Pathology EMQ template.

Name: Nathaniel Roocroft

Theme: Thyroid

 

OPTION LIST

 

A	Amiodarone-related	I	Refetoff syndrome
B	Anxiety	J	Riedel thyroiditis
C	Factitious thyrotoxicosis	K	Sick euthyroid
D	Hashimoto’s thyroiditis	L	Struma Ovarii
E	Graves’ disease	M	Subacute de Quervain’s thyroiditis
F	Iodine deficiency	N	Toxic adenoma
G	Pituitary adenoma
H	Postpartum thyroiditis

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all. (Normal Values for this question; TSH = 0.5-5.7mU/L, T4 = 70-140nmol/L)

 

1. A 32-year old had a scan of her thyroid after losing weight, which, whilst mostly negative showed a small nodule which “lit up”. Blood tests had shown TSH of  0.08 and T4 of 287.

            

 

2. A 27-year old woman presents with a small painless mass on her neck. She also mentions how she has been constantly hungry, which she puts down to being over active since she gave birth two months ago.

 

 

3.  A stressed 50-year old office worker, who has had difficulty reading her computer screen lately, presents to her GP with a tremor and fatigue. A routine blood test shows TSH of 0.1 and T4 of 261.

 

 

4. A 46-year old presented to A and E excessively sweating with a very fast pulse. She boasted of how she had lost 16kg of weight recently since she had started taking some pills she had been given by a friend.

 

 

5. A 30-year old woman presents with weight loss, tremor, thin skin, and irritability.  Along with a T4 of 299, the patients TSH is 8.2

 

 

 

ANSWERS

1. N

2. H

3. E

4. C

5. G