!

"#"$%& (
SLaLlon courLesy of ur L.8ogers

)&*%+,$&- .$/"%,0 !"#"$%&


1$2$&3/

1 mloote fot cooJlJote to move to stotloo/ teoJ tosk

10 mlootes fot cooJlJote to be ossesseJ oo O5c stotloo

1 mloote befote eoJ of stotloo, ptompt tbe cooJlJote fot o ploo, lf
tepolteJ.


4$" ,-56$,-*

cC (Al)

7,$-8$&3/

8tlef slmoloteJ potleot/octots

9%2#$&/ #//-//-*

e.q.
nlstoty tokloq skllls
Ceoetotloq o Jlffeteotlol
lotetptetotloo of lovestlqotloos
Moooqemeot

!"#"$%& (
SLaLlon courLesy of ur L.8ogers
:;!1<=>1:?;! )@AB:;)< C )&*%+,$&-

?D-,D$-E

1bls ls o 11-mloote stotloo to test tbe cooJlJotes oblllty to toke o
tbotooqb blstoty, qeoetote o Jlffeteotlol Jloqoosls, opptoptlotely
lovestlqote ooJ tbeo loltlote o moooqemeot ploo. lt ls oot expecteJ tbot
tbey qet tbe Jloqoosls ftom tbe blstoty bot tbey sboolJ be oble to
lovestlqote lt opptoptlotely ooJ tbeo ftom tbe tesolts come to o
cooclosloo.

?FG-+"$D-/

1be cooJlJote sboolJ.

1. 1ake a Lhorough hlsLory & presenL flndlngs
2. rovlde a dlfferenLlal dlagnosls
3. lnLerpreL laboraLory resulLs
4. SuggesL approprlaLe managemenL


>#&*$*#"-/ 1#/HC ?ou are Lhe loundaLlon ?ear 1 uocLor worklng on a
Ceneral Medlcal Ward. A 48-year-old lady has been admlLLed
complalnlng of welghL loss.


I<?BI1 JK Summarlse Lhe hlsLory

I<?BI1 LK resenL a dlfferenLlal dlagnosls
PyperLhyroldlsm
Coellac dlsease
Addlson's dlsease
l8u (Crohn's or uC)
Cancer
uepresslon


I<?BI1 MK WhaL blood LesLs would you do?
Clve Lhe resulLs of Lhe lnvesLlgaLlons Lhey ask for. lf Lhey move on
from blood LesLs wlLhouL menLlonlng 1l1's presenL Lhem wlLh Lhe
!"#"$%& (
SLaLlon courLesy of ur L.8ogers
LCC (Al). lf Lhls sLlll doesn'L prompL Lhem Lo ask for 1l1's glve Lhem
Lhe resulLs. lf Lhey ask for 1l1's ask Lhem ls Lhere anyLhlng else Lhey'd
llke Lo do (l.e. LCC, glve Lhem Lhe LCC).

7N%%* 1-/"/
O7> =P)Q/ RO1Q/ 1O1Q/ >%,"$/%N normal
Pb 130 Cr 70 Alb 42 1SP Low ><I normal
WCC 7.2 ur 4.7 AL 43 14 .$3S )!< normal
lLs 400 na+ 142 AL1 13 13 .$3S TN6+%/- normal
MCv 90 k+ 3.6 8lll 7

I<?BI1 UK WhaL ls Lhe llkely dlagnosls?

I<?BI1 VK Pow could Lhls condlLlon be managed?
1. Medlcal, propranolol (lmmedlaLe sympLom conLrol),
carblmazole (LlLraLe), propylLhlouracll
2. Surglcal, LhyroldecLomy
3. CLhers, radlolodlne (
131
l)
!"#"$%& (
SLaLlon courLesy of ur L.8ogers

:;!1<=>1:?;! >A;9:9A1)


"#$%&'()*+,

?ou are Lhe loundaLlon ?ear 1 uocLor worklng on a Ceneral Medlcal
Ward. A 48-year-old lady has been admlLLed complalnlng of welghL loss.


1#/H
1ake a Lhorough hlsLory
resenL your flndlngs Lo Lhe examlner
Clve a dlfferenLlal dlagnosls
lnLerpreL Lhe LesL resulLs
SuggesL an approprlaLe managemenL plan
























!"#"$%& (
SLaLlon courLesy of ur L.8ogers
:;!1<=>1:?;! !:B=RA1)9 IA1:);1 C )&*%+,$&-

1bls ls o blstoty stotloo fot tbytotoxlcosls. cooJlJotes ote NO1 expecteJ
to qet tbe Jloqoosls ftom tbe blstoty. 1ty ooJ ooly qlve lofotmotloo owoy
lf tbey osk yoo oboot speclflc symptoms.

?ou are a 48-year-old female (Lmma eel) halrdresser.
u.C.8 24/2/1966

?ou've losL a sLone over Lhe lasL 3 monLhs desplLe noL Lrylng Lo (force
Lhe candldaLe Lo geL Lhe speclflcs don'L glve Lhem away). ?our appeLlLe
has also changed, lL's lncreased (only glve lf asked speclflcally). ?our
eaLlng far more Lhen usual buL Lhe welghL ls sLlll falllng off you. ?ou are
'-#../ $(*$-'*-+ abouL Lhls because your moLher dled of cancer several
years ago and you remember Lhls happenlng Lo her.

?our husband has sald you're crabby and lrrlLable buL your unsure as Lo
why. Pe's also sald LhaL you can'L slL sLlll. ?ou've noLlce a mlld Lremor
LhaL's developed over Lhe lasL few monLhs when drlnklng cups of Lea
and LhaL your muscles Lend Lo ache all Lhe Llme.

?ou feel hoL all Lhe Llme and sweaL more Lhan usual.
?our sLools have become looser Lhan Lhey used Lo be.

?our son has sLaLed your eyes look a blL 'welrd' 'goggley' even and you
have noLlced some double vlslon buL Lhls ls only when your Llred.

?our perlods have also become lnfrequenL over Lhe lasL 3 monLhs buL
you LhoughL Lhls was [usL down Lo Lhe 'change' (only glve Lhls
lnformaLlon lf speclflcally asked abouL LM).

8efore you were admlLLed Lo hosplLal you were seelng Lhe C because
you'd had a few eplsodes of feellng 'buLLerflles' ln your chesL buL are
oLherwlse well.

MPx, no

uPx, occaslonal mulLlvlLamlns
when you remember
Allergles, nkuA
SPx, occaslonal L1CP

lPx, laLher, 11uM
MoLher, Addlson's dlsea
!"#"$%& (
SLaLlon courLesy of ur L.8ogers
B#,H !S--"W ?!>)0 1#'+2(3#4$).#' 56#72*#82(* 98#82(*

Lxamlner's name: CandldaLe name:

Scorlng: 0=lnadequaLe/noL done, 1=adequaLe, 2/3 =done well
1he global score reflecLs Lhe general aLLlLude and compeLence of Lhe candldaLe.


Sklll

Marks CommenLs
ALLlLude lnLroducLlon, approach Lo paLlenL, clarlLy of lnsLrucLlons,
empaLhy
0 1
PlsLory

Conflrms welghL loss, onseL, duraLlon, amounL, lnLenLlonal 0 1 2 3
Change ln appeLlLe (lncreased or decreased) 0 1 2
8esLlessness/aglLaLlon 0 1
ulfflculLy concenLraLlng 0 1
Muscle weakness 0 1
PeaL lnLolerance, excesslve sweaLlng 0 1 2
Loose sLool 0 1
1remor 0 1
Changes ln vlslon 0 1
ulfflculLy swallowlng or breaLhlng 0 1
alplLaLlons 0 2
Changes ln perlods 0 2
ulfferenLlal
dlagnosls
PyperLhyroldlsm 0 2
Any oLher 2 or more 0 2
8lood LesLs
requesLs
l8C, u&L's, Ll1's plus 1l1's. +(C8/LS8, glucose or
corLlsol)
0 1 2
lnLerpreLaLlon CorrecL ldenLlflcaLlon of blood resulLs 0 1 2
CorrecL lnLerpreLaLlon of LCC (Al)

0 1 2
ulagnosls PyperLhyroldlsm 0 2
ManagemenL Medlcal, carblmazole, propylLhlouracll, propranolol 0 1 2 3
Surglcal, LhyroldecLomy 0 1
CLher, radlolodlne 0 1
1oLal /36


Lxamlners please make Lhls [udgemenL:

Clobal !udgemenL
Clear fall 8orderllne Clear pass very Cood
pass
LxcellenL
pass






I-,/%&#N O--*F#+H 8%, >#&*$*#"-X !633-/"$%&/ P >%22-&"/







Candidate name: