Thyroid Nodules

Question 1

What is the primary aim when investigating a thyroid nodule?

Answer 1

To exclude thyroid cancer

Question 2

Approximately what percentage of thyroid nodules are malignant?

Answer 2

Around 5%

Question 3

How may thyroid nodules be detected clinically?

Answer 3

Patient-noticed lump, clinical examination, or incidental imaging finding

Question 4

What are the most common benign causes of thyroid nodules?

Answer 4

Multinodular goitre, thyroid adenoma, Hashimoto’s thyroiditis, thyroid cysts

Question 5

What types of cysts can form thyroid nodules?

Answer 5

Colloid, simple, or haemorrhagic cysts

Question 6

What is the most common malignant cause of a thyroid nodule?

Answer 6

Papillary thyroid carcinoma

Question 7

Which thyroid cancer arises from parafollicular (C) cells?

Answer 7

Medullary thyroid carcinoma

Question 8

Which thyroid malignancy is associated with Hashimoto’s thyroiditis?

Answer 8

Thyroid lymphoma

Question 9

Which thyroid cancer is aggressive and often presents with pressure symptoms?

Answer 9

Anaplastic thyroid carcinoma

Question 10

What blood test should be checked in all patients with a thyroid nodule?

Answer 10

Thyroid function tests

Question 11

Why are thyroid function tests important in thyroid nodule assessment?

Answer 11

To identify hyperfunctioning nodules and guide further investigation

Question 12

What is the first-line imaging investigation for thyroid nodules?

Answer 12

Thyroid ultrasound

Question 13

What is the role of thyroid ultrasound in nodule assessment?

Answer 13

To assess size, structure, and features suspicious of malignancy

Question 14

Which ultrasound features suggest malignancy in a thyroid nodule?

Answer 14

Solid hypoechoic nodule, irregular margins, microcalcifications, taller-than-wide shape

Question 15

What is the next step if a thyroid nodule has suspicious ultrasound features?

Answer 15

Fine needle aspiration (FNA)

Question 16

Why is fine needle aspiration important in thyroid nodules?

Answer 16

It helps differentiate benign from malignant nodules cytologically

Question 17

What type of thyroid nodule is suggested by suppressed TSH?

Answer 17

A hyperfunctioning (toxic) nodule

Question 18

Why are hyperfunctioning nodules rarely malignant?

Answer 18

Autonomous hormone production is usually benign