Thyroid: 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.

Try it

General Surgery · Thyroid

Sample item

A thyroid nodule has FNAC showing medullary carcinoma and the patient's mother had episodic hypertension and thyroid cancer. Which test must be done before thyroidectomy?

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

The answer and the reasoning

C. Plasma or urine metanephrines

Medullary carcinoma arises from parafollicular C cells and may be part of MEN 2, which can include phaeochromocytoma. Excluding and, if present, treating a phaeochromocytoma first is essential because anaesthesia or surgery can precipitate a hypertensive crisis.

Option by option

  • A. Serum thyroglobulin

    Thyroglobulin is a marker for follicular-derived cancers, whereas calcitonin and CEA follow medullary carcinoma.

  • B. TSH receptor antibody titre

    TSH receptor antibodies relate to Graves disease and have no bearing on a medullary tumour.

  • C. Plasma or urine metanephrines (correct)

    Correct. Metanephrines screen for phaeochromocytoma in MEN 2 before any operation.

  • D. Radioiodine uptake scan

    C cells do not concentrate radioiodine, so the scan is not informative for this tumour.

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, Plasma or urine metanephrines. Medullary carcinoma arises from parafollicular C cells and may be part of MEN 2, which can include phaeochromocytoma.

Why is "Serum thyroglobulin" not the answer?

Thyroglobulin is a marker for follicular-derived cancers, whereas calcitonin and CEA follow medullary carcinoma.

Why is "TSH receptor antibody titre" not the answer?

TSH receptor antibodies relate to Graves disease and have no bearing on a medullary tumour.

Why is "Radioiodine uptake scan" not the answer?

C cells do not concentrate radioiodine, so the scan is not informative for this tumour.

What concept does this question test?

It tests Thyroid in General Surgery. Excluding and, if present, treating a phaeochromocytoma first is essential because anaesthesia or surgery can precipitate a hypertensive crisis.

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 Thyroid?

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.