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Review of Clinical Signs Review Questions

Woltman’s Sign of Hypothyroidism

Author: Mark A. Marinella, MD

1. Woltman’s sign is best defined as which of the following?

  1. A rapid relaxation phase of a deep tendon reflex
  2. A delayed relaxation phase of a deep tendon reflex
  3. Failure to elicit a deep tendon reflex
  4. Uncontrollable myoclonus after tapping the patellar tendon
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2. Which of the following may be observed in patients with untreated hypothyroidism?

  1. Constipation
  2. Heat intolerance
  3. Hot, sweaty skin
  4. Tachycardia
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3. Which one of the following statements regarding prolongation of the relaxation phase of a deep tendon reflex in hypothyroid patients is correct?

  1. The diagnostic utility is 10%
  2. The relaxation half-time is typically 10 milliseconds
  3. The degree of relaxation prolongation is proportional to the severity of hypothyroidism
  4. The phase is markedly prolonged in patients with subclinical hypothyroidism
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4. In addition to hypothyroidism, the differential diagnosis of a prolonged reflex relaxation time includes:

  1. Anorexia nervosa
  2. Hypercalcemia
  3. Hyperthermia
  4. Toxic multinodular goiter
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