Head and neck tumours: subacute thyroiditis: practice question

A ENT 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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ENT · Head and neck tumours: subacute thyroiditis

Sample item

A 40-year-old woman has severe anterior neck pain radiating to the ear after a viral illness, with a tender firm thyroid, raised ESR and low radioiodine uptake. What is the initial treatment?

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

The answer and the reasoning

A. NSAIDs, with a short steroid course if severe, and beta-blocker for symptoms

Subacute (de Quervain) granulomatous thyroiditis is self-limiting. Pain is treated with NSAIDs or a short course of prednisolone, and a beta-blocker covers thyrotoxic symptoms. Antithyroid drugs do not help because the thyrotoxicosis is from leakage of stored hormone.

Option by option

  • A. NSAIDs, with a short steroid course if severe, and beta-blocker for symptoms (correct)

    Correct. Treatment is supportive with anti-inflammatory drugs and a beta-blocker, as the disease resolves spontaneously.

  • B. Carbimazole for six months

    Carbimazole blocks synthesis, but here hormone leaks from damaged follicles, so it is ineffective.

  • C. Radioiodine ablation

    Radioiodine is useless since uptake is low and the disease resolves by itself.

  • D. Total thyroidectomy

    Thyroidectomy is not indicated for a self-limiting inflammatory condition.

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 ENT question

What is the answer to this ENT question?

The best answer is A, NSAIDs, with a short steroid course if severe, and beta-blocker for symptoms. Subacute (de Quervain) granulomatous thyroiditis is self-limiting.

Why is "Carbimazole for six months" not the answer?

Carbimazole blocks synthesis, but here hormone leaks from damaged follicles, so it is ineffective.

Why is "Radioiodine ablation" not the answer?

Radioiodine is useless since uptake is low and the disease resolves by itself.

Why is "Total thyroidectomy" not the answer?

Thyroidectomy is not indicated for a self-limiting inflammatory condition.

What concept does this question test?

It tests Head and neck tumours: subacute thyroiditis in ENT. Pain is treated with NSAIDs or a short course of prednisolone, and a beta-blocker covers thyrotoxic symptoms. Antithyroid drugs do not help because the thyrotoxicosis is from leakage of stored hormone.

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 Head and neck tumours: subacute thyroiditis?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.