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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#16 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Oral propylthiouracil therapy 🔍 / 📺 / 🌳 / 📖
tags: endo

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submitted by seagull(1933)
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Order of treatment for acute hyperthyroid symptoms

Beta Blocker --> PTU---> Radioactive Iodine

Beta blocker wasnt an answer option but would be correct if given.

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wutuwantbruv  Just as a side note, RI is contraindicated in moderate to severe Grave's ophthalmopathy as it can worsen it. +5



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submitted by step_prep5(246)
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  • Young woman with subacute palpitations, anxiety, weight loss, heat intolerance, diarrhea, lid lag and exophthalmos with a large, nontender thyroid gland with diffuse increased uptake and low TSH with increased T4 levels, most consistent with Graves’ disease
  • Graves disease and other forms of hyperthyroidism should be treated with propylthiouracil or methimazole
  • Key idea: All causes of hyperthyroidism can lead to lid lag and lid retraction secondary to sympathetic activation of the superior tarsal muscle, but Graves specifically leads to exophthalmos and impaired extra-ocular motion due to glycosaminoglycan deposition behind the eyes

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