Pathology EMQ template

YourName: Odiri Eneje

YourIdentifier:

Theme: Lower GI Path

OPTION LIST

A	Anal fissures	I	Diverticular Disease
B	Anal fistula	J	Haemorrhoids
C	Angiodysplasia	K	Irritable bowel syndrome
D	Anorectal abscesses	L	Mega Colon
E	Clostridium Difficile infection	M	Rectal prolapse
F	Colonic Polyps	N	Salmonella infection
G	Colorectal carcinoma	O	Schistosomiasis
H	Crohn’s Disease	P	Ulcerative Colitis

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 26 year old female how has been recently dismissed from work, presents with a 3 month history of alternating constipation and diarrhoea with the passage of pellet-like stools. She also complains of left sided iliac fossa pain which is relieved by defecation or the passage of wind.

2. A 38 year old lady, non smoking lady presents with gradual onset of diarrhoea mixed with blood and mucus. Macroscopic appearance of a biopsy of the large bowel shows superficial and continuous ulceration. Crypt abscesses are present on microscopic examination.

3. A 65 year old man comes to his G.P having noticed bright red blood coating his stools. On further questioning it emerges that he has a history of constipation and prolonged straining before defecation. His Hb is 13.2

4. A 72 year old lady recently back from holiday, having attending her granddaughter’s wedding, presents with a history of diarrhoea, abdominal discomfort, fever and vomiting. You saw her in you clinic last week where you prescribed clindamycin to treat her chest infection. On sigmoidioscopy, plaques of inflammatory exudates giving the appearance of pseudomembranous colitis were seen.

5. A 58 year old man with chronic constipation presents with a history of faecal impaction and soiling. He admits to using laxatives ‘for as long as i can remember’ to contra act his constipation. On examination he has reduced rectal sensation and increased anal tone. Rectal biopsy shows depletion of ganglionic cells in the submucousal plexus

ANSWERS

1. K

2. P

3. J

4. E

5. L