Head and neck: tuberculous lymphadenitis: 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 · Head and neck: tuberculous lymphadenitis

Sample item

A young adult from an endemic area has a chronic matted cervical lymph node mass with a cold abscess that tracks through deep fascia, forming a collar-stud abscess. What is the first-line treatment?

ACorticosteroids aloneBIncision and drainage as the primary treatmentCImmediate wide excision of all nodesDAntitubercular chemotherapy with aspiration of the abscess if needed

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

The answer and the reasoning

D. Antitubercular chemotherapy with aspiration of the abscess if needed

Tuberculous cervical lymphadenitis (scrofula) is the commonest form of extrapulmonary tuberculosis, and a collar-stud abscess forms when pus passes through the deep cervical fascia into the subcutaneous tissue. Standard antitubercular therapy for six months is the mainstay, and drain by aspiration rather than incision to avoid a chronic sinus. Surgery is limited to persistent nodes.

Option by option

A. Corticosteroids alone
Steroids alone do not treat the infection.
B. Incision and drainage as the primary treatment
Incision can leave a chronic discharging sinus.
C. Immediate wide excision of all nodes
Radical excision is not first-line.
D. Antitubercular chemotherapy with aspiration of the abscess if needed (correct)
Correct. Medical therapy is the mainstay, with aspiration if needed.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Antitubercular chemotherapy with aspiration of the abscess if needed. Tuberculous cervical lymphadenitis (scrofula) is the commonest form of extrapulmonary tuberculosis, and a collar-stud abscess forms when pus passes through the deep cervical fascia into the subcutaneous tissue.

Why is "Corticosteroids alone" not the answer?

Steroids alone do not treat the infection.

Why is "Incision and drainage as the primary treatment" not the answer?

Incision can leave a chronic discharging sinus.

Why is "Immediate wide excision of all nodes" not the answer?

Radical excision is not first-line.

What concept does this question test?

It tests Head and neck: tuberculous lymphadenitis in General Surgery. Standard antitubercular therapy for six months is the mainstay, and drain by aspiration rather than incision to avoid a chronic sinus. Surgery is limited to persistent nodes.

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 Head and neck: tuberculous lymphadenitis?

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.