Pathology EMQ template.

Name: Ed Middleton

Theme: Opportunistic Viral Infections

 

OPTION LIST

 

A	Human Herpes Virus 8	I	Herpes Simplex Virus
B	Adenovirus	J	BK Virus
C	Epstein Barr Virus	K	Parainfluenza Virus
D	JC Virus	L	HIV
E	Parvovirus	M	Cytomegalovirus
F	Respiratory Syncytial Virus	N	Influenza Virus
G	Varicella Zoster Virus	O	Human Herpes Virus 6
H	Measles	P	Norovirus

 

 

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. An immunocompromised patient attends a clinic appointment complaining of fatigue and shortness of breath. On examination, his respiratory rate is raised and he appears pale. A blood test is taken for a full blood count and PCR.

 

 

2. A patient attends routine clinic, 30 days after a liver transplant. He complains of nausea, diarrhoea and heartburn. On examination, he appears jaundiced. The treating physician identifies a pizza-pie appearance of the retina on ophthalmoscopy.

 

 

3. A 36 year-old heroin user presents to A&E with dark-red papular lesions covering the skin. He is cachectic and complains of nausea and vomiting. The rash started on the hard-palate, where it spread to cover a lot of the skin surface area, and has formed hard plaques in places. The patient has not had access to HIV medication for some time.

 

 

4. An acutely-unwell, immunocompromised patient is admitted to hospital with shortness of breath, fever and a productive cough. Lung histopathology shows a giant cell pneumonia. The treating physician immediately administers HNIG.

 

 

5. A patient presents with a 4 day history of blood in the urine. On examination, he appears slightly jaundiced and has a raised respiratory rate. He reports having had a bone-marrow transplant 1 month ago. The managing team reduce his immunosuppressants and start Ribavirin.

 

 

 

ANSWERS

1. E

2. M

3. A

4. H

5. B