Pathology EMQ

Name:  Sonja FOO

Theme: Genitourinary Disease 2

 

OPTION LIST

 

A	Appendicitis	I	Neisseria gonorrhoeae infection
B	Toxic shock syndrome	J	Atrophic vaginitis
C	Reiter’s syndrome (Chlamydia trachomatis infection)	K	Ovarian torsion
D	Cystitis	L	Gardnerella vaginalis infection
E	HSV-1 infection	M	Ectopic pregnancy
F	Polycystic ovarian syndrome	N	HSV-2 infection
G	Endometriosis	O	Candidal vulvovaginitis
H	Behçet’s disease	P	Fitz-Hugh-Curtis 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.   A 13-year-old girl arrives in A&E having collapsed. Her temperature is 39°C and blood pressure is 88/50. Her palms and soles are covered with a blanching diffuse maculopapular rash.

 

2.   A 50-year-old Afro-Caribbean lady presents with a 4-day history of pruritus vulvae and frothy grey, foul-smelling vaginal discharge. A vaginal swab is taken and potassium chloride added, yielding a positive finding. Clue cells are found under wet mount microscopy. Gram staining is indeterminate.

 

3.   A 31-year-old Pakistani lady complains of pain from recurrent oral herpetiform ulcers and labial lesions as well as arthritis. She has also experienced a headache with a low-grade fever and slight neck-stiffness. In addition, her eyes appear red and watery. Genetic tests reveal HLA-B51.

 

4.   A 47-year-old woman presents with a month’s history of gradually worsening dysuria and leukorrhea. On further questioning, she also admits to dyspareunia and has just completed treatment for breast cancer. Examination reveals an inflamed perineum with patchy erythema. Vaginal pH is 5.5 whilst a wet mount shows white blood cells with a scarcity of Lactobacillus. A large proportion of parabasal cells are evident on Papanicolau smear.

 

5.   A thin 35-year-old Caucasian woman presents with non-specific abdominal discomfort, dysmenorrhea, dyschezia and dysuria. The severity of these symptoms follows a cyclical pattern. She shows signs of depression and upon examination, a pelvic mass is palpable in the right iliac fossa. A biopsy of the intestine reveals chronic inflammation with fibrosis and hemosiderin-laden macrophages.

 

 

ANSWERS

1. B

2. L

3. H

4. J

5. G