Pathology EMQ template.

Name: Hannah Barrett

Theme: Calcium Handling

 

OPTION LIST

 

A

Di George Syndrome

I

Osteoporosis

B

Hypoparathyroidism

J

Primary hyperparathyroidism

C

Long term immobility

K

Pseudohypoparathyroidism

D

Malignancy releasing PTHrp

L

Pseudo-pseudohypoparathryoidism

E

Metastatic bone disease

M

Secondary hyperparathyroidism

F

Myeloma

N

Tertiary hyperparathyroidism

G

Osteitis fibrosa cystica

O

Thyrotoxicosis

H

Osteomalacia

P

Tuberculosis

 

 

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 1 year old is brought to A and E by his mother after he begins to convulse. His mother tells you that when he was born he underwent open heart surgery to repair a problem with his aorta. He has always been difficult to feed and has had 7 infections requiring antibiotics. Investigations reveal: Hb 12g/dl, corrected Ca2+ 1.1mmol/L, PO43- 2.1mmol/L, PTH 1.3pg/mL, Alkaline phosphatase 200IU/L, Creatinine 50μmol/L.

 

2. A 23 year old woman presents to her GP feeling tired. She says she is otherwise well. She says she had asthma as a child and has always suffered from IBS but has never seen a doctor about it. Investigations reveal: Hb 10g/dL, corrected Ca2+ 1.8mmol/L, PO43- 3.0mmol/L, PTH 80pg/mL, Alkaline phosphatase 200IU/L, Creatinine 60μmol/L.

 

3. A 55 year old male presents with low grade fever, generalised weakness and weight loss for the past 5 months. Investigations reveal: Hb 11g/dL, corrected Ca2+ 3.2mmol/L, PO43- 1.9mmol/L, PTH 0.5pg/mL, Alkaline phosphatase 40IU/L, Creatinine 90μmol/L.

 

4. A 67 year old woman goes to her GP as she has noticed muscle cramps. She has also noticed her lips tingling. She is being treated for oropharyngeal cancer by the oncology team. Investigations reveal: Hb 11g/dL, corrected Ca2+ 1.5mmol/L, PO43- 2.0mmol/L, PTH 0.5pg/mL, Creatinine 80μmol/L.

 

5. An 8 year old boy is brought to the GP by his mother. She has noticed he is considerably shorter than the other children in his class. On examination you note his hands appear ‘strange’. Investigations reveal: Hb 12g/dL, corrected Ca2+ 1.7mmol/L, PO43- 2.0mmol/L, PTH 90pg/mL, Creatinine 80μmol/L.

 

 

 

ANSWERS

1. A

2. M

3. P

4. B

5. K