Thyroid: post-operative haematoma: practice question

A General Surgery 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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General Surgery · Thyroid: post-operative haematoma

Sample item

Three hours after total thyroidectomy, a 40-year-old woman has progressive neck swelling, stridor and a muffled voice. Oxygen saturation is falling. What is the immediate action?

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

The answer and the reasoning

D. Open the wound at the bedside and evacuate the haematoma

A tense haematoma beneath the strap muscles compresses the trachea and obstructs venous and lymphatic drainage, causing laryngeal oedema. Airway rescue is by immediate removal of the skin and strap muscle sutures at the bedside, then return to theatre to find the bleeding point. Delay for imaging can be fatal.

Option by option

  • A. Perform needle aspiration of the swelling

    Clotted blood cannot be aspirated through a needle.

  • B. Arrange an urgent CT scan of the neck

    Imaging delays airway rescue in an unstable patient.

  • C. Give intravenous dexamethasone and observe

    Steroids do not relieve mechanical compression by a tense haematoma.

  • D. Open the wound at the bedside and evacuate the haematoma (correct)

    Correct. Decompression relieves tracheal compression immediately and can be life-saving.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Open the wound at the bedside and evacuate the haematoma. A tense haematoma beneath the strap muscles compresses the trachea and obstructs venous and lymphatic drainage, causing laryngeal oedema.

Why is "Perform needle aspiration of the swelling" not the answer?

Clotted blood cannot be aspirated through a needle.

Why is "Arrange an urgent CT scan of the neck" not the answer?

Imaging delays airway rescue in an unstable patient.

Why is "Give intravenous dexamethasone and observe" not the answer?

Steroids do not relieve mechanical compression by a tense haematoma.

What concept does this question test?

It tests Thyroid: post-operative haematoma in General Surgery. Airway rescue is by immediate removal of the skin and strap muscle sutures at the bedside, then return to theatre to find the bleeding point. Delay for imaging can be fatal.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: post-operative haematoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.