Pathology EMQ template.

Name: Harriet Lister

Candidate number:

Theme: Non-neoplastic bone disease

 

OPTION LIST

 

A	Osteoporosis	I	Osteitis fibrosa cystica
B	Osteomalacia	J	Osteomyelitis
C	Ricket’s	K	Gout
D	Paget’s disease	L	Osteoarthritis
E	Hyperparathyroidism	M
F	Hypoparathyroidism	N
G	Sarcoidosis	O
H	Disuse osteopaenia	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 60 year old female from Southampton comes to the GP complaining of pain particularly in her back with symptoms of acute sciatica. You have to keep repeating yourself in obtaining the history as she struggles to hear what you’re saying. You test levels of calcium, phosphate, PTH, AlkPhos and VitD, finding her calcium and phosphate levels to be normal but with some abnormality in the other levels.  What is the diagnosis?

 

2. A 49 year old smoker with longstanding rheumatoid arthritis is visiting the rheumatoid clinic today a routine appointment. She has extensive joint swelling and deformity of the fingers. She tells you she finds it more difficult getting around these days and how she fell over whilst doing her grocery shopping last month and fractured her femoral neck. You suggest a diagnosis.

 

 

3. A 25 year old male broke both his legs a year ago and has since used it as an excuse to lie about on the sofa all day making his girlfriend wait on his hand and foot. After threatening to break up with him he decides to get off his bum and get a job, but notices his legs feel quite weak.

 

 

4. A 40 year old woman with hyperparathyroidism presents to the GP with a 2 week history of nausea and vomiting, and complains of bone pain. On X-ray you notice brown tumours.

 

 

5. A 70 year old lady comes in complaining of back pain. You do some tests, indicating a markedly raised alkaline phosphatase, with her calcium, phosphate, PTH and vitamin D appearing to be normal.

 

 

 

ANSWERS

1. D

2. A

3. H

4. I

5. D