Thyroid: nodule evaluation: 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.

Try it

General Surgery · Thyroid: nodule evaluation

Sample item

A 45-year-old woman has a solitary 2.5 cm thyroid nodule. TSH is 0.05 mIU/L with a raised free T4. What is the most appropriate next investigation?

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

The answer and the reasoning

B. Technetium-99m pertechnetate thyroid scan

A suppressed TSH in a patient with a nodule suggests an autonomously functioning nodule, so the next test is a radionuclide scan. A hot nodule is almost never malignant and is treated as toxic adenoma with radioiodine or surgery, whereas a cold nodule would then go for FNAC.

Option by option

  • A. Diagnostic hemithyroidectomy

    Surgery before functional and cytological evaluation is premature.

  • B. Technetium-99m pertechnetate thyroid scan (correct)

    Correct. A scan separates a hot, autonomous nodule from a cold one.

  • C. Serum thyroglobulin

    Thyroglobulin is raised in many benign thyroid conditions and cannot diagnose a nodule.

  • D. PET-CT of the neck

    PET-CT is not part of the routine work-up of a thyroid nodule.

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 B, Technetium-99m pertechnetate thyroid scan. A suppressed TSH in a patient with a nodule suggests an autonomously functioning nodule, so the next test is a radionuclide scan.

Why is "Diagnostic hemithyroidectomy" not the answer?

Surgery before functional and cytological evaluation is premature.

Why is "Serum thyroglobulin" not the answer?

Thyroglobulin is raised in many benign thyroid conditions and cannot diagnose a nodule.

Why is "PET-CT of the neck" not the answer?

PET-CT is not part of the routine work-up of a thyroid nodule.

What concept does this question test?

It tests Thyroid: nodule evaluation in General Surgery. A hot nodule is almost never malignant and is treated as toxic adenoma with radioiodine or surgery, whereas a cold nodule would then go for FNAC.

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: nodule evaluation?

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.