Pathology EMQ template

Name: ZAINUDDIN, Hanaa

Theme: Paediatric Clinical Chemistry (Childhood Jaundice)

 

OPTION LIST

 

A	Choledocal cyst	I	Down’s syndrome
B	Biliary atresia	J	Lactose intolerance
C	Crigler-Najjar syndrome	K	Breast milk jaundice
D	Dubin-Johnson syndrome	L	Galactosaemia
E	Hypothyroidism	M	Physiologic neonatal jaundice
F	Glucose-6-phosphate dehydrogenase deficiency	N
G	Gilbert’s syndrome	O
H	Rotor’s syndrome	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.   Whilst on your elective in Malaysia, you notice a two-day-old neonate with yellow sclerae. Otherwise, she appeared to be well and thriving, and her medical notes disclosed no other abnormalities.

 

 

2.   A worried young mother brings her newborn son to casualty, and tells you that he has been ‘yellow’ since his full-term delivery two weeks ago. She was told then that her son was ‘normal’ and that he was ‘going to be fine’. Over the last couple of days, her son had felt increasingly limp and floppy in her arms. She also noticed a lump in his belly button, and that his tongue protruded ‘all the time’.

 

3.   Mei-Li is a month-old baby, whose parents brought to casualty because she had started to appear jaundiced. During consultation, they described the dark colour of Mei-Li’s urine, which stained her nappy. They also asked if it was unusual for her stool to be beige, and sought advice for her lack of weight gain. A blood sample showed raised bilirubin, alkaline phosphatase and γ-glutamyl transferase (>100 IU/L; normal range: 20 – 40 IU/L).

 

4.   You meet six-year-old Paul and his mother during your GP rotation. Paul looked perfectly healthy; his mother, however, tells you about his recent bout of jaundice, which developed towards the end of a bad episode of vomiting and diarrhoea. The jaundice resolved without treatment.

 

5.   During your paediatrics rotation, you were asked to keep an eye on Louise, a three-month old baby at the end of whose cot was the sign ‘No Milk/Lactose’. She was admitted the previous day for jaundice. When you looked into her eyes, you saw that both lenses were cloudy.

 

 

 

ANSWERS

1. M

2. E

3. B

4. G

5. L