Epidemiology & Prevention USMLE Step 1 Practice Question
A 52-year-old woman presents with weight loss and palpitations. Vital signs: BP 142/88, HR 108, RR 18, Temp 37.2Ā°C, SpO2 98%. Laboratory studies show elevated free T4 (28 pg/mL) and suppressed TSH (0.01 mIU/L); thyroid ultrasound reveals a 1.2-cm hypoechoic nodule. A hospital designs a two-step screening program for thyroid cancer. The first test should miss as few true cases as possible, whereas the second will confirm disease among screen-positive patients. Which test combination is most appropriate?
Answer choices
- AFirst test with high specificity, second test with high sensitivity
- BFirst test with low negative predictive value, second test with low positive predictive value
- CBoth tests with low sensitivity
- DBoth tests with low specificity
- EFirst test with high sensitivity, second test with high specificityCorrect answer
- FBoth tests prioritizing sensitivity for all stages
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