USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

Solitary thyroid nodules are more likely to be malignant in which of the following populations?

1. Men or children

2. Postmenopausal women

3. Young adults

4. Pregnant women

The correct answer is: Men or children

In evaluating the risk of malignancy associated with solitary thyroid nodules, certain demographics have been found to have a higher likelihood of these nodules being malignant. Men and children are particularly noteworthy populations in this regard. Men tend to have a higher incidence of thyroid cancer associated with solitary nodules compared to women, making any solitary nodule in men a point of concern for potential malignancy. Additionally, children are at an increased risk for thyroid malignancies when presenting with solitary nodules, primarily due to their lower baseline incidence of benign thyroid conditions. The nature of thyroid disorders often allows clinicians to be more vigilant in these populations, leading to a higher suspicion and subsequent testing for malignancy. In contrast, while postmenopausal women are at risk for a variety of endocrine neoplasms, the prevalence of malignant solitary nodules is generally lower in this group than in men or children. Young adults also experience a relative decrease in thyroid cancer risk for solitary nodules compared to the aforementioned demographics. Although pregnant women can develop thyroid nodules, the hormonal changes associated with pregnancy do not significantly elevate the risk for malignancy of these nodules in the same manner that it does for men and children. Therefore, considering these factors, solitary thyroid nodules are more