1. A 42-year-old woman presents with a 2cm solitary thyroid nodule on ultrasound. She is asymptomatic. Which of the following is the best next step?

• Repeat thyroid ultrasound in 6 months
• Measure serum TSH level
• Perform fine needle aspiration biopsy of the nodule
• Start levothyroxine therapy

2. A 32-year-old man presents with a right-sided thyroid mass. Fine needle aspiration reveals follicular lesions of undetermined significance (FLUS). Which of the following is the best next step in management?

• Repeat fine needle aspiration in 3 months
• Order molecular testing of the specimen
• Recommend right thyroid lobectomy
• Start levothyroxine therapy

3. A 22-year-old woman is diagnosed with hyperthyroidism due to Graves’ disease. She is started on methimazole but remains symptomatic after eight weeks. Which additional therapy is now indicated?

• Radioactive iodine therapy
• Selenium supplementation
• Propranolol administration
• Levothyroxine therapy

4. A 63-year-old woman with multinodular goitre is found to have a 3 cm complex nodule with microcalcifications on ultrasound. Fine needle aspiration reveals Bethesda VI (malignant) cytology. Which of the following is indicated?

• Near-total thyroidectomy
• Radioactive iodine therapy
• Repeat ultrasound in 6 months
• Levothyroxine suppressive therapy

5. A 67-year-old man undergoes a total thyroidectomy for papillary thyroid cancer. Post-operative staining reveals tumour invasion into locoregional lymph nodes. A radioactive iodine scan shows uptake outside the thyroid bed. What is the best next step?

• Serum thyroglobulin level
• Empiric radioactive iodine therapy
• PET scan
• MRI of neck/chest