Thyroid nodule resident survival guide: Difference between revisions

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== FIRE ==
== FIRE ==
{| align=center
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{{familytree/start |summary=Thyroid Nodule Evaluation Algorithm}}
{{familytree | | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | A01=<div style="float: left; text-align: left; line-height: 150% "> '''Thyroid nodule found clinically or incidentally'''<br>
❑ <br> ❑ <br> ❑ <br> ❑ <br> ❑ <br> ❑ <br>
----
'''Associated symptoms:'''<br>
❑ <br> ❑ <br> ❑ <br>
----
'''Epidemiological factors:'''<br> ❑ <br> ❑ <br> ❑  <br> ❑ <br>❑  <br> ❑ <br> ❑ <br> ❑ </div>}}
{{familytree | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | | | | | | | | B01 | | | | | | | | | | | | | B01=''' TSH evaluation:'''<br><div style="float: left; text-align: left; line-height: 150% ">
❑ <br>
❑ <br>
❑ <br>
❑ <br>
❑ <br>
❑ <br>
❑ <br></div>}}
{{familytree | | | | | | | | | | | | | | | | | | | |!| |  | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | |,|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|-|.| | | }}
{{familytree | | | | | | | | | C01 | | | | | | | | | | | | | | | | | | C02 | C01 = '''TSH normal or elevated''' | C02 = '''TSH subnormal'''}}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | |!| | | | | |}}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | C01 | | | | | | C01 = '''Radionuclide thyroid scan'''}}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | |,|-|-|-|-|^|-|-|-|-|.| |}}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | C01 | | | | | | | | C02 | | | C01 = '''Cold nodule''' <br> Nodule is non-functional | C02 = '''Hot nodule''' <br> Nodule is functional}}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | |!| | | | | | | | | |!| | | | }}
{{familytree | | | | | | | | | |`|-|-|-|-|-|-|-|-|-|-|-|-|-| C01 | | | | | | | | C02 | | | | C01 = Ultrasound evaluation | C02 = Check thyroid hormones<br> '''Free T4 and T3 check'''}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | | | |,|-|-|-|-|-|^|-|.| | | | | |,|-|^|-|.| }}
{{familytree | | | | | | | | | | | | | | | | | | C01 | | | | | | C02 | | | | C03 | | C04 | C01 = Meets the criteria <br> | C02 = Doesn't meet criteria | C03 = Normal <br> '''Subclinical hypothyroidism''' | C04 = Elevated <br> '''Thyroid adenoma''' <br> ''' Hyperthyroidism'''}}
{{familytree | | | | | | | | | | | | | | | | | | |!| | | | | | | |!| | | | | |!| | | |!| | | }}
{{familytree | | | | | | | | | | | | | | | | | | C01 | | | | | | |`|-|-|v|-|-|'| | | C02 | | C01 = '''FNA''' | C02 = '''Treat hyperthyroidism'''}}
{{familytree | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | C04 | | | | | | | | | C04 = '''Monitoring'''}}
{{familytree | | | |,|-|-|-|-|-|-|-|-|-|v|-|-|-|-|+|-|-|-|-|v|-|-|-|-|v|-|-|-|-|v|-|-|-|.| }}
{{familytree | | | A01 | | | | | | | | A02 | | | A03 | | | A04 | | | A05 | | | A06 | | A07 | | | A01 = '''Follicular neoplasm''' | A02 = '''FLUS''' | A03 = '''FLUS''' | A04 = '''Benign''' | A05 = '''Suspicious for malignancy''' | A06 = '''Papillary thyroid carcinoma''' | A07 = '''Nondiagnostic'''}}
{{familytree/end}}
|}


†<small>Illness severity:
*Severe: Total disability due to diarrhea;
*Moderate: Able to function but with forced change in activities due to illness;
*Mild: No change in activities</small>
== Diagnosis ==
== Diagnosis ==



Revision as of 17:20, 2 August 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Thyroid nodule Resident Survival Guide Microchapters
Overview
Classification
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Overview

Classification

Causes

FIRE

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Thyroid nodule found clinically or incidentally








Associated symptoms:




Epidemiological factors:







 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TSH evaluation:








 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{ }}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TSH normal or elevated
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TSH subnormal
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Radionuclide thyroid scan
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cold nodule
Nodule is non-functional
 
 
 
 
 
 
 
Hot nodule
Nodule is functional
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Ultrasound evaluation
 
 
 
 
 
 
 
Check thyroid hormones
Free T4 and T3 check
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Meets the criteria
 
 
 
 
 
Doesn't meet criteria
 
 
 
Normal
Subclinical hypothyroidism
 
Elevated
Thyroid adenoma
Hyperthyroidism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FNA
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Treat hyperthyroidism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Monitoring
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Follicular neoplasm
 
 
 
 
 
 
 
FLUS
 
 
FLUS
 
 
Benign
 
 
Suspicious for malignancy
 
 
Papillary thyroid carcinoma
 
Nondiagnostic
 
 

Illness severity:

  • Severe: Total disability due to diarrhea;
  • Moderate: Able to function but with forced change in activities due to illness;
  • Mild: No change in activities

Diagnosis

Treatment

Do's

Don'ts

References