Pathology EMQ template.

Name: Hannah Beckett

Theme: Calcium Handling

 

OPTION LIST

 

A	PTH 6.9, Ca 2.81, PO4 0.76, ALP 135	I	PTH 6.8, Ca 3.26, PO4 0.6, ALP 60
B	PTH 0.8, Ca 2.12, PO4 0.7, ALP 150	J	PTH 23, Ca 3.6, PO4 0.8, ALP 145
C	PTH 5.4, Ca 2.45, PO4 1.1, ALP 170	K	PTH 5.2, Ca 2.53, P04 1.1, ALP 310
D	PTH 8.9, Ca 2.10, PO4 0.6, ALP 155	L
E	PTH 1.4, Ca 2.89, PO4 0.76, ALP 135	M
F	PTH 2.6, Ca 2.26, PO4 1.2, ALP 110	N
G	PTH 2.3, Ca 2.89, PO4 1.0, ALP 136	O
H	PTH 0.5, Ca 2.67, PO4 1.3, ALP 25	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 55 year old lady awaiting surgery is treated with fluid restriction and bisphosphonates. She has had 5 hospital admissions with renal colic over the last year.

 

2. A young girl sustains a fractured tibia after tripping on a pavement. She tells you she visited the GP last week complaining of muscle weakness and bone pain. On examination she looks pale.

 

3. An elderly man attends the GP complaining of pain in his hip and spine. He is also hard of hearing. His Xrays show ‘abnormal bone architecture’.

 

4. A lady with bipolar disorder complains of abdominal pain, nausea, constipation and weakness of a week-long duration. She has taken lithium carbonate daily for 10 years although has felt more depressed lately.

 

5. An elderly lady sustains a right fractured neck of femur. Last year she had a left hip replacement following a similar fracture, and tells you she has ‘weak bones’.

 

Normal values:

Ca 2.2-2.6 mmol/L

PTH 1.3-7.7 pmol/L

PO4 0.8-1.2 mmol/L

ALP 20-140 IU/L

 

ANSWERS

1. A

2. D

3. K

4. G

5. F