Pathology EMQ template.

Name: Adeel Aftab

Theme: Adrenal

 

OPTION LIST

A	20 mg/day prednisolone for 2 months	I	External pituitary irradiation of tumour
B	50 mg/day prednisolone for 1 month	J	Iatrogenic Addisons disease
C	Addisonian Crisis	K	Nelson’s Syndrome
D	Aldosterone Secreting Adrenal Adenoma	L	Pseudo-Cushing’s Syndrome
E	Congenital Adrenal Hyperplasia	M	Renal Failure
F	Conn’s syndrome	N	Schmidt’s Syndrome
G	Cushings syndrome	O	Trans-sphenoidal removal of tumour
H	Ectopic ACTH secretion	P	Waterhouse-Friderichson syndrome

 

 

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. What is the treatment option of choice for a patient with pituitary dependent Cushing’s disease?

 

2. A 31 year old female arrives in A&E at 18:30 in a very distressed state.  Examination reveals tachycardia and postural hypotension.  She complains of lethargy and confusion following a recent operation on her knee.  Blood tests reveal hyperkalaemia, hyponatraemia.  Further tests measure cortisol levels at 50 nmol/L.

 

3. A 65 year old female presents to her new GP 5 years after an operation on her abdomen.  She cannot remember the details of the operation but does remember that she was suffering from severe Cushing’s Disease at the time.  She now notes a progressive “tanning” of the skin.

 

4. A 32 year man unconscious old man is rushed into A&E. He has severe hypotension and a widespread purpuric rash.

5. A middle aged overweight man comes in to see you for a follow up to his blood pressure management. He swears that he has cut salt out his diet and has cycled to work for the past few months, but his blood pressure has not dropped at all. You notice that his K+ even though within the normal range, is on the low side.

 

 

 

 

 

 

ANSWERS

1. O

2. C

3. K

4. P

5. F