Pathology EMQ template.

Name:

Candidate number:

Theme: Upper GI Disease - Dysphagia

 

OPTION LIST

 

A	Plummer-Vinson Syndrome	I	Globus Hystericus
B	Achalasia	J	Pharyngeal Pouch
C	Diffuse oesophageal spasm	K	Syringobulbia
D	Adenocarcinoma of oesophagus	L	Myasthenia Gravis
E	Squamous cell carcinoma of oesophagus	M	Oesophagitis
F	Chagas’ disease	N
G	Systemic Sclerosis	O
H	Aortic Aneurysm	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 50 year old obese man presents with dysphagia and vomiting. This is new but he says he has had heartburn for years. He has also gone off his food lately and has lost some weight.

 

 

2. A 30 year old woman complains of difficulty swallowing and cramping retrosternal chest pain. She finds it difficult to swallow both liquids and solids. CXR reveals a dilated oesophagus behind the heart and barium swallow shows the distal oesophagus to have a “birds beak” appearance.

 

 

3. A 45 year old woman presents with difficulty swallowing solids. This is painless and she can point to where she feels the food gets stuck. She also admits she has been feeling tired and gets short of breath more easily. On examination she has koilonychia.

 

 

4. A 38 year old man presents with fatigue, dyspnoea and difficulty swallowing both liquids and solids. He has just returned from Central America where he has been living in a rural community for 15 years. On examination he has tachycardia, arrhythmia and cardiomegaly.

 

 

5. A 40 year old woman presents with heartburn and dysphagia. She also has been feeling more tired recently, has had musculoskeletal pain is worried as she has noticed her fingers swelling so much they look a bit like sausages. In the cold she also has noticed the ends of her fingers also go white, blue then red.

 

ANSWERS

1. D

2. B

3. A

4. F

5. G