Endocrinology and diabetes: amiodarone-induced thyrotoxicosis: 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: amiodarone-induced thyrotoxicosis

Sample item

A 64-year-old man on long-term amiodarone develops weight loss and palpitations. TSH is suppressed with raised free T4, radioiodine uptake is very low, colour Doppler flow is reduced and there is no goitre. Which treatment is most appropriate?

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

The answer and the reasoning

B. Oral prednisolone

Destructive thyroiditis from amiodarone releases preformed hormone, with low uptake and reduced vascularity. It responds to glucocorticoids, whereas hormone synthesis blockers do not help because synthesis is not the problem. Radioiodine is ineffective when uptake is low.

Option by option

  • A. Radioactive iodine ablation

    Radioiodine cannot work when uptake is almost absent.

  • B. Oral prednisolone (correct)

    Correct. Glucocorticoids suppress the destructive inflammatory process.

  • C. Urgent total thyroidectomy

    Surgery is reserved for refractory cases and is not first-line.

  • D. Carbimazole alone

    Thionamides block synthesis, which is not the source of the hormone excess here.

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 B, Oral prednisolone. Destructive thyroiditis from amiodarone releases preformed hormone, with low uptake and reduced vascularity.

Why is "Radioactive iodine ablation" not the answer?

Radioiodine cannot work when uptake is almost absent.

Why is "Urgent total thyroidectomy" not the answer?

Surgery is reserved for refractory cases and is not first-line.

Why is "Carbimazole alone" not the answer?

Thionamides block synthesis, which is not the source of the hormone excess here.

What concept does this question test?

It tests Endocrinology and diabetes: amiodarone-induced thyrotoxicosis in General Medicine. It responds to glucocorticoids, whereas hormone synthesis blockers do not help because synthesis is not the problem. Radioiodine is ineffective when uptake is low.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: amiodarone-induced thyrotoxicosis?

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.