Complications and emergencies: thyroid storm: practice question

A Anaesthesia 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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Anaesthesia · Complications and emergencies: thyroid storm

Sample item

A patient develops fever of 40 C, heart rate 160 and agitation on the first day after thyroidectomy for Graves disease. Which drug should be avoided?

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

The answer and the reasoning

D. Aspirin

Aspirin displaces thyroid hormone from binding proteins and raises free hormone levels, so paracetamol is preferred for fever. Propranolol, propylthiouracil, hydrocortisone and cooling are the standard treatment.

Option by option

  • A. Hydrocortisone

    Hydrocortisone reduces conversion and supports the adrenal axis.

  • B. Propylthiouracil

    Propylthiouracil inhibits synthesis and peripheral conversion.

  • C. Propranolol

    Propranolol controls the adrenergic effects and blocks T4 conversion.

  • D. Aspirin (correct)

    Correct. Aspirin raises free thyroxine and worsens the storm.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Aspirin. Aspirin displaces thyroid hormone from binding proteins and raises free hormone levels, so paracetamol is preferred for fever.

Why is "Hydrocortisone" not the answer?

Hydrocortisone reduces conversion and supports the adrenal axis.

Why is "Propylthiouracil" not the answer?

Propylthiouracil inhibits synthesis and peripheral conversion.

Why is "Propranolol" not the answer?

Propranolol controls the adrenergic effects and blocks T4 conversion.

What concept does this question test?

It tests Complications and emergencies: thyroid storm in Anaesthesia. Propranolol, propylthiouracil, hydrocortisone and cooling are the standard treatment.

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 and emergencies: thyroid storm?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.