Endocrinology and diabetes: solitary toxic adenoma scintigraphy: practice question

A General Medicine 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 Medicine · Endocrinology and diabetes: solitary toxic adenoma scintigraphy

Sample item

A 50-year-old woman has weight loss and palpitations. TSH is suppressed and T3 is raised. She has a solitary 3 cm thyroid nodule, and radionuclide scanning shows focal intense uptake in the nodule with suppressed uptake in the rest of the gland. What is the diagnosis?

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

The answer and the reasoning

C. Toxic adenoma

An autonomously functioning nodule secretes hormone independently of TSH, suppressing the rest of the gland. This shows as a hot nodule with a quiet background. Graves disease gives diffusely increased uptake, and thyroiditis gives low uptake.

Option by option

  • A. Papillary carcinoma

    Papillary carcinomas are typically cold nodules on scanning.

  • B. Graves disease

    Graves disease shows diffusely increased uptake throughout the gland.

  • C. Toxic adenoma (correct)

    Correct. A hot nodule with a suppressed remainder indicates an autonomous adenoma.

  • D. Subacute thyroiditis

    Subacute thyroiditis shows very low uptake in the whole gland.

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 Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Toxic adenoma. An autonomously functioning nodule secretes hormone independently of TSH, suppressing the rest of the gland.

Why is "Papillary carcinoma" not the answer?

Papillary carcinomas are typically cold nodules on scanning.

Why is "Graves disease" not the answer?

Graves disease shows diffusely increased uptake throughout the gland.

Why is "Subacute thyroiditis" not the answer?

Subacute thyroiditis shows very low uptake in the whole gland.

What concept does this question test?

It tests Endocrinology and diabetes: solitary toxic adenoma scintigraphy in General Medicine. This shows as a hot nodule with a quiet background. Graves disease gives diffusely increased uptake, and thyroiditis gives low uptake.

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 Endocrinology and diabetes: solitary toxic adenoma scintigraphy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.