Pathology EMQ template.

Name: Caroline Bullen

Candidate number:

Theme: Chem path lab (antibodies and other tests)

OPTION LIST

A	Anti-acetylcholine receptor antibody	I	Osmotic fragility test
B	Anti-endomysial antibody	J	p-ANCA
C	Anti-intrinsic factor antibody	K
D	Anti-GAD	L
E	Anti-mitochondrial antibody	M
F	Anti-smooth muscle antibody	N
G	c-ANCA	O
H	Coombs test	P

For each scenario below, match the test most likely to confirm a diagnosis in the clinical presentations below. Each option may be used once, more than once or not at all.

1. A 50 year old receptionist presents to her GP with a history steatorrhoea, abdominal pain and weight loss, as well as feeling tired all the time. Initial blood tests reveal a microcytic anaemia.

2. A 60 year old woman complains of tiredness and dyspnoea. On examination she is found to be mildly jaundiced and blood tests show a macrocytic anaemia.

3. A 40 year old plumber presents to his GP with a history of wheezing and lethargy, along with recurrent nose bleeds. On examination he has crackles in his upper left lung field. Urine dipstick is positive for blood and protein.

4. A 30 year old market trader presents with tiredness and jaundice, and further history reveals he suffered from a chest infection one week previously. On examination mild splenomegaly is noted, and blood tests show reticulocytosis, hyperbilirubinaemia, and spherocytosis.

5. An 80 year old retired clerk presents with a 2 month history of skin itching and lethargy. Examination is normal. LFTs are: bilirubin 6umol/l (reference range 0-17umol/l); ALT 24U/l (reference range 0-31U/l); Alk Phos 500U/l (reference range 30-130U/l).

ANSWERS

1. B

2. C

3. G

4. I

5. E