Pathology EMQ template.

Name:

Candidate number:

Theme:

 

OPTION LIST

 

A

Troponin

I

Myoglobin

B

Creatine Kinase

 

J

Brain Natriuretic Peptide (BNP)

C

Lactate Dehydrogenase (LDH)

 

K

Glucagon

D

Alanine aminotransferase (ALT)

 

L

Insulin

E

Gamma Glutamyl Transpeptidase (GGT)

 

M

 

F

Alkaline Phosphotase

 

N

 

G

Amylase

 

O

 

H

Aspartate aminotransferase (AST)

 

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 4 year old boy is brought in by his mother. She reports that she has noticed that his muscle bulk has reduced, except at the calves, which are in fact bigger than before. He has also been walking funnily, with increasing clumsiness and has frequent falls. DNA testing confirms the diagnosis. Which enzyme would you expect to be raised by >10X the ULN.

2.     A 78 year old lady with longstanding hypertension comes to you complaining of progressively worse shortness of breath, especially when she lies down. She even wakes up in the middle of the night with shortness of breath, and has to sit up to relieve this. Her CXR shows cardiomegaly and loss of the costophrenic angles. Which enzyme is increasingly being used as a marker of this condition?

3.     A 38 year old man comes in to A&E after being hit by a double decker bus. Thankfully he walks away with only a broken arm. Which enzyme would be raised?

4.     A confused 50 year old woman with a background of diabetes and hypertension presents to A&E complaining of shortness of breath and fatigue, which started approximately 40 minutes ago. She denies any chest pain. On inspection she is pale and clammy. Urine test is normal.  Which enzyme will you be planning to test for soon?

5.     A 20 year old man presents with pallor and fatigue. He has recently recovered from Glandular fever. On examination you notice yellow sclera and a palpable spleen. Upon questioning, he remembers that his mother told him that he looked a bit yellow when he was born. You request an osmotic fragility test which is positive. Which enzyme is likely to be raised?  

 

ANSWERS

1.  B

2.  J

3. F

4. A

5. C