Pathology EMQ template.

Name: Ektoras Georgiou

Candidate number: 00412153

Theme: Enzymology

OPTION LIST

A	AFP	I	GGT
B	ALT	J	LDH
C	ALP (bone isoenzyme)	K	Myoglobin
D	ALP (liver isoenzyme)	L	Total CK
E	Amylase	M	Troponin C
F	AST	N	Troponin I
G	CA-125	O	Troponin T
H	CA 19-9	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. Which enzyme is physiologically elevated in growing infants?

2. Even though it’s non-specific, which is the earliest marker of a myocardial infarction?

3. A 65 year old man presents to his GP complaining of worsening back pain. To your bemusement, his wife adds that his face increasingly resembles that of a lion. You decide to X-ray his spine, which shows osteosclerotic and osteolytic lesions. Which enzyme would you expect to be raised?

4. A 70 year old lady presents to A&E with crushing central chest pain, nausea and sweating. A diagnosis of MI is made based on ECG changes and elevated Troponin T levels. Two days later, a third year medical student notices a rise in one of the LFT values and wonders what may be the cause. Which enzyme is responsible for his observation?

5. A 63 year old man with a 40 pack year smoking history presents with painless jaundice, weight loss and on examination the gallbladder is palpable. Which tumour marker is likely to be raised based on your findings?

ANSWERS

1. C

2. K

3. C

4. F

5. H