Pathology EMQ template.

Name:Thanighan Kirupananthan

Theme:Malabsorption

 

OPTION LIST

A	Chronic Pancreatitis	I	Short Gut Syndrome
B	Coeliac Disease	J	Tropical Sprue
C	Crohns Disease	K	Ulcerative Colitis
D	Giardiasis	L	Zollinger–Ellison syndrome
E	Hookworm	M
F	IBS	N
G	Periodic acid-Schiff-negative macrophages	O
H	Periodic acid-Schiff-positive macrophages	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 31 year old Irish female presents with weight loss, abdominal bloating and mouth ulcers. The stools are bulky and difficult to flush away. O/E she appears to have a vesicular rash over her lower back. Investigations reveal Hb = 8.4 g/dl

 

 

2. A 24 year old female presents with a rash over her lower legs. She gives a long-standing history of weight loss, diarrhoea and abdominal pain. O/E there are tender erythematous nodules over her shins, a mass in the right iliac fossa and apthous ulcers in the mouth.

 

 

3. A 47 year old female presents with a history of abdominal pain, weight loss and arthritis.  She also has steatorrhoea.  What would a jejunal biopsy show?

 

 

4. A 34 year old man who is a frequent traveller to Barbados presents with a history of diarrhoea, weight loss, indigestion, malaise and lethargy. A small bowel biopsy reveals villous stunting and increased crypt depth. Symptoms were improved with a course which included tetracycline.

 

 

5. A 49 year old female presents with loss of weight and diarrhoea. She has had multiple operations for Crohn’s disease of the small bowel. O/E she looks emaciated and there are multiple scars on her abdomen. Investigations reveal that inflammatory markers are not raised.

1. B

2. C

3. G

4. J

5. I

ANSWERS