Pathology EMQ template.

Name:

Candidate number:

Theme: Neoplastic bone disease

 

OPTION LIST

 

A	Chondrosarcoma	I	Osteoporosis
B	Ewing's sarcoma	J	Osteosarcoma
C	Fibrous dysplasia	K	Pleomorphic sarcoma
D	Giant cell tumour	L	Simple bone cyst
E	Leiomyosarcoma	M
F	Neuroblastoma	N
G	Osteochondroma	O
H	Osteomalacia	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. 49 y.o. housewife complains of an ache in the pelvic area to her GP, who refers her for further investigation. Histology shows hyperchromic nuclear polymorphism with areas of necrosis. Radiology shows thickened cartilage.

 

 

2. 15 y.o. boy comes to A&E with an intense pain in his back, radiating to his legs. The pain has been intermittent in the last 3 weeks. On examination, he looks unwell, and is pyrexic. There is a large mass on his back with is tender to touch. Radiology of the proximal femur shows an onion-skin like appearance.

 

 

3. 23 y.o. builder complains of pain in his right leg, especially during night, and has recently noticed a swelling near the knee. He noticed he is becoming weak and it is interfering with his job. He is extremely concerned he won't be able to support his girlfriend and 4 children.

 

 

4. A mother brings her 4 y.o. boy to A&E who presents with high fever, decreased appetite, and a distended belly. He is also constipated. He says his legs hurt, and is observed to limp when walking. You have no idea what this is, and do all possible investigations and find raised catecholamines in the blood.

 

 

5. 67 y.o. retired African nurse is brought into A&E by her daughter, after she found her at home on the floor with a suspected broken hip. She complains of pain in the back and hip, and the daughter tells you she is considering putting her mother in a home as she is not leaving the house and eating badly.

 

 

 

ANSWERS

1. A

2. B

3. J

4. F

5. H