Manifestations of endemic cretinism include-

Ans. is 'c' i.e., Strabismus & Spastic deplegia Cretinism o Cretinism is a condition of severely stunted physical and mental growth due to untreated congenital hypothyroidism or from prolonged nutritional deficiency of iodine. o When cretinism is due to nutritional deficiency of iodine it is referred to as endemic cretinism. o When critinism is due to congenital hypothyroidism it is called sporadic cretinism. Endemic cretinism The term endemic cretinism includes two different overlapping syndromes. Neurologic syndrome Myxedematous syndrome Neurological Myxedematous Thyroid gland Enlarged (goitre) Normal in size Hormonal status Euthyroid Hypothyroid (I T4, T TSH) Mental R. Present, severe Present but less severe Deaf Mutism Usually present Absent Cerebral Diplegia Often present Absent Squint Present Stature Usually Normal Severe growth retardation General features No physical sign Physical signs present of hypothyroidism eg. Coarse dry skin, husky voice Reflexes Brisk Delayed relaxation ECG Normal Small voltage QRS X - ray Normal Epiphyseal dysgenesis Effects of Thyroid No effect Improvement Hormone substitution Note : Dearness occurs hut facial N. involvement is not seen usually.