General Surgery Board Review Endocrine Surgery 1

Question 1

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

Accepted Answer

Papillary thyroid carcinoma

Answer

Papillary thyroid carcinoma is the most common thyroid malignancy (~80%), characterized by psammoma bodies, orphan Annie eye nuclei, and a favorable prognosis.

Question 2

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

Accepted Answer

Ipsilateral vocal cord paralysis

Answer

The RLN innervates the intrinsic laryngeal muscles ipsilaterally; unilateral injury causes ipsilateral vocal cord paralysis and hoarseness.

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

PTU is given first because it blocks thyroid hormone synthesis and inhibits peripheral T4-to-T3 conversion; iodine must be given at least 1 hour after PTU to prevent providing substrate for new hormone synthesis.

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

N1b disease requires a therapeutic lateral neck dissection encompassing Levels II through V, as these compartments represent the lymphatic drainage of the lateral neck.

Question 5

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

Accepted Answer

Primary hyperparathyroidism

Answer

Primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting, caused by a solitary parathyroid adenoma in ~85% of cases.

General Surgery Board Review Practice Test

General Surgery Board Review Practice Test

General Surgery Board Review Endocrine Surgery 1