Pathology EMQ template.

Name:

Candidate number:

Theme: Cardiac Pathology

 

OPTION LIST

A

Acute myocarditis

I

 

B

Hypertrophic cardiomyopathy

J

 

C

Noonan’s Syndrome

K

 

D

Cardiac Tamponade

L

 

E

Infective Endocarditis

M

 

F

Rheumatic fever

N

 

G

Eisenmenger’s Syndrome

O

 

H

Acute pericarditis

P

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 36 yr old London based Scandinavian stockbroker presents to A&E complaining of fever, night sweats and malaise. Examination reveals mid-systolic click and a late systolic murmur which is a new presentation due to an echocardiogram two months ago from an annual BUPA health check up did not reveal any abnormalities. In his social history the stockbroker confesses to regularly injecting himself with heroine to relieve himself from the boredom of his work. What is the most likely diagnosis?

 

2. 20yr old black American college basketball player suffers a syncopal episode whilst practising for an AAA championship game. An echocardiogram reveals asymmetrical septal hypertrophy. What is the most likely diagnosis?

 

3. A 52yr old Asian gentleman with a past history of diabetes, 23 pack years and persistent cholesterol level of, suffers from a sudden onset central chest pain whilst playing cricket game. The pain was worse on inspiration and when his team mates laid him flat on wicket. Upon admission to A&E his 12 lead ECG demonstrated a concave ST segment elevation on all chest leads. What is the most likely diagnosis?

 

4. A 58 yr old lady with a history of   , is currently being treated with warfarin and collapses whilst on the bus travelling to Portobello market. She is rushed to A&E and a young Imperial SHO performs a cardiac examination on her. His findings suggest Beck’s triad of falling BP, rising JVP and a small quiet heart. What is the most likely diagnosis?

 

5. A 14 yr old polish girl recently arrived in the UK presents to her GP complaining of red raised rash around her thighs and arms along with a fever. She informs the GP she had a throat infection 3 weeks ago. Upon auscultation the GP hears a murmur. What is the most likely diagnosis?

 

ANSWERS

1. E

2. B

3. H

4. D

5. F