Pathology EMQ template.

Name:  

Candidate number:

Theme: Neonatal jaundice

 

OPTION LIST

 

A	Ascending cholangitis	I	Hepatitis A
B	Biliary atresia	J	Hepatitis B
C	Choledocal cyst	K	Rh disease
D	Congenital hypothyroidism	L	Spherocytosis
E	Crigler- Najjar type 1	M
F	Feeding problems	N
G	Galactosaemia	O
H	Glucose-6-phosphate dehydrogenase deficiency	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 10 day old boy of Middle-Eastern descent with anaemia and neonatal jaundice is found to have a total bilirubin of 331.5 umol/l.  His Uncle became similarly ill with jaundice once when he took anti-malarial drugs.

 

 

2.      A 2 week old neonate is treated with phototherapy for jaundice which does not clear up.  She is found to have a conjugated bilirubin of 40 umol/l with grossly deranged liver enzymes.  Her stools are clay colored and her urine is dark.

 

 

3.      A 3 week old baby with low birth weight, responds to phototherapy for jaundice but is found to have a swollen tongue and umbilical hernia.  The mother says the baby hardly ever cries.

 

 

4.      A 3 month old baby has failure to thrive and develops jaundice with abdominal distension.  On examination he is found to have ascites, and hyperbilirubinemia (primarily conjugated bilirubin).  His mother is a known IVDU.

 

 

5.      A 5 day old baby whose parents are known to be related develops Kernicterus.  She has an unconjugated bilirubin of 420 umol/l and normal LFTs. The Doctors are finding it difficult to diagnosis her.

 

 

 

ANSWERS

1. H

2. B

3. D

4. J

5. E