Which manifestation is associated with hypothyroidism?

Choice A reason: Warm skin indicates adequate blood flow and perfusion, often seen in normal or hyperemic states. Poor perfusion, due to reduced blood flow, typically causes cool skin as less warm blood reaches tissues, making this choice incorrect for poor perfusion.

Choice B reason: Pink nailbeds reflect good oxygenation and perfusion, as hemoglobin carries oxygen effectively to capillaries. Poor perfusion leads to pale or cyanotic nailbeds due to reduced blood flow or oxygen delivery, making this choice incorrect for indicating poor perfusion.

Choice C reason: Strong pulses indicate robust blood flow and adequate perfusion, as the heart pumps blood effectively to peripheral tissues. Poor perfusion is associated with weak or thready pulses due to low cardiac output, making this choice incorrect.

Choice D reason: Pale lips indicate poor perfusion, as reduced blood flow to peripheral tissues results in less hemoglobin delivering oxygen, causing pallor. This is a classic sign of hypoperfusion, often seen in shock or circulatory compromise, making this the correct choice.

Choice A reason: Heart failure is a consequence of CAD, not a cause. It results from impaired cardiac function, often due to ischemia from CAD, but does not directly contribute to coronary artery plaque formation, making this incorrect.

Choice B reason: Pneumonia affects the lungs, causing infection and inflammation, not coronary arteries. It may increase cardiac demand, but it does not cause atherosclerosis or CAD, making this choice incorrect for CAD development.

Choice C reason: Low blood pressure does not cause CAD; it may result from cardiac issues. CAD is driven by atherosclerosis from risk factors like diabetes, not hypotension, making this choice incorrect for causing CAD.

Choice D reason: Diabetes causes CAD by promoting atherosclerosis through hyperglycemia, which damages endothelial cells, increases inflammation, and accelerates plaque formation in coronary arteries. This is a major risk factor, making this the correct choice.