Can someone post the scenario here please
From Loovan’s masterclass, the scenario is something like this:
You are FY2 in GP Surgery.
The patient (a post-menopausal woman aged around 45-50 I think) has had tiredness for a while and there has been done some blood tests for this. All results come back normal except Vit D is low (around 16-18).
Talk to the patient, explain her test results, and address her concerns.
Patient info: Postmenopausal woman with tiredness for weeks. There is also constipation.
She is a teacher. Sister has hypothyroidism. She asks if this is hypothyroidism as well.
What to do:
ODIPARA for tiredness. Differentials for tiredness (since we have results, it can be cut short).
Ask about other symptoms of Vit D deficiency:
Muscle cramps
Bone and joint pains
Fractures (bone loss)
Mood changes
Constipation (she gave this one already)
Then, investigate the reason for Vit D deficiency:
Sunlight exposure
Sunscreen use
Dietary factors: Ask about foods that are rich in Vit d such as egg yolk, meat, fish, mushrooms
Any bowel or stomach surgery.
Explain the diagnosis. Explain that it is not hypothyroidism, and her TFT is normal. All of her symptoms are caused by vitamin D deficiency. Results of prolonged Vitamin D deficiency as well.
Management: You have to replace vitamin D. At first 6 weeks, we have to give a loading dose: 50.000 units once a week oral tablet. After that 1000 units daily to complete it in 3 months. (note sure about this one.)
Advice to eat more foods that are rich in vitamin D.
Follow up after 3 months I think.
This is what I get from Lovaan, correct me if I am mistaken. Hope this helps. Very easy follow up scenario I think.
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