Head and neck tumours: hypothyroidism after neck radiotherapy: 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: hypothyroidism after neck radiotherapy

Sample item

A patient treated years ago with radiotherapy to the neck for lymphoma develops fatigue and weight gain. Which investigation is most appropriate?

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

The answer and the reasoning

A. Serum TSH and free thyroxine

Radiotherapy to the neck commonly causes hypothyroidism, which may appear months to years later, so TSH is monitored regularly in survivors. Early detection allows replacement with levothyroxine. Radiation also increases the long-term risk of thyroid cancer and carotid disease.

Option by option

  • A. Serum TSH and free thyroxine (correct)

    Correct. Thyroid function should be checked.

  • B. Chest radiograph

    A chest radiograph is not relevant to these symptoms.

  • C. Serum calcium only

    Calcium alone does not assess hypothyroidism.

  • D. Pure tone audiometry

    Audiometry is not relevant.

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 A, Serum TSH and free thyroxine. Radiotherapy to the neck commonly causes hypothyroidism, which may appear months to years later, so TSH is monitored regularly in survivors.

Why is "Chest radiograph" not the answer?

A chest radiograph is not relevant to these symptoms.

Why is "Serum calcium only" not the answer?

Calcium alone does not assess hypothyroidism.

Why is "Pure tone audiometry" not the answer?

Audiometry is not relevant.

What concept does this question test?

It tests Head and neck tumours: hypothyroidism after neck radiotherapy in ENT. Early detection allows replacement with levothyroxine. Radiation also increases the long-term risk of thyroid cancer and carotid disease.

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: hypothyroidism after neck radiotherapy?

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.