Pathology EMQ template.

Name: Craig Raymond Blower    

Theme: Cerebrovascular Disease 1

 

OPTION LIST

 

A

Acute Disseminated Encephalomyelitis

I

Huntington’s Disease

B

Acute Cerebrovascular Accident

J

Motor Neurone Disease

C

Alzheimer’s Disease

 

K

Multiple Sclerosis

D

Behçet’s Disease

 

L

Parkinson’s Disease Dementia

E

Beriberi

 

M

Pick’s Disease

 

F

Dementia with Lewy Bodies

N

Recurrent Disseminated Encephalomyelitis

G

Frontotemporal Lobar Degeneration

O

Transient Ischaemic Attack

H

Gaucher’s Disease

 

P

Vitamin B12 Deficiency

 

 

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 30 year-old man presents to his GP with confusion, memory loss and a painful oral ulcer. On examination the GP notes a mild anterior uveitis and an aphthous ulcer on his oral mucosa.

 

 

2. A 78 year-old man presents to his GP after being nagged by his wife to do so. His wife tells the doctor that her husband has been speaking ‘funny’ and getting confused for a while. She has noticed him using incorrect words. He slowly deteriorates, losing his memory and is no longer able to recognise his wife. He dies a year later. Neurofibrillary tangles composed of Tau are picked up using immunohistochemical labelling. The pathologist also notes senile plaques.

 

 

3. A 26 year-old lady presents with depression, low mood, fatigue and weakness. The doctor notices some dysarthria in her speech. The lady, a gymnast, states she can no longer support her own weight in the gym. On MRI the radiologist spots some areas of demyelination in both the brain and the spinal cord.

 

4. A 45 year-old man has been fired at work due to being ‘inappropriate’ with female staff. His best friend said he no longer recognises his buddy who used to be so warm and friendly, but is now cold and moody. When discussing this with your friendly hospital pathologist he mentions the man is likely to have certain ‘bodies’ which are ‘large dark-staining aggregates of proteins’­­­ throughout his neural tissue.­

 

 

5. You are the new FY1 on a busy care of the elderly ward and your consultant is on annual leave. A nurse asks you to insert a cannula into Kenneth. When you reach Kenneth you notice he has a resting tremor and will not answer any of your questions. When you go back to see him after performing some other jobs you notice he seems quite perky, the tremor isn’t there and he is conversing well with you. In fact he teaches you a thing or two about the current Eurozone debt crisis. He also tells you he has been having some very vivid hallucinations.

 

 

 

ANSWERS

1. D

2. C

3. K

4. M

5. F