skip to main content

Thyroid storm — USMLE Step 2 CK MCQ

Instant feedback + full explanation. One question, done properly.

ModerateInternal MedicineThyroid stormUSMLE Step 2 CK

A 32-year-old White woman comes to the urgent care clinic because of neurologic symptoms. History and focused examination are notable for fever, delirium, atrial fibrillation, tremor, and suppressed TSH. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate pharmacotherapy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Propranolol followed by propylthiouracil and iodine

The vignette describes Thyroid storm, supported by fever, delirium, atrial fibrillation, tremor, and suppressed TSH. Propranolol followed by propylthiouracil and iodine is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: American Thyroid Association Hyperthyroidism Guideline