Breast and endocrine surgery: Graves orbitopathy and radioiodine: practice question

A General Surgery 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 Surgery · Breast and endocrine surgery: Graves orbitopathy and radioiodine

Sample item

A 35-year-old smoker with Graves disease has active moderate thyroid eye disease. Which definitive treatment is most likely to worsen the eye disease unless steroid cover is given?

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

The answer and the reasoning

A. Radioactive iodine

Radioiodine can precipitate or worsen Graves orbitopathy, particularly in smokers and in patients with active eye disease, so prophylactic prednisolone is given or another modality chosen. Smoking cessation is advised. Surgery does not exacerbate orbitopathy.

Option by option

  • A. Radioactive iodine (correct)

    Correct. Radioiodine is associated with progression of orbitopathy, especially in smokers.

  • B. Total thyroidectomy

    Thyroidectomy removes the antigen source and does not aggravate eye disease.

  • C. Carbimazole

    Carbimazole controls hormone levels without worsening the eyes.

  • D. Propranolol

    Propranolol gives symptomatic relief and does not affect the orbitopathy.

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 Surgery question

What is the answer to this General Surgery question?

The best answer is A, Radioactive iodine. Radioiodine can precipitate or worsen Graves orbitopathy, particularly in smokers and in patients with active eye disease, so prophylactic prednisolone is given or another modality chosen.

Why is "Total thyroidectomy" not the answer?

Thyroidectomy removes the antigen source and does not aggravate eye disease.

Why is "Carbimazole" not the answer?

Carbimazole controls hormone levels without worsening the eyes.

Why is "Propranolol" not the answer?

Propranolol gives symptomatic relief and does not affect the orbitopathy.

What concept does this question test?

It tests Breast and endocrine surgery: Graves orbitopathy and radioiodine in General Surgery. Smoking cessation is advised. Surgery does not exacerbate orbitopathy.

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 Breast and endocrine surgery: Graves orbitopathy and radioiodine?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.