Here’s another practice question that drove me C-R-A-Z-Y
A 56-year-old male complains of anxiety and insomnia. Examination reveals a fine tremor, enlarged thyroid, and an irregularly irregular heartbeat, rate of 112 bpm. BP is 162/78. Skin is moist; nails and hair are brittle. ECG shows fine atrial fibrillation with irregular ventricular beats. What is the recommended treatment?
a. Amiodarone
b. Methimazole
c. Levothyroxine
d. β-Blocker
e. Hydrocortisol
D or B?
Controlling the most important symptoms now would be the Beta blocker but treating the underlying problem and therefore the patient as a whole would be Methimazole. ARRRGG
I chose B and got it wrong. The answer was treating the symptoms in front of you; of course you’d later move on to treating the disease long-term. Instead I tried to guess which answer THEY would want me to put down. I figured the beta blocker was too obvious. Stupid.
Don’t overthink it. Choose the answer that you think makes the most sense and stick with it.
Although without using The Final Step, I wouldn’t even have remembered that methimazole is used to treat hyperthyroidism.
Check it out here
Brian Wallace