Exam |
Test |
Results |
Actions |
Initial patient visit |
Medical history |
History of exposure only with normal examination and screening tests |
Educate patient on early warning signs of thyroid and parathyroid diseases. |
|
Physical exam with thyroid gland palpation |
Thyroid nodule found (1 cm or larger) |
Begin screening workup. Schedule next visit. |
|
Serum thyroid stimulating hormone (TSH) level |
TSH or serum free thyroxine (FT4) abnormalities |
Obtain levels of serum calcium,
parathyroid hormone (PTH), FT4,
and antithyroid peroxidase antibodies.
Refer patient to an endocrinologist, as
appropriate. |
|
|
Abnormal serum
calcium level |
Redraw blood; if abnormal, test for
PTH and refer to endocrinologist as
appropriate. |
|
|
Abnormal antithyroid
peroxidase antibody
level |
Schedule repeat exam in 1 year with
palpation and thyroid function tests.
Refer patient to an endocrinologist, as
appropriate. |
|
|
Normal antithyroid
peroxidase antibody
level |
|
Follow-up visit for a
patient with a palpable
thyroid nodule |
Follow medical
protocol for ultrasound
and fine-needle aspiration biopsy |
Normal or benign |
Schedule next visit. |
|
|
Abnormal or
nondiagnostic |
Schedule for evaluation by surgeon. |
During future physical
examinations |
Medical history update |
|
|
|
Serum TSH and
calcium levels |
Normal examination
and tests |
Educate patient on early warning signs
of thyroid and parathyroid diseases. |
|
|
Abnormal examination
or tests |
Schedule for evaluation by surgeon. |
|
Physical exam with
thyroid palpation |
Thyroid nodule found
(1 cm or larger) |
Begin screening workup. Schedule next
visit. |