Systemic paediatrics: Hashimoto thyroiditis: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: Hashimoto thyroiditis

Sample item

A 12-year-old girl has fatigue, constipation, weight gain and slowing of growth. She has a firm, diffuse, non-tender goitre. TSH is high and free T4 is low. Which antibody is most likely positive?

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

The answer and the reasoning

C. Anti-thyroid peroxidase antibody

Chronic lymphocytic (Hashimoto) thyroiditis is the commonest cause of acquired hypothyroidism and goitre in children. Anti-thyroid peroxidase and antithyroglobulin antibodies are positive. Levothyroxine is the treatment.

Option by option

  • A. TSH receptor stimulating antibody

    TSH receptor stimulating antibodies cause Graves disease with hyperthyroidism.

  • B. Anti-21-hydroxylase antibody

    Anti-21-hydroxylase antibodies are found in autoimmune adrenal insufficiency.

  • C. Anti-thyroid peroxidase antibody (correct)

    Correct. Anti-thyroid peroxidase antibodies mark autoimmune thyroiditis.

  • D. Anti-glutamic acid decarboxylase antibody

    Anti-GAD antibodies are found in type 1 diabetes.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Anti-thyroid peroxidase antibody. Chronic lymphocytic (Hashimoto) thyroiditis is the commonest cause of acquired hypothyroidism and goitre in children.

Why is "TSH receptor stimulating antibody" not the answer?

TSH receptor stimulating antibodies cause Graves disease with hyperthyroidism.

Why is "Anti-21-hydroxylase antibody" not the answer?

Anti-21-hydroxylase antibodies are found in autoimmune adrenal insufficiency.

Why is "Anti-glutamic acid decarboxylase antibody" not the answer?

Anti-GAD antibodies are found in type 1 diabetes.

What concept does this question test?

It tests Systemic paediatrics: Hashimoto thyroiditis in Pediatrics. Anti-thyroid peroxidase and antithyroglobulin antibodies are positive. Levothyroxine is the treatment.

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 Systemic paediatrics: Hashimoto thyroiditis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.