Recall questions of mrcp part 1 2091/3(sept 3)

UK MRCP
#1

RECALL QUESTIONS OF MRCP PART 1 2091/3(SEPT 3)
CARDIOLOGY

  1. What happens in Rapid depolarisation phase of action potential -----Rapid sodium influx/ rapid pot influx/ calcium
  2. Causes of a loud S2 ---- pulmonary hypertension (loud P2)/ ASD/PDA
  3. Brugada sysyndrome mutation SCN5A----- sodium ion channel protein
    4)oxygen more in Rt ventricle than SVC— ASD/PDA/PFA/FT
    5)a lady running for a bus suddenly collapsed and lost consciousness , then regain cons ----cardiac syncope/vasovagal syncope/epilepsy
  4. a lady while standing suddenly collapse and fell down, after some time became allright with some disturbance------?Drop attacks
    7)a man dyspnoec with marked Troponin T… pulm embolism/ pericarditis/asthma
    8)HOCM , the mutation is in -----b heavy myosin/a tropinin /actin/
  5. a carribean African man no control of BP with ACE, what to do----calcium channel blocker/thaizide/furesimide
  6. Acute MI, PCI to reopen Stenosis unsuccessful…what area of the heart involvement…? inferior wall… Anterior wall… lateral wall… interventricular septum — right ventricle/ right atrium/left ventricle
  7. after 3 DC shocks still pt not responding-----give amidorone 300mg /give verapmil
    12)long QT interval -----potassium channel blocker/sodium chnnel/calcium channel blocker
  8. person with Digoxin toxicity, after giving potassium became ok—what is the mechanism------?
  9. question related to AF -----Amidorane/flecainide/Digoxin/
  10. Turner syndrome description, what abnormality-----bicuspid Aortic valve/Corctation of Aorta
  11. question about patient collapsed found at home, no JVP seen, BP low-----?
  12. pt intolerant to Clopidogrel , changed to dypyramidol—action of Dipyramidol---- ADP i inhibitor/cyclo oxy/
  13. Aspirin mechanism of action— Cyclo oxygenase
  14. short QT interval seen in — hyper calcemia/hypocalce/hypomagnesemia
  15. how much Adrenaline/epinephrine to be given in cardiac arrest----1mg IV/10mg IV/.1mg Iv.
  16. question related to pericardial effusion in a pt with pleural effusion and no JVP------?
  17. a pt with heart failure, which diuretic is good----- thiazide/ furosumide
  18. a question about which BP drug to start—Ramipril/ Ramipril with Furosemide/Atenolol
  19. a pt with cirrhosis of liver , which diuretic to start—furosemide/ spirolactone
  20. outermost layer of Atheroma=----smooth muscle layer/ fibroblasts/cholesterol/
    NEUROLOGY
    26)A persons Temporl lobe is removed-what defect he will have— hemianopia/quadrianopia/

27)Huntington;s disease is a … autosomal dom/x linked/triplet repeat

  1. Bilateral pinpoint pupils ---- pontine hemorrhage

29)pt with ipsilateral facial pain and temp loss, contralateral loss of temp and pain in limb and torso… ant cerebral artery occlusion/posterior cerebellar artery occlusion

30)pt with stoke---- CT of carotid artery/echocardiography/mri brain

  1. Holme’s Addie syndrome----un equal pupil with loss of ankle reflex

  2. question about medial rectus palsy(unable to adduct eye) with normal other eye…?

33)Migrane , pt with pain periorbital and optic with vomiting 8-10 times in a month staying for 8-12 hrs
34) another question on migrane

  1. Downbeat nystagmus-----?

  2. Sleep apnoea---- daytime sleeping----- Modafinil/mandibular technique/

  3. repeated blinking of both eyes----- myokymia/ benign essential blepharism/tourettes syndrome/ticks

  4. one question about sub arachnoid hemorrhage, thunder clap headache—

  5. QUESTION ABOUT PARKINSONISM/LEWY BODY DEMENTIA/Alzehimers

40)anticholnergic symptoms— bradycardia with urinary retention/ tachy cardia with miosis/bradycardia with mydriasis/ tachycardia with urinary retention

  1. Herpes simplex encephalitis---- CSF with high protei and normal glucose, lymphosis and CT showing temporal lobe multiple hyperechoic pattern

  2. neurofibromatosis 1---- phaechromocytoma

43)Gullian barry syndrome-----FVC/FEV1/Spirometry

44)medial lumbricals affted with hypothenar wasting----ulnar nerve effected at elbow/ ulnar nerve affected G tunnel/ median nerve/Radial nerve

45¬) person cannot abduct his shoulder initially---- deltoid muscle/supra spinatus/

HEMATOLOGY & ONCOLOGY
46)mechanismm of action of LMWH…activates thrombin /inhibits
Xa/
47)DDAVP helps in …factor VIII/factorIX/factor VII
48)low platelets, low Hb,low fibrinogen----DIC/Auto immune hemolysis/
49) low platelets, low WBC,PT increase ,APTT increase------give FFP/Cryo PPT/Prothrombin complex concentrate
50) HB low , other cells normal… give Packed RBC/
51)blood transfusion within minutes pt becomes restless …ABO incompatibility
52) platelets transfusion which bacteria commonly contaminate…E-coli/streptococcus/staph
53)Dog bite wound infected, pus coming out , what organisms found…pasturella/C.canimorus/streptococcus
54)nurse accidently had needle stick injury after drawing blood from HB positive pt…what is the test which shows she got the infection…viral load/HbSag/
55) haemophilia a positive father, mother not a carrier, sons will have— 100% chances/50%chances /0%chances
56) non hodgkins lymphoma-----?
57) poor prognosis in CLL-------?
58) post exposure/needle stik injury from a HB positive pt treat with…Tenofovir/interferon alpha
59) multiple myeloma/Walderstrongs /mugs…?
60)breakthrough dose of morphine 30mg bd is—20mg/10mg/30mg
61) morphine not giving relief, shift to ----apomorhine/oxycodeine / diclofenac
62) Diagnosis for thrombotic thrombocytopenic purpura… ?
63) presence of positive crystals in knee swollen and chondrocalcinosi… hemochromatosis/gout/septic arthritis
ENDOCRINOLOGY
64)ANTERIOR PITUITARY damaged, which hormone production not affected… TSH/Prolactin/Vasopressin
65)Terlipressin… increase splanchnic vasoconstriction/increase portal vasodilation
66)Aqua porin 2 helps in water absorption at collecting ductsin …nephrogenic DI/Cranial DI/SIADH
67)Growth hormone measurement----OGTT with growth hormone measurements
68)Growth hormone deficiency---- IGF/IGF 3 binding protein/Insulin stress test
69)Pt with lethargy and skin hyerpigmentation , which test to confirm…short synactin/high dose dexamethasone
70)Low tsh,low acth and low growth hormone…non functioning pituitary tumour
71)Graves disease… low TSH, high T3 and T4
72)PTH increased markedly, Ca low, Phosphate high----PTH increase in due to…high phosphate/ low calcium/
73)A small neck swelling in anterior part of neck… do FNAC/Biopsy
74)Primary hyper parathyroidism…Ca high, phos low, alk po4 n
75)Pt with some finding, 3 and 4th metacarpal small… Pseudohypothyroidism
76)Lethargy,low bp…Hypo adrenalism
77)Pheochromocytoma treatment…give first phenoxybenzamine
78)SGLT2 ,loss of glucose is at----proximal convulated tubule/distal/collectin o
79)Mech of action of Glaicazide… increases insulin secretion
80)Metformin 1gm tds ,not tolerable…shift to another medicine/ change to modified released metformin
81)Type 2 DM… strong family history/loss of beta cells/loss of pancreatic cells
82)MODy question –strong family history
83)Anorexia nervosa----lanugo hair
GASTROENTEROLOGY
84)A pt loses conscious ness after a local anaesthetic mixed with adrenaline for 10 minutes…check mast cell tryptase/check basophills histamine level/monocytes
85) in a case of food regurgitation on endoscpopy , what is the investigation further required…barium meal follow through/us scan/(case of pharyngeal pouch)
86) birds peak appearance in a barium meal seen in—Achalysia
87) Barretts oesophagus with mild dysplasia— repeated endoscopic surveillance and high dose PPI/ funduplication operation.
88) pain epigatrium after food in a previously treated H pylori pt… give PPI/
89) acanthosis nigricans -----stomach cancer/ lung cancer/spleen cancer
90)Diarrhoea in a pt with terminal ileal resection… vit B12 not absorbed leads to bacterial colonization in colon/malabsorption of bile salts/osmotic fluid overload in colon
91) Diarrhoea, wt loss, opthalmoplegia… whipples disease
92)Refeeding syndrome … hypophosphatemia
93) pancreatitis …glasgow scale…hypo calcemia <2
94) in a party person becomes unconscious after excessive Alcohol---- accumulation of NAD/ glycogenolysis/gluconeogenesis
95)Autoimmune hepatitis/alcoholic hepatitis,?
96) intra hepatic cholestasis of pregnancy---- /
97) bleeding per rectum. Malena , pt un conscious…diverticulosis/
NEPHROLOGY
98)PT WITH tuberculosis started on 4 medicines Rifam,etham,pyriz,isonia, after some days his urine becomes dark coloured… due to rifampicin/due to ethambutal/due to isoniazid
99) microscopic haematuria… Alports synd
100)post dysentery ,blood shows shistocytes-----HUS
101)IgA nephropathy…mascropic hematuria and proteinuria
102) protenuria more than 5gm/24hrs seen in----Membranous glomeruloneph/focal seg/rapidly
103) un equal/shrunken kidney… do MRA/ US scan/ ct
104)FSGS…Heroin addicts
105) Renal biopsy…
106) urge incontinence---- intermittent self catherization/biofeeding/bladder training
107) scarring in kidneys due to reflux nephropathy… micturating cystourography
108) uti in pregnancy , which antibiotic to use…nitrofurantoin/ trimethoprim/ciproflox
RESPIRATORY SYSTEM
109)OXYGEN dissociation curve shifting to left is seen in…high acidity/increased DGP/low co2
110)A person has certain lung volumes, which of these values decrease after 40 years from now … vital capacity/ total lung volumes/ residual volume
111)Hyper capnia in type 2 resp failure is due to…Neuromuscular weakness/
112 ) limb girdle muscle dystrophy, which respiratory to be monitored…FEV1 / total lung
volume/ FVC
113) Suspected occupational Asthma…check PEFR repeatedly/ vital capacity/FeV1
114) Asthma confirmed if PEFR varies …>20%
115) TLCO is reduced in …Asthma/ Anaemia/polycythemia./male sex
116) External compression of the Respiratory pathway can be assessed with…Flow Volume loop/spirometry/us scan
117) exacerbation of respiratory infections in COPD patients most common organisms …Streptococcus/ pneumococcus/H.influenza
118) a person with sudden shortness of breathing , tachycardia and temp 37.5… Asthma/PE/
119)Pt with dyspnoea ,cough and fever , IV drug user, xray shows basl consolidation…
pneumococcus pneumonia/ streptococcus aureus pneumonia /klebsella
120) 45 yrs old pt with pneumonia with crp 18,RR 25,BP110/85,Urea 11mmol…which is the poor prognostic marker…CRP/RR/BP/UREA
121) staphylococcus pneumonia treatment---- co-amoxy clav/ flucloxicillin/trimetho/azithromycin
122) one question on legionella pneumonia— low sodium, person attended some conference , lethargy , malaise, fever and dry cough
123)treatment in apergillus infection… no teaatment required/ itraconazole with steroids/ amphotericin
124) one question related to asbestosis
125) question about mesothelioma
126) question about lung cancer ?
127) a question of lung fibrosis, with some history and findings , i put the answer as—Idiopathic pulmonary fibrosis
128) question related to pneumothorax/pleural effusion ?
RHEUMATOLOGY
129)Early x-ray change in RA…peri articular osteopenia/periarticular erosion/narrowing of joint space
130) A 25-year-old woman presents with a symmetrical arthropathy affecting her hands. On examination she has synovitis of the 2nd and 3rd metacarpophalangeal joints.what is the diagnosis…psoriatic arthritis/RA/Reactive Arthritis
131)a person aged 55yrs cannot abduct his shoulder initially…supra spinatus tendinitis/ deltoid /rotator cuff injury
132)Ankylosying spondylosis…increase in lumbar lardosis/schobers test positive/ trendenbergs test positive
133)one question describing behecets syndrome and pathergy
134) pain lateral epicondyle increased on wrist extension and supination— lateral epicondylitis
135)one question about Anti jo1 antibody…polymyositis
136) one question about ANA antibody
137) Gout increased after taking allupurinol---- prescribing allupurinol in active disease
138)before starting Aziothioprim, which test to cofirm…TMPT
139) a question on sarcoidosis findings asked treatment…observation/steroids/cyclophosphamide
140)SLE which antibody helps in disease activity…double stranded DNA/Anti smith./ANA
141) pt with epistaxis,hemoptysis,sinusitis, which antibody positive…C anca/P anca/
142) pt with asthma,raised eosinophils and vasculitis…chrug straus syndrome/ wegeners granulomatosis/ microscopic polyangitis
143)one question about polyarteritis nodusa, mentioned about fever malaise, livedo reticularis
144) a pt with absent Radial and brachial pulses in one hand and normal in other hand… Takayasu arteritis/
145) a question about Dupuytrens contracture and Alcoholic,
PHARMACOLOGY
146) Nitroglycerine effects becomes reduced on long term treatment reason…Tolerance/ …zero order kinet
147) A lady wantto become pregnant, she wants advice about congenital abnormalities , what medicines to take…Folic acid/B12/b6
148) A girl took overdose of PCM attempting suicide, which another medicine taken simultaneously leads to poor prognosis…alcohol/tricyclic antidepressants/
149) Lithium toxicity…levels 5mmom…hemodialysis/ bicarbonate/
150) Side effect of long term treatment with olanzipine…wt gain/cardiac problems/
151) Vincristine side effect…peripheral neuropath
152) Cisplatin side effect…hypomagnesemia/
153) After gentamycin pt develops oliguria…?
154) Quinine treated pt side effect…hypoglycemia/
155) Alpha calcidol in the answers , question about PTH levels
156) Heroin withdrawal .what medicine to give…methadone/buprenorphine/
157) Vomiting not controlled by ondensetron in chemotherapy pt…give metoclopramide/ dexamethasone
158) oligospermia/Infertility is seen with…mesalizine/sulphasalazine/ciclosporin/methotrexate
DERMATOLOGY
159)rash affecting nose, cheeks and chin, with erythema, pustules and papules…Rosacea/acne vulgaris/lupus
160)blisters and rash present on hands ,feet and back of neck, blisters which rupture …PCT/AIP/Behecets/phempigus
161)a patient getting crops of papules and urticarial rash daily,remaing for 4-5 hrs and going away … … give cetrizine/corticosteroids/
162) one question about ?SJS/TEN?/Epidermobullosis?
163) a question about rash ans scales shiny present on groin, flexor surfaces of limbs…lichen planus (lichen sclerosus not given)
164)a pt with chronic psoriasis treated with PUVA and other medicines got a lesion at the shin of lower limb…melanoma/sq cell carcinoma/
165)one question on phemphigoid gestatinalis
OPTHALMOLOGY
166 ) PAINless loss of vision in one eye//… central retinal vein thrombosis/cRA thrombosis
167) a patient with floaters and flashes of light in one eye…vitreous detatchment/ retinal detachment/vitreous hemarrhoge
168)one question on Retinoblastoma
PSYCHIATRY
169) a case of Somatization syndrome
170) A pt with symptoms resembling that of Hypochonrical , but with motor and sensory symptoms//… conversion disorder/hypochondical disorder
171) Factitious disorder… person not having money to purchase ticket to come for mothers funeral
172) Person complains of his suffering from early childhood till no …Dysthymia/cyclothymia/
173) A Neck pain, insomnia, Recent accident, head on collision- other motorist died, he only abrasion wound-…post traumatic stress syndrome/conversion disorder
174) Dental chair don’t want to sit due to painful experience 2times triggered phobia/ptsd/conversion disorder
175) A question related to borderline disorder
BASIC SCIENCES
176) DOWNS SYNDROME… non dysjunction/ Robertsonian/
177) A lady showing all signs of Turner synd… 45XO/ 46XY/47XXY
178) Micro RNA… translation/ Transcription/
179) A question about mitochondrial disorders.in a man …all his
sons will be affected/all daughters/
180) A question about mixed respiratory and metabolic acidosis
181) Interferon gamma is produced by… Tlymphocytes/ mast cells/monocytes/basophils
182) Number needed to treat…25/100/5/10
183) Specivity is/ …98% without disease / 98% with disease/
2% with disease
184) Question about type of relationship between e cigarette and lung cancer in case control study … case control study
185) Question about correlation coefficient/linear

MISCELLANEOUS QUESTIONS
186) which vessels respond to hypoxia- carotid body and proximal branches /pulmonary artery/pul vein
187) Progressive worsening breathlessness. CT honeycomb- UIP, IPF- Bronchoalveolar lavage.
188) Best preserved RP- Stop smoking/CONTROL BP
189) Asthma patient on regular pred >30mg/day planned for vaccination to avoid- Yellow fever
190) Diabetic foot ulcer with penicillin allergy choice of antibiotic
191) Patient with trip to sub Sahara having a sanguineous rash in foot diagnosis … stercoalis stryngloidosis/hook worm/
192) Cause of visual loss occuring in neurofibromatosis
193) Gait defect causing leaning back while walking in old woman with reduced hip extension. Which muscle is defective. …Gluteus maximus/
194) Recurrent belching with no dysphagia, epigastric tenderness, or abdominal discomfort, H/o H.pylori eradication 7 years back. Diagnosis (Possibly aerophagia)
195) GFR reduced in a patient with diabetes and hypertension. Which drug should be stopped… metformin/ramipril/glacazide/
196) Omeprazole/or pantoprzole SE
197)one question on some gene mutation for ?..C-myc gene/M-myc gene/ and 2 other options
198) a case given about pt with fever pulse 70/min, constipated, with some more history , answers were/…Amoebiasis/giardiasis/salmonella paratyph/shigella/camylo jujeni
199) Lumbar punctre done 12 hrs after CT in a case of Sub Arachnoid hemorrhage…Xanthocromia is seen, it is due to…Blood/bilirubin
200) Guy with weakness of intrinsic muscles weakness. Wasting of hypothenar muscles. Difficulty holding things with index and thumb. H/O computer work for long time. Site of lesion. Ulnar nerve at Guyon’s canal/Median nerve at wrist/Radial nerve/ Ulnar nerve at forearm.