Pathology EMQ template.

Name: Simon Bellringer

Candidate number: 00429553 CID

Theme: Calcium Handling

OPTION LIST

A	Cushings Disease	I	Paget’s Disease
B	Familial Benign Hypercalcaemia	J	Primary Hyperparathyroidism
C	Hypoparathyroidism	K	Pseudohypoparathyroidism
D	Malignancy	L	Pseudopseudohypoparathyroidism
E	Milk Alkali Syndrome	M	Renal Stones
F	Osteomalacia	N	Rickett’s
G	Osteopenia	O	Sarcoidosis
H	Osteoporosis	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 60 year old women present with a painful shin. There is no history of trauma but on examination the tibia does appear to be outwardly curved. Being an attentive student, you notice that she is also wearing a hearing aid.

2. While on residency, a 60 year old man presents with pain in her hip joint and also complains that he is finding it difficult to stand up from his chair. An X-Ray reveals what the local GKT “student” believes to be a fracture, but you correctly identify as a Looser’s zone.

3. A concerned man brings his son to see his GP. He is worried that his boy is shorter than the rest of children and that he is being bullied because he has a round face. You notice that the child has short 4^th and 5^th metacarpals. Thinking that this may have been one of the rarer diseases that you were meant to learn in 2^nd year, you order calcium, phosphates and PTH levels, but they are all normal.

4. A elderly woman present with a fractured neck of femur and a subsequent DEXA Scan reveals a T score of -2.1 SD.

5. A patient present with a history of renal stones, constipation and depression. Thinking that high calcium may be responsible you check the Calcium, Phosphate and PTH levels. Results:- Calcium 3.2mmol/l (norm;2.2-2.65), Phosphate 0.69mmol/l (norm;0.8-1.4), PTH 4pM/l (norm;1.1-6)

ANSWERS

1. I

2. F

3. L

4. G

5. J