Pathology EMQ template.

Name:  Anja Saso                

Theme: Upper GI disease

 

OPTION LIST

 

A	Achalasia	I	Crohn’s disease
B	Acute gastritis	J	GORD
C	Adenoma	K	Hiatus hernia
D	Adenocarcinoma	L	Oesophageal stricture
E	Barrett’s oesophagus	M	Oesophageal carcinoma
F	Bulbar palsy	N	Peptic ulcer disease
G	Chagas’ disease	O	Pharyngeal pouch
H	CREST syndrome	P	Pharyngeal web

 

 

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 61-year-old woman presents to his GP with a four-month history of ‘acid heartburn’. On examination, she is pale but there are no other significant findings. Upper GI endoscopy shows 3cm of red, velvety patches in the lower oesophagus and biopsy confirms foci of intestinal metaplasia.

 

 

2. A 52-year-old Brazilian man is finding it difficult to swallow and is regurgitating solids and liquids equally, both of which occur shortly after swallowing. He is also suffering from some mild constipation. Further questioning reveals that he is already well known to the cardiology team for his worsening symptoms of heart failure.

 

 

3. A 65-year-old man has a long history of reflux and dyspepsia. Over the last couple of months, however, he has developed dysphagia to solids, which he describes as food ‘sticking’ inside his chest. On examination, there are no significant findings. Routine investigations reveal a microcytic anaemia.

 

4. A 76-year-old smoker presents with a 3-month history of epigastric pain and nausea. Routine blood tests reveal a microcytic anaemia. Endoscopy shows a mass in the gastric antrum. Biopsies of the mass reveal infiltration of the muscularis mucosae and clusters of signet-ring cells.

 

 

5.  A 72-year-old man presents with a 4-month history of difficulty swallowing both solids and liquids. Barium swallow revealed an irregular ‘apple core’ appearance.

 

 

 

ANSWERS

1. E

2. G

3. L

4. D

5. M