Endocrinology: subclinical hypothyroidism: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Endocrinology: subclinical hypothyroidism

Sample item

A non-pregnant adult has TSH of 12 mU/L with normal free T4, repeated twice. What is the recommendation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Start levothyroxine because TSH exceeds 10 mU/L

Subclinical hypothyroidism is raised TSH with normal free T4. Treatment is usually given when TSH is persistently above 10 mU/L, or at lower levels in pregnancy, infertility, positive anti-TPO antibodies with symptoms or goitre. Antithyroid drugs treat hyperthyroidism.

Option by option

  • A. Give radioiodine

    Radioiodine causes hypothyroidism.

  • B. Observe indefinitely

    Observation is for mild elevation.

  • C. Start levothyroxine because TSH exceeds 10 mU/L (correct)

    Correct. TSH above 10 warrants treatment.

  • D. Start carbimazole

    Carbimazole worsens hypothyroidism.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Start levothyroxine because TSH exceeds 10 mU/L. Subclinical hypothyroidism is raised TSH with normal free T4.

Why is "Give radioiodine" not the answer?

Radioiodine causes hypothyroidism.

Why is "Observe indefinitely" not the answer?

Observation is for mild elevation.

Why is "Start carbimazole" not the answer?

Carbimazole worsens hypothyroidism.

What concept does this question test?

It tests Endocrinology: subclinical hypothyroidism in General Medicine. Treatment is usually given when TSH is persistently above 10 mU/L, or at lower levels in pregnancy, infertility, positive anti-TPO antibodies with symptoms or goitre. Antithyroid drugs treat hyperthyroidism.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrinology: subclinical hypothyroidism?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.