Instructions
You are a medical student on placement in general practice. Your next patient is Darren Koh, 28, presenting with low sex drive. His blood results from last week are printed for you.
Take a focused history
Outline to the examiner:
- Your findings
- Your interpretation of the results
- Your most likely diagnosis and differentials
- Next steps in management, including relevant investigations
- You do not need to examine the patient; the examiner will give you any findings you ask for
- Ask the examiner for any further results you want
- You do not need to write a prescription or a referral letter
Blood tests (taken last week, 8 am, fasting)
| Item | Value | Reference range |
|---|---|---|
| Total testosterone | 4.2 nmol/L | 8.6-29.0 nmol/L |
| LH | 0.6 IU/L | 1.7-8.6 IU/L |
| FSH | 0.5 IU/L | 1.5-12.4 IU/L |
| Prolactin | 210 mIU/L | 86-324 mIU/L |
| Haemoglobin | 178 g/L | 130-180 g/L |
| Haematocrit | 0.53 L/L | 0.40-0.52 L/L |
| White cell count | 6.4 x10^9/L | 4.0-11.0 x10^9/L |
| Platelets | 235 x10^9/L | 150-400 x10^9/L |
| ALT | 52 U/L | 5-40 U/L |
| Ferritin | 160 ug/L | 30-500 ug/L |
| TSH | 1.6 mIU/L | 0.5-4.0 mIU/L |
| HDL cholesterol | 0.7 mmol/L | 1.0-2.2 mmol/L |
| LDL cholesterol | 3.9 mmol/L | <3.0 mmol/L |