Pathology EMQ template

 

YourName:         James E. Bowler

YourIdentifier:    00494404

Theme:                Cerebrovascular disease

 

OPTION LIST

 

A

Alzheimer’s disease

I

Pontine haemorrhage

B

Brain stem infarction

J

Raised intracranial pressure

C

Cerebellar stroke

K

Subarachnoid haemorrhage

D

Cerebral embolus

L

Subdural haemorrhage

E

Extradural haemorrhage

M

Temporal arteritis

F

Meningitis

N

Transient Ischaemic attack

G

Opiate overdose

O

Transient hypotension

H

Panic attack

P

Vascular dementia

 

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 35 year old woman was brought to A&E with a severe headache. She was lucid and mentioned that she suffered from frequent headaches but that this one felt like a hammer-blow. She was photophobic and nauseous with slight neck stiffness. Her pulse rate was 75bpm, and BP was 130/80. 

 

2. A 70 year old woman goes to her GP accompanied by her daughter who looks after her. She has started undressing and wandering the streets in the night and she is aggressive and argumentative. She had a stroke 3 years ago and recovered well with only some transient ischaemic attacks recorded since. A CT scan has since shown areas of scattering of low density in the white matter.

 

3. An 86 year old man is admitted to A&E having collapsed at his home. He is unconscious and a couple of days later he is still deeply unconscious. His pupils are pin-point and their reaction to light is difficult to see clearly.

 

4. A 20 year old man was taken to A&E after a pub brawl where he was stamped on whilst trying to break up a fight. He remained lucid for approximately 3 hours after the incident and then slipped in and out of consciousness with hemiparesis afterwards. He had a deep laceration on the side of his head. A CT scan showed high attenuation adjacent to the skull and a midline shift.

 

5. A 42 year old lady went to her GP in a frightened, agitated and still dazed state as the previous day she had what she described as a ‘strange migraine’ but without the headache when, she said, she suddenly could not see the TV. She said she thought it affected just the one eye and that she felt disorientated and unable to speak what she wanted to say. This lasted approximately 2-3 hours and then slowly started to clear. He was tachycardic with hot, sweaty palms.

 

 

ANSWERS

1. K

2. P

3. B

4. E

5. N