<prompt> Which of the following has more anti-thyroid action?I131Sodium iodideCarbimazoleNeomercazole  <response>: Ans. a I131Ref: Bailey and Love Principles and Practice of Surgery, 26th edition, Page 758Methods of treating a Thyrotoxic Patient from Bailey and Love Antithyroid Drugs: Carbimazole is the DOC for preparing the patient to euthyroid state. It is given in a dose of 10mg three times daily. Once patient becomes euthyroid: Carbimazole is given a maintenance dose of 5mg three times daily for 6-24 months. Block and replacement therapy - Another method of preparation by giving heavy dose carbimazole and making patient euthyroid and supplementing with 0.1mg thyroxine Recurrence of thyrotoxic feature is nearly 50 Surgery: is around 5 and this has its own risk of surgery. RAI: Response is slow but substantial improvement occurs 8-12 weeks. Two or more doses are required for 20 cases.Choice of treatment in Each case: Diffuse toxic goiter: Initial dose of anti-thyroid drugs followed by RAI. Toxic Nodular goiter - Surgery is best, RAI produces lesser response here Toxic nodule - Surgery or RAI is appropriate Recurrent thyrotoxicosis after Surgery - Radioiodine is best Failure of Previous antithyroid drugs or RAI: Surgery is best 