this definitely needs some work based off a recent question I did with the uworld 18539 chart on evaluating thyroid nodules - first step is always TSH + thyroid U/S, next step if TSH is normal or elevated is “Consider FNA based on size and U/S findings”
next step for low TSH is “radioactive iodine scintigraphy” if we want to clarify in extras furhter
It may take some time to consolidate this group of cards since they will have to be rewritten to appropriately test the different parts of the pathway
1535312104327 and 1557000290495 I think are actually fine as written, consistent with uworld 18539
the true next step I would interpret as ultrasound, surely? Needs clarification that USS already performed. post-USS, dynamed advises USS surveillance surveillance only for most that ≥5mm but <1cm, except with high risk features, and all that are <5mm regardless of features. FNA not needed for purely cystic unless complex or aspiration req’d. I’ll attach a screenshot of advice, as there’s too much to summarise here without linebreaks.
These guidelines are very complex - definitely some variation across societies, too (ACR vs. ATA). Personally I think the cards need to be structured in accordance with UpToDate algorithm and specifics (i.e., what are suspicious features) can just be part of extra