Head and neck tumours: phaeochromocytoma exclusion before thyroidectomy: 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: phaeochromocytoma exclusion before thyroidectomy

Sample item

A patient has medullary thyroid carcinoma and a RET mutation consistent with MEN 2A. Before thyroidectomy, which must be done first?

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

The answer and the reasoning

C. Biochemical exclusion of phaeochromocytoma

In MEN 2, phaeochromocytoma must be excluded and treated with alpha blockade before any surgery, as anaesthesia can precipitate a hypertensive crisis. Plasma metanephrines are measured.

Option by option

  • A. Prophylactic neck radiotherapy

    Radiotherapy has no role before surgery.

  • B. TSH suppression

    TSH suppression does not treat a C-cell tumour.

  • C. Biochemical exclusion of phaeochromocytoma (correct)

    Correct. Phaeochromocytoma is excluded first because surgery can trigger a crisis.

  • D. Radioiodine ablation

    Medullary carcinoma does not take up radioiodine.

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 ENT question

What is the answer to this ENT question?

The best answer is C, Biochemical exclusion of phaeochromocytoma. In MEN 2, phaeochromocytoma must be excluded and treated with alpha blockade before any surgery, as anaesthesia can precipitate a hypertensive crisis.

Why is "Prophylactic neck radiotherapy" not the answer?

Radiotherapy has no role before surgery.

Why is "TSH suppression" not the answer?

TSH suppression does not treat a C-cell tumour.

Why is "Radioiodine ablation" not the answer?

Medullary carcinoma does not take up radioiodine.

What concept does this question test?

It tests Head and neck tumours: phaeochromocytoma exclusion before thyroidectomy in ENT. Plasma metanephrines are measured.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: phaeochromocytoma exclusion before thyroidectomy?

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.