Pathology EMQ template.

Name: Jenna Lau

Candidate number: 00395609

Theme: LYMPHOMA

OPTION LIST

A	Follicular lymphoma	I	Burkitt’s lymphoma
B	CLL	J	Diffuse large B-cell lymphoma
C	goitre	K	Adult T-cell lymphoma
D	H. pylori eradication	L	Miliary Tuberculosis
E	Bone marrow transplant	M
F	Involved field radiotherapy with ABVD x2-4 cycles	N
G	Mantle radiotherapy	O
H	ABVD x6-8 cycles	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 72-year old farmer presents to A&E with an infected superficial laceration of his left hand due to a farming accident. Whilst treating him for his laceration, you notice a large lump on his neck. On further questioning, you discover he is originally from the Caribbean, and has had SOB on exertion for the past month. What is the most likely diagnosis?

2. A 19-year old male visits his GP after being afflicted with a strange low-grade fever that seems to come and go for about 2 weeks at a time. He has recently been to Fresher’s Fortnight at his medical school and is concerned that he might have caught something from his fellow freshers. He has a cough and enlarged nodes on both sides of his neck. His GP refers him to the local hospital which carries out tests showing lymph node involvement on one side of his diaphragm, and cells with mirror-image nuclei. What treatment is most suitable for this patient?

3. You are working in a hospital in central Africa, when you encounter a young boy in A&E who has been brought in by his mother. They tell you that he has had night sweats, fever and weight loss for the past month. History and examination reveals he has AIDS, abdominal swelling and a neck lump that did not respond to antibiotics. Biopsy of the neck lump shows a ‘starry sky’ appearance. What is the most likely diagnosis?

4. A 56 year-old gentleman presents with epigastric pain and dyspepsia. He is found to have a positive urea breath test and a diagnosis of MALT lymphoma is made. What is the treatment of choice for gastric MALT lymphoma?

5. This type of lymphoma involves a 14;18 translocation involving the bcl-2 gene. It is usually indolent, but can transform to a high grade lymphoma.

ANSWERS

1. K

2. F

3. I

4. D

5. A