American Board of Family Medicine (ABFM) Practice Exam 2026 - Free ABFM Practice Questions and Study Guide

In the case of a patient with a thyroid nodule larger than 1 cm and a normal TSH level, the most appropriate next step is to conduct a biopsy. This recommendation aligns with current clinical guidelines, which emphasize the importance of evaluating thyroid nodules that meet certain criteria for size and associated risk factors.

Performing a biopsy is crucial because thyroid nodules can be benign or malignant, and determining the nature of the nodule is necessary for guiding management. A biopsy, typically performed via fine-needle aspiration, allows for cytological examination of the nodule cells, helping to identify any neoplastic changes that might indicate cancer.

In contrast, other approaches like a radionuclide uptake scan or scheduling clinical follow-ups may be less appropriate as immediate steps for this specific scenario. Radionuclide scans are generally reserved for nodules that are suspicious based on ultrasound characteristics or in the setting of hyperthyroidism, which is not suggested here due to the normal TSH level. Likewise, simply rechecking TSH levels in 6 months would not provide the necessary information regarding the nodule itself and would delay necessary evaluation and management.

Thus, conducting a biopsy is the most logical and evidence-based approach in managing patients with thyroid nodules over