Question

A 30-year-old female presented with swelling in the neck. What is the next step in evaluation?

• A. I131
• B. FNAC
• C. TSI & T4
• D. FSH

Hint:

Measuring thyroid hormones (TSH, T3, T4) is crucial for diagnosing thyroid disorders in patients with neck swelling.

Answer 1

The Correct Option is C

When a 30-year-old female presents with neck swelling, it can be indicative of thyroid gland involvement, such as goiter or thyroid dysfunction. To properly assess and evaluate this condition, laboratory tests can help determine the underlying cause.

The given options for the next step in evaluation are:

I131

FNAC

TSI & T4

FSH

Let's analyze each:

1. I₁₃₁: This is a radioactive iodine uptake test primarily used to assess thyroid function and diagnose hyperthyroidism. However, it is not the first-line test for evaluating neck swelling.
2. FNAC (Fine Needle Aspiration Cytology): This procedure helps in obtaining tissue samples for cytological examination and is usually recommended when there is suspicion of a thyroid nodule or malignancy.
3. TSI & T4: These are blood tests measuring Thyroid Stimulating Immunoglobulin (TSI) and thyroxine (T4), respectively. TSI is particularly useful in evaluating autoimmune thyroid conditions (e.g., Graves' disease), while T4 levels indicate overall thyroid function. It helps in assessing thyroid gland activity in cases of swelling, potentially due to hyperthyroidism.
4. FSH (Follicle Stimulating Hormone): This is related to reproductive health and is not relevant to assessing thyroid-related neck swelling.

Considering the options, the most pertinent step for evaluating neck swelling of likely thyroid origin is to perform blood tests to check for thyroid function and autoimmunity. Therefore, the next step should be measuring TSI & T4 levels to gain insight into the thyroid's activity and possible autoimmune involvement.