Question of the Week - December 2021
December 1st, 2021
A 16-year-old female presents to the ED complaining of right-sided throat pain and painful swallowing over the past 6 days. Physical exam reveals an erythematous, swollen right tonsil with left uvular deviation. Needle aspiration yields purulent fluid. Patient’s mother states that she has had three previous episodes over the past few years.
What is the next best step in management?
A. Oral penicillin, ibuprofen and observation
B. Repeat drainage over the next 8-12 hours
C. Tonsillectomy
D. Warm salt water gargling and rinsing
-
Patients with recurrent tonsillitis (≥3 episodes in the previous 1 to 3 years) should be considered for tonsillectomy.
December 15th, 2021
A 48-year-old woman presents to your office after undergoing a fine needle aspiration biopsy of a 1.7 cm nodule located within her right thyroid lobe. The pathology report states "Suspicious for a follicular neoplasm." Based on these results, which of the following should be considered for the next steps in clinical management?
A. Clinical and sonographic follow-up in 6 months
B. Repeat FNA with ultrasound guidance
C. Molecular testing and lobectomy
D. Near-total thyroidectomy
-
According to Bethesda System for Reporting Thyroid Cytopathology, the recommended management of a patient with a diagnosis of follicular nodule or suspicious for follicular nodule (FN/SFN) is surgical excision of the lesion, most often a hemithyroidectomy or lobectomy, but molecular testing may be used to supplement risk assessment rather than proceeding directly to surgery.
SUPER high-yield for sub-I rotations!