Endocrinology: Graves disease in a child: 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 · Endocrinology: Graves disease in a child

Sample item

A 12-year-old has weight loss, tremor, goitre and exophthalmos with suppressed TSH and high free T4. What is the first-line therapy?

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

The answer and the reasoning

A. Carbimazole or methimazole

Graves disease in children is initially treated with antithyroid drugs for 2 or more years, with propranolol for symptoms. Radioiodine or surgery is considered for relapse. Propylthiouracil is avoided because of hepatotoxicity.

Option by option

  • A. Carbimazole or methimazole (correct)

    Correct. Thionamides are first line.

  • B. Radioiodine as first choice

    Radioiodine is generally avoided in young children.

  • C. Levothyroxine

    Levothyroxine would worsen thyrotoxicosis.

  • D. Total thyroidectomy upfront

    Surgery is reserved for failure of medical therapy.

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 A, Carbimazole or methimazole. Graves disease in children is initially treated with antithyroid drugs for 2 or more years, with propranolol for symptoms.

Why is "Radioiodine as first choice" not the answer?

Radioiodine is generally avoided in young children.

Why is "Levothyroxine" not the answer?

Levothyroxine would worsen thyrotoxicosis.

Why is "Total thyroidectomy upfront" not the answer?

Surgery is reserved for failure of medical therapy.

What concept does this question test?

It tests Endocrinology: Graves disease in a child in Pediatrics. Radioiodine or surgery is considered for relapse. Propylthiouracil is avoided because of hepatotoxicity.

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 Endocrinology: Graves disease in a child?

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.