Endocrinology: subacute thyroiditis: practice question

A Physiology 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.

Try it

Physiology · Endocrinology: subacute thyroiditis

Sample item

A woman has fever, a tender thyroid and palpitations two weeks after a viral illness. Free T4 is raised, TSH is suppressed and the ESR is high, but thyroid radioiodine uptake is very low. What explains the low uptake?

AExcess dietary iodide permanently blocks the sodium-iodide symporterBAutonomous nodules take up all of the tracer from the bloodCStimulating antibodies drive iodine uptake into the whole glandDDamaged follicles leak hormone and suppressed TSH limits trapping

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

The answer and the reasoning

D. Damaged follicles leak hormone and suppressed TSH limits trapping

In subacute thyroiditis, follicular injury releases preformed hormone, which suppresses TSH. Without TSH, the remaining tissue traps little iodide, so uptake is low. In Graves disease, uptake is high.

Option by option

A. Excess dietary iodide permanently blocks the sodium-iodide symporter
The picture follows a viral illness with a tender gland; it is not an iodide excess effect.
B. Autonomous nodules take up all of the tracer from the blood
Autonomous nodules would give focal high uptake and not a painful gland with a raised ESR.
C. Stimulating antibodies drive iodine uptake into the whole gland
Stimulating antibodies cause high uptake, as in Graves disease.
D. Damaged follicles leak hormone and suppressed TSH limits trapping (correct)
Correct. Hormone leakage causes thyrotoxicosis while TSH suppression and tissue damage lower tracer uptake.

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.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is D, Damaged follicles leak hormone and suppressed TSH limits trapping. In subacute thyroiditis, follicular injury releases preformed hormone, which suppresses TSH.

Why is "Excess dietary iodide permanently blocks the sodium-iodide symporter" not the answer?

The picture follows a viral illness with a tender gland; it is not an iodide excess effect.

Why is "Autonomous nodules take up all of the tracer from the blood" not the answer?

Autonomous nodules would give focal high uptake and not a painful gland with a raised ESR.

Why is "Stimulating antibodies drive iodine uptake into the whole gland" not the answer?

Stimulating antibodies cause high uptake, as in Graves disease.

What concept does this question test?

It tests Endocrinology: subacute thyroiditis in Physiology. Without TSH, the remaining tissue traps little iodide, so uptake is low. In Graves disease, uptake is high.

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: subacute thyroiditis?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.