Thyroid: follow-up of cancer: 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: follow-up of cancer

Sample item

A patient has had total thyroidectomy and radioiodine ablation for papillary thyroid carcinoma. Which marker is most useful in long-term surveillance for recurrence?

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

The answer and the reasoning

C. Serum thyroglobulin

After total thyroidectomy and ablation, no normal or malignant follicular cell should remain, so detectable thyroglobulin signals residual or recurrent disease. Anti-thyroglobulin antibodies can interfere, so they are measured together. Calcitonin follows medullary carcinoma, which arises from C cells.

Option by option

  • A. Serum CEA

    CEA is a secondary marker in medullary carcinoma and colorectal cancer.

  • B. Serum alpha-fetoprotein

    Alpha-fetoprotein is a marker for hepatocellular carcinoma and germ cell tumours.

  • C. Serum thyroglobulin (correct)

    Correct. Thyroglobulin is produced only by follicular-derived tissue and tracks differentiated carcinoma.

  • D. Serum calcitonin

    Calcitonin is the marker for medullary carcinoma, not papillary carcinoma.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Serum thyroglobulin. After total thyroidectomy and ablation, no normal or malignant follicular cell should remain, so detectable thyroglobulin signals residual or recurrent disease.

Why is "Serum CEA" not the answer?

CEA is a secondary marker in medullary carcinoma and colorectal cancer.

Why is "Serum alpha-fetoprotein" not the answer?

Alpha-fetoprotein is a marker for hepatocellular carcinoma and germ cell tumours.

Why is "Serum calcitonin" not the answer?

Calcitonin is the marker for medullary carcinoma, not papillary carcinoma.

What concept does this question test?

It tests Thyroid: follow-up of cancer in General Surgery. Anti-thyroglobulin antibodies can interfere, so they are measured together. Calcitonin follows medullary carcinoma, which arises from C cells.

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: follow-up of cancer?

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.