Path Key Points 5 (2)

Question 1

CSF

Answer 1

Bacterial - turbid, very high neutrophils, low glucose
TB - clear/turbid, high lymphocytes, high protein, low glucose
Viral - clear/turbid, high lymphocytes, normal glucose

Question 2

Ductal pancreatic adenocarcinoma

Answer 2

Old age, M>F, K-RAS mutation
Intraductal mucinous neoplasm - usually head of pancreas
RFs - smoking, diabetes, obesity, chronic pancreatitis

Question 3

Chronic cholecystitis

Answer 3

Chronic inflammation, fibrosis
Diverticula - Rokitansky-Aschoff sinuses
Gallstones

Question 4

Causes of AKI

Answer 4

Pre-renal - reduced renal perfusion - volume depletion, oedematous state, NSAIDs, calcineurin inhibitors, ACEI/ARB, diuretics
Renal - glomerulonephritis, SLE, sarcoidosis, prolonged hypotension, rhabdomyolysis, myeloma, CMV, aminoglycosides, acyclovir
Post-renal - obstruction to urine flow - ureteric obstruction, prostatic/urethral obstruction, blocked catheter

Question 5

Stages of CKD

Answer 5

1 - GFR >90
2 - GFR 60-89
3 - GFR 30-59
4 - GFR 15-29
5 - GFR <15 or dialysis

Question 6

CKD

Answer 6

Due to diabetes, atherosclerosis, hypertension, chronic glomerulonephritis, infective/obstructive uropathy, PKD
Acidosis, hyperkalaemia, anaemia, uraemia, osteomalacia, osteitis fibrosa

Question 7

HIV management

Answer 7

2 of non-nucleoside reverse transcriptase inhibitors (efavirenz), nucleoside reverse transcriptase inhibitors (zidovudine, tenofovir), protease inhibitors (ritonavir)
1 of fusion inhibitors (enfurvitide), CCR5 receptor antagonist (maraviroc), integrase inhibitors (raltegravir)
Start when CD4 count <350

Question 8

Acute promyelocytic leukaemia

Answer 8

Immature cells with granules + auer rods + DIC

Question 9

Febrile non-haemolytic transfusion reaction

Answer 9

During/soon after transfusion
Rigors, chills
Mx - slow down or stop transfusion + give paracetamol if needed

Question 10

Allergic transfusion reaction

Answer 10

During/after transfusion (especially plasma)
Itchy rash and wheeze
Mx - IV antihistamines + slow down or stop tansfusion

Question 11

ABO incompatibility reaction (immediate transfusion reaction)

Answer 11

Low BP + low HR + high temperature
Vomiting, chest/loin pain, collapse
Monitor - FBC, U&E, coagulation screen, cross math, DAT
Mx - stop transfusion + IV fluids + discuss with haematology

Question 12

Anaphylaxis

Answer 12

Soon after start
Low BP + high HR
Very breathless, laryngeal/facial oedema
Mx - stop transfusion + anaphylaxis treatment

Question 13

Transfusion associated circulatory overload (TOCA)

Answer 13

SOB, low O2, high HR, low BP

Question 14

Rocky Mountain spotted fever

Answer 14

Tick bite

Headache, fever, maculopapular rash starts peripherally and then spreads centrally

Question 15

Most common type of prostate cancer

Answer 15

Adenocarcinoma

Question 16

Most common type of germinal tumour

Answer 16

Seminoma

Question 17

Most common type of bladder cancer

Answer 17

Transitional cell cancer - specifically urothelial tumours

Question 18

Schistosomiasis is associated with what type of bladder cancer

Answer 18

Squamous cell carcinoma

Question 19

Most common cause of PID

Answer 19

Chlamydia

Question 20

CXR shows halo sign

Answer 20

Aspergillus

Question 21

Dry cough + CXR has ground glass appearance

Answer 21

PCP

Question 22

Wet slide microscopy

Answer 22

Trichomonas vaginalis

Question 23

Grey film over epiglottis

Answer 23

Diphtheria