Endocrinology and metabolism: recognition: practice question

A General Medicine 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 Medicine · Endocrinology and metabolism: recognition

Sample item

A 40-year-old woman has painful, tender thyroid swelling radiating to the jaw one week after an upper respiratory infection. She has fever, ESR of 80 mm/hr, raised T4 and low radioiodine uptake. What is the diagnosis?

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

The answer and the reasoning

A. Subacute granulomatous thyroiditis

A post-viral painful gland with a high ESR and thyrotoxicosis with low uptake is classic. Stored hormone leaks from inflamed follicles, followed by hypothyroid and recovery phases. It is treated with NSAIDs or steroids.

Option by option

  • A. Subacute granulomatous thyroiditis (correct)

    Correct. Painful gland, high ESR and low uptake fit the diagnosis.

  • B. Riedel thyroiditis

    Riedel thyroiditis gives a stony-hard painless gland.

  • C. Graves disease

    Graves disease has high radioiodine uptake and is painless.

  • D. Hashimoto thyroiditis

    Hashimoto thyroiditis is painless with high antibody titres.

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 Medicine question

What is the answer to this General Medicine question?

The best answer is A, Subacute granulomatous thyroiditis. A post-viral painful gland with a high ESR and thyrotoxicosis with low uptake is classic.

Why is "Riedel thyroiditis" not the answer?

Riedel thyroiditis gives a stony-hard painless gland.

Why is "Graves disease" not the answer?

Graves disease has high radioiodine uptake and is painless.

Why is "Hashimoto thyroiditis" not the answer?

Hashimoto thyroiditis is painless with high antibody titres.

What concept does this question test?

It tests Endocrinology and metabolism: recognition in General Medicine. Stored hormone leaks from inflamed follicles, followed by hypothyroid and recovery phases. It is treated with NSAIDs or steroids.

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 and metabolism: recognition?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.