FCPS Part 1 Surgery: Endocrine Surgery MCQs — High-Yield Practice Questions

Thyroid, parathyroid and adrenal surgery MCQs for FCPS Part 1 Surgery and Allied — FNAC, MEN syndromes, phaeochromocytoma management, post-thyroidectomy hypocalcaemia and more, each explained.

Endocrine surgery — thyroid, parathyroid and adrenal — is tested as part of FCPS Part 1 Surgery and Allied, and in HighYield's own Surgery question bank it carries real depth. It just hasn't had its own dedicated practice set until now. Here is a sample.

Sample MCQs

1. What is the single best initial investigation for a solitary thyroid nodule found on examination?

A) Fine needle aspiration cytology (FNAC) ✅
B) CT scan of the neck
C) Thyroid scintigraphy
D) Core needle biopsy

FNAC is the first-line investigation for a solitary thyroid nodule to assess malignancy risk before imaging or surgery.

2. The most common cause of primary hyperparathyroidism is:

A) Parathyroid adenoma ✅
B) Parathyroid carcinoma
C) Multi-gland hyperplasia
D) Parathyroid cyst

A solitary parathyroid adenoma accounts for the large majority of primary hyperparathyroidism cases.

3. Bilateral recurrent laryngeal nerve injury during thyroidectomy classically presents with:

A) Hoarseness only
B) Acute airway obstruction requiring emergency airway management ✅
C) No symptoms
D) Dysphagia only

Bilateral RLN injury leaves both cords in a paramedian position, obstructing the airway — a surgical emergency.

4. Among functioning adrenal incidentalomas, the most common type secretes:

A) Cortisol ✅
B) Aldosterone
C) Catecholamines
D) Androgens

Most adrenal incidentalomas are non-functioning, but among functioning ones, cortisol-secreting adenomas are the most common.

5. MEN type 2A classically includes medullary thyroid carcinoma, phaeochromocytoma and:

A) Primary hyperparathyroidism ✅
B) Pituitary adenoma
C) Pancreatic islet cell tumour
D) Mucosal neuromas

MEN2A pairs medullary thyroid carcinoma and phaeochromocytoma with hyperparathyroidism; mucosal neuromas and a marfanoid habitus point to MEN2B instead.

6. Before surgical removal of a phaeochromocytoma, which class of drug must be started first?

A) Alpha-adrenergic blockers ✅
B) Beta-blockers alone
C) ACE inhibitors
D) Calcium channel blockers alone

Alpha-blockade must precede beta-blockade; starting a beta-blocker first can cause unopposed alpha stimulation and a hypertensive crisis.

7. Transient hypocalcaemia after total thyroidectomy is most commonly due to:

A) Removal or devascularisation of the parathyroid glands ✅
B) Hypoalbuminaemia
C) Vitamin D toxicity
D) Renal failure

The parathyroid glands sit close to the thyroid and are at risk of inadvertent removal or devascularisation during thyroidectomy.

8. Which of the following is NOT a standard treatment option for Graves' disease?

A) Antithyroid drugs
B) Radioactive iodine
C) Subtotal or total thyroidectomy
D) External beam radiotherapy ✅

Graves' disease is managed with antithyroid drugs, radioactive iodine or surgery — external beam radiotherapy is not a standard option.

Why This Subject Gets Overlooked

Candidates often focus their Surgery revision on General Surgery and the classic acute-abdomen topics, and treat endocrine surgery as a minor add-on. At FCPS Part 1 depth, thyroid, parathyroid and adrenal questions are tested with the same rigour, and the core concepts — FNAC-first for nodules, alpha-before-beta in phaeochromocytoma, MEN syndromes — repeat across sittings.

HighYield's FCPS Part 1 Surgery and Allied question bank covers endocrine surgery alongside every other subject in the paper, each question explained. See the FCPS Surgery syllabus guide for the full topic breakdown, or General Surgery, Anatomy & Pathology MCQs for the bank's three largest subjects. Try the first 20 questions free, no sign-in required.

Frequently Asked Questions

Is endocrine surgery a separate paper in FCPS Part 1 Surgery?

No. FCPS Part 1 Surgery and Allied is tested as a single paper, with endocrine surgery as one of several basic-and-applied-science subjects within it.

What's the most tested endocrine surgery topic?

Thyroid pathology (nodules, Graves' disease, thyroidectomy complications) and the MEN syndromes come up most consistently across past-paper-style questions.