Pathology EMQ template.

Name: Will Bermingham

Theme: Calcium Handling: Hypercalcaemia

 

OPTION LIST

 

A	Thyrotoxicosis	I	Familial benign hypocalciuric hypercalcaemia
B	Pagets Disease	J	Seizure
C	Metastatic Breast Cancer	K	Sarcoidosis
D	Prostate Cancer	L	Dehydration
E	Vitamin D Overdose	M	Primary hyperparathyroidism
F	Milk alkali syndrome	N	Secondary  hyperparathyroidism
G	Total thyroidectomy	O	Malnourishment
H	Over-hydration	P	Multiple Myeloma

 

 

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.  57yo Lady presents feeling drowsy with generalised weakness, nausea and vomiting. She also complains of some back pain. You not that she looks dehydrated. She reports that she takes HRT. The only relevant family history is that of her mother who died age 50 of “some kind of cancer.” Calcium = 3.7mmol/litre

 

 

2. Calcium: 3.4mmol/litre, Albumin: 3.1g/dL Phosphate: 0.3mmol/L Urea: 3mmol/L

 

 

3. Patient present with erythema nodosum and polyarthralgia. Blood tests show: corrected calcium: 2.8, Phosphate: 1.7mmol/L, ALP: 40iu/L. Biopsy shows non caseating granulomata

 

 

4. You are the FY1 on nights when a nurse calls you to review some blood results. They show: Albumin 60g/L, Urea 10mmol/L, Calcium: 2.8

 

 

5. An asymptomatic man is found to be hypercalcaemic on routine bloods. On further investigation he is also found to have a low level of calcium in his urine.

 

 

 

ANSWERS

1. C

2. M

3. K

4. L

5.