Pathology EMQ template.

Name: Thomas Stokes

Theme: Zoonoses

 

OPTION LIST

 

A	Anthrax	I	Plague
B	Brucellosis	J	Q fever
C	Cat scratch disease	K	Rabies
D	Chagas disease	L	Toxoplasmosis
E	Leptospirosis	M	VTEC O157
F	Listeriosis	N
G	Lyme borreliosis	O
H	Malaria	P

 

 

For each scenario below, choose the most appropriate diagnosis from the list above. Each option may be used once, more than once or not at all.

 

1. A 31 year old man presents with confusion and agitation after a one week trip to West Africa.  His symptoms persist but are punctuated by lucid intervals.  He develops seizures and hyperextension of the neck as well as drooling.  It is noted that he is particularly anxious when offered water.  After seven days of intensive care in isolation the patient dies.

 

 

2. An abattoir worker from Eastern Europe presents with flu-like symptoms, especially fever, joint and muscle pains, and sweating.  Six week culture of bone marrow grows Gram negative bacteria.

 

 

3. A sewer worker had four days of fever which spontaneously resolved.  Two days later he presents with recurrence of the fever as well as jaundice.  Blood tests showed raised bilirubin with normal AST, ALT and ALP, as well as raised urea and creatinine.  Proteinuria on urine dipstick.

 

 

4. A farmer presents with abrupt onset of fever, headache and myalgia. He tells you that the lambing season has just ended. Chest X ray reveals right lower lobe consolidation but there is no clinical evidence of pneumonia and blood and sputum cultures are negative for typical bacterial lung pathogens.

 

 

5. An 18 year old girl has just returned from a camping trip in USA and presents with a growing “rash” on her leg.  Similar “rashes” have appeared on other parts of her body and she now has fever and fatigue.  On examination you notice that she has right ptosis and her sclera are yellow.

 

 

 

ANSWERS

1. K

2. B

3. E

4. J

5. G