Pathology EMQ template.

Name: Rachel Williams       

Candidate number:

Theme: Wound, Bone & Joint Infections

OPTION LIST

A	Staph. Aureus	I	Clostridium Tetani
B	Strep. Pyogenes	J	Pasteurella multocida
C	Flucloxicillin	K	Vancomycin
D	Benzylpenicillin	L	Ciprofloxacin
E	Staphylococcal Osteomyelitis	M	Brodie’s abscess
F	Septic Arthritis	N	Leishmaniasis
G	Clostridium Perfringens	O	Metronidazole
H	Actinomycoses	P	Tuberculous osteomyelitis

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. Mrs Smith a 50yr old woman presents to A+E after she developed facial spasms, she also describes difficulty swallowing, and neck stiffness. Whilst examining you notice a large cut on her right palm and that her hands are quite dirty. Mrs Smith tells you she has spent a lot of time gardening recently whilst the weathers been nice. Which organism do you think is responsible for her symtoms?

2. Mr Jenkins is a 47year visits his GP after noticing a swelling on the left side of his jaw 3 weeks ago after having a tooth removed at the dentist. On examination you find an indurated swelling localised to lower part of the mandible. There is no lymphandenopathy and the pt denies any pain, you also notice he has poor dental hygiene.

3. A solider returns from Afghanistan he has an extensive shrapnel wound on his left thigh. His leg is grossly oedematous, discoloured & there are multiple necrotic bullae. Cultures from the wound demonstrate Gram +ve spore-forming rods. The surgeons confide to you they are concerned this is gas-gangrene.

4. This organism accounts for 90% of osteomyelitis cases. It is a coagulase +ve Gram +ve coccus that appears in clusters when cultured. Which antibiotic would you use to treat infections caused by this organism?

5. This condition arises weeks-months after being bitten by a sand-fly & manifests as skin ulcers.

ANSWERS

1. I

2. H

3. G

4. C

5. N