Pathology EMQ template.

Name: Andrew Mowat

Candidate number: 00565691

Theme: Multiple Myeloma

 

 

OPTION LIST

 

A

This is not a complication of multiple myeloma

I

Osteoporosis

B

Streptococcal infection

J

Fractured neck of femur

C

DentÕs Disease

K

Carpal Tunnel Syndrome

D

Myeloma induced anemia

L

Peripheral Neuropathy

E

Hypercalcaemia

M

Dislocation of the hip

F

Hypocalcaemia

N

Right Bundle Branch Block

G

Hyponatraemia

O

TB

H

E.coli infection

P

Renal failure

 

 

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 67-year old man with a diagnosis of multiple myeloma presents to his GP complaining that he canÕt get to sleep at night. The problem is a tingling sensation in his hands, particularly the index and middle fingers which resolves if he gets up and shakes the hand off. On examination, the GP notices wasting of the thenar eminence.

 

2. A 73 year old lady who has just begun chemotherapy for her myeloma is found wandering her nursing home late at night. The nurse reports the patient is confused and distressed and smells a bit worse than usual.

 

3. A 57 year old man slips on the ice and hears a cracking sound coming from his left hip. He is surprised by the amount of pain that he is in as the fall was not particularly violent. An ambulance is called when the paramedics arrive they find that the patient is unable to weight bear and his leg is grossly shortened and externally rotated.

 

4. A 78 year old Indian gentleman who has a diagnosis of multiple myeloma presents to his GP complaining of episodes of feeling faint. The GP requests numerous investigations including a 24 hr ECG which shows a shortened QT interval and a widened T wave. On further questioning the patient lets slip he has had problems with his bowels of late.

 

5. A 47 year old lady who has had a diagnosis of Òsmoldering myelomaÓ suffers from severe shortness of breath on exercise, and claudication in her feet. She has a history of thyroid problems. Blood tests are ordered which shows the following results:

           

Hb = 6.8 mmol/l

 

MCV = 108 mcv

 

 

ANSWERS

1. K

2. H

3. J

4. E

5. A