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Thyroid nodule — USMLE Step 2 CK MCQ

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HardSurgeryThyroid noduleUSMLE Step 2 CK

A 42-year-old Native American woman comes to the urgent care clinic because of progressive symptoms. History and focused examination are notable for solitary thyroid nodule with suspicious ultrasound features and normal TSH. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most appropriate initial diagnostic study?

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Correct answer: D — Fine-needle aspiration biopsy

The vignette describes Thyroid nodule, supported by solitary thyroid nodule with suspicious ultrasound features and normal TSH. Fine-needle aspiration biopsy is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-39