Pathology EMQ template.

Name: Hannah Bryars

Theme: Cerebrovascular Disease

 

OPTION LIST

 

A	Alzheimer's disease	I	Vascular dementia
B	Amaurosis fugax	J
C	Extradural haemorrhage	K
D	Left sided stroke	L
E	Right sided stroke	M
F	Subarachnoid haemorrhage	N
G	Subdural haematoma	O
H	Temporal arteritis	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. A 72 year old female smoker with a history of hypertension presents to A&E with difficulty swallowing and marked weakness in her right arm and leg.

 

 

2. A 67 year old man reports 3 episodes of vision loss in his left eye, each lasting a few hours, all of which resolved in less than 24 hours. He described the experience as like a ‘shutter coming down’ in front of his eye.

 

 

3. A 27 year old man is rushed to A&E having suffered a rapid loss of consciousness preceded by vomiting and a severe headache. His friends tell you they were playing cricket in the park several hours ago at which time he sustained a blow to the head from the ball. However, as he played on until the end of the match nobody suspected there was a problem.

 

 

4. A 56 year old woman experiences excruciating scalp pain when attempting to brush her hair. The pain comes on suddenly and resolves after a few minutes. She also has a fever and pain in her jaw when chewing. Tests reveal a raised ESR and CRP.

 

 

5. A 77 year old diabetic, hypertensive man is brought to the GP by his daughter. He had a stroke 10 months ago and she is concerned by his gradual onset of forgetfulness, mood swings, hallucinations and occasional incontinence. She says he gets confused (especially at night) and that sometimes ‘he seems to get a little better but then gets worse again’. On examination his speech is slurred and he exhibits a shuffling gait and balance problems.

 

ANSWERS

 

1. D

2. B

3. C

4. H

5. I