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Thyroid nodule — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareThyroid noduleUSMLE Step 3

A 46-year-old woman has a 1.8-cm thyroid nodule found incidentally. TSH is normal. Ultrasound shows a solid hypoechoic nodule with irregular margins and microcalcifications. She has no compressive symptoms. Which of the following is the most appropriate at this time?

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Reveal the answer and explanation

Correct answer: D — Perform ultrasound-guided fine-needle aspiration

Suspicious ultrasound features and size meeting threshold warrant fine-needle aspiration to evaluate for malignancy.

Reference: American Thyroid Association Thyroid Nodule Guideline