USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

Thyroid storm can be effectively managed by which of the following treatment approaches?

1. Corticosteroids alone

2. Antithyroid medication only

3. Sympathetic blockade with β-blockers

4. Surgical removal of the thyroid gland

The correct answer is: Sympathetic blockade with β-blockers

Thyroid storm, a severe and potentially life-threatening exacerbation of hyperthyroidism, requires prompt and effective management to stabilize the patient. The administration of sympathetic blockade with β-blockers is a critical aspect of treatment due to the adrenergic symptoms associated with thyroid storm, such as tachycardia, hypertension, and anxiety. β-blockers help to mitigate these symptoms by blocking the effects of excess circulating thyroid hormones on the cardiovascular system, providing significant symptomatic relief and lowering the risk of complications like cardiac arrhythmias. In addition to β-blockers, other treatments for thyroid storm typically include antithyroid medications to reduce the production of thyroid hormones, as well as supportive measures such as fluid management and temperature control. However, while antithyroid medications are essential, they do not provide immediate symptom relief, which is why β-blockers are often prioritized. Corticosteroids can be used as adjunctive therapy because they may help reduce inflammation and potentially provide some benefit in terms of hormone suppression, but they are not the primary treatment. Surgical removal of the thyroid gland may be necessary in specific situations, such as in patients with a goiter causing compressive symptoms or when rapid control of hyperthyroidism is required, but it is not