AANPCB FNP-C Prep Online

Fine-needle aspiration (FNA) biopsy is the preferred procedure to determine whether a thyroid nodule is malignant or benign because it obtains cells for cytologic evaluation. Thyroid ultrasound is essential for characterizing a nodule and risk stratifying it, but it does not provide a tissue diagnosis. A CT scan may help define anatomy or evaluate invasive disease but is not used to establish benign versus malignant cytology. A radioactive iodine uptake test helps assess nodule function (hot vs cold) in the setting of hyperthyroidism and is not the primary diagnostic test for malignancy.

Hyperprolactinemia causes galactorrhea and suppresses pulsatile GnRH release, leading to oligomenorrhea or amenorrhea. The choice mentioning a prolactinoma best explains the combination of new bilateral milky nipple discharge and menstrual irregularity in a nonpregnant patient without medication triggers. Hypothyroidism can increase prolactin via elevated TRH, but it would more often be accompanied by symptoms such as fatigue, weight gain, cold intolerance, or constipation. Endometriosis is classically associated with cyclic pelvic pain and dyspareunia rather than galactorrhea. Polycystic ovary syndrome commonly causes irregular menses but typically features hyperandrogenism (hirsutism/acne) and does not usually cause galactorrhea.

Lyme disease can present with acute peripheral facial nerve palsy, particularly in patients with potential tick exposure or residence/travel in an endemic area. Because management changes (antibiotic therapy is indicated when Lyme is confirmed or strongly suspected), clinicians should consider serologic testing when the clinical context supports it. An ischemic stroke typically causes central facial weakness with relative forehead sparing and is evaluated primarily with neuroimaging rather than serologic testing. Ramsay Hunt syndrome is usually suggested by ear pain and vesicular rash and is often diagnosed clinically. A parotid gland tumor more often causes progressive or recurrent facial nerve dysfunction rather than sudden-onset palsy.