PANCE Endocrinology Practice Test

Graves' disease in nonpregnant adults is usually managed first with medication that directly lowers thyroid hormone production. Methimazole is the preferred antithyroid drug because it effectively inhibits thyroid peroxidase, reducing synthesis of T3 and T4, and it can be given once daily with a favorable safety profile in adults. This approach aims to restore euthyroidism without destroying the thyroid, preserving gland function and avoiding immediate definitive therapy.

Radioactive iodine therapy is a definitive treatment that often leads to hypothyroidism and requires lifelong thyroid hormone replacement; while effective, it’s not typically the first choice when a reversible medical option can control the hyperthyroidism. A beta-blocker by itself helps with symptoms like tachycardia and tremor but does not reduce hormone production, so it doesn’t address the underlying hyperthyroidism. Levothyroxine would worsen the hyperthyroid state, not treat it.