Breast and endocrine surgery: lingual thyroid: 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 · Breast and endocrine surgery: lingual thyroid

Sample item

A 12-year-old girl has a smooth reddish 2 cm mass at the base of the tongue with dysphagia and a muffled voice. No thyroid gland can be felt in the neck. Which investigation is most important before any surgery?

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

The answer and the reasoning

D. Technetium-99m thyroid scan

A lingual thyroid is failure of descent of the thyroid and is often the only functioning thyroid tissue. A radionuclide scan shows whether any thyroid is present in the neck, because excision or biopsy of the mass could leave the child hypothyroid. Thyroxine suppression is tried first for symptoms.

Option by option

  • A. Contrast CT of the neck

    CT shows anatomy but does not show whether the tissue functions.

  • B. Incisional biopsy of the mass

    Biopsy risks bleeding and may destroy the only thyroid tissue.

  • C. Serum thyroglobulin level

    Thyroglobulin is a tumour marker and does not show whether other thyroid tissue exists.

  • D. Technetium-99m thyroid scan (correct)

    Correct. A scan shows whether this is the only functioning thyroid before any excision.

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, Technetium-99m thyroid scan. A lingual thyroid is failure of descent of the thyroid and is often the only functioning thyroid tissue.

Why is "Contrast CT of the neck" not the answer?

CT shows anatomy but does not show whether the tissue functions.

Why is "Incisional biopsy of the mass" not the answer?

Biopsy risks bleeding and may destroy the only thyroid tissue.

Why is "Serum thyroglobulin level" not the answer?

Thyroglobulin is a tumour marker and does not show whether other thyroid tissue exists.

What concept does this question test?

It tests Breast and endocrine surgery: lingual thyroid in General Surgery. A radionuclide scan shows whether any thyroid is present in the neck, because excision or biopsy of the mass could leave the child hypothyroid. Thyroxine suppression is tried first for symptoms.

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 Breast and endocrine surgery: lingual thyroid?

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.