ChemPath EMQ examples

Question 1

how is bone density measured

Answer 1

DEXA scan
z score = sd against same age and gender
t score - sd against healthy young patient
FRAX score = fracture risk in next 10 years

Question 2

what condition causes wrist fractures

Answer 2

primary hyperparathyroidism

Question 3

what conditions cause hip and back fractures

Answer 3

excess steroids
hyperthyroidism
post-menopausal osteoporosis

Question 4

most common cause of speptic monoarthitis is 18-30s

Answer 4

nisseria gonorrhoea

gram negative intracellular diplococcus

Question 5

19 yo student septic, pyrexis, confused, pyrexia 39 degrees, stiff neck and lp shows gram -ve intracellular diplococci

Answer 5

nisseria meningitidis

causes fatal sepsis

Question 6

cause of meningitis in:
0 yrs
6 yrs
18-25 yrs
60+ years

Answer 6

0 - E.Coli
6 - H. influenzae (not vaccinated)
18-25 - N. meningitidis (meningococcus)
60+ - S. pneumoniae (pneumococcus)

Question 7

what is strep pneumoniae

Answer 7

gram positive diplococci

Question 8

what is staph aureus

Answer 8

gram positive cocci in clusters

Question 9

what is streptococus viridans

Answer 9

gram positive cocci

Question 10

signs of infective endocarditis

Answer 10

roth spots, splinter haemorrrhages, janeway lesions, oslers nodes, clubbing, microscopic haematuria, splenomegaly

Question 11

causes of infective endocarditis

Answer 11

strep viridans - aortic and mitral valve (settles on damaged valves)
staph aureus - tricuspid (aggressive, without damage)

Question 12

does calcium go up or down slightly in addisons

Answer 12

up

to suppress PTH a little

Question 13

what condition is often seen in patients with osteomalacia

Answer 13

secondary hyperparathyroidism

Question 14

deafness in pagets disease

Answer 14

nerve and conductive deafness
pagets disease of osscicles - conductive deafness

pagets of skull can compress the 7th cranial nerve - neural deafness