Follicular Neoplasm — RACP Adult Medicine MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: B — Offer diagnostic thyroid lobectomy after endocrine-surgical review and discussion with the patient
The best answer is “Offer diagnostic thyroid lobectomy after endocrine-surgical review and discussion with the patient”. Bethesda IV cytology cannot distinguish follicular adenoma from carcinoma because capsular or vascular invasion requires histology. Diagnostic lobectomy is the usual operation when there is no separate indication for total thyroidectomy. Bethesda IV does not imply hyperfunction, and surveillance alone or hormone suppression does not resolve the histological question.
Reference: Australian Prescriber: Investigating thyroid nodules: https://australianprescriber.tg.org.au/articles/investigating-thyroid-nodules.html