EXAMINATION: CAROTID ULTRASOUND/ULTRASOUND OF NECK FINDINGS: The carotid ultrasound consists of normal color flow, B- mode and physiologic measurements. Comparison is offered to a prior study two years ago which was essentially within normal limits. Peak systolic flow in the right internal carotid artery is 81, peak systolic flow in the left internal carotid artery is 88. At most some minor plaquing is seen, degree of stenosis is in the 0 to 15% range. Both vertebral arteries are open and antegrade bilaterally. The ultrasound examination of the neck reveals a right-sided thyroid nodule measuring 2.4 cm in depth and 4.0 cm in superior inferior dimension. It is mostly solid but has small cystic areas within it.       IMPRESSION: Unremarkable carotid ultrasound, patient does have solitary complex thyroid nodule in the inferior portion of the right lobe. END OF IMPRESSION: