Endocrine drugs: radioiodine and Graves ophthalmopathy: practice question

A Pharmacology 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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Pharmacology · Endocrine drugs: radioiodine and Graves ophthalmopathy

Sample item

A 40-year-old smoker with active Graves disease and moderate thyroid eye disease is planned for radioiodine. What measure reduces the risk of worsening of the eye disease?

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

The answer and the reasoning

B. Oral glucocorticoid cover around the radioiodine dose

Radioiodine can worsen thyroid eye disease, particularly in smokers with active disease, and a course of prednisolone given around the dose lowers this risk. Stopping smoking and restoring euthyroidism are also important.

Option by option

  • A. Starting high-dose potassium iodide after treatment

    Iodide does not protect against orbitopathy and would compete with radioiodine uptake.

  • B. Oral glucocorticoid cover around the radioiodine dose (correct)

    Correct. Steroid cover reduces the chance of orbitopathy worsening after radioiodine.

  • C. Giving radioiodine without any antithyroid drug

    Omitting antithyroid drugs does not protect the eyes.

  • D. Stopping levothyroxine replacement for six months

    He is not on levothyroxine, and stopping it is not a protective measure.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Oral glucocorticoid cover around the radioiodine dose. Radioiodine can worsen thyroid eye disease, particularly in smokers with active disease, and a course of prednisolone given around the dose lowers this risk.

Why is "Starting high-dose potassium iodide after treatment" not the answer?

Iodide does not protect against orbitopathy and would compete with radioiodine uptake.

Why is "Giving radioiodine without any antithyroid drug" not the answer?

Omitting antithyroid drugs does not protect the eyes.

Why is "Stopping levothyroxine replacement for six months" not the answer?

He is not on levothyroxine, and stopping it is not a protective measure.

What concept does this question test?

It tests Endocrine drugs: radioiodine and Graves ophthalmopathy in Pharmacology. Stopping smoking and restoring euthyroidism are also important.

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 Endocrine drugs: radioiodine and Graves ophthalmopathy?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.