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


Clinical Discipline(s)/Organ System(s)
Progress Test Topic(s)
A 26 year old Māori woman presents to her GP complaining of marked weight loss. She feels irritable and too hot. She has noted a hand tremor that affects her writing.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Thyroid hormone synthesis
   - Pathophysiology of Graves' disease
   - Extra-thyroid manifestations of Graves' disease
   - Pharmacology of carbimazole, propylthiouracil and beta adrenoceptor blocking drugs
Clinical and Communication Skills 
   - Elicit a history from a patient with hyperthyroidism; consider other autoimmune conditions
   - Examine the thyroid gland; recognise thyroid eye disease, extra-thyroid manifestations
   - Differential diagnosis of hyperthyroidism
   - Interpret thyroid function tests and auto-antibody tests
   - Indications for radio-isotope scan
   - Management of hyperthyroidism: medical, radio-active iodine and surgery
   - Complications of anti-thyroid drugs
   - Complications of radio-active iodine and thyroidectomy
   - Management of thyroid eye disease
Personal and Professional Skills 
   - Undertake full informed consent process
   - Awareness of how annoyance with a patient can result in important diagnoses being missed
   - Educate patients about serious adverse drug effects and precautions regarding radio-active iodine uptake
   - Respect for patient autonomy in respect to treatment
Hauora Māori 
   - Communicating with patients and whānau
   - Understand health literacy needs of patients and whānau
   - Self-awareness of potential stereotyping
   - Access to cultural and spiritual support for patients and whānau
Population Health 
   - Epidemiology of hyperthyroidism
Conditions to be considered relating to this scenario
Graves' disease, toxic thyroid adenoma, toxic multinodular goitre, subacute thyroiditis, postpartum thyroiditis, amiodarone induced thyroiditis, increased iodine intake
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