AAAAA
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mobile nodule, mass----->fine needle biopsy, biopsy, biopsy
indurated anal mass------ I & D
lung mass, - Broch ------->still bipsy
breast mass, - mammography-------> still biopsy, biopsy
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| achilles
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how about 2-measure TSH and then go for FNAC.
nice avatar wyvern !
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| achilles
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i know TSH is usually normal in thyroid cancer...but should'nt we still do it first.
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| yasmeen
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ITS ASYMPTOMATIC SO FIRST STEP IS FNAC
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| aimhigh
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Achilles chose the right answer. This is a question from UW. The reason I put it here is that different resources seem to give different opinions about this matter.
Pretests and BP prefer FNA if there is a nodule in the thyroid. However, UW gives a clear regimen: always always TSH first and choose other methods according to the result of TSH. If TSH is normal, do fna; if TSH is low, do scan: if it's a "hot" nodule, do not need to do fna; if TSh is high, suspect tashimoto; if the size is > 1.5cm, do FNA; otherwise assume benign if seeing that the nodule reduces after a trial of levothyroxine
I think uw gave a very logical explanation but what should we choose in the real exam???
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| yasmeen
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FIRST DIAGNOSTIC STEP OF ASYMPTOMATIC THYROID NODULE SPECIALLY IN THIS AGE IS FNAC U HAVE TO SEE IF ITS MALIGNANT OR NOT.ITS WHAT IS MENTIONED IN STANDARD TEXT BOOKS
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| alenka
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yep,i remeber this question-measure TSH first.
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| achilles
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CMDT says thyroid nodules are an indication for thyroid function testing. serum determintations for TSH and free T4 are preferred.
FNAC, however, is the best test to assess a nodule.
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" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
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| wyvern
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Ya i just checked, that was a good question aimhigh.....
N thanx achilles!
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| msyamp
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THnak everyone. I would have gone for FNAC if i had not seen your discussion and cross checked it. thank you
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