PBL Case Scenario Writing for 2 nd Class students . Prepared by Dr. Aminullah Hamkar Chief Department Pathology Kabul Medical University. Background. PBL program was started in 2006 as a pilot program in the KMU In all semesters only three case scenarios were developed
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Dr. Aminullah Hamkar
Chief Department Pathology
Kabul Medical University
A 62 year old woman presented with Stridor, due to a neck mass, which was clinically suspicious of Multinodular goiter. The patient was placed on Euthyroid; however the gland continuously enlarged, over the course of three weeks as evidenced by increased Stridor and Dysphagia. She lost a 15 Kg weight loss in the last six months. Additional symptoms included Chronic Fatigue, and occasional Chills. She was a smoker.
Thyroid Studies are as follows:
Total Thyroxin = 19 ng/dl (Normal Range: 4.5-10.9 ng/dl)
TSH = 0.004 IU/dl (Normal Range: 0.4-6)
Due to compression of trachea, Total Thyroidectomy was done. The gland measured, 14x12x8cm and weighed 450 grams