Pathology EMQ template.

Name: Michelle Tseng

Candidate number: 00411368

Theme: Thyroid

OPTION LIST

A	Myxoedema coma	I
B	Primary hypothyroidism	J
C	Hashimoto’s thryoiditis	K
D	Graves’ disease	L
E	Myxoedema madness	M
F	Thyroid crisis	N
G	Schmidt’s Syndrome	O
H	de Quervain’s thyroiditis	P

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. An elderly patient presents in A&E will difficulty breathing and complains of feeling cold. Biochemistry reveals that Na = 128mmol/L, glucose = 3mM. Patient has a history of hypothyroid disease.

2. A 30 year old patient presents with vomiting and tiredness. Biochemistry: Na = 128, K = 6.5, glucose = 3mM. TSH = 55mU/l, FT4 = 4pM. Patient has known history of Addison’s disease.

3. A patient presents with high fever >40 degrees C, tachycardia, extreme restlessness and confusion. FT4 > 22pmol/L. TSH < 0.2mU/L

4. A 45 year old patient presents with fever, malaise and a pain in the neck. He has been feeling unwell for a few days. FT4 > 22pmol/L, TSH < 0.3mU/L

5. A patient presents with oligomenorrhoea, tachycardia, weight loss, tiredness and thyroid acropachy.

ANSWERS

1. A

2. G

3. F

4. H

5. D