Pathology EMQ template.

Name: Christopher Tam

Candidate number:

Theme: Thyroid Disease

 

OPTION LIST

 

A

Grave’s Disease

I

Plummer’s Disease

B

Medullary Thyroid Carcinoma

J

Post Partum Thyroiditis

C

Papilliary Thyroid Carcinoma

K

Silent Thyroiditis

D

De Quervain’s Thyroiditis

L

Follicular Thyroid Carcinoma

E

Endemic Cretinism

M

Anaplastic Thyroid Carcinoma

F

Lung Cancer with Metastasis to the Thyroid Gland

N

Lymphoma

G

Hashimoto Thyroiditis

O

Malignant Melanoma

H

Iatrogenic Hypothyroidism

P

Plummer-Vincent Syndrome

 

 

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.

 

1. A 46 year old female notices a gradual weight gain of 15 kilograms over the past year and goes to her local GP for advice. She asks her GP for advice on losing weight and adds that she used to be very thin. She admits that she has been feeling depressed lately. On further questioning the GP discovers that she had undergone a partial thyroidectomy for Plummer’s Disease 1 year ago.

 

 

2.  A 51 year old male presents to Endocrinology Outpatients and complains of a tremor, and weight loss of 10 kilograms over the last 3 months despite an increased appetite. He admits that he has been quite irritable lately, and has been feeling “moody”. As Parkinson’s disease runs in his family, he is worried that he has developed it. On examination a 3x3cm lump is found on the right side of his neck. A thyroid technetium scan reveals a single toxic nodule.

 

 

3. A 45 year old female who has recently given birth, presents at your local GP clinic with sweating, palpitations and heat intolerance – she is concerned that it may be her menopause. On further questioning she describes a sore throat a week ago. Thyroid biopsy shows multi-nucleated giant cells.

 

 

4. You pick up your Himalayan friend from Heathrow airport. You notice that his 5 year old daughter is of a short stature and shows some degree of mental retardation and has trouble walking.

 

 

5. A 35 year old secretary develops symptoms of hyperthyroidism and presents to her local endocrinologist. On examination a 3x3cm lump is found on the left side of her neck. A biopsy is taken +and Orphan Annie eye nuclear inclusions and psammoma bodies are found on light microscopy. Blood tests reveal a raised thyroglobulin level.

 

 

 

ANSWERS

1. H

2. I

3. D

4. E

5. C