USMLE Forum Archives - USMLE Step 3 - lets have a discussion
lets have a discussion
sackatdoc - 04-15-09 13:08
a patient underwent an MRI for persistent pain in tyhe neck, pain that radiates to whole arm and was treated with NSAIDS without much benefit,was found to have 0.6mm nonpalpable thyroid swelling. she doesnt have a family h/O thyroid malignancy or any thyroid symptooms, next best step??
sackatdoc - 04-15-09 13:08
a patient underwent an MRI for persistent pain in tyhe neck, pain that radiates to whole arm and was treated with NSAIDS without much benefit,was found to have 0.6mm nonpalpable thyroid swelling. she doesnt have a family h/O thyroid malignancy or any thyroid symptooms, next best step??
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Re: lets have a discussion
sackatdoc - 04-15-09 13:38 cervical spine on MRI is fine,but what you gonna do for thyroid
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Re: lets have a discussion sackatdoc - 04-15-09 13:47 how long and what should be done while watching
#6
Re: lets have a discussion bingousmle - 04-15-09 13:56 first i would like to have a thorough history regarding the pain in her neck, since thats her primary complaint and not the thyyroid nodule which csme up as an incidental finding..
watch for any symptoms of thyroid dysfunction till she comes to you.. lol
come on summarise your case.
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Re: lets have a discussion sackatdoc - 04-15-09 14:00 yes u are right in watching with 6 monthly thyroid exam looking for increase in size of the nodule
that cervical sprain will be treated with time, as no abnormality detected on MRI, or if there is it will be manged accordingly, this q was testing the management of asymptomatic thyroid nule found incidently, but if positive family history , have to do...... what ?next question?
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Re: lets have a discussion bingousmle - 04-15-09 14:04 positive family history for??? you leave your question incomplete over there..
fna under ultrasound guidance ,would be my guess, i wonder if it would be possible with a 0.6mm nodule..
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Re: lets have a discussion sackatdoc - 04-15-09 14:08 sorry 0.6cm
family h/o thyroid cancer or radiation exposure
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Re: lets have a discussion bingousmle - 04-15-09 14:12 i would still go with an fna under ultrasound guindance..
#13
Re: lets have a discussion sackatdoc - 04-17-09 20:54 yes your choice is right, if any new info here, please feel free to add
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