Ask me some inicet pyqs in thyroid

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INICET PYQ thyroid questions surgery medicine 2022 2023 2024

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Here are 10 high-yield INICET PYQs on Thyroid - curated from actual recalled questions across sessions (2020-2025), with detailed explanations:

🩺 INICET PYQs - Thyroid

Q1. (INICET Nov 2021 - Physiology) The sodium iodide symporter (NIS) is present in all of the following EXCEPT:

A. Thyroid gland
B. Placenta
C. Salivary gland
D. Pituitary gland

✅ Answer: D - Pituitary gland NIS is expressed in the thyroid, salivary glands, gastric mucosa, mammary glands, and placenta - but NOT the pituitary. This is relevant because radioiodine (I-131) can affect these non-thyroid tissues.

Q2. (INICET - Pathology) Which of the following conditions does NOT show Psammoma bodies on histology?

A. Follicular carcinoma of thyroid
B. Papillary carcinoma of thyroid
C. Meningioma
D. Serous cystadenocarcinoma of ovary

✅ Answer: A - Follicular carcinoma of thyroid Psammoma bodies (concentric calcified lamellations) are seen in Papillary thyroid carcinoma, Meningioma, Serous cystadenocarcinoma of the ovary, and Mesothelioma - but NOT in follicular carcinoma. Follicular carcinoma is characterized by capsular and vascular invasion.

Q3. (INICET - Surgery) A 30-year-old woman on post-op day 3 after total thyroidectomy for medullary carcinoma develops carpopedal spasm on inflating the BP cuff above systolic pressure (Trousseau's sign). What is the most likely cause?

A. Hypothyroidism
B. Parathyroid insufficiency
C. Nerve damage
D. Infection

✅ Answer: B - Parathyroid insufficiency Total thyroidectomy can inadvertently remove or devascularize the parathyroid glands, causing hypocalcemia. Trousseau's sign and Chvostek's sign are classic signs of hypocalcemia. Hypocalcemia typically peaks on post-op day 2-5.

Q4. (INICET - Surgery) A 27-year-old female presents with a large thyroid swelling. Which of the following is NOT a recognized complication from compression?

A. Hoarseness due to RLN compression
B. Dysphagia due to oesophageal compression
C. Superior vena cava syndrome
D. None of the above

✅ Answer: C - Superior vena cava syndrome A goiter can compress the trachea (stridor), recurrent laryngeal nerve (hoarseness), and oesophagus (dysphagia). SVC syndrome is NOT caused by a goiter - it is caused by mediastinal masses like lymphoma or lung cancer.

Q5. (INICET - Pathology/Genetics) Which of the following gene-disease associations is INCORRECT?

A. STK11 - Breast cancer
B. PTEN - Thyroid carcinoma
C. TP53 - Mucosal neuroma
D. BRCA2 - Prostate carcinoma

✅ Answer: C - TP53 - Mucosal neuroma

Mucosal neuromas are associated with MEN 2B (RET mutation), NOT TP53
PTEN mutations cause Cowden syndrome (thyroid + breast carcinoma)
STK11 mutations cause Peutz-Jeghers syndrome (GI + breast cancer risk)
BRCA2 is indeed associated with prostate carcinoma risk

Q6. (INICET - Pathology) Neurosecretory granules (dense core granules) are seen in ALL of the following EXCEPT:

A. Medullary thyroid carcinoma
B. Pituitary adenoma
C. Paraganglioma
D. Adrenocortical tumor

✅ Answer: D - Adrenocortical tumor Neurosecretory granules are found in neuroendocrine tumors (NETs): MTC (secretes calcitonin), pituitary adenomas, paragangliomas, carcinoids, phaeochromocytomas. Adrenocortical tumors arise from cortex (not neuroendocrine origin) and lack these granules.

Q7. (INICET - High Yield) The most common thyroid malignancy is:

A. Follicular carcinoma
B. Papillary carcinoma
C. Medullary carcinoma
D. Anaplastic carcinoma

✅ Answer: B - Papillary carcinoma (~85%) Key features: Orphan Annie eye nuclei, nuclear grooves, Psammoma bodies, spreads via lymphatics, excellent prognosis. Associated with RET/PTC rearrangements and BRAF V600E mutation.

Q8. (INICET - Pharmacology/Endocrinology) Thyroxine (T4) is primarily transported in blood by:

A. Albumin
B. Thyroxine-binding globulin (TBG)
C. Transthyretin (Prealbumin)
D. Haptoglobin

✅ Answer: B - TBG (carries ~75% of T4)

TBG: 75% of T4; highest affinity
Transthyretin (prealbumin): ~15%
Albumin: ~10%; lowest affinity but highest capacity Only free (unbound) hormone is biologically active.

Q9. (INICET - Surgery) Which of the following is the most feared complication of thyroid surgery that can cause stridor and respiratory distress immediately post-op?

A. Recurrent laryngeal nerve palsy
B. Bilateral RLN injury
C. Thyroid storm
D. Hypocalcemia

✅ Answer: B - Bilateral RLN injury Bilateral RLN damage leads to bilateral adductor paralysis of vocal cords - cords assume midline position, causing acute airway obstruction, stridor and emergency tracheostomy may be needed. Unilateral RLN palsy causes hoarseness only.

Q10. (INICET - Endocrinology) Which thyroid carcinoma is associated with MEN 2A and MEN 2B syndromes and secretes calcitonin?

A. Papillary thyroid carcinoma
B. Follicular thyroid carcinoma
C. Medullary thyroid carcinoma
D. Anaplastic carcinoma

✅ Answer: C - Medullary thyroid carcinoma (MTC)

MTC arises from parafollicular C-cells (neural crest origin)
Secretes calcitonin (tumor marker)
Associated with RET proto-oncogene mutations
MEN 2A: MTC + phaeochromocytoma + parathyroid hyperplasia
MEN 2B: MTC + phaeochromocytoma + mucosal neuromas + marfanoid habitus
Treatment: Total thyroidectomy (NOT RAI, as C-cells don't take up iodine)

Quick Revision Table

Topic	Key Point
Most common thyroid Ca	Papillary (85%)
Best prognosis	Papillary
Worst prognosis	Anaplastic
Psammoma bodies	Papillary (NOT follicular)
Calcitonin marker	Medullary
Post-thyroidectomy hypocalcemia	Parathyroid injury
Bilateral RLN injury	Airway emergency
SVC syndrome - NOT caused by	Goiter
NIS absent in	Pituitary
PTEN mutation	Cowden syndrome - thyroid + breast Ca

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