This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
A 6-yrs-old child complains of difficulty in swallowing and on examination there is a sublingual swelling, which is suspected to be Lingual thyroid. The 1st step in management of this child would be: 
Select and explain. 
A. Tracheostomy and airway maintenance, B. Thyroid scan, C. Intubation, D. Explain to child's parents that he may require immediate surgery
B: Thyroid scan
Answer: B: Thyroid scan 
Explanation: Lingual Thyroid It represents failure of median thyroid tissue to descend normally. Presentation * Asymptomatic * Choking, dysphagia * Airway obstruction, hemorrhage * Hypothyroidism (occasionally) Investigation. Thyroid scan- always performed before radioablative therapy or surgery as it may be the only thyroid tissue present. Treatment * Replacement thyroxine - decrease the size * Radioactive iodine - decrease the size * Surgery- excision rarely required.