Paper II
2024 August (Supplementary) (2010 Scheme)

Question

Propylthiouracil / Carbimazole for treatment of Thyroid storm

Q140.3 marksShort Answers

Answer

Propylthiouracil is the appropriate choice — beyond thioamides’ shared thyroid peroxidase-inhibiting mechanism, PTU has a second, distinct action: it also inhibits peripheral deiodinase, blocking conversion of T4 to the more active T3 in peripheral tissues. This additional peripheral action gives PTU a faster additional benefit in severely thyrotoxic states, the specific reason PTU (not carbimazole/methimazole) is preferred for thyroid storm.

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