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Papillary thyroid cancer — MCCQE Part 1 MCQ

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ModerateThyroid DisordersPapillary thyroid cancerMCCQE Part 1

A 32-year-old woman has a firm thyroid nodule, cervical lymphadenopathy and ultrasound showing a hypoechoic nodule with microcalcifications. Which of the following is the most appropriate next step?

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Correct answer: AArrange ultrasound-guided fine-needle aspiration

Arrange ultrasound-guided fine-needle aspiration is the single best answer because the age, timing, examination findings and investigations in the vignette fit Papillary thyroid cancer better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian thyroid nodule guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian thyroid nodule guidance