Pathology EMQ template

 

Name: Russell Everett

Theme: Diseases of the Pancreas

 

OPTION LIST

 

A	Acute pancreatitis	I	Type 1 diabetes
B	Ampillary carcinoma	J	Type 2 diabetes
C	Annular pancreas	K
D	Chronic pancreatitis	L
E	Ductal adenocarcinoma	M
F	Intraductal papillary mucinous tumour	N
G	Islet cell tumour	O
H	Pancreas divisum	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 45 year old man presents to A&E with a four month history of abdo pain. He says the pain ‘bores through to the back’, and says it is painful when he lies down. He thinks he may have lost some weight recently and his stools have become pale and smelly. He admits to regular alcohol consumption. On examination his gall bladder is impalpable and an ultrasound reveals a dilated biliary tree.

 

 

2. A 29 year old woman presents with confusion, stupor, sweating, palpatations and diplopia after a tennis match. She greatly improves after being given 50ml 50% dextrose solution. Laboratory tests reveal a raised plasma insulin and a raised insulin-to-glucose ratio.

 

 

3. What is the congenital abnormality of the pancreas leading to an increased risk of pancreatitis?

 

 

4. A 65 year old retired postman presents with a three month history of painless jaundice and weight loss. He has been a smoker since the age of 16 and regularly drinks alcohol. On examination he has a palpable gall bladder.

 

 

5. A 24 year old medical student presents to Charing Cross A&E with severe epigastric pain radiating to the back, profuse vomiting and confusion. On examination he is tachycardic, with a B.P. of 90/40 and a temperature of 39.6⁰C. His abdomen is rigid. An abdominal X-ray shows no psoas shadow. His friends are reluctant to give a social history.

 

 

 

 

ANSWERS

1. D

2. G

3. H

4. E

5. A