Path Key Points 2

Question 1

What causes erythema nodosum?

Answer 1

Sarcoidosis, IBD, Behcet’s disease, streptococcus, mycobacterium tuberculosis, pregnancy, OCP

Question 2

What causes parotid enlargement?

Answer 2

Sarcoidosis, Sjogren’s disease, mumps, alcoholism, parotid cancer

Question 3

Large vessel vasculitis

Answer 3

Takayasu arteritis

Giant cell arteritis - >50s, jaw claudication, scalp tenderness

Question 4

Medium vessel vasculitis

Answer 4

Polyarteritis nodosa - renal/mesenteric vessels affected, beads of vessels on angiogram
Kawasaki’s disease - children, fever, erythematous rash on palms and soles, conjunctivitis, lymphadenopathy

Question 5

Small vessel vasculitis

Answer 5

Eosinophilic granulomatosis with polyangitis (Churg Strauss) - atopy + eosinophilia + vasculitis
Granulomatosis with polyangitis (Wegener’s granulomatosis) - nose bleeds, crusting, sinusitis, ear/lung problems, haemat/proteinuria
Mx
- cyclophosphamide + steroids

Question 6

Reactions to antibiotics

Answer 6

Renal failure - gentamicin, vancomycin
Anaphylaxis - penicillin
Hepatitis - meropenem
Liver failure - fusidic acid + statin
INR raise - warfarin + ciprofloxacin/clarithromycin

Question 7

Community acquired pneumonia

Answer 7

Streptococcus pneumoniae
Haemophilus
Chlamydia

Mx - amoxicillin

Question 8

Severe community acquired pneumonia

Answer 8

Legionella
Mycoplasma

Mx - clarithromycin + amoxicillin

Question 9

Hospital acquired pneumonia

Answer 9

Empiric therapy –> tazocin, ciprofloxacin, carbapenem
Gram -ves –> cephalosporins + ciprofloxacin/gentamicin, tazocin
MRSA –> vancomycin

Question 10

Meningitis

Answer 10

Neisseria meningitidis
Streptococcus pneumoniae
Listeria - very young/old, pregnant, immunocompromised

Mx
- dexamethasone 10mg IV
THEN
- empirical therapy - ceftriaxone
- neonates/>60/immunocompromised - amoxicillin + cefotaxime
- listeria - amoxicillin/ampicillin + gentamicin
- neisseria - ceftriaxone or cefotaxime + amoxicillin if <3 months
- streptococcus - vancomycin + ceftriaxone

Question 11

Community UTI

Answer 11

Trimethoprim

Question 12

Iatrogenic UTI

Answer 12

Cephalexin/augmentin

If infected catheter - change under gentamycin cover

Question 13

C.diff enterocolitis

Answer 13

Stop offending agent - cephalosporin

PO metronidazole –> PO vancomycin

Question 14

Pneumocystis carinii

Answer 14

HIV +ve + CD4 <200

Oral co-trimoxazole

Question 15

Gout

Answer 15

Due to drugs - thiazides, furosemide, alcohol, pyrazinamide
Mx
- acute - NSAID, steroid injection, colchicine
- 2 weeks later - allopurinol

Question 16

Hairy cell leukaemia

Answer 16

Middle aged men

Pancytopenia, splenomegaly, hepatomegaly

Question 17

Burkitt’s lymphoma

Answer 17

Due to latent EBV
Mandibular/abdominal mass
Starry sky appearance on microscopy

Question 18

Hodgkin’s lymphoma

Answer 18

Painless, asymmetrical lymphadenopathy that is painful on alcohol consumption
Reed Sternberg cells

Question 19

Mantle cell lymphoma

Answer 19

Old men

Translocation between Chr 11 and 14

Question 20

Follicular lymphoma

Answer 20

Middle aged people
Translocation between Chr 14 and 18
Painless, generalised lymphadenopathy
Centrocytes and centroblasts