Pathology EMQ template.

Name: Alex Presland

Theme: Respiratory Disease

 

OPTION LIST

 

A

Alpha-1-antitrypsin deficiency

I

S. aureus

B

Asthma

J

Sarcoidosis

C

Chronic bronchitis

K

Small cell Ca

D

Cystic fibrosis

L

Squamous cell Ca

E

H. influenzae

M

Strep. pneumoniae

F

M. tuberculosis

N

Strep. viridans

G

Pneumoconiosis

O

 

H

Primary ciliary dyskinesia

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 22 year old male attends your respiratory clinic with persistent sinusitis. He has a history or recurrent respiratory tract infections which have left him with a chronic cough. He has a diagnosis of asthma, which remains poorly controlled, but is otherwise well. On questioning, he reveals that he and his partner have been trying unsuccessfully for a baby for over a year. Sweat test is negative.

 

 

2. A 38 year old teacher presents at the GP with shortness of breath on exertion, with associated wheeze. He tells you that this has been steadily worsening for many years. He admits to a chronic non-productive cough, of 2 years duration, but denies a history of smoking or weight loss. On examination, you convince yourself that the chest is hyperresonant.

 

 

3. A 50 year old female presents to A&E short of breath, with a productive cough and fever. She has a 6 month history of weight loss, since she immigrated to the UK from the East. She is a long-term smoker. She reveals that her son, who lives at home, has similar symptoms.

 

 

4. A 35 year old, with a history of drug abuse, presents to A&E acutely unwell. He is short of breath and feverish, with signs of consolidation in the right lower zone. Sputum culture reveals Gram positive, alpha-haemolytic, optochin-sensitive cocci.

 

 

5. A 33 year old female is referred from haematology, where she was found to have leukopenia and a mild anaemia. She is reported to have a mild longstanding cough, although this is of little concern to the patient. She does not smoke and denies weight loss. Physical examination reveals painless cervical and axillary lymphadenopathy. A chest x-ray confirms the diagnosis.

 

 

 

ANSWERS

1. H

2. A

3. F

4. M

5. J