MCQ 61

You arranged FNAC for patient in question 58. Showed degenerative colloid nodule with carcinomatous changes. You refer patient to Endocrine surgeon for review and further management. What is not true about Thyroid surgery from following?

1. If there are pressure symptoms due to multinodulat goitre with a dominant nodule, total thyroidectomy is recommended choice
2. In a patient with a thyroid nodule and Graves' disease, anaesthesia and surgery must be deferred until TSH has normalized
3. If there is a definite diagnose of malignancy, hemithyroidectomy is appropriate
4. The major risks of total thyroidecomy are hoarseness of the voice and permanent hypothyroidecomy
5. Surgery should be done if there is clinical suspicion about malignancy or concern about growth of nodule even if investigations are unremarkable. 

MCQ 60

Patient in question 58 came to see you again for blood result and US. TFT was unremarkable. US showed 4 cm nodule in thyroid in right side. Unable to comment whether it is malignant or not, but suggest it showed some cystic and solid area. What will be the next step?

1. US guided FNAC
2. CT scan
3. MRI
4. Nuclear medicine scan
5. Do nothing and review in 6 months time. 

MCQ 59

Patient in Question 58, you are suspicious about thyroid gland nodule. What will be the next step for investigation?

1. TFT and US of thyroid gland
2. TFT and XR of neck
3. TFT and CT scan of neck
4. TFT only
5. TFT and MRI of thyroid gland 

MCQ 58

60 y.o male presented with lump on right side of his neck, which he noted about 2 months ago and has increased in size. He is otherwise asymptomatic. His lump is about 4 cm in size and move with tongue. What is likely diagnose?

1. Lymphadenopathy
2. Thyroid nodule
3. SCM muscle haematoma
4. Skin cancer
5. Subcutaneous Lipoma