Pathology EMQ template.

Name: Claire Vassie  

Theme: Upper GI disease

OPTION LIST

A	Achalasia	I	Oesophageal adenocarcinoma
B	Coeliac disease	J	Oesophageal varices
C	Duodenal ulcer	K	Oesophageal web
D	Gastric carcinoma	L	Oesophagitis
E	Gastric MALToma	M
F	Gastric ulcer	N
G	GORD	O
H	IBS	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 42-year-old publican presents to A&E with hematemesis and pruritus. Jaundice, gynaecomastia and asterixis are noted on examination.

2. A 72-year-old Portuguese fishmonger presents to his GP complaining of weight loss, heartburn and vomiting. On examination, Troisier’s sign is positive.

3.  An obese 38-year-old lady presents with a three month history of lethargy and stomach discomfort which is worse during periods of hunger. She has noticed that occasionally her stools are very dark.  

4.  An 82-year-old man complains of odynophagia. The pain has become progressively worse over the past three months, at first only solids triggered the pain but now even sipping water is painful.

5. A 22-year-old secretary with well managed type I diabetes complains of lethargy, weight loss and intermittent diarrhoea. Blood tests demonstrate a macrocytic anaemia.

ANSWERS

1. J

2. D

3. C

4. I

5. B