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Question 504
Endocrinology → General
Classification
Question
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A breastfeeding woman with Graves disease is being considered for radioactive iodine treatment. Which statement best reflects the restrictions associated with this treatment?
Question Stem
Select the single best answer.
Options
A
Radioactive iodine is permissible throughout pregnancy provided thyroid function is monitored
B
Breastfeeding may continue without interruption after treatment
C
Radioactive iodine is absolutely contraindicated in pregnancy, and breastfeeding must be stopped for approximately 8 weeks
D
Radioactive iodine cannot cause subsequent hypothyroidism
E
Radioactive iodine reliably improves Graves ophthalmopathy without additional treatment
Explanation
Radioactive iodine is effective for Graves disease and toxic nodules but is absolutely contraindicated during pregnancy. Breastfeeding must be stopped for approximately 8 weeks. Hypothyroidism occurs in a substantial proportion of treated patients, and radioactive iodine may exacerbate Graves ophthalmopathy; corticosteroids can attenuate this risk.
Option Validity
A) Pregnancy is an absolute contraindication to radioactive iodine treatment.
B) Breastfeeding must be stopped for approximately 8 weeks.
D) Hypothyroidism is a recognised and common outcome following radioactive iodine treatment.
E) Radioactive iodine can exacerbate Graves ophthalmopathy rather than reliably improving it.
Further Reading
Saxena, MRCOG-1 Basic Sciences, Endocrinology: Hyperthyroidism - radioactive iodine, p. 309.