Pathology EMQ template.

Name: Clare Carasco

Candidate number:

Theme: Chem Path Lab

 

OPTION LIST

A	CK-MB	I	Angiogram +/- PCI
B	Xanthachromia	J	CTPA
C	Blood cultures	K	GGT
D	D-dimer	L	ALP
E	VQ scan	M
F	12 hour troponin	N
G	Serum amylase	O
H	Immediate troponin	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.

 

What investigation would aid your diagnosis.

 

1. A 29 year old lady presents with shortness of breath and pleuritic chest pain. Examination was unremarkable. ECG shows RBBB and a sinus tachycardia of 118. ABG analysis shows pH 7.42, PCO2 5.1, PO2 8.9, HCO3 22.7, Lactate 0.9.

 

 

2.  A 82 year old lady has been recently discharged from the hospital following a right THR. Three days later she returns to hospital with sudden onset shortness of breath and collapse. O/E she had cool peripheries. Her chest was clear. BP 158/92, HR 120, RR 25, T 36.5. Initial bloods were requested.

 

3. A 29 year old lady presents to A&E with sudden onset headache. She insisted that the lights were switched off and said the pain was exacerbated on head movement. On examination she was afebrile with no focal neurology. Her CT head was normal.

 

 

4. A 56 gentleman, known smoker and diabetic, presents with a 20 minute history of sudden onset central chest pain which radiates down his left arm. ECG shows T wave inversion in the lateral leads. He is currently pain free.

 

5. A 41 year old known alcoholic present to A&E with a three hour history of abdominal pain and vomiting. O/E he was maximally tender in the epigastric region. His intial blood results show: WCC 12.1; Hb 14.6, Plt 356, Na 137, K 3.2, Urea 7.6, Cr 92 and CRP 13.

 

 

 

ANSWERS

1. D

2. J

3. B

4. F

5. J