The thyroid gland

Which investigation is the gold standard assessment of nodular goitre when performed by a suitably trained and experienced operator?

Ultrasonography of a multinodular goitre shows a large dominant nodule without concerning features and a smaller nodule with concerning features. Which nodule should undergo fine-needle aspiration cytology?

Which previous operation makes completion total thyroidectomy straightforward if nodularity subsequently progresses in the remaining lobe?

Which statement correctly describes the natural history of the nodular stage of simple goitre?

Which finding is an indication for surgery in a patient with nodular goitre?

A patient with nodular goitre reports difficulty swallowing and breathing. Which investigation best assesses associated tracheal or oesophageal deviation or compression?

A patient with nodular goitre develops sudden painful enlargement of a thyroid nodule. Although carcinoma must be suspected, what is the usual cause of this presentation?

Approximately what percentage of isolated thyroid swellings prove to be malignant?

A patient with a discrete thyroid swelling has biochemically confirmed hyperthyroidism. Which pair of diagnoses does this combination indicate?

What proportion of the adult population in the UK and USA has palpable thyroid nodules?

Which ultrasonographic finding in a thyroid swelling is diagnostic of malignancy?

A patient has a discrete thyroid swelling with a palpable contralateral lobe and mild nodularity throughout the gland. What is the preferred clinical term for this swelling?

In the investigation of discrete thyroid swellings, which finding remains an indication for isotope scanning?

Which biochemical measurements should be obtained when investigating thyroid function in a patient with a discrete thyroid swelling?

A patient with a thyroid swelling has circulating thyroid antibodies and is being considered for lobectomy. Which postoperative outcome has an increased risk because of the antibody finding?

Which investigation should be used as the primary investigation of any thyroid nodule?

Ultrasonography detects additional impalpable nodules in a thyroid gland containing a palpable discrete swelling. What effect does this finding have on management of the palpable swelling?

A patient with thyroid enlargement requires assessment of tracheal compression and deviation. Which imaging modality is the stated modality of choice?

Why should preservation of large thyroid remnants be avoided when operating for Graves’ disease?

Which thyroid nodules should undergo fine-needle aspiration cytology, ideally under ultrasound guidance?

Which pair of thyroid procedures requires thyroid replacement therapy because insufficient tissue remains for normal thyroid function?

Why can fine-needle aspiration cytology not distinguish follicular thyroid adenoma from follicular carcinoma?

Which investigation is widely used before thyroid surgery to determine vocal cord mobility?

A patient has a concerning right thyroid nodule and right vocal cord palsy on laryngoscopy. This combination is usually diagnostic of which condition?

What is the stated reason that core biopsy is rarely indicated in thyroid masses?

A thyroid nodule has both cystic and solid components. Which part should be targeted during ultrasound-guided fine-needle aspiration cytology?

Why is removal advocated for all follicular thyroid neoplasms?

Which statement correctly describes the relationship between sex and thyroid malignancy risk?

For which thyroid condition is core biopsy specifically described as useful for rapid diagnosis?

Why is the term thyrotoxicosis retained instead of describing the entire disease as hyperthyroidism?

During surgery for a retrosternal goitre arising from a posteriorly positioned nodule, which displacement of the RLN should the surgeon anticipate?

A young woman develops hyperthyroidism and a diffuse vascular goitre at the same time, with associated eye signs. Which diagnosis best fits this presentation?

From which region does a retrosternal goitre receive its blood supply, reducing the risk of catastrophic bleeding from the great vessels?

In toxic nodular goitre with inactive nodules, which tissue is responsible for the thyroid overactivity?

An elderly patient has a simple nodular goitre for many years before developing hyperthyroidism. Eye signs are absent. Which diagnosis best fits this sequence?

What effect do high circulating thyroid hormone levels from a toxic nodule have on TSH secretion and the surrounding normal thyroid tissue?

A retrosternal goitre is fixed and immobile and cannot be delivered through a cervical approach. Which operative approach is indicated?

Which thyroid operation combines a total lobectomy on one side, a subtotal lobectomy on the other, and an isthmusectomy?

Which mechanism characterises hypertrophy and hyperplasia in a toxic nodule?

Which combination of surgical components constitutes a total thyroidectomy?