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Hypothyroidism
| Clinical Discipline(s)/Organ System(s) Endocrinology | Progress Test Topic(s) Homeostasis |
Description
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 2Applied 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
- 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
- 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
- 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
- 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
- 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
Common
post-radioactive iodine hypothyroidism, Hashimoto's thyroiditis, subacute thyroiditis, amiodarone use,iodine deficiency, postpartum thyroiditis
post-radioactive iodine hypothyroidism, Hashimoto's thyroiditis, subacute thyroiditis, amiodarone use,iodine deficiency, postpartum thyroiditis
Uncommon
secondary hypothyroidism, thyroid agenesis, sick euthyroid, lithium use
secondary hypothyroidism, thyroid agenesis, sick euthyroid, lithium use
