Head and neck tumours: Pemberton sign: practice question

A ENT 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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ENT · Head and neck tumours: Pemberton sign

Sample item

A 60-year-old woman with a long-standing multinodular goitre develops facial plethora, distended neck veins and dizziness when she raises both arms above her head. What is the mechanism?

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

The answer and the reasoning

B. Venous obstruction at the thoracic inlet by a retrosternal goitre

Raising the arms pulls the thoracic inlet upwards, and a retrosternal or large goitre wedged there obstructs venous return, causing facial congestion and dizziness. This is Pemberton sign and suggests thoracic inlet obstruction.

Option by option

  • A. Tracheal compression by a hot nodule

    Tracheal compression causes stridor and dyspnoea, not facial congestion on raising the arms.

  • B. Venous obstruction at the thoracic inlet by a retrosternal goitre (correct)

    Correct. A goitre wedged in the thoracic inlet obstructs venous return when the arms are raised.

  • C. Recurrent laryngeal nerve invasion

    Recurrent laryngeal nerve invasion causes hoarseness and suggests malignancy.

  • D. Carotid artery compression by the goitre

    Carotid compression would not produce venous congestion of the face.

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 ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Venous obstruction at the thoracic inlet by a retrosternal goitre. Raising the arms pulls the thoracic inlet upwards, and a retrosternal or large goitre wedged there obstructs venous return, causing facial congestion and dizziness.

Why is "Tracheal compression by a hot nodule" not the answer?

Tracheal compression causes stridor and dyspnoea, not facial congestion on raising the arms.

Why is "Recurrent laryngeal nerve invasion" not the answer?

Recurrent laryngeal nerve invasion causes hoarseness and suggests malignancy.

Why is "Carotid artery compression by the goitre" not the answer?

Carotid compression would not produce venous congestion of the face.

What concept does this question test?

It tests Head and neck tumours: Pemberton sign in ENT. This is Pemberton sign and suggests thoracic inlet obstruction.

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 tumours: Pemberton sign?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.