Head and neck: 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

Sample item

A 6-year-old girl has a painless midline neck swelling at the level of the hyoid that rises on protrusion of the tongue. What is the definitive treatment?

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

The answer and the reasoning

C. Excision of the cyst, its tract and the central part of the hyoid bone

The swelling is a thyroglossal cyst, a remnant of the thyroglossal duct. The tract passes through or behind the hyoid, so removing the central hyoid with the tract (the Sistrunk operation) minimises recurrence. Simple cyst excision leaves tract tissue behind.

Option by option

  • A. Incision and drainage

    Drainage does not remove the lining and leads to recurrence or a fistula.

  • B. Simple excision of the cyst alone

    Excising the cyst alone is followed by a high recurrence rate.

  • C. Excision of the cyst, its tract and the central part of the hyoid bone (correct)

    Correct. Removing the whole tract with the hyoid segment gives the lowest recurrence.

  • D. Hemithyroidectomy

    The cyst is not a thyroid lobe lesion, so a hemithyroidectomy is not indicated.

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 Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Excision of the cyst, its tract and the central part of the hyoid bone. The swelling is a thyroglossal cyst, a remnant of the thyroglossal duct.

Why is "Incision and drainage" not the answer?

Drainage does not remove the lining and leads to recurrence or a fistula.

Why is "Simple excision of the cyst alone" not the answer?

Excising the cyst alone is followed by a high recurrence rate.

Why is "Hemithyroidectomy" not the answer?

The cyst is not a thyroid lobe lesion, so a hemithyroidectomy is not indicated.

What concept does this question test?

It tests Head and neck in General Surgery. The tract passes through or behind the hyoid, so removing the central hyoid with the tract (the Sistrunk operation) minimises recurrence. Simple cyst excision leaves tract tissue behind.

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?

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.