This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'A one year old child preents with short stature, lethargy, & constipation. Clinical examinaton shows a palpable goiter. Laboratory investigations revealed a low T4 and elevated TSH which of the following is the most likely diagnosis. \nSelect and explain. \nA. Thyroid Dyshormonogenesis, B. Thyroid Dysgenesis, C. Central Hypothyroidism, D. TSH Receptor Blocking Antibody', 'role': 'user'}, {'content': 'Answer: A \nExplanation: This child has :-\n\n\nThyroid swelling\nLow T4 & High TSH\nAbnormal weight gain and poor activities\n\n\nAll these suggests the diagnosis of congenital hypothyroidism due to thyroid disorder (In hypothalamic diseases,TSH levels will be low).\nThe most common cause of non - endemic congenital hypothyroidism is thyroid dysgenesis.\n\n\nIn endemic regions :- Most common cause of congenital hypothyroidism is iodine deficiency in intrauterine and neonatal period (world wide).\nIn non-endemic regions :- Most common cause of congenital hypothyroidism is thyroid dysgenesis.\n\n\nHowever, in thyroid dysgenesis, thyroid gland does not enlarge to produce palpable goitre. So, this option is excluded.\nDyshormogensis is an uncommon cause of congenital goitrous hypothyroidism and account only about 10-15% of cases of congenital hypothyroidism. It results from a deficiency of one or more enzymes (most commonly, thyroid peroxidase) involved in thyroid hormone synthesis or secretion.', 'role': 'assistant'}]