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Thyroid nodule — MCCQE Part 1 MCQ

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HardNeck MassThyroid noduleMCCQE Part 1

A 42-year-old woman has a 2.4 cm thyroid nodule found on examination. TSH is normal and ultrasound shows hypoechogenicity with microcalcifications. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Fine-needle aspiration biopsy based on suspicious ultrasound features and size

Suspicious ultrasound features in a nodule of this size warrant FNA to evaluate malignancy. Normal TSH does not exclude cancer, and levothyroxine suppression is not routine for all nodules. Surgery is guided by cytology, risk and patient factors rather than performed blindly in every case.

Reference: Canadian endocrinology/thyroid nodule practice; ATA guideline used in Canadian care