Intermediate Cycle 2006/7
Semester 1 Assessment
September Paper
Biology & Epidemiology of Disease
Duration 90 Minutes
Total Marks 40
Section A
Answer all questions in this section
PLEASE USE A SEPARATE ANSWER BOOK FOR THIS QUESTION
1. CPC 30 minutes
A 50 year old lady undergoes a hysterectomy for uterine carcinoma. She has an unsettled post-operative
course and has not eaten or drunk anything and becomes dehydrated. On the 3rd post-operative day she
develops a red and tensely swollen right calf. Her past medical and surgical history is non-contributory. She
is a smoker of 30 cigarettes per day and a social drinker. She is on no medications.
On examination she is relatively well and her vital signs are as follows: pulse 110 beats per minute
(tachycardic), blood pressure 100/60 mmHg and apyrexial. The use of an intravenous drip (commenced
that morning) has partly corrected her dehydration. Blood testing shows her to be mildly anaemic and to
have an increased platelet count. A clinical diagnosis is made and she is referred for further investigation.
On the basis of these tests she is commenced on intravenous heparin.
a) What is your diagnosis?
b) If she was pyrexial could there be another explanation for her swollen leg?
c) What might the further investigations be?
d) What drug can be taken orally to produce the same effect as heparin?
e) What are the 3 components of Virchow’s triad?
f) What are this lady’s particular risk factors for her condition?
g) How might you decrease this lady’s risk for this condition?
2 days after commencement of treatment she is found collapsed in the toilet. An ECG shows a tachycardia
but no cardiac output is felt. Attempts at resuscitation are unsuccessful.
h) What do you think has happened now?
i) Name 6 types of emboli and give causes for any 3 types.
Semester 1 Assessment
September Paper
Biology & Epidemiology of Disease
Duration 90 Minutes
Total Marks 40
Section A
Answer all questions in this section
PLEASE USE A SEPARATE ANSWER BOOK FOR THIS QUESTION
1. CPC 30 minutes
A 50 year old lady undergoes a hysterectomy for uterine carcinoma. She has an unsettled post-operative
course and has not eaten or drunk anything and becomes dehydrated. On the 3rd post-operative day she
develops a red and tensely swollen right calf. Her past medical and surgical history is non-contributory. She
is a smoker of 30 cigarettes per day and a social drinker. She is on no medications.
On examination she is relatively well and her vital signs are as follows: pulse 110 beats per minute
(tachycardic), blood pressure 100/60 mmHg and apyrexial. The use of an intravenous drip (commenced
that morning) has partly corrected her dehydration. Blood testing shows her to be mildly anaemic and to
have an increased platelet count. A clinical diagnosis is made and she is referred for further investigation.
On the basis of these tests she is commenced on intravenous heparin.
a) What is your diagnosis?
b) If she was pyrexial could there be another explanation for her swollen leg?
c) What might the further investigations be?
d) What drug can be taken orally to produce the same effect as heparin?
e) What are the 3 components of Virchow’s triad?
f) What are this lady’s particular risk factors for her condition?
g) How might you decrease this lady’s risk for this condition?
2 days after commencement of treatment she is found collapsed in the toilet. An ECG shows a tachycardia
but no cardiac output is felt. Attempts at resuscitation are unsuccessful.
h) What do you think has happened now?
i) Name 6 types of emboli and give causes for any 3 types.
