Q.1 Which of the following is the most common endocrine disorder requiring surgery?
Adrenal carcinoma
Thyroid nodules
Parathyroid hyperplasia
Pheochromocytoma
Explanation - Thyroid nodules are the most common indication for endocrine surgery, often evaluated for malignancy risk.
Correct answer is: Thyroid nodules
Q.2 What is the gold standard treatment for primary hyperparathyroidism?
Medical therapy
Radioiodine ablation
Parathyroidectomy
Chemotherapy
Explanation - Surgical removal of the overactive parathyroid gland is the definitive treatment for primary hyperparathyroidism.
Correct answer is: Parathyroidectomy
Q.3 Which nerve is most at risk during thyroidectomy?
Phrenic nerve
Recurrent laryngeal nerve
Hypoglossal nerve
Accessory nerve
Explanation - The recurrent laryngeal nerve runs close to the thyroid and is at risk during thyroid surgery, leading to voice changes if injured.
Correct answer is: Recurrent laryngeal nerve
Q.4 A patient with pheochromocytoma requires which preoperative preparation?
Beta-blockers first
Alpha-blockers first
Diuretics only
Immediate surgery without preparation
Explanation - Preoperative alpha-blockade prevents hypertensive crises; beta-blockers are added after adequate alpha blockade.
Correct answer is: Alpha-blockers first
Q.5 Which thyroid cancer is most commonly associated with lymph node metastasis?
Papillary carcinoma
Follicular carcinoma
Medullary carcinoma
Anaplastic carcinoma
Explanation - Papillary thyroid carcinoma frequently spreads to cervical lymph nodes, unlike follicular carcinoma which spreads hematogenously.
Correct answer is: Papillary carcinoma
Q.6 The preferred surgical treatment for unilateral adrenal adenoma causing Conn’s syndrome is:
Bilateral adrenalectomy
Unilateral adrenalectomy
Medical therapy only
Partial adrenalectomy
Explanation - For unilateral aldosterone-producing adenomas, removal of the affected adrenal gland is curative.
Correct answer is: Unilateral adrenalectomy
Q.7 Which imaging modality is most sensitive for localizing parathyroid adenomas?
MRI
CT scan
Sestamibi scan
PET scan
Explanation - Technetium-99m sestamibi scan is highly sensitive and commonly used for parathyroid adenoma localization.
Correct answer is: Sestamibi scan
Q.8 MEN 2A syndrome is associated with which endocrine tumor?
Papillary thyroid carcinoma
Medullary thyroid carcinoma
Follicular thyroid carcinoma
Anaplastic thyroid carcinoma
Explanation - MEN 2A is classically associated with medullary thyroid carcinoma, pheochromocytoma, and parathyroid hyperplasia.
Correct answer is: Medullary thyroid carcinoma
Q.9 Which thyroid carcinoma arises from parafollicular C cells?
Papillary carcinoma
Follicular carcinoma
Medullary carcinoma
Anaplastic carcinoma
Explanation - Medullary thyroid carcinoma originates from C cells, which secrete calcitonin and are not iodine-dependent.
Correct answer is: Medullary carcinoma
Q.10 The first-line investigation for a thyroid nodule is:
Fine needle aspiration cytology
CT scan
Thyroid scintigraphy
Serum calcitonin
Explanation - FNAC is the most accurate and minimally invasive first-line test for thyroid nodules.
Correct answer is: Fine needle aspiration cytology
Q.11 Which hormone is elevated in medullary thyroid carcinoma?
Thyroxine
Calcitonin
Aldosterone
Cortisol
Explanation - Medullary thyroid carcinoma originates from parafollicular C cells and secretes calcitonin.
Correct answer is: Calcitonin
Q.12 In surgery for pheochromocytoma, sudden hypotension is commonly caused by:
Catecholamine surge
Hemorrhage
Tumor removal
Beta-blockade
Explanation - Removal of the tumor eliminates catecholamine secretion abruptly, leading to hypotension.
Correct answer is: Tumor removal
Q.13 Which complication is most feared after bilateral adrenalectomy?
Hypertension
Hypokalemia
Adrenal crisis
Osteoporosis
Explanation - Loss of adrenal function can lead to life-threatening adrenal insufficiency if not managed with steroid replacement.
Correct answer is: Adrenal crisis
Q.14 Which thyroid carcinoma has the worst prognosis?
Papillary
Follicular
Medullary
Anaplastic
Explanation - Anaplastic thyroid carcinoma is highly aggressive with poor survival rates.
Correct answer is: Anaplastic
Q.15 Which electrolyte disturbance is commonly seen after thyroidectomy?
Hyperkalemia
Hypocalcemia
Hypernatremia
Hypoglycemia
Explanation - Accidental removal or damage to parathyroids can cause hypocalcemia after thyroid surgery.
Correct answer is: Hypocalcemia
Q.16 What is the first-line treatment for differentiated thyroid carcinoma after thyroidectomy?
Chemotherapy
Radioiodine ablation
External beam radiation
Steroid therapy
Explanation - Radioiodine is effective in destroying residual thyroid tissue or metastases after thyroidectomy.
Correct answer is: Radioiodine ablation
Q.17 Which genetic mutation is associated with medullary thyroid carcinoma?
RET mutation
BRAF mutation
TP53 mutation
KRAS mutation
Explanation - RET proto-oncogene mutations are strongly linked to medullary thyroid carcinoma, especially in MEN 2 syndromes.
Correct answer is: RET mutation
Q.18 The surgical approach for bilateral adrenal pheochromocytoma is:
Bilateral adrenalectomy
Partial adrenalectomy
Medical management only
Radiotherapy
Explanation - Partial adrenalectomy helps preserve some adrenal function to avoid lifelong steroid dependence.
Correct answer is: Partial adrenalectomy
Q.19 The initial management of thyroid storm includes:
Thyroidectomy
Beta-blockers
Radioiodine therapy
Steroid withdrawal
Explanation - Beta-blockers are used first to control adrenergic symptoms in thyroid storm before other definitive therapy.
Correct answer is: Beta-blockers
Q.20 Which is the most common site of distant metastasis in follicular thyroid carcinoma?
Lungs
Liver
Brain
Bone
Explanation - Follicular carcinoma spreads hematogenously, with bones being the most common site of distant metastasis.
Correct answer is: Bone
Q.21 The main surgical treatment for Graves’ disease is:
Total thyroidectomy
Partial thyroidectomy
Radioiodine therapy
Subtotal thyroidectomy
Explanation - Total thyroidectomy is the surgical treatment of choice for Graves’ disease when indicated.
Correct answer is: Total thyroidectomy
Q.22 Which of the following is NOT a feature of MEN 1 syndrome?
Parathyroid tumors
Pituitary tumors
Pancreatic tumors
Medullary thyroid carcinoma
Explanation - MEN 1 involves parathyroid, pituitary, and pancreatic tumors; medullary thyroid carcinoma is seen in MEN 2.
Correct answer is: Medullary thyroid carcinoma
Q.23 Which artery supplies the parathyroid glands most commonly?
Superior thyroid artery
Inferior thyroid artery
Lingual artery
Carotid artery
Explanation - The inferior thyroid artery is the major blood supply to the parathyroid glands.
Correct answer is: Inferior thyroid artery
Q.24 A rapidly enlarging hard thyroid mass with hoarseness is most suggestive of:
Papillary carcinoma
Follicular carcinoma
Anaplastic carcinoma
Medullary carcinoma
Explanation - Anaplastic carcinoma presents as a rapidly growing hard thyroid mass often with compressive symptoms.
Correct answer is: Anaplastic carcinoma
Q.25 The most common cause of secondary hyperparathyroidism is:
Vitamin D deficiency
Chronic kidney disease
Parathyroid adenoma
Liver cirrhosis
Explanation - Secondary hyperparathyroidism is most commonly due to CKD causing hypocalcemia and hyperphosphatemia.
Correct answer is: Chronic kidney disease