acute bronchitis is one of the top five reasons people seek medical attention.
Approximately 5% of adults are affected, while around 6% of children experience at least
one episode each year. In the general population, the prevalence of chronic bronchitis
ranges from 3.4% to 22.0%, but in individuals with COPD, it can exceed 74.1%.
bronchitis
Types of
Acute
bronchitis

Chronic
bronchitis
• Acute bronchitis
Acute bronchitis is a respiratory condition characterized by
inflammation and swelling of the bronchi (breathing tubes),
leading to increased mucus production and other changes.
It is a short-term condition that usually resolves on its own
within a few days or weeks, and lung function returns to
normal.

• Chronic bronchitis
Chronic bronchitis is characterized by inflammation and
swelling of the bronchi, a kind of
chronic obstructive pulmonary disease (COPD) condition
referred to as productive cough that lasts for at least 3
months or more, occurring within a span of 2 years which
is more serious than acute.
Acute bronchitis risk factors
• Smoking: Cigarette smoking or inhaling second-hand smoke (inhaling smoke
that is exhaled by smokers) can break down the body's defence against
infection. People who smoke are at a higher risk of developing acute bronchitis
and experiencing a longer duration that could lead to chronic bronchitis.
• Weakened immune system: Having a weakened immune system makes it
more difficult for the body to fight infections, raising the risk of bronchitis. Even
a common cold or illness can strain the immune system.
• Gastroesophageal Reflux Disease (GERD): GERD may increase the risk of
acute bronchitis by causing the stomach acids to backflow into the bronchial
tree or from windpipe to air sacs.
• Chronic respiratory conditions: Chronic conditions like asthma, COPD, and
bronchiectasis increase the risk of acute bronchitis in many ways due to
continuous inflammation and damage of airways, mucos production, and
decreased lung function making them more susceptible to infections and
inflammation, which can trigger bronchitis.
Chronic bronchitis risk factors
• Older age: A study shows that the majority of people with chronic
bronchitis start experiencing symptoms when they are at least 40 years
old. As age increases, lung function decrease, which means the lungs
become less effective at taking in air, even if they do not smoke or are not
exposed to any lung irritants.

• Family history of lung disease: A family history of chronic obstructive

pulmonary disease (COPD) also increases the risk of developing chronic
bronchitis. If someone in the family has lung problems, they might be at
high risk, especially if they are smokers.

• Female smoker: Women are more prone to the lung-damaging effects of

cigarettes than men; they are likely to experience COPD and decreased
lung function at an earlier age and or with lower levels of exposure.
 Health history and Chest X-rays
physical exam

Diagnosis

Pulmonary function tests Sputum and nasal

Blood tests discharge samples
 Treatment
• Encourage the child to rest and avoid strenuous
Rest activities.

• Encourage the child to drink plenty of fluids to

Fluids thin out mucus.

• Bronchodilators: To help open up the airways.

• Expectorants: To help loosen and clear mucus.
Medications • Antibiotics: If the bronchitis is caused by a bacterial
infection.

Oxygen therapy • If the child is experiencing severe respiratory

distress.
Complications

Chronic lung
disease:
Respiratory Repeated
failure: In episodes of
Pneumonia: severe cases, bronchitis can
Infection can the child may lead to
spread to the require chronic lung
lungs. mechanical disease.
ventilation.
 Good hygiene: Encourage the
Vaccinations: Ensure the child child to practice good hygiene,
is up-to-date on all such as washing hands
recommended vaccinations. regularly.

Prevention

Avoid exposure to pollutants: Breastfeeding: Breastfeeding

Avoid exposing the child to can help protect the child from
pollutants, such as tobacco respiratory infections.
smoke and dust.
Introduction

•Bronchiolitis is a common
chest infection that affects
babies and children under .
•It's usually mild and can be
treated at home, but it can
be serious.
• OTHERS

•
•ASTHMA
Definition
•Type 1 diabetes is a chronic (life-
long) autoimmune disease that
prevents your pancreas from
making insulin.
•Insulin is an
important hormone
that regulates the
amount of glucose
(sugar) in your
blood.
•Under normal
circumstances,
insulin functions in
the following steps:
 Insulin helps glucose in
Your body breaks down
Glucose enters your your blood enter your
the food you eat into
bloodstream, which muscle, fat and liver cells
glucose (sugar), which is
signals your pancreas to so they can use it for
your body’s main source
release insulin. energy or store it for later
of energy.
use.

If you don’t have enough

When glucose enters your insulin, too much sugar
cells and the levels in builds up in your blood,
serious health problems
your bloodstream causing
or even death if it’s not
decrease, it signals your hyperglycemia (high blood
sugar) treated.
pancreas to stop
producing insulin. , and your body can’t use
the food you eat for
energy.
 Risk Factors
• There are several risk factors for developing type 1 diabetes:
• Family History
• Family history of type 1 diabetes will increase the risk of a relative
developing it by 10 times
• A child’s risk of inheriting type 1 diabetes from their affected parent
can vary between 1% and 9%
• Family history of other autoimmune diseases (hypothyroidism,
pernicious anemia, celiac disease, etc) will increase the risk of
developing type 1 diabetes
• Environmental Factors
• In genetically susceptible individuals, some environmental factors
can trigger the development of type 1 diabetes
• Obesity
• Poorly-diverse gut microbiome
• Diet
• Breastfeeding is possibly associated with a lower risk of
the infant developing type 1 diabetes
• Early introduction of cow’s milk to an infant’s diet is
possibility associated with a higher risk of developing
type 1 diabetes
• Early introduction of cereal (prior to 3 months of age) is
possibility associated with a higher risk of developing
type 1 diabetes
• Lack of vitamin D exposure
• Regular doses of vitamin D early in life have been shown
to decrease the risk of developing type 1 diabetes
• People in northern climates seem to be at higher risk of
developing type 1 diabetes than in southern climates
• Diagnosis rate of type 1 diabetes is also higher in winter
months and lower in summer months
Excessive thirst. Frequent urination, including Excessive hunger. Unexplained weight loss.
frequent full diapers in infants
and bedwetting in children.

Fatigue. Blurred vision. Slow healing of cuts and sores. Vaginal yeast infections.
Fruity-smelling breath

Nausea and vomiting.

Abdominal (stomach) pain

Rapid breathing

Confusion

Drowsiness

Loss of consciousness
 diagnostic evaluation of juvenile diabetes

Fasting
Oral Glucose Glycated
Plasma
Tolerance Test Hemoglobin
Glucose (FPG)
(OGTT) (HbA1c) Test
Test

Random Islet Cell

Plasma C-peptide Test Antibody (ICA)
Glucose Test Test
Definition

•Hypothyroidism is a condition in
which the thyroid gland, located in
the front of the neck, does not
produce enough thyroid hormones,
which control overall metabolism and
many bodily functions.
 Primary causes

• Hashimoto’s thyroiditis
Auto immune
disease

• Treatment with Iodine-131

Radiation • Surgical removal of the thyroid gland
• External irradiation of the neck for
treatment lymphoma or cancer
 • Drugs that suppress serum TSH levels
• Drugs that alter thyroid hormone secretion

Drugs
• Drugs that alter t3 and t4 metabolism
• Drugs that reduce T4 and T3 binding
• Drugs that Increase thyroglobulin levels

• Absent or ectopic thyroid gland

Congenital
• dyshormonogenesis (hereditary defects in the steps of thyroid
hormone synthesis and secretion)
• TSH-R mutation Iodine deficiency
hypothyroidism

• Amyloidosis

Infiltrative
• Sarcoidosis
• Hemochromatosis
• Scleroderma
disorders •
•
Cystinosis
Riedel’s thyroiditis
 Isolated TSH
Hypopituitarism deficiency

Secondary
causes

Bexarotene Hypothalamic
treatment disease
Transient causes

Postpartum thyroiditis (Hypothyroidism in pregnancy)

Subacute thyroiditis

Thyroidectomy
 Thyroid-
stimulating
Medical and hormone (TSH)
family history

Total Thyroxine
(T4)
Physical
examination
Diagnosis
Free Thyroxine
(T4)

Blood tests Total

Triiodothyronin
e (T3)

Free Thyroxine
Index

Thyroid
antibody test
 How to self-diagnose
hypothyroidism?
It can be done in 3 simple steps:
• Step 1: Have the patient stand in front of the
mirror with their head back. The patient should
make sure that their throat area (between the
collar bone and Adams apple) is clearly visible
in the mirror.
• Step 2: Pour some water in a glass.
• Step 3: The patient should drink some water
and examine their throat (with their head back).
Treatment

Thyroid hormone
replacement
therapy

Pure synthetic
thyroxine