ANCC AGPCNP-BC Prep Online

Ultrasound features that raise concern for thyroid cancer include a solid hypoechoic nodule, microcalcifications, and irregular or infiltrative margins (often also a taller-than-wide shape or evidence of extrathyroidal extension). A spongiform appearance and comet-tail artifacts are more typical of benign colloid nodules. A simple anechoic cyst is usually benign. A well-circumscribed isoechoic nodule with a thin halo is generally a lower-suspicion pattern.

Allergic contact dermatitis is most likely because the eruption began after exposure to a new bracelet and is localized to the area of contact, with an eczematous morphology (erythema, pruritus, vesicles, weeping, and crusting from excoriation). Jewelry commonly contains allergens such as nickel, which can trigger a delayed (type IV) hypersensitivity reaction. Atopic eczema is typically a chronic, relapsing condition often associated with a personal or family history of atopy and commonly involves flexural surfaces rather than being limited to a discrete contact pattern. Psoriasis usually presents as well-demarcated erythematous plaques with silvery scale and less commonly has prominent vesiculation or weeping. Seborrheic dermatitis favors sebaceous areas (scalp, eyebrows, nasolabial folds, chest) with greasy scale and is not usually confined to a single contact site or characterized by vesicles and oozing.

Live attenuated vaccines are contraindicated in pregnancy because of the theoretical risk of fetal infection. For this reason, they should also be avoided when a patient is planning pregnancy in the near future and cannot reliably avoid becoming pregnant during the recommended avoidance interval after vaccination. A minor afebrile illness, routine vitamin use, and mild fatigue after a prior vaccination are not contraindications to receiving live attenuated vaccines.