Neck swellings: branchial cyst: 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 · Neck swellings: branchial cyst

Sample item

A 22-year-old has a soft, fluctuant, painless swelling at the anterior border of the upper third of the sternocleidomastoid. Aspirate contains cholesterol crystals. What is it?

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

The answer and the reasoning

A. Branchial cyst from the second branchial cleft

Branchial cysts present in young adults at the junction of the upper and middle thirds of the anterior border of sternocleidomastoid, and contain turbid fluid with cholesterol crystals. They arise from second cleft remnants and are excised completely with the tract to prevent recurrence. Thyroglossal cysts lie in the midline.

Option by option

  • A. Branchial cyst from the second branchial cleft (correct)

    Correct. Site and cholesterol crystals indicate a branchial cyst.

  • B. Thyroglossal cyst

    Thyroglossal cysts are midline and move on swallowing and tongue protrusion.

  • C. Dermoid cyst

    Dermoid cysts are midline and contain keratin.

  • D. Cystic hygroma

    Cystic hygroma is a multiloculated lesion presenting at birth or in infancy.

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 A, Branchial cyst from the second branchial cleft. Branchial cysts present in young adults at the junction of the upper and middle thirds of the anterior border of sternocleidomastoid, and contain turbid fluid with cholesterol crystals.

Why is "Thyroglossal cyst" not the answer?

Thyroglossal cysts are midline and move on swallowing and tongue protrusion.

Why is "Dermoid cyst" not the answer?

Dermoid cysts are midline and contain keratin.

Why is "Cystic hygroma" not the answer?

Cystic hygroma is a multiloculated lesion presenting at birth or in infancy.

What concept does this question test?

It tests Neck swellings: branchial cyst in General Surgery. They arise from second cleft remnants and are excised completely with the tract to prevent recurrence. Thyroglossal cysts lie in the midline.

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 Neck swellings: branchial cyst?

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.