Thyroid storm — SCE Endocrinology MCQ

Correct answer: C — Multimodal thyroid-storm treatment with thionamide before iodine

The best answer is “Multimodal thyroid-storm treatment with thionamide before iodine”. Thyroid storm is a clinical multiorgan emergency; treatment blocks new synthesis and hormone release, reduces T4-to-T3 conversion and supports precipitant and organ failure management without awaiting confirmatory tests. “defer intervention until TRAb confirmation before starting thyroid-directed treatment” is less appropriate because delay materially increases mortality and Graves disease is already established “Use radioactive iodine as the emergency hormone-lowering intervention” is less appropriate because radioiodine acts too slowly and iodine uptake is impaired during acute iodine treatment “Give levothyroxine with intravenous fluid restriction” is less appropriate because thyroid hormone would worsen the crisis and blanket fluid restriction does not constitute supportive care “Use beta blockade alone when biochemical thyrotoxicosis is severe” is less appropriate because rate control alone leaves hormone synthesis, release and systemic decompensation untreated and may need modification in heart failure

Reference: Endotext: Thyroid storm. https://www.ncbi.nlm.nih.gov/books/NBK278927/