Endocrinology
CANDIDATE INSTRUCTIONS
You are a resident year 2 doctor in the GP Surgery. Ms Amy Fergoson, 20-year-old lady presented with some concerns of tiredness and lethargy.
Take a focused patient's history.
At 7 minutes, the examiner will stop you to ask you some questions.
2 Minutes Reading Time
10 Minutes Station Time
Total 12 Minutes
EXAMINER INSTRUCTIONS
Timing Instructions: At 7 minutes, stop the candidate and ask the following questions:
Question 1: What is your provisional diagnosis?
Answer 1: Addison's Disease
Question 2: What is the diagnostic confirmatory test to diagnose?
Answer 2: Adrenocorticotropic hormone simulation (Synacthen) test
Question 3: What are the other relevant investigations needed for this patient?
Answer 3:
Routine blood test: Full blood count, Renal profile, Urea and Electrolytes, Liver Function test
Blood Glucose
Serum corticol levels
Thyroid function test
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Addison’s Disease
PATIENT INSTRUCTIONS
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Name: Amy Fergoson
Age: 20 Years Old
Date of Birth: 5th June 2004
Location: GP Surgery
Occupation: Student
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“I have been feeling tired for 2 months”
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Onset: 2 months ago
Duration: Always there
Intensity: Constant
Progression: Constant
Aggravating: None
Relieving: None
Anything else:
Polydipsia, polyuria
Craving for salty foods
Skin pigmentation over knuckles and feet
Feels dizzy occasionally (due to hypotension)
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NO to All
Anemia: No pallor, recent faints
TB: No haemoptysis
Cancer: No constitutional symptoms such as loss of weight and loss of appetite
CFS: No (diagnosis of exclusion)
Diet: No iron deficient diet
Endocrine: No hypothyroidism symptoms
Fibromyalgia: No muscle aches
-
Ideas: “No idea doctor."
Expectations: “Can you help me?”
Concerns: “What do I have?“
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Otherwise, NO fever, recent infections
NO headache, chest pain, palpitations, shortness of breath
NO vomiting, diarrhea, abdominal pain.
Normal bowel habits.
-
Previous hospital admissions: None
Previous surgeries: None
Medical conditions: Type 1 Diabetes Mellitus
Medications:
Insulin (Actrapid)
Over the counters:
None.
Allergies:
None.
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My sister has hypothyroidism. Otherwise, other family members are healthy and well
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Smoking: Does not smoke
Alcohol: Does not drink alcohol
Recreational drugs: Never
Diet: Eats a well balanced diet
Exercise: No
Ill contacts: No
Occupation: Student
MARK SCHEME
Introduction
Chief Complaint
History of Presenting Complaint
Systems Review
Past Medical History
Drug History
Family History
Social History
Questions
Patient Scores
Enter Your Score Here: /40
SCORE GUIDE
Pass: 26 - 40
Borderline Pass: 15 – 25
Fail: 0 - 15
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