🏥 USMLE Exam Prep

A 45-year-old female with a history of Graves' disease presents to the ED with fever (103°F), tachycardia (160 bpm), agitation, and mild jaundice. Her blood pressure is 150/90 mmHg. After initiating supportive care (IV fluids, cooling blankets), which medication should be administered first?

A Propranolol
B Propylthiouracil (PTU)
C IV hydrocortisone
D Saturated solution of potassium iodide (SSKI)

✓ Correct Answer: Option B

In thyroid storm, antithyroid medications like propylthiouracil (PTU) block new hormone synthesis and should be given first. Iodide agents (like SSKI) block hormone release and should be given at least an hour *after* antithyroid drugs to prevent worsening symptoms.

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