Mr. Silva went to his family physician due to a lump he noticed on the right side of his neck while shaving. His only past history was one of recurrent kidney stones. His only family history of disease is that his father died of a stroke at 40 years of age. Mr. Silva is married with a 5 year-old son. He works as a plumber. Physical examination reveals a firm 2.3 cm nodule in the right side of his thyroid gland. There are also some palpable nodes in his right cervical chain. BP was elevated at 180/90 but his family doctor did not want to diagnose him with hypertension based on one reading. A recommendation was made for a low sodium diet, blood work sent for TSH and calcium profile and referral made to an endocrinologist for the thyroid lump.