Thyroid and parathyroid: localisation of parathyroid adenoma: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Thyroid and parathyroid: localisation of parathyroid adenoma

Sample item

A 50-year-old woman with primary hyperparathyroidism and a high calcium level needs preoperative localisation of the adenoma. Which isotope scan is commonly used?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Technetium-99m sestamibi scan

Sestamibi is taken up and retained in the mitochondria-rich adenoma while washing out from the thyroid, which shows on delayed images. It is combined with neck ultrasound to guide minimally invasive parathyroidectomy. A single adenoma accounts for about 85 percent of cases.

Option by option

  • A. Technetium-99m sestamibi scan (correct)

    Correct. Sestamibi localises abnormal parathyroid tissue.

  • B. Bone scan

    A bone scan does not localise adenomas.

  • C. Radioiodine scan

    Radioiodine is taken up by the thyroid.

  • D. Gallium scan

    Gallium scanning is used for inflammatory and some tumour lesions.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Technetium-99m sestamibi scan. Sestamibi is taken up and retained in the mitochondria-rich adenoma while washing out from the thyroid, which shows on delayed images.

Why is "Bone scan" not the answer?

A bone scan does not localise adenomas.

Why is "Radioiodine scan" not the answer?

Radioiodine is taken up by the thyroid.

Why is "Gallium scan" not the answer?

Gallium scanning is used for inflammatory and some tumour lesions.

What concept does this question test?

It tests Thyroid and parathyroid: localisation of parathyroid adenoma in ENT. It is combined with neck ultrasound to guide minimally invasive parathyroidectomy. A single adenoma accounts for about 85 percent of cases.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thyroid and parathyroid: localisation of parathyroid adenoma?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.