Endocrinology and diabetes: postpartum thyroiditis: 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 and diabetes: postpartum thyroiditis

Sample item

Three months after delivery, a woman has palpitations, weight loss and a small painless goitre. TSH is suppressed, free T4 is raised, radioiodine uptake is low and anti-TPO antibodies are positive. What is the most appropriate management?

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

The answer and the reasoning

A. Propranolol for symptoms with observation

Postpartum thyroiditis is an autoimmune destructive thyroiditis with a thyrotoxic phase followed by possible hypothyroidism and then usually recovery. Because thyroid hormone synthesis is not increased, antithyroid drugs do not help in the thyrotoxic phase. A beta blocker controls symptoms, and thyroid tests should be monitored.

Option by option

  • A. Propranolol for symptoms with observation (correct)

    Correct. The thyrotoxic phase is self-limiting, and beta blockade relieves the symptoms.

  • B. Carbimazole for a full 18-month course

    Carbimazole blocks synthesis, which is not raised, so it is unhelpful.

  • C. Total thyroidectomy as definitive surgery

    Surgery is unnecessary for a transient condition.

  • D. Radioiodine ablation of the gland

    Radioiodine is ineffective with a low uptake and is avoided in a woman who may be breastfeeding.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Propranolol for symptoms with observation. Postpartum thyroiditis is an autoimmune destructive thyroiditis with a thyrotoxic phase followed by possible hypothyroidism and then usually recovery.

Why is "Carbimazole for a full 18-month course" not the answer?

Carbimazole blocks synthesis, which is not raised, so it is unhelpful.

Why is "Total thyroidectomy as definitive surgery" not the answer?

Surgery is unnecessary for a transient condition.

Why is "Radioiodine ablation of the gland" not the answer?

Radioiodine is ineffective with a low uptake and is avoided in a woman who may be breastfeeding.

What concept does this question test?

It tests Endocrinology and diabetes: postpartum thyroiditis in General Medicine. Because thyroid hormone synthesis is not increased, antithyroid drugs do not help in the thyrotoxic phase. A beta blocker controls symptoms, and thyroid tests should be monitored.

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 and diabetes: postpartum thyroiditis?

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.