Complications of pregnancy: thyroid storm: practice question

A OBG 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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OBG · Complications of pregnancy: thyroid storm

Sample item

Which antithyroid drug is preferred in the first trimester for Graves disease?

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

The answer and the reasoning

C. Propylthiouracil

Propylthiouracil is preferred in the first trimester because methimazole and carbimazole are linked to aplasia cutis and choanal atresia. After the first trimester many switch to methimazole to avoid PTU hepatotoxicity. Radioactive iodine is contraindicated.

Option by option

  • A. Methimazole

    Methimazole is teratogenic during the first trimester.

  • B. Radioactive iodine

    Radioactive iodine destroys fetal thyroid and is contraindicated.

  • C. Propylthiouracil (correct)

    Correct. PTU is preferred during organogenesis.

  • D. Potassium iodide in high dose for the entire pregnancy

    Prolonged high-dose iodide causes fetal goitre and hypothyroidism.

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 OBG question

What is the answer to this OBG question?

The best answer is C, Propylthiouracil. Propylthiouracil is preferred in the first trimester because methimazole and carbimazole are linked to aplasia cutis and choanal atresia.

Why is "Methimazole" not the answer?

Methimazole is teratogenic during the first trimester.

Why is "Radioactive iodine" not the answer?

Radioactive iodine destroys fetal thyroid and is contraindicated.

Why is "Potassium iodide in high dose for the entire pregnancy" not the answer?

Prolonged high-dose iodide causes fetal goitre and hypothyroidism.

What concept does this question test?

It tests Complications of pregnancy: thyroid storm in OBG. After the first trimester many switch to methimazole to avoid PTU hepatotoxicity. Radioactive iodine is contraindicated.

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 Complications of pregnancy: thyroid storm?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG 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.