You are a PE teacher in a secondary school (use own dob).

Your opening statement is:

“Over the last month I’ve been feeling very nervous and anxious which is really unusual for me, and over the past few days I’ve had palpitations on and off.”

Over the last month you’ve also noticed that your clothes have become looser and you were surprised when you weighed yourself how much weight you have lost as you have not been trying to lose weight. Despite losing weight you have had an increased appetite eating lots more than usual. The palpitations have happened once a day, they are regular but feel very fast, they last about 15 minutes then stop by themselves, they are not associated with chest pain, shortness of breath or fainting, you are well during the episodes. You are having difficulty sleeping which is unusual for you. Currently there is nothing stressful going on at work or with your personal life. You have noticed that recently you have become very sensitive to heat feeling hot all the time. You have had no change in bowel habit, no problems with urination, (no change in your periods, if appropriate) no hair loss, no neck swelling. You have no other medical problems, you do not take any medications, and you have no drug allergies. You don’t smoke, you don’t drink any alcohol, you don’t drink caffeine and you don’t take any illicit drugs. You have a family history of hyperthyroidism- your mother has hyperthyroidism.

Your demeanour is friendly and approachable but you are slightly agitated and a little anxious. You have a good understanding about health and readily offer information, but please be very succinct as the students only have 6 minutes for this.

• Ideas: maybe you have the same as your mum
• Concerns: that you have lost so much weight despite the fact that you’re eating all the time and not trying to lose weight.
• Expectations: a blood test to be arranged