This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Endocrinology and breast, Subject name: Surgery
Treatment of Medullary Ca of thyroid with lymph node metastasis 
Select and explain. 
A. Sub total thyroidectomy + Radioiodine + TSH supression, B. Subtotal thyroidectomy + Radiotherapy, C. Total thyroidectomy + Radioiodine, D. Total thyroidectomy + Radiotherapy
D: Total thyroidectomy + Radiotherapy
Answer: D: Total thyroidectomy + Radiotherapy 
Explanation: .In medullary carcinoma thyroid , total thyroidectomy is treatment of choice. Radiotherapy can be considered in unresectable cases or after complete surgical resection in few cases. Note : Since medullary thyroid cancer doesnot arise from follicular cells, TSH suppression and RAI (radio active iodine) therapy have no role. Source : Sabiston 20th edition pg 910