Professional and Linguistic Assessments Board (PLAB) Practice Exam

Which medication is recommended for treating Graves' disease during pregnancy?

1. Levothyroxine

2. Cabergoline

3. PTU

4. Carbimazole

The correct answer is: PTU

In the context of treating Graves' disease during pregnancy, propylthiouracil (PTU) is the preferred medication. This is due to its lower risk of crossing the placenta and affecting the fetal thyroid function compared to other antithyroid agents, such as carbimazole. PTU also inhibits the synthesis of thyroid hormones, effectively controlling the hyperthyroid state. The choice of PTU is particularly significant during the first trimester of pregnancy since the risk of complications from the mother’s hyperthyroidism can impact both maternal and fetal health. While carbimazole is effective for managing hyperthyroidism, its use is generally avoided during early pregnancy due to potential teratogenic effects associated with it. Therefore, PTU is recommended as the first-line treatment for managing Graves' disease in pregnant patients to ensure the safety of both the mother and the developing fetus.