Thyroid storm — SCE Endocrinology MCQ

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

HardThyroidThyroid stormSCE Endocrinology

A 50-year-old woman presents with fever, agitation and diarrhoea. She has untreated Graves' disease, pulse 148/min and temperature 39.4°C. TSH is <0.01 mU/L and free T4 is 72 pmol/L. There is new atrial fibrillation and mild heart failure. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: B — Thyroid storm

Severe thyrotoxicosis with hyperthermia, CNS disturbance, tachyarrhythmia and cardiac failure is thyroid storm. Phaeochromocytoma crisis can mimic adrenergic symptoms but would not explain the known Graves' biochemistry. The pearl is that treatment is multimodal: beta-blockade, thionamide, iodine after thionamide, steroids and supportive care.

Reference: NICE NG145, BNF