8- MRCP Part 1 - Recall May 2013

MRCP part 1 Recall May 2013 ( Note: some answers are not correct )

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123) 1

MRCP part 1 - Recall May 2013

1. Patient is unable to take his arm beyond or pain wen rising above 140-180

degree. ( Supraspinatus tendinitis).

2.Sensory loss of middle finger and some other features. (C7 involvement).

3. Pt having diarrhea for last one month following passing holidays somewhere

and stool microscopy shows Strongolides. (Albendazole).

4. Protien 3D view. (western method)

5.Patient having recurrent chest infection. (Complement levels)..

6. Mechanism of Action of meglitinides. (DPP-4 inhibitor)

7. Mechanism of action of Flecanide. (sodium channel blocker).

8. Herpetic lesion on wrist then after few days macular rash over the body.

(Erythema Multiforme).

9. Pt having low calcium, low phosphate, low Vit-D, ALP raised, parathyroid

hormone raised. How to manage. (Oral vit-D).

10. Pt having Ankylosing spondilitis. chose feature. (Global Axial decrease

mobility)

11. Pt having itchy scales on sternum, eyelids, face, nasal bridge. (Sebohric

dermatitis).

12. Pt having lesion on toes, microscopy shows Trychophytum rubrum.

(terbinafine)

13. Pt having sever photosensitivity, malar rash and some other findings. (SLE).

14. Piercing pain in the eye. (trigeminal neuroglia) not sure on this.

15. Pt having ischemic colitis, which part of colon is involved. (Spleenic flexure).

16. Continuous bleeding from pt after vena puncture. PT-raised, APPT-raised,

Fibronogen-low, D-dimers-raised. (DIC)

17. Poor prognostic factor in leukemia.



18. Question from statistics about positive predictive value. answer 10%

19. Vit- D Resistant rickets. (X-link Dominant).

20. Hereditary telangictasia (Autosomal Dominant)

21.Pt having dizziness, vertigo and eye examination was normal. (Mieniers

disease)

22. Specify the site of lesion that pt is unable to abduct his eye and some other

features. (PONS) not sure,

23. There was a question in which a pt is having lower motor neuron lesion in

upper limb and upper neuron lesion in lower limbs. (Amytropic lateral

sclerosis)

24. PCR...(fromation od DNA from RNA)

25. Where RNA splicing take place.

26. Pat had mastoid surgery for deafness and there was renal involvement showing

blood+, Protien+ in urine. (Alport syndrome).

27. PT diabetic and HTN having painless decrease vision in one of the eye.

fundoscopy shows cotton wools, haemorrhage. (Not sure)

28. CSF examination. glucose normal, protein normal, Lymphos raised, neutros

normal. (Viral infection)

29. Diagnosis of pt on basis of investigation , Von Willbrand antigen low, Von

Willbrand activity low, factor VIII low. (Von willbrand disease).

30. Pt having plasmodium Vivax infection. wt is the benefit of giving

chloroquine+primaquine. (Decrease resistant)

31. 1 cm rim of pneumothorax. (Discharge and repeat X-ray after 7 days).

32. Pt having small lung carcinoma, having SOB. Increase cortisol level due to

ectopic production of ACTH.

33. Pregnant lady increase frequency of SOB and wheeze. she is on salbutamol

inhaler. (Add steriods)



34. Pt on long term tx for rheumatoid arthritis. some other features. (Rectal biopsy

for amyloidosis).

35. Pt having barret oesophagus on proven following endoscopy. (Acid

suppression and repeat biopsy).

36. Pt having dyspepsia for long time. (endoscopy)

37. Pt having sever chest infection and was admitted in the hospital. IV antibiotics

are given. 10 days after that pt feel SOB and x-ray shows large plural Effusion.

(Empyema) not sure.

38. Pt had chemotherapy and presented SOB and muffled heart sounds. (Cardiac

temponade)

39. MOA of Bivalirudin. ( direct thrombin inhibitor)

40. Pt having numbness on the lateral boarder of foot. (S1 lesion)

41. CREST complication. (Malabsorption)

42. Pt having lytic lesion on radio graphy. (Protien electrophoresis)

43. Rt sided apical lung cancer involving brachial plexus. Mode of tx. Not sure.

44. Which of the following causing upper lobe fibrosis. (Allergic Fibrosing

alvelitis)

45. Which of the following cell is raised in Aspergiollus infection. (Eosinophill)

46. Pt having painlees or red urine and SOB. TX not sure

47. Pt going for chemoptherapy which of the measures should taken prior to tx.

(Red pack cell transfusion)

48. Pt taking DEMARDS drugs and having oral ulcer. (candidiasis)

49. Tricyclic overdose. (IV NaHCO3)

50. Methnol Over dose. (Dialysis)

51. Pt collapse not breathig, no pulse, next step. ( Call for Help)



52. patient with abdomina lpain and vomitting and acidosis nothing about

ketonemia mentioned given insulin in infusion waht nest step. ( Normal Saline)

53. Hypertention and palpitaion thyroin cancer removed in the hx( carcenoma)

what is the diagnosis: pheochromocytoma.

54. Which drug will u give wen pt with pheochromocytomo going for surgery.

(phenoxybenzamine)

55. ECG show st depression in V5 and V6. (Circumflex artery)

56. Pt with obstructive sleep apnea. CPAP, BIPAP, some instruments use. not sure

in this senario.

1.Adenosine mech of action - G-couple receptors

2.Strongloides tx - albendazole

3. Rupturing blisters - bullous pemphigoid

4.Boy with down syndrome and murmur and parasternal heave - Ebstein Abn

5.Pregnant lady with worsening asthma - beclomethasone

6.Lady known diabetic with postural drop - hypopitutarism

7. ischaemic colitis - splenic flexure

8. what rhematoid factor target - ? citrulline

9. Boy with hypercalcemia and xray changes - sarcoidosis

10. positive predictive value statistics - 1%

11. Man U whitney for the question about blood pressures

12. another statistics - sensivity 9 is the answer)

13. Question about pernicious anemia - anti parietal cell antibodies

14. What causes repolarization - pottasium channels



15. What causes prolongation of QT - pottasium channel blockage

16. CNS- patient with ipsilateral and contralateral sisns - where is the lesion -

lateral medulla

17 Patient with mark-gunn pupils - lesion in occipital lobe

18 patient with a non secreting pituitary tumor - what could it cause a few yrs

down the line - bitemp hemianopia

19. Lady with bleeders on colonoscopy Hb 9.2 - i said to transfuse(?)

20. Young man with haematuria and past history of deafness plus proteinuria - ???

Alports, IgA nephropathy

21. lady with rash and signs of - ITP

22. 9:22 translocation - CML

23 patient with bloating with all those haematological signs - Myelodysplastic syn

24. Tear drops poikilocytes - myelofibrosis

25. line infection - s epidermis

26. Lady with increased ALP, what further test - Anti mitochondrail

27. Patient with IBS with non specific signs of - Bacterial overgrowth

28. Lady with altered bowel habit, past hx of depression - Irritable bowel synd

29. Young man with dyspepsia, no other signs - Urea breadth test

30. Young lady, pneumothorax 1.5 cm no SOB - outpatient xray

31. old man with pagets disease, no fractures - ? residronate

32. 19 year old with neck tremors and snoring in class - ? Wilson's dx

33. Barretts oesophagus - Endoscopy surveillance

34. Man with polyuria, loss of libido and back pain - Do transferrin sat.

35.Villous adenoma - can remember question



36. Patient with diarhoea, chest infection etc - X-linked agammaglobulinemia (

Wiskott Aldrich - i think)

37. Loss of sensation dorsum of foot etc - S1 root compression

38. Question about - frozen shoulder

39. Another one with answer as - ulnar neuropathy

40. Lady with recurrent bacterial pneumonia - check immunoglobulins

41. Ramipril induced angioedema, what cause - Bradykinin

42. Hereditary Haemorrhagic telangiectasia - Autosomal dominant

43. What does primaquine do in vivax plasmodium - destroy gametes- i think

44. Man with insect bite from south africa ( no lymes !! ) - Rickettsia

45. Anorexia on NG feeding - hypophosphatemia

46. DM - Action of Sitalgliptin - DDP-4 inhibitor

47. Before starting on warfarin - P450

48. which cell organelle splices RNA to protein - Ribosome

49. reverse transcriptase - amplifies DNA

50. CT scan multiple enhancing lesion , what to start after dexa - sulp +

pyremerhamine

51. cANCA + symptoms - I chose Wegners - did anybody choose Microscopic

polyangitis?

52. Marfan's syndrome - Aut dominant

53. ST changes in V5-V6, what are you likely to see on coronary angio -

Circumflex lesion

54. SVT , you gave adenosine 6 mg, nothing happens, what next - repeat

adenosine

55. Vit D resistant ricketts - X linked dominant



56. Young man , bipolar, with polyuria - Lithium

57.Patient on clarithromycin, dont give - simvastatin

58. Bivarudin , mech of action - direct thrombin inhibitor

59. Amitriptylline overdose, low GCS - IV bicarb

60. Methanol overdose, GCS 5 - Haemodyalysis

61. Man who had viral infection, now comes with rash - erythema multiforme

62. Red eye pain - scleritis

63. Intermittent blurred vision - normal on corrected - cataract ?

64. First order kinetics - bioavailability

65. LVF, what med to add - Digoxin

66. patchy hair loss - alopecia areata

67. Dementia, loss of inhibition - Lewy body

68. Dementia recurrent falls - stop haloperidol

69. Patient with worsening renal fxn - I will stop metformin

70. Severe acne - isotretinoin

71. Lorazepam - increases GABA activity

72. 70 yr old man with LVF, which antiHTN - I chose ramipril

73. Ashtmatic - severely acute, not responding - IV Mg sulphate

74. Patient on pergolidine - organise ECHO

75. Anti HBc positive, HBsAG negative - Do Hep E serology

76. man with signs of MG etc - Thymoma

77. Man with neck stiffness, headache - AV malformation



78. Girl with reduced consiousness and seizures when disturbed - ? complex

partial ? primary generalised

79. Headache piercing the eyes - Cluster headache

80. MND - with LMN and UMN signs - Amyotropic lateral sclerosis

81. Girl with menorrhagia - Activated protein C resistance

82. Man with tumour of apex, which condition will you not operate - FVC 1.8 ??

83. Which intervention decreases colon cancer - etoricoxib ???

84. Which intervention decreases risk of pre-ecclampsia - ?? aspirin... LMWH (

patient is 12 wks)

85. leukaemia good prognosis - t(15:17)

86. Woman with sudden onst SOB, just started chemo for BRCA - Anthracycline

Cardiomyopathy ?

87. Uncomplicated clamydia treatment - Doxycycline

88. Man presented with urethral discharge - swab - neisseria gonococcus, but

blood cultures negative, why - co-existence of Chlamydia

89. Man with painful genital ulcers - chanchroid

90. Woman whose husband died, but she still sees him talking to her - ? PTSD ???

91. Man with low mood, no eye contact, 2nd person

auditory hallucination, drinker, suicidal - ? psychotic depression ?

92. man convinced he had cancer despite all negative tests - hypochondriac

93. Man presenting with symptoms, despite tests he believed there still there -

Somatisation

94. man with parkinsons, agitated, abusive - haloperidol

95. Joint sepsis - staph aureus



96. man with bloody diarrhoea, children's school mates recently had diarrhoea - ?

rotavirus

97. lady admitted with sweating and palpitations - Phaeochromocytoma

98. Complete heart block - variable intensity S1

99. Dermatomyositis, initial mgt - prednisolone

100. African lady, symptoms suggestive of leprosy - biopsy a skin lesion.

101. ETT, strongest indicator to stop - angina

**102. Heart murmur in 2nd and 3rd ic space - PS

**103. mitral stenosis, indicator of severity - Degree of Pulmonary capillary

wedge pressure (pulmonary HTN)

104. infective endocarditis risk highest with previous IE

105. Patient with cardiogenic syncope - SA dysfunction

106. physiologic change after one minute of standing - increased cardiac output

**107. maximum absorption of Na in salt and water depleted patient - still

proximal tubule and TAL ?

**108. pulmonary hypertension diagnosis - 2Decho

109.alcholic, camunity acuired pnemonia, treated in icu, again fever, ?empyema

**110. idiopathic pulmonary fibrosis, finding on xr - lower zone heart border

blurring

***111. extertringic allergic alviolitis, investigation, CXR shows upper zone

involvement

***112 Allergic bronchopulmonary aspergilosis, investigation - precipitins - most

specific

113 Small cell carcinoma, one of its paraneoplastic syndromes was given

114. lambert eton syndrome, antibodies to VGCC



115. pain in fore arm on resistance of extension of wrist, lateral epicondolyitis

*116. Multiple sclesosis, patient with past histery of arm problem, now vision

117. hopital acquired pnemonia... tazosin

118. patient with fever and jaundice, picture of asending cholangitis, - CBD stone

119. patient with ingestion of 20 paracetamol pills, PT

** 120.feature of anemia of chronic disease

121. patient wid ulcerative collitis and now joint pains - enteropathic arthritis

122. dka, iv insulin was given, iv n saline

123. Test of Acromegaly, insulin with oral glucose toleance test

** 124. feature most strongly associated with tb recurrence - ?CXR granulomas

indicate previous infection

125. treament startd with acylovir, csf feature most strongly associated wid

diagnosis - lymphocytosis

** 126 . man with 3 yrs h/o lesion on shin - Bowens disease

** 127. diabetic patient, poorly controlled, type of diabetes

128. Patient with pheochoromsytoma, what treatment shoud be

started..?phenoxybenzamine

129. flash pulmonary edema.... renal artery stenosis

130. resistant hypertension, hypokalemic alkalosis - renin/aldo ratio

131. patient with early mornign stiffness and uper arms tenderness,, polymylgia

rheumatica

132. patient with father with psoriasis, now with inflammatory oligoarthritis but

no other systemic features - spondyloarthropathy

133. ankylising spondolyits, clinical feature reduced joint excursion in all

directions



134. patient with picture of RA, on nsaid, next treatment option - MTX

135. patient in hospital, got gout, treatment with colchicine

136. patient with hearing loss, tinnitus and vertigo.. ?meniere's disease

**137. sudden onset visual loss, retinal hemrges and cotton wool spots - CRVO

138. thyroid swelling, investigation.... FNAC

139. collapsed patient....call for help first - early access as per ACLS/BCLS

140. 3d image of protein - electron microscopy. Xray crystallography is for 3d

visualisation of crystals

141. seborrhic dermatitis.. scaly lesion on face, nose scalp sternum i think

142. xray osteosclerosis ---osteoarthritis old lady with varus deformity 3 months

pain

143. PCOD--- test... high LH/FSH ratio

144. boy with abnormal movements tourette syndrome

** 145. pt on chemotherapy was given ondansatron but vomiting not controlled -

nabilone

146. Ciclosporin in post renal transplant - Tcell function suppressed

147. A subject with urethritis, gram neg intracellular diplococci, VDRL +ve -

False positive VDRL

148.Creatinine increased after Trimethoprim - decreased tubular secretion

(trimethoprim decreases tubular secretion of creat)

149. things move or spin with head position change = BPV = Dix Halpik

maneuver.

**150 circular lesion on dorsum of the hand = granuloma annulare (thoguht not

mentioned diabetic). ?BCC

**151. on lithium & hypertensive = give amlodipine (SHOULD BE alpha blocker)



152. a young man diagnosed with IBD (crohns) and started treatment what is the

advice = stop smoking

153. Mechanism of action of Flecanide. (sodium channel blocker).

154. Pt having low calcium, low phosphate, low Vit-D, ALP raised, parathyroid

hormone raised. How to manage. (Oral vit-D).

155. Pt having lesion on toes, microscopy shows Trychophytum rubrum.

(terbinafine)

156. Continuous bleeding from pt after vena puncture. PT-raised, APPT-raised,

Fibronogen-low, D-dimers-raised. (DIC)

157.Pt having dizziness, vertigo and eye examination was normal. (Mieniers

disease)

158. Pt having lytic lesion on radio graphy. (Protien electrophoresis for myeloma)

159. Patient hiking in west scotland, has a bite on thigh but no other symptoms -

observe

160. Tricyclic overdose. (IV NaHCO3)

**161. Pt with obstructive sleep apnea. CPAP

162.normal aonion gap metabolic acidosis- type II RTA

**163. ?Addison's disease

164. location of mechanism of action of spirinolactone

165. Occupational asthma - monitor PEFR on weekdays and weekends

**166. Diplopia and proximal myopathy - MG

167. Unequal blood pressures in both arms in asian lady - Takayasu's arteritis

**168. which anti depressant to use in young type I DM patient? mirtazapine?

others were SSRI/venlafaxine

169. Rash and renal impairment - HSP

** 170. mechanism of inactivation of cortisol - ?free excretion



171. klienfilter syndrome - small testes, primary testicular failure

** 172. Patient with hypocalcemic hyper calciuria. How to treat? -

**173. Red urine, facial swelling amongst symptoms - likely PNH over PCH

174. bilirubin mild elevated and other LFT normal next test - reticulocytes

175. Organism causing epiglottitis - Hib

176. Lung fibrosis finding? - Reduced TLCO

** 177. Patient with newly diagnosed Chron's disase, started on prednisolone,

which is next best treatment advice - mesalazine vs quit smoking

178. Type I DM not well controlled on OHGAs, looks like will be insulin

requiring - LADA

Mixed respiratory and metabolic acidosis

ETT, strongest indicator to stop

Heart murmur in 2nd and 3rd ic space,

mitral stensis, indicator of severity

infective endocarditis risk

cardiogenic, ?vasogenic syncope in patient wid 1st degree heart block

physiologic change after one minute of standing

maximum absorption of Na in salt and water depleted patient

pulmonary hypertension diagnosis

treatment option for mild heart failiur with no edema

?cardiac temponade, patient with markedly elevated jvp

treatment of hypertension in patient wid peripheral vascular disease



alcholic, camunity acuired pnemonia, treated in icu, again fever, ?empyema

idiopathic pulmonary fibrosis, finding on xr

extertringic allergic alviolitis, investigation, ?esoinophilia

Allergic bronchopulmonary aspergilosis, investigation

Small cell carcinoma, one of its paraneoplastic syndromes was given

lambert eton syndrome, antibodies

Systemic sclerosis, wot next can be affcted

pain in fore arm on resistance of extension of wrist, ?epicondolyitis

osteoarthritis of hip, treatmnet option

patient with problem of speech, carotid artery diseciton etc were options

Multiple sclesosis, patient with pst histery of arm problem, now vision

? hopital acquired pnemonia... tazosin

patient wid fever and juandice, picture of asending cholangitis, where is the

promblem? cbd etc were options

spontaneous becteriia peritonitis, organism

patient wid ingestion of 20 paracetamol pills, PT

? VOn wilibrand disease, patient with menoragia

feature of anemia of chronic disease

patient wid ulcerative collitis and now joint pains

dka, iv insulin was given, iv n saline

patient wid low TSH, cortisol etc, hypopiturism

Test of Acromegally, insulin toleance test?

feature most strongly associated wid tb



treament startd wid acylovir, csf feature most strongly associated wid diagnosis

man wid 3 yrs h/o lesion on shin

diabetic patient wid episodic loss of conciousness ?automic neuropathi

diabetic patient, poorly controlled, type of diabetes

Patient wid pheochoromsytoma, wot treatment shoud be started..?

phenoxybenzamine

flash pulmonary edema.... renal artery stenosis

resistand hypertension, wot inx should be done

patient wid early mornign stiffness and uper arms tenderness,, polymylgia?

patient wid fater has soriasis, now joint pains

ankylising spondolyits, clinical feature

patient wid picture of RA, on nsaid, next treatment option

patient in hospital, got gout, treatment?

patient wid hearing loss, tinnitus and vertigo.. ?meniere's disease

sudden onset visual loss, retinal hemrges and cotton wool spots

thyroid swelling, investigation.... ?FNA

colon cancer-- aspirin

more qs...

=collapsed patient.... compression first

=reactivation of TB test...gamma interferon

=case of ketoacidosis dehydrated what next after insulin.... normal saline

=3d image of ? protien test?



=case of pulmonary stenosis

=hep c with cryoglobulin disorder somthing like that

=pulmonary hypertension ...confirmatory test?? patient with dyspnea...echo or

V/Q perfusion to confirm sec to emboli

=seborrhic dermatitis.. scaly lesion on face, nose scalp sternum i think

=xray osteosclerosis ---osteoarthritis old lady with varus deformity 3 months pain

=PCOD--- test... high LH/FSH ratio .. increased androgen

=boy with abnormal movements ? tourette syndrome

=recurrent uri ---- to check for complement def

=weak extension at elbow and wrist with some sensory loss--? post interosseos

nerve another q was on cervical radiculomylelopathy

=one patient with heart failure ...was on ramipril, furosemide aspirin ? need to ad

bisoprolol

-collpased pt-i think u give rescue breaths first

-diabetic pt 15 yrs-collapsed,no postural drop , prolonged pr interval-SA Node.

-pt on chemo,vomiting-i went for steroids,as this chemo is highly ematoigenic and

we give steroids for another few days to help with same

-colon ca-aspirin

-pt on lithium and started frusemide,polyuria.only low urine osmolality,i went for

frusemide as it does not fit with DI secondary to lithium ?

-cluster headaches

-carotid dissection

CCF-add B.Blockers

-loss of sensation dorsum foot/ankle reflex ? i think L5



-methanol OD with low GCS,I think that methanol levels were very high,in that

case i went for Haemodialysis,ethanol infusion will be an answer if the levels

were not high enough,now i dont know 500 is mildly/or highly raised

- 70 yr old LVF - Bendroflu

-man with tumour at apex lung-i think he had metastatic disease ,i did not went for

FEV's

-pregnant lady,known pre eclampsia,i went for salt restriction?do we give aspirin

in pregnancy

-diarrhoea,recently children had it in school-rota virus

-pt had acute gout with ccf-steroids to start with

-worsening renal fuction-continoue.creatinine still < 150

-girl with syncope,but normal after the episode-vasovagal.

Pergolide - echo (causes valvular heart disease and cardiac fibrosis)

3D structure of protein - Xray crystallography

Ciclosporin in post renal transplant - Tcell function suppressed

A subject with urethritis, gram neg intracellular diplococci, VDRL +ve - False

positive VDRL

Ischemic colitis - Splenic flexure commonest site

Creatinine increased after Trimethoprim - decreased tubular secretion

(trimethoprim decreases tubular secretion of creat)

Down's syndrome valvular HD - VSD

Myelofibrosis - fatigue commonest symptom

The question on ABG - mixed metabolic and respiratory acidosis

Relative afferent pupillary defect - Optic nerve is site of lesion

Lesion in pituitary (0.9 cm) not increasing in size over one year - a probable

incidentaloma...no effect



* things move or spin with head position change = BPV = Dix Halpik maneuver.

* false positive VDRL = thinks about yaws (trponemal species)

* collapsed patient with no breath or pulse: chest compression ? (before AHA

guidelines 2010 PP argues abt asking for help).

*someone with Howel-Jowel = Coealiac (a known casue of hyposplenism).

* circular lesion on dorsum of the hand = granuloma annulare (thoguht not

mentioned diabetic).

* multiple enhance ring in CT = crebral toxoplasmoisi = give pyrimeth+

sulfazianize (Co tir.)

* resistant hypertension with the investigations are consistent with Conn's

syndrome = check Rennin-Aldo ration.

* on lithium & hypertensive = give amlodipine

* contraindication to samll cell caner = infliltration of brachial plexus (or volue <

1.5 not 1.8 in options)

*lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels

* pain in the forearm worst by wrist extension = radial tunnel syndrome ( more

distal than tenis elbow).

* malingering man asking fir sick report and he drinks alcohol = alcohol

dependence.

* woman who sees her dead husband = readjustment.

* a young man diagnosed with IBD (crohns) and started treatment what is the

advice = stop smoking

*recurren vertigo = BPV = Dix Halpik maneuver.

* false +ve VDRL = yaws (trponemal species).

* collapsed pt & breath or pulse: chest compression ? (before AHA 2010 PPl

argued abt asking for help).

* Howel-Jowel =hyposplenism = Coealiac.



* circular lesion on dorsum of the hand = granuloma annulare.

* multiple enhance ring in CT = c.toxoplasmoisi =pyrimeth+ sulfazianize.

* resistant hypertension =Conn's syndrome=Rennin-Aldo ration.




*lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels.




dependence.

* woman who sees her dead husband = ?readjustment.

* a young man diagnosed as crohn and started treatment =advice = stop smoking.

* ibsilateral facial loss + ibsl horner + con.lt weaknes = posterior inferoir

cerebellar

*red eye with mild tenderness = epislcleritis

* digested into glucose and galactose = lactose.

* penumia in ICU improved then high fever with p effusions = empyema

* gout in CVS problem = cholcicine (others have risk of fluids retention).

* weird movements in class = tourret syndome.

*which is correct---cluster or analgesia induced headache

*which is correct ---to prevent colon cancer--w3 or vit -3 or etoricoxib

*in preclamsia--treament--salt restriction or nifedipine



*occupational asthma---is it correct --do pefr to do work and away from work

*following uti with red urine ,mastoid surgery-iga or alport

*in plasmodium vivax -primaquine used due to reduce gamate or liver stage

*diabetic retinopathy---stop smoking correct or no*

*sciatic or s1 nrve compressio*

*red urine with howell jolly body-pnh or pch

*severe dyspepsia after treatment-do endoscopy or others

*in ra ---ig or citrulline

***arnold chiarri or ms

*optic nerve or occiptal lobe-maccunn

*in severity of ms --which one correct i la size or pul artery pressure

*in ulner nerve anatomy-1 st or 2nd lumbrical

*psudomona-tazobactam or cefotaxime

*esbl -impenem or other

*bowens or granloma annulare

*gilbert ----iv nicotinamide or fasting 48 hours

*in eyes---osmolality change or cataract

*in youge age af ---flecainide or digixoin

*recurren vertigo = BPV = Dix Halpik maneuver.

* false +ve VDRL = yaws (trponemal species).

* collapsed pt & breath or pulse: chest compression ? (before AHA 2010 PPl

argued abt asking for help).

* Howel-Jowel =hyposplenism = Coealiac.



* circular lesion on dorsum of the hand = granuloma annulare.

* multiple enhance ring in CT = c.toxoplasmoisi =pyrimeth+ sulfazianize.

* resistant hypertension =Conn's syndrome=Rennin-Aldo ration.




*lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels.




dependence.

* woman who sees her dead husband = ?readjustment.

* a young man diagnosed as crohn and started treatment =advice = stop smoking.

* ibsilateral facial loss + ibsl horner + con.lt weaknes = posterior inferoir

cerebellar

*red eye with mild tenderness = epislcleritis

* digested into glucose and galactose = lactose.

* penumia in ICU improved then high fever with p effusions = empyema

* gout in CVS problem = cholcicine (others have risk of fluids retention).

* weird movements in class = tourret syndome.

* asian woman with unequal blood pressur = Takayasu

* pt wheneve has flu urine turn dark = IgA nephropathy

*cholangitis with 4-fold rise in S.amylase = stone as pancreatic duct?

* discritpiton of sata disribution around mean = SD?



*pituitary incidentalom prognosis = no progress

* insulinoma = supervised 72h hrs fasting.

topics asked were:

1. lateral epicondyitis

2. ischaemia mesenteric

3.ra

4.sle

5.htn treatement in more than55

6.malignant htn

7.hf

8.vsd

9.ps or aortic valve bicuspid ?

10.normal aonion gap metabolic acidosis

11.ppv

12.ppv

13.nonparametric test

14.exercise tolerance test

15.ihd location of artey

16.men 2 pheochromocytoma

17.treatment of pheochromocytoma

18.infective endocarditis



19. rf

20.ankylosing spondylosis

21.gout

22. oa

23.septic arthrits

24.septic arthritis

25 psoritic arthritis

26 enteric arthritis

27.metronidazole -ileic involvement in chrons

28.dka

29.addisons disease

30 hypertension with low potasium.

31.mechanism of action of spirinolactone

32 direct thrombin agonist

33.eea

34.iaa

35.telangestasia

36 marfans

37,complement

38.arnold chiari

39. catract

40.retinal vien obstruction



41, carotid artery dissection

42. alzehmars disease

43. clear airways / call for help

44.peritoneal dialyses

45. occupational asthma

46.copd

47 . mg sulphate

48.scleritis

49.mgravis/

50.s1 lesion

51.radial nerves branch lesion.

52.frozen shoulder

53.bph

54.ceolic disease

55. systemic sclerosis

56.osteomalacia

58.pagets disease.

59 cushings

60. graves

61. subacute thyrotoxicosis

62.unequal blood pressures

63.psedomonas.



64.hypochondriasis.

65.schizophrenia,

66.seizures

67. head tremor

68 .motor neuron disease.

69.pons

70.intrasellar piytutary

71.hypopitutarism

72.smivastativ+clarithromycin

73.meiners disease.

74.tertiray hyperparathriodism

75.acromegaly

76 insulinoma

77.di lithium.

78. siadh.fluxetine

79. fluoxitine in young patient

80.alcohol piosing

81.wegeners

82 alport

83.hsp

84 iga nephropathy.

85.erythrema multiforme



86.bullous pempigoid

87.seboric dermatits

88.psoriasis

89. granuloma annulare

90.ulnar nerve leision

91.dyspepsia.

92.uc

93.ibs

94.yersinia

95.mechanism of inactivity of cortisol.

96.pcos

97.klienfilter

98.hypothriodism

99.myeloma

100.primary hyperparathyriodism

101.diuretic used in calcium stones

102.cml

103.cll

104. 15.17 translocation

105.mylofibrosis

1o6.dic

107.myelofroliferative disorder



108.pnh

109.anaemia of chronic disease

110.vonwilbrand

111.bilirubin mild elevated next test

112. chronic hepatitis c -cryoglobinemia

113.paracetamol poising- pt

114.mitral valve severity.

115.heriditary angieoedema -c4 level

116.alopecia

117.small cell ca.

118. bpaspergilosis.

119.aspiration pneumonia

120.pregnanat treat asthma

121.prophylaxis in previous preeclampsia

122.iv bypass the first order kinectics -

123.epiglotitis

124.oral painful ulcers.

125 treatement of toxoplasmosis

126.xlinked dominant rickets

127.tlco reduced in lung fibrosis

128.plural effusion

129.cluster headache



130.tricyclic overdose' bicarbonate

131.adenosine first in svt then give again

132.adenosine mechanism

133.inflixanib

134.risk factor crohons smoking

135-omega 3 use

MRCP part 1 - Recall May 20131. Patient is unable to take his arm beyond or pain wen rising above 140-180 degree. ( Supraspinatus tendinitis).2.Sensory loss of middle finger and some other features. (C7 involvement).3. Pt having diarrhea for last one month following passing holidays somewhere and stool microscopy shows Strongolides. (Albendazole).4. Protien 3D view. (western method)5.Patient having recurrent chest infection. (Complement levels)..6. Mechanism of Action of meglitinides. (DPP-4 inhibitor)7. Mechanism of action of Flecanide. (sodium channel blocker).8. Herpetic lesion on wrist then after few days macular rash over the body. (Erythema Multiforme).9. Pt having low calcium, low phosphate, low Vit-D, ALP raised, parathyroid hormone raised. How to manage. (Oral vit-D).10. Pt having Ankylosing spondilitis. chose feature. (Global Axial decrease mobility)11. Pt having itchy scales on sternum, eyelids, face, nasal bridge. (Sebohric dermatitis).12. Pt having lesion on toes, microscopy shows Trychophytum rubrum. (terbinafine)13. Pt having sever photosensitivity, malar rash and some other findings. (SLE).14. Piercing pain in the eye. (trigeminal neuroglia) not sure on this.15. Pt having ischemic colitis, which part of colon is involved. (Spleenic flexure).16. Continuous bleeding from pt after vena puncture. PT-raised, APPT-raised, Fibronogen-low, D-dimers-raised. (DIC)17. Poor prognostic factor in leukemia.18. Question from statistics about positive predictive value. answer 10%19. Vit- D Resistant rickets. (X-link Dominant).20. Hereditary telangictasia (Autosomal Dominant)21.Pt having dizziness, vertigo and eye examination was normal. (Mieniers disease)22. Specify the site of lesion that pt is unable to abduct his eye and some other features. (PONS) not sure,23. There was a question in which a pt is having lower motor neuron lesion in upper limb and upper neuron lesion in lower limbs. (Amytropic lateral sclerosis)24. PCR...(fromation od DNA from RNA)25. Where RNA splicing take place.26. Pat had mastoid surgery for deafness and there was renal involvement showing blood+, Protien+ in urine. (Alport syndrome).27. PT diabetic and HTN having painless decrease vision in one of the eye. fundoscopy shows cotton wools, haemorrhage. (Not sure)28. CSF examination. glucose normal, protein normal, Lymphos raised, neutros normal. (Viral infection)29. Diagnosis of pt on basis of investigation , Von Willbrand antigen low, Von Willbrand activity low, factor VIII low. (Von willbrand disease).30. Pt having plasmodium Vivax infection. wt is the benefit of giving chloroquine+primaquine. (Decrease resistant)31. 1 cm rim of pneumothorax. (Discharge and repeat X-ray after 7 days).32. Pt having small lung carcinoma, having SOB. Increase cortisol level due to ectopic production of ACTH.33. Pregnant lady increase frequency of SOB and wheeze. she is on salbutamol inhaler. (Add steriods)34. Pt on long term tx for rheumatoid arthritis. some other features. (Rectal biopsy for amyloidosis).35. Pt having barret oesophagus on proven following endoscopy. (Acid suppression and repeat biopsy).36. Pt having dyspepsia for long time. (endoscopy)37. Pt having sever chest infection and was admitted in the hospital. IV antibiotics are given. 10 days after that pt feel SOB and x-ray shows large plural Effusion. (Empyema) not sure.38. Pt had chemotherapy and presented SOB and muffled heart sounds. (Cardiac temponade)39. MOA of Bivalirudin. ( direct thrombin inhibitor)40. Pt having numbness on the lateral boarder of foot. (S1 lesion)41. CREST complication. (Malabsorption)42. Pt having lytic lesion on radio graphy. (Protien electrophoresis)43. Rt sided apical lung cancer involving brachial plexus. Mode of tx. Not sure.44. Which of the following causing upper lobe fibrosis. (Allergic Fibrosing alvelitis)45. Which of the following cell is raised in Aspergiollus infection. (Eosinophill)46. Pt having painlees or red urine and SOB. TX not sure47. Pt going for chemoptherapy which of the measures should taken prior to tx. (Red pack cell transfusion)48. Pt taking DEMARDS drugs and having oral ulcer. (candidiasis)49. Tricyclic overdose. (IV NaHCO3)50. Methnol Over dose. (Dialysis)51. Pt collapse not breathig, no pulse, next step. ( Call for Help)52. patient with abdomina lpain and vomitting and acidosis nothing about ketonemia mentioned given insulin in infusion waht nest step. ( Normal Saline)53. Hypertention and palpitaion thyroin cancer removed in the hx( carcenoma) what is the diagnosis: pheochromocytoma.54. Which drug will u give wen pt with pheochromocytomo going for surgery. (phenoxybenzamine)55. ECG show st depression in V5 and V6. (Circumflex artery)56. Pt with obstructive sleep apnea. CPAP, BIPAP, some instruments use. not sure in this senario.1.Adenosine mech of action - G-couple receptors2.Strongloides tx - albendazole3. Rupturing blisters - bullous pemphigoid4.Boy with down syndrome and murmur and parasternal heave - Ebstein Abn5.Pregnant lady with worsening asthma - beclomethasone6.Lady known diabetic with postural drop - hypopitutarism7. ischaemic colitis - splenic flexure8. what rhematoid factor target - ? citrulline9. Boy with hypercalcemia and xray changes - sarcoidosis10. positive predictive value statistics - 1%11. Man U whitney for the question about blood pressures12. another statistics - sensivity 9 is the answer)13. Question about pernicious anemia - anti parietal cell antibodies14. What causes repolarization - pottasium channels15. What causes prolongation of QT - pottasium channel blockage16. CNS- patient with ipsilateral and contralateral sisns - where is the lesion - lateral medulla17 Patient with mark-gunn pupils - lesion in occipital lobe18 patient with a non secreting pituitary tumor - what could it cause a few yrs down the line - bitemp hemianopia19. Lady with bleeders on colonoscopy Hb 9.2 - i said to transfuse(?)20. Young man with haematuria and past history of deafness plus proteinuria - ??? Alports, IgA nephropathy21. lady with rash and signs of - ITP22. 9:22 translocation - CML23 patient with bloating with all those haematological signs - Myelodysplastic syn24. Tear drops poikilocytes - myelofibrosis25. line infection - s epidermis26. Lady with increased ALP, what further test - Anti mitochondrail27. Patient with IBS with non specific signs of - Bacterial overgrowth28. Lady with altered bowel habit, past hx of depression - Irritable bowel synd29. Young man with dyspepsia, no other signs - Urea breadth test30. Young lady, pneumothorax 1.5 cm no SOB - outpatient xray31. old man with pagets disease, no fractures - ? residronate32. 19 year old with neck tremors and snoring in class - ? Wilson's dx33. Barretts oesophagus - Endoscopy surveillance34. Man with polyuria, loss of libido and back pain - Do transferrin sat.35.Villous adenoma - can remember question36. Patient with diarhoea, chest infection etc - X-linked agammaglobulinemia ( Wiskott Aldrich - i think)37. Loss of sensation dorsum of foot etc - S1 root compression38. Question about - frozen shoulder39. Another one with answer as - ulnar neuropathy40. Lady with recurrent bacterial pneumonia - check immunoglobulins41. Ramipril induced angioedema, what cause - Bradykinin42. Hereditary Haemorrhagic telangiectasia - Autosomal dominant43. What does primaquine do in vivax plasmodium - destroy gametes- i think44. Man with insect bite from south africa ( no lymes !! ) - Rickettsia45. Anorexia on NG feeding - hypophosphatemia46. DM - Action of Sitalgliptin - DDP-4 inhibitor47. Before starting on warfarin - P45048. which cell organelle splices RNA to protein - Ribosome49. reverse transcriptase - amplifies DNA50. CT scan multiple enhancing lesion , what to start after dexa - sulp + pyremerhamine51. cANCA + symptoms - I chose Wegners - did anybody choose Microscopic polyangitis?52. Marfan's syndrome - Aut dominant53. ST changes in V5-V6, what are you likely to see on coronary angio - Circumflex lesion54. SVT , you gave adenosine 6 mg, nothing happens, what next - repeat adenosine55. Vit D resistant ricketts - X linked dominant56. Young man , bipolar, with polyuria - Lithium57.Patient on clarithromycin, dont give - simvastatin58. Bivarudin , mech of action - direct thrombin inhibitor59. Amitriptylline overdose, low GCS - IV bicarb60. Methanol overdose, GCS 5 - Haemodyalysis61. Man who had viral infection, now comes with rash - erythema multiforme62. Red eye pain - scleritis63. Intermittent blurred vision - normal on corrected - cataract ?64. First order kinetics - bioavailability65. LVF, what med to add - Digoxin66. patchy hair loss - alopecia areata67. Dementia, loss of inhibition - Lewy body68. Dementia recurrent falls - stop haloperidol69. Patient with worsening renal fxn - I will stop metformin70. Severe acne - isotretinoin71. Lorazepam - increases GABA activity72. 70 yr old man with LVF, which antiHTN - I chose ramipril73. Ashtmatic - severely acute, not responding - IV Mg sulphate74. Patient on pergolidine - organise ECHO75. Anti HBc positive, HBsAG negative - Do Hep E serology76. man with signs of MG etc - Thymoma77. Man with neck stiffness, headache - AV malformation78. Girl with reduced consiousness and seizures when disturbed - ? complex partial ? primary generalised79. Headache piercing the eyes - Cluster headache80. MND - with LMN and UMN signs - Amyotropic lateral sclerosis81. Girl with menorrhagia - Activated protein C resistance82. Man with tumour of apex, which condition will you not operate - FVC 1.8 ??83. Which intervention decreases colon cancer - etoricoxib ???84. Which intervention decreases risk of pre-ecclampsia - ?? aspirin... LMWH ( patient is 12 wks)85. leukaemia good prognosis - t(15:17)86. Woman with sudden onst SOB, just started chemo for BRCA - Anthracycline Cardiomyopathy ?87. Uncomplicated clamydia treatment - Doxycycline88. Man presented with urethral discharge - swab - neisseria gonococcus, but blood cultures negative, why - co-existence of Chlamydia89. Man with painful genital ulcers - chanchroid90. Woman whose husband died, but she still sees him talking to her - ? PTSD ???91. Man with low mood, no eye contact, 2nd personauditory hallucination, drinker, suicidal - ? psychotic depression ?92. man convinced he had cancer despite all negative tests - hypochondriac93. Man presenting with symptoms, despite tests he believed there still there - Somatisation94. man with parkinsons, agitated, abusive - haloperidol95. Joint sepsis - staph aureus96. man with bloody diarrhoea, children's school mates recently had diarrhoea - ? rotavirus97. lady admitted with sweating and palpitations - Phaeochromocytoma98. Complete heart block - variable intensity S199. Dermatomyositis, initial mgt - prednisolone100. African lady, symptoms suggestive of leprosy - biopsy a skin lesion.101. ETT, strongest indicator to stop - angina**102. Heart murmur in 2nd and 3rd ic space - PS**103. mitral stenosis, indicator of severity - Degree of Pulmonary capillary wedge pressure (pulmonary HTN)104. infective endocarditis risk highest with previous IE105. Patient with cardiogenic syncope - SA dysfunction106. physiologic change after one minute of standing - increased cardiac output**107. maximum absorption of Na in salt and water depleted patient - still proximal tubule and TAL ?**108. pulmonary hypertension diagnosis - 2Decho109.alcholic, camunity acuired pnemonia, treated in icu, again fever, ?empyema**110. idiopathic pulmonary fibrosis, finding on xr - lower zone heart border blurring***111. extertringic allergic alviolitis, investigation, CXR shows upper zone involvement***112 Allergic bronchopulmonary aspergilosis, investigation - precipitins - most specific113 Small cell carcinoma, one of its paraneoplastic syndromes was given114. lambert eton syndrome, antibodies to VGCC115. pain in fore arm on resistance of extension of wrist, lateral epicondolyitis*116. Multiple sclesosis, patient with past histery of arm problem, now vision117. hopital acquired pnemonia... tazosin118. patient with fever and jaundice, picture of asending cholangitis, - CBD stone119. patient with ingestion of 20 paracetamol pills, PT** 120.feature of anemia of chronic disease121. patient wid ulcerative collitis and now joint pains - enteropathic arthritis122. dka, iv insulin was given, iv n saline123. Test of Acromegaly, insulin with oral glucose toleance test** 124. feature most strongly associated with tb recurrence - ?CXR granulomas indicate previous infection125. treament startd with acylovir, csf feature most strongly associated wid diagnosis - lymphocytosis** 126 . man with 3 yrs h/o lesion on shin - Bowens disease** 127. diabetic patient, poorly controlled, type of diabetes128. Patient with pheochoromsytoma, what treatment shoud be started..?phenoxybenzamine129. flash pulmonary edema.... renal artery stenosis130. resistant hypertension, hypokalemic alkalosis - renin/aldo ratio131. patient with early mornign stiffness and uper arms tenderness,, polymylgia rheumatica132. patient with father with psoriasis, now with inflammatory oligoarthritis but no other systemic features - spondyloarthropathy133. ankylising spondolyits, clinical feature reduced joint excursion in all directions134. patient with picture of RA, on nsaid, next treatment option - MTX135. patient in hospital, got gout, treatment with colchicine136. patient with hearing loss, tinnitus and vertigo.. ?meniere's disease**137. sudden onset visual loss, retinal hemrges and cotton wool spots - CRVO138. thyroid swelling, investigation.... FNAC139. collapsed patient....call for help first - early access as per ACLS/BCLS140. 3d image of protein - electron microscopy. Xray crystallography is for 3d visualisation of crystals141. seborrhic dermatitis.. scaly lesion on face, nose scalp sternum i think142. xray osteosclerosis ---osteoarthritis old lady with varus deformity 3 months pain143. PCOD--- test... high LH/FSH ratio144. boy with abnormal movements tourette syndrome** 145. pt on chemotherapy was given ondansatron but vomiting not controlled - nabilone146. Ciclosporin in post renal transplant - Tcell function suppressed147. A subject with urethritis, gram neg intracellular diplococci, VDRL +ve - False positive VDRL148.Creatinine increased after Trimethoprim - decreased tubular secretion (trimethoprim decreases tubular secretion of creat)149. things move or spin with head position change = BPV = Dix Halpik maneuver.**150 circular lesion on dorsum of the hand = granuloma annulare (thoguht not mentioned diabetic). ?BCC**151. on lithium & hypertensive = give amlodipine (SHOULD BE alpha blocker)152. a young man diagnosed with IBD (crohns) and started treatment what is the advice = stop smoking153. Mechanism of action of Flecanide. (sodium channel blocker).154. Pt having low calcium, low phosphate, low Vit-D, ALP raised, parathyroid hormone raised. How to manage. (Oral vit-D).155. Pt having lesion on toes, microscopy shows Trychophytum rubrum. (terbinafine)156. Continuous bleeding from pt after vena puncture. PT-raised, APPT-raised, Fibronogen-low, D-dimers-raised. (DIC)157.Pt having dizziness, vertigo and eye examination was normal. (Mieniers disease)158. Pt having lytic lesion on radio graphy. (Protien electrophoresis for myeloma)159. Patient hiking in west scotland, has a bite on thigh but no other symptoms - observe160. Tricyclic overdose. (IV NaHCO3)**161. Pt with obstructive sleep apnea. CPAP162.normal aonion gap metabolic acidosis- type II RTA**163. ?Addison's disease164. location of mechanism of action of spirinolactone165. Occupational asthma - monitor PEFR on weekdays and weekends**166. Diplopia and proximal myopathy - MG167. Unequal blood pressures in both arms in asian lady - Takayasu's arteritis**168. which anti depressant to use in young type I DM patient? mirtazapine? others were SSRI/venlafaxine169. Rash and renal impairment - HSP** 170. mechanism of inactivation of cortisol - ?free excretion171. klienfilter syndrome - small testes, primary testicular failure** 172. Patient with hypocalcemic hyper calciuria. How to treat? -**173. Red urine, facial swelling amongst symptoms - likely PNH over PCH174. bilirubin mild elevated and other LFT normal next test - reticulocytes175. Organism causing epiglottitis - Hib176. Lung fibrosis finding? - Reduced TLCO** 177. Patient with newly diagnosed Chron's disase, started on prednisolone, which is next best treatment advice - mesalazine vs quit smoking178. Type I DM not well controlled on OHGAs, looks like will be insulin requiring - LADAMixed respiratory and metabolic acidosisETT, strongest indicator to stopHeart murmur in 2nd and 3rd ic space,mitral stensis, indicator of severityinfective endocarditis riskcardiogenic, ?vasogenic syncope in patient wid 1st degree heart blockphysiologic change after one minute of standingmaximum absorption of Na in salt and water depleted patientpulmonary hypertension diagnosistreatment option for mild heart failiur with no edema?cardiac temponade, patient with markedly elevated jvptreatment of hypertension in patient wid peripheral vascular diseasealcholic, camunity acuired pnemonia, treated in icu, again fever, ?empyemaidiopathic pulmonary fibrosis, finding on xrextertringic allergic alviolitis, investigation, ?esoinophiliaAllergic bronchopulmonary aspergilosis, investigationSmall cell carcinoma, one of its paraneoplastic syndromes was givenlambert eton syndrome, antibodiesSystemic sclerosis, wot next can be affctedpain in fore arm on resistance of extension of wrist, ?epicondolyitisosteoarthritis of hip, treatmnet optionpatient with problem of speech, carotid artery diseciton etc were optionsMultiple sclesosis, patient with pst histery of arm problem, now vision? hopital acquired pnemonia... tazosinpatient wid fever and juandice, picture of asending cholangitis, where is the promblem? cbd etc were optionsspontaneous becteriia peritonitis, organismpatient wid ingestion of 20 paracetamol pills, PT? VOn wilibrand disease, patient with menoragiafeature of anemia of chronic diseasepatient wid ulcerative collitis and now joint painsdka, iv insulin was given, iv n salinepatient wid low TSH, cortisol etc, hypopiturismTest of Acromegally, insulin toleance test?feature most strongly associated wid tbtreament startd wid acylovir, csf feature most strongly associated wid diagnosisman wid 3 yrs h/o lesion on shindiabetic patient wid episodic loss of conciousness ?automic neuropathidiabetic patient, poorly controlled, type of diabetesPatient wid pheochoromsytoma, wot treatment shoud be started..? phenoxybenzamineflash pulmonary edema.... renal artery stenosisresistand hypertension, wot inx should be donepatient wid early mornign stiffness and uper arms tenderness,, polymylgia?patient wid fater has soriasis, now joint painsankylising spondolyits, clinical featurepatient wid picture of RA, on nsaid, next treatment optionpatient in hospital, got gout, treatment?patient wid hearing loss, tinnitus and vertigo.. ?meniere's diseasesudden onset visual loss, retinal hemrges and cotton wool spotsthyroid swelling, investigation.... ?FNAcolon cancer-- aspirinmore qs...=collapsed patient.... compression first=reactivation of TB test...gamma interferon=case of ketoacidosis dehydrated what next after insulin.... normal saline=3d image of ? protien test?=case of pulmonary stenosis=hep c with cryoglobulin disorder somthing like that=pulmonary hypertension ...confirmatory test?? patient with dyspnea...echo or V/Q perfusion to confirm sec to emboli=seborrhic dermatitis.. scaly lesion on face, nose scalp sternum i think=xray osteosclerosis ---osteoarthritis old lady with varus deformity 3 months pain=PCOD--- test... high LH/FSH ratio .. increased androgen=boy with abnormal movements ? tourette syndrome=recurrent uri ---- to check for complement def=weak extension at elbow and wrist with some sensory loss--? post interosseos nerve another q was on cervical radiculomylelopathy=one patient with heart failure ...was on ramipril, furosemide aspirin ? need to ad bisoprolol-collpased pt-i think u give rescue breaths first-diabetic pt 15 yrs-collapsed,no postural drop , prolonged pr interval-SA Node.-pt on chemo,vomiting-i went for steroids,as this chemo is highly ematoigenic and we give steroids for another few days to help with same-colon ca-aspirin-pt on lithium and started frusemide,polyuria.only low urine osmolality,i went for frusemide as it does not fit with DI secondary to lithium ?-cluster headaches-carotid dissectionCCF-add B.Blockers-loss of sensation dorsum foot/ankle reflex ? i think L5-methanol OD with low GCS,I think that methanol levels were very high,in that case i went for Haemodialysis,ethanol infusion will be an answer if the levels were not high enough,now i dont know 500 is mildly/or highly raised- 70 yr old LVF - Bendroflu-man with tumour at apex lung-i think he had metastatic disease ,i did not went for FEV's-pregnant lady,known pre eclampsia,i went for salt restriction?do we give aspirin in pregnancy-diarrhoea,recently children had it in school-rota virus-pt had acute gout with ccf-steroids to start with-worsening renal fuction-continoue.creatinine still < 150-girl with syncope,but normal after the episode-vasovagal.Pergolide - echo (causes valvular heart disease and cardiac fibrosis)3D structure of protein - Xray crystallographyCiclosporin in post renal transplant - Tcell function suppressedA subject with urethritis, gram neg intracellular diplococci, VDRL +ve - False positive VDRLIschemic colitis - Splenic flexure commonest siteCreatinine increased after Trimethoprim - decreased tubular secretion (trimethoprim decreases tubular secretion of creat)Down's syndrome valvular HD - VSDMyelofibrosis - fatigue commonest symptomThe question on ABG - mixed metabolic and respiratory acidosisRelative afferent pupillary defect - Optic nerve is site of lesionLesion in pituitary (0.9 cm) not increasing in size over one year - a probable incidentaloma...no effect* things move or spin with head position change = BPV = Dix Halpik maneuver.* false positive VDRL = thinks about yaws (trponemal species)* collapsed patient with no breath or pulse: chest compression ? (before AHA guidelines 2010 PP argues abt asking for help).*someone with Howel-Jowel = Coealiac (a known casue of hyposplenism).* circular lesion on dorsum of the hand = granuloma annulare (thoguht not mentioned diabetic).* multiple enhance ring in CT = crebral toxoplasmoisi = give pyrimeth+ sulfazianize (Co tir.)* resistant hypertension with the investigations are consistent with Conn's syndrome = check Rennin-Aldo ration.* on lithium & hypertensive = give amlodipine* contraindication to samll cell caner = infliltration of brachial plexus (or volue < 1.5 not 1.8 in options)*lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels* pain in the forearm worst by wrist extension = radial tunnel syndrome ( more distal than tenis elbow).* malingering man asking fir sick report and he drinks alcohol = alcohol dependence.* woman who sees her dead husband = readjustment.* a young man diagnosed with IBD (crohns) and started treatment what is the advice = stop smoking*recurren vertigo = BPV = Dix Halpik maneuver.* false +ve VDRL = yaws (trponemal species).* collapsed pt & breath or pulse: chest compression ? (before AHA 2010 PPl argued abt asking for help).* Howel-Jowel =hyposplenism = Coealiac.* circular lesion on dorsum of the hand = granuloma annulare.* multiple enhance ring in CT = c.toxoplasmoisi =pyrimeth+ sulfazianize.* resistant hypertension =Conn's syndrome=Rennin-Aldo ration.* on lithium & hypertensive = give amlodipine* contraindication to samll cell caner = infliltration of brachial plexus (or volue < 1.5 not 1.8 in options)*lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels.* pain in the forearm worst by wrist extension = radial tunnel syndrome ( more distal than tenis elbow).* malingering man asking fir sick report and he drinks alcohol = alcohol dependence.* woman who sees her dead husband = ?readjustment.* a young man diagnosed as crohn and started treatment =advice = stop smoking.* ibsilateral facial loss + ibsl horner + con.lt weaknes = posterior inferoir cerebellar*red eye with mild tenderness = epislcleritis* digested into glucose and galactose = lactose.* penumia in ICU improved then high fever with p effusions = empyema* gout in CVS problem = cholcicine (others have risk of fluids retention).* weird movements in class = tourret syndome.*which is correct---cluster or analgesia induced headache*which is correct ---to prevent colon cancer--w3 or vit -3 or etoricoxib*in preclamsia--treament--salt restriction or nifedipine*occupational asthma---is it correct --do pefr to do work and away from work*following uti with red urine ,mastoid surgery-iga or alport*in plasmodium vivax -primaquine used due to reduce gamate or liver stage*diabetic retinopathy---stop smoking correct or no**sciatic or s1 nrve compressio**red urine with howell jolly body-pnh or pch*severe dyspepsia after treatment-do endoscopy or others*in ra ---ig or citrulline***arnold chiarri or ms*optic nerve or occiptal lobe-maccunn*in severity of ms --which one correct i la size or pul artery pressure*in ulner nerve anatomy-1 st or 2nd lumbrical*psudomona-tazobactam or cefotaxime*esbl -impenem or other*bowens or granloma annulare*gilbert ----iv nicotinamide or fasting 48 hours*in eyes---osmolality change or cataract*in youge age af ---flecainide or digixoin*recurren vertigo = BPV = Dix Halpik maneuver.* false +ve VDRL = yaws (trponemal species).* collapsed pt & breath or pulse: chest compression ? (before AHA 2010 PPl argued abt asking for help).* Howel-Jowel =hyposplenism = Coealiac.* circular lesion on dorsum of the hand = granuloma annulare.* multiple enhance ring in CT = c.toxoplasmoisi =pyrimeth+ sulfazianize.* resistant hypertension =Conn's syndrome=Rennin-Aldo ration.* on lithium & hypertensive = give amlodipine* contraindication to samll cell caner = infliltration of brachial plexus (or volue < 1.5 not 1.8 in options)*lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels.* pain in the forearm worst by wrist extension = radial tunnel syndrome ( more distal than tenis elbow).* malingering man asking fir sick report and he drinks alcohol = alcohol dependence.* woman who sees her dead husband = ?readjustment.* a young man diagnosed as crohn and started treatment =advice = stop smoking.* ibsilateral facial loss + ibsl horner + con.lt weaknes = posterior inferoir cerebellar*red eye with mild tenderness = epislcleritis* digested into glucose and galactose = lactose.* penumia in ICU improved then high fever with p effusions = empyema* gout in CVS problem = cholcicine (others have risk of fluids retention).* weird movements in class = tourret syndome.* asian woman with unequal blood pressur = Takayasu* pt wheneve has flu urine turn dark = IgA nephropathy*cholangitis with 4-fold rise in S.amylase = stone as pancreatic duct?* discritpiton of sata disribution around mean = SD?*pituitary incidentalom prognosis = no progress* insulinoma = supervised 72h hrs fasting.topics asked were:1. lateral epicondyitis2. ischaemia mesenteric3.ra4.sle5.htn treatement in more than556.malignant htn7.hf8.vsd9.ps or aortic valve bicuspid ?10.normal aonion gap metabolic acidosis11.ppv12.ppv13.nonparametric test14.exercise tolerance test15.ihd location of artey16.men 2 pheochromocytoma17.treatment of pheochromocytoma18.infective endocarditis19. rf20.ankylosing spondylosis21.gout22. oa23.septic arthrits24.septic arthritis25 psoritic arthritis26 enteric arthritis27.metronidazole -ileic involvement in chrons28.dka29.addisons disease30 hypertension with low potasium.31.mechanism of action of spirinolactone32 direct thrombin agonist33.eea34.iaa35.telangestasia37,complement38.arnold chiari39. catract40.retinal vien obstruction41, carotid artery dissection42. alzehmars disease43. clear airways / call for help44.peritoneal dialyses45. occupational asthma46.copd47 . mg sulphate48.scleritis49.mgravis/50.s1 lesion51.radial nerves branch lesion.52.frozen shoulder53.bph54.ceolic disease55. systemic sclerosis56.osteomalacia58.pagets disease.59 cushings60. graves61. subacute thyrotoxicosis62.unequal blood pressures63.psedomonas.64.hypochondriasis.65.schizophrenia,66.seizures67. head tremor68 .motor neuron disease.69.pons70.intrasellar piytutary71.hypopitutarism72.smivastativ+clarithromycin73.meiners disease.74.tertiray hyperparathriodism75.acromegaly76 insulinoma77.di lithium.78. siadh.fluxetine79. fluoxitine in young patient80.alcohol piosing81.wegeners82 alport83.hsp84 iga nephropathy.85.erythrema multiforme86.bullous pempigoid87.seboric dermatits88.psoriasis89. granuloma annulare90.ulnar nerve leision91.dyspepsia.92.uc93.ibs94.yersinia95.mechanism of inactivity of cortisol.96.pcos97.klienfilter98.hypothriodism99.myeloma100.primary hyperparathyriodism101.diuretic used in calcium stones102.cml103.cll104. 15.17 translocation105.mylofibrosis1o6.dic107.myelofroliferative disorder108.pnh109.anaemia of chronic disease110.vonwilbrand111.bilirubin mild elevated next test112. chronic hepatitis c -cryoglobinemia113.paracetamol poising- pt114.mitral valve severity.115.heriditary angieoedema -c4 level116.alopecia117.small cell ca.118. bpaspergilosis.119.aspiration pneumonia120.pregnanat treat asthma121.prophylaxis in previous preeclampsia122.iv bypass the first order kinectics -123.epiglotitis124.oral painful ulcers.125 treatement of toxoplasmosis126.xlinked dominant rickets127.tlco reduced in lung fibrosis128.plural effusion129.cluster headache130.tricyclic overdose' bicarbonate131.adenosine first in svt then give again132.adenosine mechanism133.inflixanib134.risk factor crohons smoking135-omega 3 use

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8- MRCP Part 1 - Recall May 2013