General practice · Explanation & counselling

TSH of 18

Easy

10 min station · 2 min reading · Curtin Year 4

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Z N B Z

2 min reading · 10 min station · reminders at 2 min

Instructions

You are a medical student on placement in general practice. Karen Doyle, 44, an electrician, had bloods last week for tiredness and feeling cold. She has come back for the results.

  1. Take a focused history

  2. Interpret the results provided and explain them to Ms Doyle

  3. Counsel Ms Doyle on starting thyroxine and agree a management plan

  • You do not need to examine the patient

Blood tests

Blood tests
ItemValueReference range
TSH18.0 mU/L0.5-4.0 mU/L
Free T48 pmol/L10-20 pmol/L
TPO antibodiesStrongly positive (610 IU/mL)<35 IU/mL
Total cholesterol5.9 mmol/L<5.5 mmol/L
LDL3.8 mmol/L<3.0 mmol/L
Practising alone? Ask the examinerFindings appear only when you ask for them

Investigations