Pathology EMQ template

 

YourName: Marya Zia

YourIdentifier: 412109

Theme: Zoonoses

 

OPTION LIST

 

A

Viral encephalitis

I

Leptospirosis

B

Ehrlichiosis

J

Hepatitis E

C

Brucella melitensis

K

Hydatid disease

D

Borrelia burgdorferi

L

 

E

West Nile Virus

M

 

F

Dengue

N

 

G

Q-fever

O

 

H

Coxiella burnetii

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 19 year old gap-year student has returned from the Middle East, during which time he worked on a farm.  He presents to you complaining of a variety of non-specific symptoms, including occasional fevers, loss of appetite, lethargy, constipation and arthralgia.  He has also lost 10kg since his return to England two months ago.

 

 

2. A 42-year old woman complains of general tiredness and malaise after a trip to Canada for her friendŐs wedding.  A thorough examination reveals spreading erythematous rings with central fading on her back and thighs, although she denies being bitten by any insects whilst on holiday.

 

 

3. A 28-year old man presents to A&E with a high grade fever and sudden onset of a severe headache and muscle pains.  He is extremely hot and has thus come to A&E dressed in khaki shorts, sandals and a vest.  You notice a bright red petechial rash across his calves and feet.  He also reports mild gastric disturbance, but puts this down to his very recent holiday to Samoa. 

 

 

4. An anxious 32-year old man is brought into A&E by a concerned friend at work, complaining of an intense headache, photophobia and mild confusion.  History reveals that he had the flu a week ago, suffering from a fever, cough and generalised weakness.  The microbiology lab reports that his blood cultures and CSF sample have both cultured the same motile, spirochete organism.  Although the man is admitted to hospital, he says he is anxious to get back to the townŐs sewage works, where he works as a team leader.

 

 

5. A 48-year old farmer is brought to A&E by his wife who says that although her husband has not been himself for a while now, his condition has suddenly become worse over the past few hours. On examination he appears unresponsive and agitated, and has a GCS of 11. He is salivating profusely and scratching his left shoulder.  Examination of the area reveals a bite mark.

 

 

ANSWERS

1. C

2. D

3. F

4. I

5. A