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Qs NBME -
#1
pern

A 27 year-old-man is found to have a solitary thyroid nodule during a routine health examination. A thyroid ctscan shows uptake of radioactive iodine by the nodule. Which is the diagnosis?

A- Hashimoto's thyroiditis
B- follicular adenoma
C- granulomatous thyroiditis
D- medullary carcinoma
E- papillary carcinoma
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#2
pern

can anybody answer it , please, I think is B but I don't sure because in kaplannotes say the opposite and in BRS is not clear
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#3
Rav

Yeah,--i wud go with b--what do Kaplan notes say???
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#4
kiddyfriend

I'm pretty sure it's follicular adenoma.

It's not Hashimoto - doesn't make nodules.
It's not granulomatous thyroiditis (=Subacute Thyroiditis is marked by sudden, painful enlargement of the thyroid gland. It tends to affect young and middle-aged women most often. )
It's not medullary Ca as ´that wouldn't take up iodine.

Leaves papillary Ca v. adenoma. Aren't cancers usually considered to be "cold" lesions, meaning not taking up iodine? So I go with follicular adenoma. Also the age isn't right for cancer.
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#5
tj

goljan says any nodule in a male or a child is ca.
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#6
pern

Tks a lot !
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#7
nani

goljan can kiss my ass. you can not tell a thyroid nodule is Ca just because it´s on a child or male. you need a biopsy.

i would pick B) because of: hot nodule and frecuency.
hashimoto id difuse tiroyditis and cancer is almost always cold at ctscan.
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#8
pern

tks nani, i guess the same thing
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#9
apr - aprguez

answer B
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#10
Igor-Germany

it is B
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