Pathology EMQ template.

Name: Cattleya Godsave

Candidate number:

Theme: Fungal Infections

 

OPTION LIST

 

A

Aspergillus fumigatus

I

Trichophytum rubrum

B

Blastomyces

J

Tinea capitis

C

Candida albicans

K

Tinea corporis

D

Cryptococcus

L

 

E

Histoplasma

M

 

F

Malassezia furfur

N

 

G

Pityriasis vesicolor

O

 

H

Strongyloides stercoralis

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 53 year old builder comes into your clinic complaining of a 6 month history of cough and tiredness.  He has lost 10kg in the last 3 months.  A CXR shows a round opacity within a cavity in the apical region of his left lung.  What is the most likely organism?

 

2. A worried mother comes into the GP with her 5 month old girl.  She has noticed a rash in the nappy area that started yesterday.  She has tried antibacterial creams but they do not help.  On examination, you find an erythematous rash including the skin flexures with satellite regions.  You prescribe a topical antifungal cream.  What was the causative fungus?

 

3.  A 27 year old man comes in with increasing headaches and confusion over the past months.  On further questioning he tells you he has sex with other men.  He is pyrexial when you see him.  You order an HIV test, bloods and an LP.  His HIV test comes back positive and his LP has a raised opening pressure, and testing for a particular antigen is positive.  What caused his symptoms?

 

4.  A 35 year old cook comes into the GP complaining of pain and discomfort around her first toe nail.  She is very embarrassed about it and thinks it is serious as her nail has gone yellow.  On examination, you find a hyperkeratotic nail with onycholysis.  Which organism is most likely?

 

5.  A 10 year old boy comes with his mother, who is keen to get him back to school.  You notice he is itching his head and on further inspection you see a round, scaly, itchy lesion on his scalp.  Mum tells you that there are several other children at school with a similar problem.  You culture the skin scraping and find hyphae.

 

 

 

ANSWERS

1. E

2. A

3. G

4. D

5. F