Pathology EMQ template.

Name: Rebecca Le Vay

Theme:

 

OPTION LIST

 

A	Acute disc prolapse	I	Retroperitoneal haematoma
B	Ankylosing spondylitis	J	Sclerotic metastases
C	Lytic metastases	K
D	Multiple Myeloma	L
E	Osteoarthritis	M
F	Osteoporotic collapse	N
G	Paget’s disease of the spine	O
H	Pott’s disease of the spine	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 25 yr old man comes to the GP with a 4 month history of increasing pain in his lumbar spine. It radiates to his buttocks and down the backs of his legs. He also complains of painful red eyes over the last few weeks. Radiographs of his lumbar spine and pelvis show erosions of his sacroiliac joints.

 

 

2. A 67 yr old man presents to his GP with increasing lower back pain, malaise and lethargy. OE he is clinically anaemic, and has purpura on his forearms. He has hepatosplenomegaly but no associated lymphadenopathy and is tender over L3/L4. Investigations show: Hb 6.1 g/dl, MCV 89 fl, WCC 3.2, platelets 21, ESR 117 mm/h.

 

 

3. A 39 yr old homeless man is admitted with severe mid thoracic back pain. OE the patient is unwell, pyrexic and tender over T8/T9. Radiograph shows loss of intervertebral space between T8 +T9 and erosion of the two vertebral bodies.

 

 

4. A 47 yr old woman comes to her GP with a 5 month history of change in bowel habit and weight loss. Colonoscopy reveals a large polypoid tumour 37cm from the anal margin, which is surgically removed. 4 months later she returns with severe lumbar back pain.

 

 

5. A 76 yr old man comes to his GP with severe lower back, hip and pelvic pain. Pelvic radiographs show “increased trabecular pattern with cortical thickening”.

 

 

 

ANSWERS

1. B

2.D

3. H

4. C

5. G