Pathology EMQ template.

Name: Kate Richmond                      

Theme: Sodium Handling

 

OPTION LIST

 

A	Prolonged vomiting	I	Conn’s Sydrome
B	Diuretic	J	Liver cirrhosis
C	Addison’s Disease	K	hypothyroidism
D	Cardiac failure	L	Psychogenic Polydipsia
E	SIADH	M
F	Diabetes Incipidus	N
G	Cushing’s syndrome	O
H	Type 2 Diabetes Mellitus	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. An 80 year old woman presents drowsy and confused.  Blood tests reveal a low sodium.  medications include digoxin, atenolol, losartan and bendroflumethiazide which she has been taking for two years following a severe MI.  Examination reveals sacral oedema and bibasal crepitations

 

 

2. A 20 year old male recovering in hospital following head trauma sustained in a RTA becomes lethargic and nauseous.  His sodium is 130 mmol/L

 

 

3. A 40 year old man presents with polyuria and polydipsia.  His fasting plasma glucose was 5 mmol/L.  During a water deprivation test his serum plasma osmolality rose significantly and urine output remained constant

 

4. A 50 year old man presents with collapse.  Electrolyte investigation reveals a potassium of 6mmol/L. O/E he is noted to be very tanned

 

 

5. A 67 year old man presents in A and E with a seizure prior to which he had become increasingly drowsy and confused.  Medications include propanalol, ramipril and bendroflumethiazide which was started by his GP one week previously.

 

ANSWERS

 

1. D

2. E

3. F

4.  C

5. B