<prompt> Which one of the following features may not be seen in hypothyroidism?Cold intoleranceDeafnessPericardial effusionPretibial myxedema  <response>: D Pretibial myxoedema Blood flow is diverted from the skin, producing the cool extremities.cold intolerance is seen. Pericardial effusions occur in up to 30 of patients but rarely compromise cardiac function. Increased dermal glycosaminoglycan content traps water, giving rise to skin thickening without pitting myxedema. Typical features include a puffy face with edematous eyelids and nonpitting pretibial edema. Impaired hearing is present, but not deafness.SIGNS AND SYMPTOMS OF HYPOTHYROIDISM DESCENDING ORDER OF FREQUENCYSymptomsSigns Tiredness, weakness Dry skin Feeling cold Hair loss Difficulty concentrating and poor memory Constipation Weight gain with poor appetite Dyspnea Hoarse voice Menorrhagia later oligomenorrhea or amenorrhea Paresthesia Impaired hearing Dry coarse skin; cool peripheral extremities Puffy face, hands, and feet myxedema Diffuse alopecia Bradycardia Peripheral edema Delayed tendon reflex relaxation Carpal tunnel syndrome Serous cavity effusions 