Collected q & answers of MRCP part 1 september 2013.
1.Negative Predictive Value = 890/900
2.Relative risk reduction = 50%
3.Study following adverse drug reaction what to
do to establish the association - ? cohort
(prospective )
4.p < 0.02 – the chance that nulls hypothesis is
true is < 2%
5.Power of a study – probability of type 1 error
6.Pie chart - ethnicity
7.lp sample- gm positive diploccoci-
streptococcus pneumonia
8.lp sample- increased protein, lymphocytes-viral
meningitis
9.Frontal - perserveration
10.Lateral Medullary Syndtome Post inf cerebellar
art
11.Motor nuron dis - Riluxole
12.Cyclosporine - Tremor
13.vertigo,tinnitus multiple episodes - Ménière’s
disease
14.Allopurinol- inhibition of xanthine oxidase
15.Osteoarthritis rx - Paracetamol
16.A pt with churg sr syndrome - ANCA
17.Subfertility/azoospermia - Sulfasalazine
18.RA with dry eyes - Sicca syndrome
19.Headache with ptosis – carotid artery
dissection
20.Seronegative arthritis - HLA B27
21.Ab with Cardiovascular involvemnent in SLE
- ? anti ro
22.Low glycated Hb in poorly controlled DM-
Sickle Cell disease
23.Abg- mixed metabolic acidosis and resp
alkolosis
24.Raised left diaphragm in CXR- left phrenic n
palsy
25.Alpha antitrypsin - n elastase
26.COPD - LTOT
27.Bird fancier’s lung(avian proteins) - Steroids
28.Lung Surgery contraindication - ? peripheral
neuropathy
29.B/l apical fibrosis – Ank Spond
30.Respiratory physiology question– Tidal volume
31.Foam Cells - Monocytes/Macrophages
32.HOCM - Myosin
33.Lady found with empty bottle,ecg wide qrs,
tachycardic- amitriptlline
34.AF to maintain sinus rhytmn- amiodarone
35.PR depression - Pericarditis
36.SVT - Adenosine
37.Ebstein anamoly – reduced rt ventricular
pressure
38.Investigation for lyme dis- Bordetella IgM
39.Painless genital ulcer - Treponema
40.Gonococcal urethritis - ceftriaxone
41.Vaccine contraindicated - yellow fever
42.Septic shock prognosis - lactate
43.HIV +ve male with low HBsAb – chronic hep c
44.HIV Needle Stick - Post exposure prophlaxis
45.HIV with diarrhea - Cryptospo
46.Emperical antibiotic for Cystitis in 5 wks post
partum with penicillin ANAPHYLAXIS - ?
Trimethoprim
47.Pancreatic exocrine function - feacal elastase
48.Ulcerative collits - smoking
49.Esophageal varices prophylaxis - Propranolol
50.Cryoglobins in Nephritic - Hep C
51.Nephrotic - Anti-thrombin III
52.AML - Cytogenetics
53.Burkits Lymphoma = t 8,14
55.Imatinib - vegfr receptor
56.Rituximab - CD 20
57.Polycythemia - JAK 2
58.Pencil shaped poikilocytes RBC - Iron
Defeciency
59.Girl with recurrent bleeding and elevated APTT - vWF
60.Homocystinuria= pyridoxine
61.Graves- Pretibial myxedma
62.Thyroditis – ?anti TPO
63.Water derprivation test on lithium -
Nephrogenic Di
64.Hormone replacement - post menopausal
symptoms
65.ADH - Collecting Duct
66.Cushings - 24 hr urine cortisol
67.Thyroid nodule next investigation - ? FNAC
68.Acromegaly - GTT
69.Hyponatremia and hyperkalemia - Addisons
70.Dermatitis herpetiformis - IgA deposits
72.Px on dexamethasone -Steroid Psychosis
73.Young man with grandiose delusion -Mania
74.Depression following death of wife/ ? B12 def
75.Uncontrolled HTN with LVH and gout-add acei
76.DOC for HTN with b/l renal scarring on USG-
Amlodipine
77.Diplopia on looking to the left - ? CN VI palsy
78.Supra normal FVC(100% predicted),no h/o of
smoking - ?Asthma
79.Lady with symptomatic peritonitis – Rx ascitic
tap
80.VFib has been refractory to an initial shock -
CPR
81.Cardiac pacemaker driving- after 1 week
82.Lithium monitoring - 3 months
83.Empyema-pH of pleural fluid
84.Pneumothorax fails treatment 48hrs -Refer
Surgeons
85.Marfan-fibrillin
86.Paradoxical embolus-PFO
87.Abd distension,diarrhea,relieved by opening
bowel -Irritable bowel syndrome
88.Osteoporosis - Alendronate
89.Dexa Osteoporosis: (T score ≤-2.5).
Osteopenia: (T score less than -1 but above
-2.5).
90.Adult poly cystic kidney family screening(all >
20 yeas age)-?USG for all first degree relatives
91.Cause of pulsus paradoxus - reduced left atrial
filling
92.Cause of IE post valve replacement -staph
epidermidis
93.Finding in severe ms - ? length of murmur, ?
preaccentuation
94.Cardiac cath finding in chronic primary pulm
hypertension – ? mean arterial pressure
elevation?
95.Amyloid – Restrictive cardiomyopathy
96.Causr of high co2 btw svc n rt ventricle - ASD
97.Meds causing long QT - citalopram
98.Meds to treat familial long QT - Beta block
99.Cholesterol emboli - Eosinophili
100.Diabetic eye new vessel mx - photocoag
101.DFU in diabetic - prev ulcer
102.High tsh in pt on thyroxine meds - ?ask
compliance
103.High tsh lh in prem - ovarian failure
104.Achalasia- poor lower esophageal relaxatio
105.Coeliac ds in PBC with rash
106.Colonoscopy in new UC
107.Chlordiazeoxide in alcoholic
108.Prognostic indicator in chronic liver dsz –
ascites ( Child Purgh classification)
109.Rash n bloody diarhoea -pyoderma
110.Aortic stenosis, anemia, normal scope -
mesenteric angiography
111.Cause of arf in liver failure pt - ? Intrarenal
vasoconstric
112.Staph infection treatment in ijc cath - fluclox
113.Cause of breathlessness in pt ESRF on
dialysis - PE
114.Screening in ADPKD – Ultrasound scan in
first degree relative
115.Recovery in HSP – full renal recovery
116.Skin malignancy post renal transplant - ? Scc
117.Metabolic acidosis in sjogren - distal
118.Findings in CLL -? Hepato megaly ? Bibasal
crackles
119.Cause of low plt in elderly pt - ITP
120.Use of human immunoglobulins - ITP
121.Raised Immunoglobulins, and monoclonal
antbodises - MGUS
122.Renal pathology, bleeding,n prolonged APTT
due to phenytoin – Lupus anticoag
123.Yellow fever vaccine c/I in pt on steroid
124.Pyrimethamine on cerebral toxoplasmosis
125.HIV post exposure – HAART
126.Drug to add in gonorhea - ceftriaxone
127.RUQ pain and fever 6 wks after return from
Nepal – hepatitis A ( incubation 3-6wks)
128.Fever n middle lobe consolidation –
Mycoplasma Pneumonia
129.Proteinuria, urinary incontinence, worsening
confusion/ consiousness after after Kenya - ?
Dengue Fever ? Cerebral Malaria
130.Neuroleptic sensitivity in lewy dzs
131.Daughter with fit n clumsiness - ? non-
epileptiform seizure disorder syndrome
132.Parkinsom pt with dystonia - procyclidine
133.Medial finger weakness abd digiti minimi
134.Fixed flex finger - Flexor digitorum
superficialis
135.Unable to flex n ext foot- sciatica nerve
136.Unilateral eye pain n partial ptosis - cluster
headache
137.Weakness after painting house carotid artery
dissection
138.Haloperidol in acute delirium
139.Riluzole in MND
140.Upper limb weakness with reduce pain/temp
sparing joint/vibration-syringomyelia
141.Cerebellar sign, horner ,& contralateral limb
weakness/ reduced sensation - PICA/lat
medullary
142.Painon shoulder abd? - ? supraspinatus
tendinitis
143.Laughing and limb weakness cataplexy
144.Allopurinol xanthine oxidase inhibitor
145.Reactivr atthritis -B27
146.Pt with limited sclerosis with diarhoea -
bacterial overgrowth
147.Headache, gradual eye vision loss, high esr -
GCA
148.ANCA in Churg Strauss
149.SLE with heart problem - anti ro
150.DM with knee pain n fever, gram staim n
crystal negative - pseudogout
151.Xray finding in osteomyelitis – periosteal
reaction
152.Cause of erythema multiforme - Herpes
153.What affect creat clearance - muscle mass
154.Acute phase reactant - ferritin
155.Abg finding mixed resp alkalosis met acidosis
156.Fracture with bowed knee , and
prostatomegaly - Paget dx
157.Fibrillin in Marfan
158.Mitochondrial dzs - optic atrophy
159.Dorzolamide - carbonic anhydrase inh
160.Th2 - interleukin 4
161.Mediators of acute response - ?T cells
162.Recurrent Neisseria meningitis -complement
def
163.Angioedema and abd pain - c1 est inh
deficiency
164.Rash following urti - guttate psoriasis
165.Tense blister sparing mucosa - pemphigoid
166.Oral ulcer and crusted lesion over face/scalp - pemphigus vulgaris
167.Yellow palm, tachy - what concern will be
lanugo hair (anorexia)
168.Headache n request ct brain -
hypochondriacal
169.Pancreatic exocrine enzyme - faecal elastase
170.Salt requirement - 6g
171.RA pt not controlled on nsaids - add on
methotrexate
172.Loading dose amiodarone - ?long half life
173.Pericarditis - ECG - PR depression
174.SVT narraw complex - after vagal mano -
what Rx - Adenosine
175.Bacillus - fried rice.
176.Bronchiectasis - postural drainge
177.Oral morphine to SC morphine - 60 mg
178.Dx of sleep apnea – overnight oximetry
179.Paracetamol over dose pt at risk more.
(Anorexia Nervosa)
180.Pt with hemolyitic uremic syndrome, cells on
smear. (Fragmented cells)
181.Man with staph aureu isolated from recurrent
boils, what strain of staph? - ?? leucocidin?
182.Pt with symptoms of hemisection of spinal
cord. – sup combined deg of the spinal cord
183.Frequent PEs – low transfer factor
184.CML with huge spleen – what other sign - ?
lymphadenopathy, ? hepatomegaly, ? bibasal
crackles
185.RHD poor sign – left ventr hypertrophy
186.Man with pneumonia, what other test to
assess severity – urea ( CURB-65 score)
- DM px having microalbumin what other
finding – retinopathy
188.female with hypo and family history of taking
thyroxine?dyshormogenesis - Cystic fibrosis dead, what will you find on
autopsy - ???lymphocytes? - AF to maintain sinus rhythm – amiodarone
- Mechanism of ACEi causing dry cough –
Histamine release