Breast and endocrine surgery: toxic multinodular goitre: 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 · Breast and endocrine surgery: toxic multinodular goitre

Sample item

A 60-year-old woman with a long-standing nodular goitre develops tachycardia, weight loss and a suppressed TSH. A radioiodine scan shows multiple hot nodules with suppression of the remaining gland. What is the definitive treatment?

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

The answer and the reasoning

A. Radioactive iodine ablation or thyroidectomy

Toxic multinodular goitre does not remit, so definitive therapy is radioiodine or surgery after rendering the patient euthyroid with antithyroid drugs. Levothyroxine would worsen thyrotoxicosis, and beta-blockers only control symptoms.

Option by option

  • A. Radioactive iodine ablation or thyroidectomy (correct)

    Correct. Radioiodine or surgery gives definitive treatment.

  • B. Beta-blocker alone indefinitely

    A beta-blocker controls symptoms but leaves the disease active.

  • C. TSH-suppressive levothyroxine

    Levothyroxine adds to the excess thyroid hormone.

  • D. External beam radiotherapy

    External radiotherapy is not used for benign thyrotoxic goitre.

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 A, Radioactive iodine ablation or thyroidectomy. Toxic multinodular goitre does not remit, so definitive therapy is radioiodine or surgery after rendering the patient euthyroid with antithyroid drugs.

Why is "Beta-blocker alone indefinitely" not the answer?

A beta-blocker controls symptoms but leaves the disease active.

Why is "TSH-suppressive levothyroxine" not the answer?

Levothyroxine adds to the excess thyroid hormone.

Why is "External beam radiotherapy" not the answer?

External radiotherapy is not used for benign thyrotoxic goitre.

What concept does this question test?

It tests Breast and endocrine surgery: toxic multinodular goitre in General Surgery. Levothyroxine would worsen thyrotoxicosis, and beta-blockers only control symptoms.

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 Breast and endocrine surgery: toxic multinodular goitre?

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.