Features of hypothyroidism except?

PGIMER NO - 2020

Medical & Surgical Nursing

Easy

Appeared in: PGIMER NO - 2020

Explanation

Tetany is characterized by muscle spasms, cramps, and neuromuscular irritability.
This condition is a hallmark sign of hypocalcemia (low blood calcium).
Hypocalcemia is primarily caused by hypoparathyroidism (deficient parathyroid hormone), not hypothyroidism (deficient thyroid hormone).
Therefore, tetany is not a direct feature of hypothyroidism and is the correct exception.

Option B: Muscle weakness is a common symptom of hypothyroidism due to a generalized decrease in the body's metabolic rate, which affects muscle energy and function.
Option C: Weight gain is a classic feature of hypothyroidism. The slowed metabolic rate leads to reduced calorie expenditure and fluid retention (myxedema), contributing to an increase in weight.
Option D: Constipation is a very common gastrointestinal symptom of hypothyroidism. The decreased metabolic rate slows down peristalsis and overall gut motility.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differentiating the clinical manifestations of hypothyroidism from other endocrine disorders as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to differentiate symptoms. Recognizing that tetany is not a sign of hypothyroidism but of potential hypocalcemia is critical, especially in post-thyroidectomy patients where parathyroid glands may have been inadvertently damaged.
Post-thyroidectomy, a nurse must monitor for signs of both hypothyroidism (if replacement therapy is inadequate) and hypocalcemia (tetany, Chvostek's/Trousseau's signs).
What if? If a patient who recently had thyroid surgery develops tingling in their fingers and muscle cramps (tetany), the nurse's priority action is not to adjust thyroid medication but to notify the provider immediately and anticipate orders for an urgent serum calcium level check and possible IV calcium gluconate administration.

How to Approach the Question

First, identify the keyword 'EXCEPT' in the question. This means you are looking for the option that is NOT a feature of hypothyroidism.
Recall the primary function of the thyroid gland: to regulate metabolism. A deficiency (hypo-) means a slowed metabolism.
Think through the consequences of a slowed metabolism: decreased energy (fatigue, muscle weakness), slower GI function (constipation), and reduced calorie burning (weight gain).
Evaluate each option: 'Muscle weakness,' 'Weight gain,' and 'Constipation' are all consistent with a slowed metabolism.
Consider the remaining option, 'Tetany.' Recall or deduce that tetany relates to muscle spasms and is caused by electrolyte imbalances, specifically low calcium, which is regulated by the parathyroid glands, not the thyroid gland.
Conclude that tetany is the correct exception.

Concept Tested & Keywords

Concept Tested: Differentiating the clinical manifestations of hypothyroidism from other endocrine disorders.
Stem keywords: hypothyroidism, features
Lead-in keywords: except
Negative lead-in flag: Question asks for the exception

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