Return to Scenario ListShow Learning Points most relevant to Phase 1:


Clinical Discipline(s)/Organ System(s)
Progress Test Topic(s)
A 32 year old Chinese woman presented originally with an overactive thyroid gland. She was treated with carbimazole but suffered side effects. She was then treated with radioactive iodine. She attends a follow-up clinic appointment with fatigue, lethargy and feeling cold all the time (despite the summer weather).
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Anatomy and physiology of thyroid gland
   - Pathology of thyroid gland
   - Metabolism of T3 and T4
   - Science of negative feedback loops
   - Pathophysiology of Hashimoto’s disease
   - Pharmacology of thyroxine, iodine and carbimazole
Clinical and Communication Skills 
   - Elicit a history from a fatigued patient; consider autoimmune conditions
   - Examine the thyroid gland; recognise a goitre
   - Request appropriate thyroid function tests and interpret them
   - Understand that many symptoms may suggest hypothyroidism, but thyroid function tests are definitive diagnostic tests
   - Management of hypothyroidism
   - Complications of hypothyroidism and its treatment
   - Recognise the need to increase thyroid hormone supplementation in early pregnancy
Personal and Professional Skills 
   - Demonstrate empathy and compassion for a person with an illness which has affected their quality of life
   - Discussion of side-effects of treatments
   - Managing patient's ideas, concerns and expectations, particularly in the context of unproven alternative therapies
Hauora Māori 
   - Consideration of health literacy needs of patient and whānau
Population Health 
   - Epidemiology of hypothyroidism
   - Role of dietary supplementation with iodine in pregnancy
   - Awareness of safety of medications in early pregnancy and their use in reproductive age women
Conditions to be considered relating to this scenario
post-radioactive iodine hypothyroidism, Hashimoto's thyroiditis, subacute thyroiditis, amiodarone use,iodine deficiency, postpartum thyroiditis
secondary hypothyroidism, thyroid agenesis, sick euthyroid, lithium use
Related Scenarios
[Hyperthyroidism], [Panhypopituitarism]