You are asked to review a 22-year-old motorcyclist who is recovering on the Neurosurgery Ward after suffering a high speed impact accident. The neurosurgeons fear that he has suffered a left trochlear nerve palsy. He reports vertical diplopia.
What would you expect to see when this patient is looking straight at you?
Head tilted back
Head tilted forward
Head tilted to the left
Head tilted to the right
A 55 year old man presents with chest pain and is thrombolysed for an acute myocardial infarction. His blood pressure was 85/40 for several hours on admission. Two days later his blood tests show a urea of 22 mmol/l and creatinine of 300 μmol/l (U+Es were normal on admission). What would a renal biopsy show?
A. Positive antibody to fibrinogen
B. Thickened capillary loops
C. Loss of tubular cells
D. IgG deposition in the basement membrane
E. IgA mesangial deposits
The most common causes of transudaitve effusions is CHF.Nephrotic syndrome is another cause.
The four principal causes of exudative effusions are,
1)Microbial invasion through direct extension of a pulmonary infection or blood borne seeding
2)Cancers of lung,breast or lymphoma
3)Pulmonary infarction
4)Viral pleuritis
Other causes include tuberculosis, SLE,rheumatoid arthritis,uremia,previous thoracic surgery,esophageal rupture or pancreatic disease, intra-abdominal abscess and any trauma.
An 18-year-old man presented with acute hepatitis, nausea, jaundice, elevated transaminases and a prolonged prothrombin time. On examination, there were signs of chronic liver disease and a brown-green ring at the periphery of the iris in both eyes. His serum copper level was low.
What other laboratory findings would be expected?
High serum caeruloplasmin level and low urinary copper excretion
High serum uric acid level and high urinary copper excretion
High serum uric acid and low serum caeruloplasmin levels
Low serum caeruloplasmin level and low urinary copper excretion
Low serum uric acid level and high urinary copper excretion
A 35 year old man presents with 2 bowls full of haemetemesis. He drinks 10 pints of beer a day and has done so for 10 years. Upper GI endoscopy reveals oesophageal varices. Which of the following is effective in reducing the rates of rebleeding in the future?
A. Lisinopril
B. Nadolol
C. Simvastatin
D. Ranitidine
E. Naproxen
A 45 year old man has chest pain walking up hills. Which of the following investigations would be best for risk stratification of angina?
A. ECG
B. Troponin T
C. Echocardiogram
D. Coronary angiogram
E. Thallium myocardial perfusion scan
FIVE eye symptoms that you should never ignore:
-
Silver- or copper-colored arteries
It’s might mean high blood pressure. -
A mole on the eye’s inner layer
… It might mean melanoma. -
Leaky blood vessels
It might mean diabetes. -
Inflammation
It might mean autoimmune disease. -
Interior blisters
It could be central serous retinopathy or CSR.
A 40 years old male patient who has had wheezy breathlessness for many years and who has previously been shown to have pulmonary infiltrates on chest X-ray and blood eosinophilia undergoes a high-resolution computed tomographic scan. This shows proximal bronchiectasis.
Which of the following tests would be most useful in establishing the cause of her bronchiectasis?
A.Aspergillus skin-prick test
B.Bronchoscopy and bronchoalveolar lavage
C.Histamine challenge test
D.Measurement of total IgE
E.Serum anti-neutrophil cytoplasmic antibody (ANCA)
An 8-year-old boy presents with a 6-month history of gradually progressive swelling and pain below the right knee. On examination, the knee joint appears normal. An X-ray shows a lytic lesion with sclerotic margins in the upper tibial metaphysis.
What is the most probable diagnosis?
Brodie’s abscess
Classical osteomyelitis
Ewing’s sarcoma
Osteoclastoma
Osteogenic sarcoma
MRCP Part 1 May Exam Feedback
Use the feedback we have gained after the May sitting of the MRCP Part 1 exam to ensure you have the right knowledge ahead of the September sitting.
We have discovered that candidates experienced a number of challenging topics in the May exam which included:
- Blood film analysis - candidates found it difficult to determine the diagnosis when shown a blood film with features characteristic of a haematological malignancy
- Skin lesions - in other image questions, candidates struggled to name a non-pigmented lesion and determine the diagnosis when given an image of the histology of another skin condition
- Microbiology - candidates were asked the most common causative organism in cholecystitis
- Hydronephrosis - candidates were instructed to choose the most appropriate immediate management of a patient who presented with hyperkalaemia and AKI, secondary to bilateral hydronephrosis
- Anatomy - in a scenario where the patient presented with bilious vomiting, candidates were required to choose the most likely site of intestinal obstruction
Use the keyword search feature in Work Smart to answer questions on these topics today.
Good luck with your revision. Sign-up to our MRCP Part 1 revision resource today: http://bit.ly/2asXRt8