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Medicine Endocrinology b2832601

which one of the following is not the appropriate treatment of hypehyroidism due to subacute thyroiditis?

A
Propylthiouracil
B
Suppoive treatment
C
Subtotal thyroidectomy
D
beta blockers
High-Yield Explanation
Subacute thyroiditis is a self-limited thyroid condition associated with a triphasic clinical course of hypehyroidism, hypothyroidism, and return to normal thyroid function. Subacute thyroiditis may be responsible for 15-20% of patients presenting with thyrotoxicosis and 10% of patients presenting with hypothyroidism . Recognizing this condition is impoant; because it is self-limiting, no specific treatment, such as antithyroid or thyroid hormone replacement therapy, is necessary in most patients. In some cases antithyroids are used to allete the symptoms . In general, the following three forms of subacute thyroiditis are recognized: Subacute granulomatous thyroiditis - Also known as subacute painful or de Quervain thyroiditis Subacute lymphocytic thyroiditis - Also known as subacute painless thyroiditis Subacute postpaum thyroiditis Treatment The treatment of subacute thyroiditis is generally suppoive to reduce the symptoms of thyrotoxicosis and to control neck pain in the setting of subacute granulomatous thyroiditis. Because no new hormone is being made, antithyroid medications are not effective in these conditions. Although the abnormal thyroid levels are temporary, emotional suppo is often necessary. Patients are often dehydrated from thyrotoxicosis; encourage all patients to drink 6-8 cups per day of noncaffeinated fluids. Surgical care is almost never recommended for subacute thyroiditis. In rare cases, surgery is recommended for patients who have frequent recurrences of thyrotoxicosis from subacute lymphocytic thyroiditis or recurrent pain from subacute granulomatous thyroiditis Ref - harrison internal medicine 20e p2708-2709

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