A thyroid nodule is found on a 40-year-old woman on routine evaluation. She has no prior history of thyroid disease and clinically feels well. There is a 20-mm nontender nodule on the right lobe of the thyroid with no associated lymphadenopathy. Thyroid function tests are normal. Which of the following is the most appropriate next step in management?
سؤال مجاني 9 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Fine needle aspiration (FNA) biopsy
A 2 cm nodule with normal thyroid function needs tissue diagnosis: FNA biopsy is the only test that reliably separates benign from malignant nodules. A thyroid scan is only useful if TSH is low or cytology is indeterminate; waiting 6 months is inappropriate for a nodule this size; surgery is decided by the FNA (Bethesda) result.
ليش كل خيار صح أو غلط
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A
ليش غلط
A thyroid scan plays only a supplemental role: it is done when FNA is indeterminate or when TSH is low. This patient's TSH/function is normal and FNA has not been done.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 12 -
B
ليش صح
FNA biopsy is the only test that can reliably separate benign from malignant nodules, so it is the next step for a 2 cm nodule with normal thyroid function.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 12 -
C
ليش غلط
Observation with periodic ultrasound (about 1 year) is for nodules already shown benign on FNA; this nodule has not been biopsied yet.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 12 -
D
ليش غلط
Surgery is decided after FNA (malignant/suspicious, follicular neoplasm, or indeterminate with a cold scan); no FNA has been done, so partial thyroidectomy is premature.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 12 -
E
ليش غلط
Complete thyroidectomy is not a first step: surgery is indicated only once FNA is suspicious/malignant (or follicular neoplasm), and FNA has not been done.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 12
- المصدر
- Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 12
Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 13 - المحاضرة
- Thyroid Disorders · Endocrinology · Module B
- ظهر في
- Endo bank