There’s 4 cards in this bulk suggestion, each should be voted/discussed individually
From AMBOSS overview
“Subacute thyroiditis is a group of conditions characterized by transient inflammation of the thyroid that classically progresses through a triphasic course: thyrotoxicosis, followed by hypothyroidism, and eventually a return to a euthyroid state. The two main subtypes are subacute granulomatous thyroiditis (de Quervain thyroiditis) and subacute lymphocytic thyroiditis (silent or painless thyroiditis), which includes postpartum thyroiditis.”
UW Step 2 QID check needed, Step 3 5239 agrees with general idea (see below). Could consider moving NSAIDs up in extra for prominence or as additional c1 since this is directly tested for Step 3
“Subacute thyroiditis is a self-limited condition. Treatment consists primarily of nonsteroidal anti-inflammatory drugs for pain relief and beta blockers to minimize thyrotoxic symptoms. Severe or refractory cases may require glucocorticoid therapy.”
AMBOSS has all of those too so i’ll change the extra field.
Only thing I want to mention against doing additional c1 is that subacute lymphocytic thyroiditis is painless so prn NSAIDs shouldn’t be needed.
Tagged Step 2 QID 4286 is a pt with symptomatic painless thyroiditis, and requests management. answer is a β-blocker.
the explanation states “Painless thyroiditis does not require specific antithyroid therapy; however, patients with signs of adrenergic overstimulation (eg, palpitations, tachycardia, tremulousness) should be treated with a beta blocker (eg, propranolol) rather than only observation and monitoring.”
Looks great - I am also in favor of adding a note that we don’t give methimazole since the pathophys involves preformed thyroid hormone (and methimazole only works to inhibit synthesis of new thyroid homrone). Two answer choices on the Step 3 question that I mentioned were differentiated by methimazole vs. no methimazole
Alternative to current suggestion would be:
Treatment of symptomatic subacute thyroiditis includes {{c1::β-blockers}} ± NSAIDs
Both meds are really just for symptom management, so I think it is reasonable to try to include both in text since we are lumping both subtypes together here
Support and added.
Extra field already has the perfect explanation for the ± reasoning