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Old 02-06-2012
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Default Thyroid nodule workup: When to do FNA?

Hi,

I'm kinda of confused at the moment since UW and kaplan Qbank have different approaches to FNA!

UW thyroid nodule workup includes: do TSH first>

a) if low>do radionuclide thyroid scan
i) if high uptake>investigate causes of hyperthyroidism
ii) if low uptake> investigate by thyroid ultrasound (b)
b) if high or normal> do thyroid Ultrasound
- if benign features> follow up and surviellance
-if malignant features> do FNA

Kaplan Qbank workup includes:

if TSH is low> do FNA to rule out thyroid cancer!



so which one should I go with?


Thanks

Last edited by drZoe; 02-06-2012 at 03:08 PM.
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Old 02-06-2012
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Quote:
Originally Posted by drZoe View Post
Hi,

I'm kinda of confused at the moment since UW and kaplan Qbank have different approaches to FNA!

UW thyroid nodule workup includes: do TSH first>

a) if low>do radionuclide thyroid scan
i) if high uptake>investigate causes of hyperthyroidism
ii) if low uptake> investigate by thyroid ultrasound (b)
b) if high or normal> do thyroid Ultrasound
- if benign features> follow up and surviellance
-if malignant features> do FNA

Kaplan Qbank workup includes:

if TSH is low> do FNA to rule out thyroid cancer!



so which one should I go with?


Thanks
Now this is getting confusing.
Anyway, What I learnt from MTB-Ck was that in thyroid nodule, you do TSH/T4 first. If T4 is high or TSH is low, it is not cancer (since cancer does not cause hyperfunctioning of the gland) so no need to do FNA .
But if TSH and T4 is normal, then do FNA to rule out malignancy
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Old 02-06-2012
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Quote:
Originally Posted by OzoneZone234 View Post
Now this is getting confusing.
Anyway, What I learnt from MTB-Ck was that in thyroid nodule, you do TSH/T4 first. If T4 is high or TSH is low, it is not cancer (since cancer does not cause hyperfunctioning of the gland) so no need to do FNA .
But if TSH and T4 is normal, then do FNA to rule out malignancy
That's what I thought so too. But the Qbanks beg to differ..

Thanks Ozone
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