In this MRCS Part B scenario are the SHO in ENT clinic. Your next patient is Mrs Johnston who has noticed a lump in her neck.

Please take a history.

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History of presenting complaint

I first noticed the lump 2 months ago.

It is in the centre of my neck, and seems to have grown since.

I have not noticed any changes in my voice, difficulty swallowing or any pain.

I have lost weight in the past two months, which is great, but have also been more anxious than normal and have had spells I can only describe as hot flushes where I sweat a lot.

I have not noticed any change in vision, or any differences in my eyes.

I do not have diarrhoea, and I am menstruating normally.

I have never had anything like this before.