Pathology EMQ template.

Name: Wakana Teranaka   

Theme: Thrombosis

OPTION LIST

A	Antiphospholipid syndrome	I	Hypertrophic Obstructive Cardiomyopathy
B	Arrythmia	J	Paroxysmal nocturnal haematuria
C	Chronic Kidney Failure	K	Protein C deficiency
D	Diabetes Mellitus	L	Renal cancer
E	Factor V Leiden	M	Scott Syndrome
F	Haemophilia A	N	Uraemia
G	Haemophilia B	O	Wiskott-Aldrich Syndrome
H	Heparin-Induced thrombocytopenia	P	Von Willebrand Disease

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 23 year old student’s mother calls the ambulance as her daughter has suddenly developed difficulty breathing. She has 9/10 central chest pain that began at rest. There have been no previous episodes. She is on OTC vitamins and the oral contraceptive pill. Her mother says she had 2 similar episodes in her youth before she stopped taking the pill. Investigations reveal both mother and daughter have activated protein C resistance.

2. A 60 year old man with severe abdominal pain is brought into the emergency department. His GP says he has recently reported changes in his waterworks. His urine is darker, especially in the evening. He has been feeling tired recently and had seemed anxious that he had not been able to satisfy his wife in bed.

3. A 35 year old woman complains of a swollen leg. On examination, her left leg is red, warm and larger in diameter than the right. She has had similar episodes in the past and has also had 2 spontaneous miscarriages. An ELISA confirms the presence of anticardiolipin antibodies.

4. A man with a history of sudden death in his family collapses in a supermarket. He is unconscious on arrival at the local hospital but is treated with thrombolytic agents. When he regains consciousness a few hours later, the registrar suggests the patient that a pacemaker be placed.

5. A patient that has been placed on thromboprophylaxis after a major surgery suffers acute chest pain later confirmed to be a pulmonary embolus. ELISA shows presence of IgG autoantibodies. The medication is altered and she is now on low molecular weight heparin.

ANSWERS

1. D

2. J

3. A

4. B

5. G