MRCP-1 8th January 2019

Medicoman · January 11, 2019, 4:46am

Blistering rash with hyperteichosis…porphyria cautinea tarda
the answer is Rheumatoid factor…it was siogren with cryoglobulinemia
Treatment of sxhistosomiasis praZiquatnel
ischarmic colitis spleenic flxr
waterlow scr decibitus ulcer
ispsiltrl horner contraltrl pain temp lost posterior inferior cerebellar
stroke upper limb greater than lower middle cerebral
Young age patient air travel Australia to UK got TIA like symptoms— transthoracic echo
Methotrexate MoA…DHF inhibitor
Rituximab Inhibits B cell
dicrotic notch signifies --aortic valve closure
sudden death autopsy fibrofatty tissue---- arythmogenic right ventricular dysplsa
Coronary sinus location-Right Atrium
option one was correct 95 of test was neative in 95 disease negative condition
Multiple cranial palsies-Lesion in cavernous sinus
U wave in hypokalemia?
Sensitivity answer was 80 perecnet
PPV was 40 percent
PKD screening usg of all 1st degree relatv by USG abdomen
Kaposi Sarcome HHV8
Factor 5 laiden deficency causes protein c resistance?
Stoamtoform…
Malingering. For gain of methadone
fondaparinux-Inhibits factor Xa
abxicimab-- glycoprotein 2b/3a inhibitr
Tx of supra ventricular tachycardia after failure of manoeuvre Verapamil since adenosine contraindicated in asthma
Additional Tx of nisseria gonorrhea after azithromycin==Ceftriaxone
Organism responsible for human bite infection: Ekinella
Exacerbating drug in psoriasis—Propanolol
Patch lesions on body with skin atrophy and hair plugging-- discoid lupus erythematous
Multiple lesions with wickham striae in mouth— lichen planus
Fulminating hepatotis pathology— Necrosis
Jerky hand Movement—Huntington
Pericarditis - ECG changes ST waves concave upward
Which will be normal after 36 hours of paracetamol poisoning
Bilirubin album ast alp— Albumin ?
Lithium toxicity in elderly pt cause-----Decrease renal clearance?
Tx of diagnosed dm whose creatinine was at upper limit and RBS was 15— Metformin
Marker of diagnosing DM type 1… Ketones
Ketonuria: Lipolysis
Autoimmune thyroiditis? Which cancer—Lymphoma
Medulary cc.----Ret oncogene
Why give loading dose of amiodarone—due to long half life
Lab like dic except high platelet alongwith Sepsis— DIC ?
pitutiary apoplexy
Strongylodosis
SAH most common cause of rupture—(Berry was not in option)—post communicating artery?
Diarrhoea in nursing home–norvovirus
gastroenteritis just after meal in 03 friends and after 24 hours in 03 frnds— Bacillus Bruceus?
Pilocarpine MoA-Muscarinic agonist
Chronic anal fissure, constipation with mental confusion presented with painful defecation—glyceryl tri nitrate-methylcellulose tx?
Nonvisible haematuria but the usg was normal next investigation----flexible cystoscopy
Von hipp landu syn–retinal haematoma
Paget disease-Give Bisphosphonate
16 year girl with leg rash, hematuria and proteinuria?
hx of throat infection and palpable rash on leg…it was HUS ?
SLE -Low C4
Malt… Eradicate h. Pylori,
rx responds… Urea breath test
Worsen opthalmoplegia after —radioiodine therapy
UGIB-PPi to reduce rebledd
76 years old with AF –dabigatrin
Child with abd pain since chilhood now ankle edema, plus inc. creatinine low albumin… Minimal, IgA, Membranous (?)
armenian descent-arthalgia-renal affection and peritonitis causing abdominal pain-- familial meditarranen fever…
After Veitnam trip of 03 months pleural effutn and erythema nodosm— TB
Patient afib normal bp ischemic stroke presented after 6 hours? Treatmen to give asprin
Empyema = low PH
Post renal transplant lesion with behind ear lesion… cutaneous B cell (PTDLT) or squamous ?
APC gene–colon carcinoma
Brca… Ovarian
break frm boyfriend visual and auditory hallucinatn vivid dream— adjustmen disorder/ mefloquine toxicity, schizophrenia, herpes encephalitis?? –
COPD patient, best way for oxygen–ventuuri mask
Obese man cause of false high measured bp—undersized cuff
Cystic fibrosis–pancreatic insufficiency— fecal elastase
Distal IP+ proximal IP+ spared MCP+ dactylitis sausage finger- psoriatic arthritis
unsighty nails…what investigation— nail clippings for mycology
man with backpain with vertebral collapse-What to check---- serum testosterone
Lady was on dialysis- constantly had hyper PTH—parathyroidectomy
Ventricular tachycardia most probably finding- AV dissociation
involvement of deltoid , weakness, atropy… Axillary nerve
Diarrhoea with electrolyte imbalance— hyperchloremic metabolic acidosis
Haemoptysis with p-anca positive and raised creatinine- Microscopic polyangitis
Feature most consistent with Dementia (Alzheimer’s)- disorientation in time
pregnancy Herpez zostr serology negative… Give immunoglobulin
Post jugular line, drop in spo2 with decreased breath sounds and dull on percussion- Haemothorax
Variable region of antibody- FAB
Patient chronic smoker and shipyard worker, pleural plaques in x ray, FEV1/FVC- 0.39, cause of recent breathlessness- COPD
Episodic asthma, investigation- serial peak flow measurement
Diabetes—Adhesive Capsulitis
Cough causing medicine—Ace-inhibitor
Constipation—Ca+ channel blocker
Power of the test===
Specificity—
Sensitivity—
Diagnosis—Pagets Disease
CKD with Hypoparathyroidism in young – Psudo, primary ?
Pitutary apoplexy
Insulinoma—Serum Insulin after 72 hours of fasting
Parkinsonism – Levodopa
Alzheimer—Donepizil
Central Vein Occlusion in painless visual loss—cottol wool exudate , hypertensive
Bathlow score—cognitive function, incontinence
RA patient—episcleritis
Did athermoatous because the patient had tia recently abd also carotid bruit
closure of pda with ibuprofen in pregnancy- last trimester
-turner, murmer and hypertension>> CoA
erect peanut aspiration, which lobe—
seminoma prognostic marker>BHCG
best marker for hemochromatosis monitoring—ferritin
LFT results ALP was elevated and most likely site of obstruction withthin the biliary system ? CBD

small kindey sizes, bruit—atheromatous disease

Young girl with menorrhagia from the onset of puberty… Positive history of mother and sister---- Vwd
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Myasthenia with strabismus
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botulism
one MS
Carbimazole given which serum marker will be correct first
Free t4 ?
Superior oblique muscle
cholestatic picture— Flucoxacillin
Pt with severe parkinson left iliac fossa pain and bleeding pr. Diverticulitis
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popliteal cyst rupture—DVT
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DVT-- Thalidomide—
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alpha 1 deficiency answer? ZZ
Pt had type 1 dm hypothyroidism , with tetany. Low ca low pth. Primary hypoparathyroidism?
Most contagious—VZV
jejunal bipsy

Acute graft rejection ---- lymphocytes and NK cells

Thalamus: allodynia case poststroke
copd case spo2—90%
Rituximab—MOA: suppress B ells
Vision issue. TB regimen—Ethambutol
St elevation in 11 111 avf. Right coronary
Before giving tnf—checking mycobacterium
MRSA patient on vancomyvin develop anaphylactic—Linezolid, red man;slow infusion ?
Asthma,–LRTA
Onandesetron—5 ht3
Cholesterol emboli. Post coronary pt
80 yr old with benign positional vertigo–Next to do dix hallpike
Coronary sinus empty—Right atrium
Alcohol dependence syndrome
for facial nerve–There is last of taste 2/3 ; facial canal carries chorda tympani(taste) and nerve to stapedius(hyperacusis)
Neonatal LE more chances in pregnant woman if positive—Anti RO
detrusor instability— Solifenacin
Aortic dissection— Labetolol
Swollen knee join aspiration all ok… next step—polarized light
CSF Culture all ok Nisseria meningitis suspected
Idiopathic lung fibrosis- what feature found in x ray
Alkaptunuria—Aminoacid
Under continuous inhibition: Prolactin
Anti basement membrane antibody—good pasture
MCA… upper limb >lowe
Cavernous sinus- 3rd, 5th and 6th Cranial nerve involved.
H/o fall, abnormal pupil constrictive reflex: Base of skull fracture, Normal variant ?
Braf—PCR
Oesophageal varices: inj terlipressin
Oesophageal varices: observe
Oesophageal varices: Iv fluids
Diaphragmatic Palsy
Autosomal dominant PCKD–50% chances in all children
Copd exacerbation. pH 7.30. Carbon dioxide 7.1. Oxygen normal—Observe( bcs pt is improving---- NIV bcs CO2 is 7.1
Sciatic Nerve Palsy
Commonest immunoglobulin found?—IgG
Pyoderma gangrenonum im RA treatment— Oral steroid
Mycosid fungoided treatment after failure of topical steroids—UVA therapy
Painful lesions on leg and cxr with bilateral lymphadenopathy— steroid
Empyema low PH
patient who had long term bronchiectesis - was afebrile but renal function was off … option had membranous / focal segmental—amyloidosis

bloody diarrhoea responded well to metronidazole what was the organism--- Ent amoeba

which part will be impermeable to water ? Ascending limb of loop of henle
an SBP ( febrile + ascites ) question where the next step — Ultrasound
impaiered sweating in forheadin horner internal carotid artery??
Intention to treat mcq?
Filariasis after mountain hiking swelling in leg
Platelet 15 asymptomatic: platelet infusion
Radiotherapy done but again haemoptysis—most appropriate therapy : radiation-
Platelet infusion chance of infection: strep
Blood infusion—irradiated
Permanent pacemaker indication: 3rd degree heart block
Short synachten test
OGTT for confirmation of Acromegaly
hnf1alpha
Scenario of febrile neutropenia. What coverage is must for antibiotic of choice? Pseudomonas or pneumocystic jiroveci ?
Power of study means : ?
Maculopapular rash on groin and buttocks, rhabditiform larvae on stool? Strongyloides
Features of some haemotological malignancy with swollen cervical lymph node , diagnostic test lymph node biopsy
Vision issue. TB regimen.—Ethambutol
Psoriasis aggravating factor: B blocker
Exacerbation of copd.
Alpha antitrypsin deficiency genotype---- homogeneous PiZZ
Beta3 microglobulin
AL amyloidosis or B3 microglobulin
Chronic subdural hematoma scenario
Common peroneal nerve foot drop
diagnosis of aspergillus—precipitin test
trigeminal neuralgia or tmj dysfunction= trigeminal neuralgia ?
Latex Allergy—Patch test
Mechanism of ciclosporin: (Ciclosporin or cyclosporin A inhibits calcineurin, an enzyme that is required for transcription of interleukin-2.) Interleukin 2
Duchene muscular dystrophy – X inactivation

Haemophilia which family member likely to be affected- Mother’s brother

Pcychiatry. One who saw an angel, offering ecstasy to doctor. Has HIV and having a long history of bizarre attitude: Antisocial ?
Closes eye and the arm pronate n drift downwards?—Cerebellar
One angiodysplasia associated with aoritc stenosis!!

Best of Luck !!!