Thyroid: thyroid storm: practice question

A General Surgery 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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General Surgery · Thyroid: thyroid storm

Sample item

A thyrotoxic patient develops fever of 40 C, agitation, tachycardia and vomiting after emergency surgery. Which treatment sequence is correct?

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

The answer and the reasoning

D. Beta blocker, thionamide (propylthiouracil), then iodine at least one hour later, plus steroids and cooling

Thyroid storm is a life-threatening hypermetabolic state treated with propranolol, a thionamide to block new synthesis, and iodine to block release about an hour after the thionamide. Hydrocortisone reduces peripheral T4 to T3 conversion, and supportive care includes cooling and fluids. Giving iodine first can provide substrate for more hormone synthesis.

Option by option

  • A. Radioiodine immediately

    Radioiodine acts too slowly for storm.

  • B. Surgery for all cases

    Surgery is not an acute treatment.

  • C. Iodine first, then antithyroid drug the next day

    Iodine given first may fuel hormone synthesis.

  • D. Beta blocker, thionamide (propylthiouracil), then iodine at least one hour later, plus steroids and cooling (correct)

    Correct. Block synthesis before blocking release.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Beta blocker, thionamide (propylthiouracil), then iodine at least one hour later, plus steroids and cooling. Thyroid storm is a life-threatening hypermetabolic state treated with propranolol, a thionamide to block new synthesis, and iodine to block release about an hour after the thionamide.

Why is "Radioiodine immediately" not the answer?

Radioiodine acts too slowly for storm.

Why is "Surgery for all cases" not the answer?

Surgery is not an acute treatment.

Why is "Iodine first, then antithyroid drug the next day" not the answer?

Iodine given first may fuel hormone synthesis.

What concept does this question test?

It tests Thyroid: thyroid storm in General Surgery. Hydrocortisone reduces peripheral T4 to T3 conversion, and supportive care includes cooling and fluids. Giving iodine first can provide substrate for more hormone synthesis.

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 Thyroid: thyroid storm?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.