General Surgery Board Review Endocrine Surgery

Question 1

Which thyroid cancer histotype accounts for approximately 80% of all thyroid malignancies?

Accepted Answer

Papillary thyroid carcinoma

Answer

Follicular thyroid carcinoma

Answer

Medullary thyroid carcinoma

Answer

Anaplastic thyroid carcinoma

Question 2

During thyroidectomy, unilateral injury to the recurrent laryngeal nerve (RLN) results in which complication?

Accepted Answer

Ipsilateral vocal cord paralysis

Answer

Transient hypocalcemia

Answer

Contralateral vocal cord paralysis

Answer

Permanent hypoparathyroidism

Question 3

A patient presents with thyroid storm. Which medication should be administered FIRST to block new thyroid hormone synthesis?

Accepted Answer

Propylthiouracil (PTU)

Answer

Propranolol

Answer

Saturated solution of potassium iodide (SSKI)

Answer

Hydrocortisone

Question 4

A patient with papillary thyroid carcinoma has clinically apparent lateral neck lymphadenopathy (N1b disease). Which surgical procedure is required for the lateral neck?

Accepted Answer

Therapeutic lateral neck dissection (Levels II-V)

Answer

Level I node dissection only

Answer

Central neck dissection (Level VI) only

Answer

Total lateral neck dissection including Level VII

Question 5

Which of the following is the most common cause of hypercalcemia in ambulatory outpatients?

Accepted Answer

Primary hyperparathyroidism

Answer

Malignancy-associated hypercalcemia

Answer

Vitamin D toxicity

Answer

Sarcoidosis

Question 6

A patient develops perioral tingling and carpopedal spasm 24 hours after total thyroidectomy. What is the most likely diagnosis?

Accepted Answer

Hypocalcemia from hypoparathyroidism

Answer

Bilateral RLN injury

Answer

Thyroid storm

Answer

Wound hematoma with airway compression

Question 7

What is the preferred initial imaging modality for localizing a parathyroid adenoma before first-time parathyroid exploration?

Accepted Answer

99mTc-sestamibi scintigraphy

Answer

CT scan of the neck with contrast

Answer

MRI of the neck without contrast

Answer

F-18 FDG PET scan