yotsubatoI think that this question is phrased atrociously,
Just like the rest of the NBME+32019-06-12T11:16:54Z
b1ackcoffeeexactly how does maternal hashimoto can cause cretinism?+2020-02-13T19:09:56Z
neonemI don't understand the last part of this question stem though... if the mother's TSH *increases* during pregnancy? Wouldn't this further increase her (and/or the fetus's) production of T4 and thus counteract the hypothyroidism?+2019-05-29T00:58:23Z
poojaym@neonem no. Autoimmune hypothyroidism is a destruction of the thyroid gland, and a decrease in production of T3/T4.
An increase in TSH means that there is not enough T3/T4 to inhibit TRH, and so TSH is being released to stimulate the thyroid gland.+62019-06-03T19:37:52Z
arezprTSH, T3, T4 and thyroglobulin cannot cross the placental barrier. +2019-06-05T01:30:39Z
chamaleo@arezpr although those hormones can't cross, the autoantibodies from Hashimoto's can+2019-06-06T02:18:35Z
yotsubatoThe baby has its own TSH though +2019-06-12T11:16:01Z
sbryant6TSH comes from the pituitary, and act on the thyroid. Autoantibodies attack the thyroid, so TSH doesn't work.+2019-06-30T03:18:41Z
thotaakAccording to Robbins pathology+12019-09-14T05:12:45Z
aesalmonI agree, the article you linked states "signs of fetal hyperthyroidism such as tachycardia, intrauterine growth retardation, cardiac failure, and the development of fetal goitre"
I chose answer E during the exam - "Thyroid gland enlargement"
Still trying to understand how they linked cretinism to a case where the mother's hypothyroidism was well controlled, and then asked for the sequelae if her TSH increased. Maybe increased TSH is supposed to indicate worsening hypothyroid - low T3/T4 needing to be stimulated by TSH?+2019-05-29T19:39:29Z