12 september 2006 mrcp part1

Discussion in 'MRCP Forum' started by halit2005, Sep 19, 2006.

  1. halit2005

    halit2005 Guest

    the exam was confusing actually.

    may be not more than 5 questions from onexamination.com

    one question was about a patient who was recently diagnosed with small cell lung carcinoma started on etoposide and cisplatin developed tingling sensations in his hands and feet. cisplatin side effect?
  2. cisplatin even though does not have much bone marrow suppression can be neurotoxic
  3. halit2006

    halit2006 Guest

    mrcp 1 12 9 2006

    the warfarin is interacting with carnberry juice as there was a question asking about it

    the evidence is here:

    Possible Interaction Between Cranberry Juice and Drug Warfarin
    The British Medicines and Healthcare products Regulatory Agency (MHRA) reported five cases that suggest a food-drug interaction between cranberry juice and warfarin that could cause internal hemorrhage.

    One of these cases involved a man who suffered a fatal internal hemorrhage. His blood clotting levels increased dramatically six weeks after starting to drink cranberry juice.

    In another case, blood clotting levels increased less dramatically but returned to the normal range after cranberry juice was discontinued.

    Many women drink cranberry juice to prevent bladder infections.
  4. Guest

    Guest Guest

    ARey yaar Guys, those of you who have sat for the sept 2006 . Could you please come forward for question discussions , plz
  5. halit2005

    halit2005 Guest

    12 september 2006

    why not lets come out foe the discussion of 12th september mrcp1 2006 questions if you like

    thank you
  6. Guest

    Guest Guest

    hi
    here are alot of question to discuss

    i would welcom any comment/discussion


    [b]1) Valproate s/e……………TREMORS
    2) Pt having recurrent attacks of migraine, WHAT TO DO NOW??...........5HT2 ANTAGONIST
    3) Pt taking Li, toxic level increases, cause?........LOOP DIURETICS
    4) Elderly male, Parkinson disease..tremors, what to do 4 tremors…………ANTICHOLOINERGIC, BENZHEXOL
    5) Parkinsons dis, started on levo dopa, worsens, cause………….LEWY BODY DEMENTIA
    6) s/e of mesalasine
    7) HRT, most compelling indication to start…………..FOR OSTEOPROSIS, INC BMD
    8) Female…..38yrs showed low BMD, investigation to find the cause? LH, FSH
    9) Choloestrol level low, u want 2 inc HDL level, Rx? NICOTINIC ACID
    10) Pt of CHF, getting all Rx, EF low on echo, what 2 do to improve sym? DIGOXIN
    11) Renal failure, which antibiotic will cause hyperkalemia? AMPHOTERICIN/ AMINOGLYCOSIDE?
    12) MOA imatanib………….TK INHIBITOR
    13) MOA acyclovir………….DNA POLYMERASE INH
    14) MOA bisphosphonate……….OSTEOCLAST INH
    15) MOA n-acetyl cystine……….INC GLUTATHIONE LEVEL
    16) In normal physiological condition wat act as pulm vasodilator? PROSTACYCLINS
    17) Pulm HTN, which clinical finding is u most likely to find? LOUD P2
    18) Pt of DVT, warfarin given wid target of 3, after 2 days INR 2.1, he was asked to stay in hosp for 2 days n receive heparin. reason? DEC PROTEIN C & S LEVEL
    19) Pt wid factor v leden mutation, wat will occur in him? DEC ACTION OF PROTEIN C
    20) Pt of HIV wid Kaposi sarcoma, virus? HHV-8
    21) Pt of COPD, wat on PFT will confirm diagnosis? FEV1/FVC =50%
    22) Pt wid SOB, PFT showing restrictive pattern, dec TLCO inc KCO, cause of SOB? OBESITY
    23) Pt suffering from COPD whose oxygen pressure was very low somewhere about 6.3.. which Rx is going to be of greatest help? …. LTOT
    24) Pt underwent pneumectomy, wat will be normal on PFT? KCO
    25) Pt had spinal cord lesion, which finding do u expect after 2 weeks? CLONUS??
    26) Sarcoidosis, erythema nodsom…prognosis? IMPROVE WID NO CONSEQUENCES
    27) Pt started on methotrexate, took daily for a week instead of weekly dose, wat do u expect in him? NEUTROPENIA/ HEPATIC DAMAGE ??
    28) Gonorrhoea Rx? CIPROFLOXACIN
    29) Anti emetic which act thru peripheral receptors? NABILONE
    30) Upper lobe cavitating pneumonia? KLEBSIELLA
    31) Alchoholic pt wid fever, pneumonia, heavy sputum…lung abscess?.. wat imp information in history will help u find the cause of symptoms? RECENT HISTORY OF ALCOHOL RELATED FITS
    32) 1 week after influenza developed chest infection, b/l crackles, cause? STAPH AUREUS
    33) 10 days after staying in ICU, in ward chest inf, b/l basal crepts, cause?……… MRSA
    34) s/e cisplatin? HYPOCALCEMIA
    35) BRCA-2 gene +ve, daughter is at risk of ? OVARIAN CA
    36) Pt of HNPPC was found to be MSH-2 +ve, daughter should b screened for? ENDOMETRIAL CA
    37) Young child wid classical s/s of inf mononucleosis, thrombocytopenia. What 2 do? STEROIDS
    38) Transgenic mice used 4 antibody proliferation n used therapeutically, technique known as? RECOMBINANT DNA TECHNOLOGY
    39) Young pt, spontaneous pneumothorax, 50% collapse on CXR, ABGs normal….what 2 do? NEEDLE ASPIRATION
    40) Pt with IgA def, which statement is true? LIKELY TO GET REACTION ON BLOOD TRANSFUSION
    41) Platelet count fail to rise after platelet transfusion, what to do now? HLA-MATCHED PLT
    42) Pt getting TPN thru jugular vein. What is the most common complication of this practice? INF.ENDOCARDITIS/ SEPTICEMIA??
    43) F/H of deafness, hematuria n RBC casts, diagnosis? ALPORT SYN
    44) Female pt took some weeds? Vegetables, developed goitre, mech? DYSHARMONOGENESIS
    45) Female pt , hepatosplenomegaly, low grade fever 6 months, slide 4 MP –ve, diagnosis? LEISHMANIASIS
    46) CARCINOID SYN
    47) Hemachromatosis, screening test? TRANSFERRIN SATURATION
    48) Ant mediastinal mass? THYMUS
    49) HIV CD count 50, taking no med, fever + rt hemiplegia, CT multiple ring enhancing lesions, fundus normal……..diagnosis? TOXOPLASMOSIS
    50) AML…..test to find bad prognosis? % OF BLAST CELL ON BONE MARROW
    51) Lymphoma, nodular sclerosing, bad prognosis? DRENCHING SWEATS
    52) Eosinophilia………..IL5
    53) HBsAg +, HBeAg - LFT normal, PCR <400…….what Rx ? DO NOTHING
    54) Alcoholic pt, underwent surgery, on 3rd post op day…visual hallucination, diagnosis? DELIRIUM TREMENS
    55) Pt investigated for palpitations last year...found normal n reassured dat he is not suffring frm serious heart disease..this time insistin dat he has cancer despite all normal findings...diagnosis HYPOCHONDRIASIS
    56) Pt complainig of joint pain ..normal findin...few months later comlainin abd pain..again normal...next time another complain....no findins on exm, extensive tests performed, normal...diagnosis SOMATOFORM DISORDER
    57) Severe depression with psychosis………….SEVERE DEPRESSION
    58) Psychosis, started on haloperidol, now fever, wat on exam will suggest NMS? MS RIGIDITY
    59) Pt complain of amnesia for 1 week..acc to his wife he left home was found wanderin in streets by police..was complty consciuos and oriented but cudnt remember any thin abt himself...disturbed relations wid partener...diagnosis? TRANSIENT GLOBAL AMNESIA
    60) Female pt c/o itching & insects crawling all over body, no body else in her home has itching, she has brought some insects in a matchbox, which she collected from hair, what do u expect to find? SQUAMOUS DEBRIS
    61) 40yr male, fever sorethroat n low platelet, Rx? STEROIDS, ITP?
    62) Pt started on ATT, co dyspnea, airway obstruction, wat to do now? STEROIDS/ STENT??
    63) Pt wid ca lung, edema rt hand, svc obstruction,wat to do next? RADIOTHERAPY
    64) Female pt, itching L hand for a year, with scaling over palm n prominent palmer crease. Wat test will u do to confirm ur diagnosis? SCRAPING UNDER WOOD LIGHT/ BIOPSY?
    65) Coelic dis, dermatitis herpetiformis, biopsy taken, what will be deposited at dermoepidermal junction? IgA
    66) Black necrotic skin lesion on shins, for a year, not changing? KERATOACANTHOMA
    67) 56 yr female, diagnosed TB, before starting ATT, vision was tested which showed color vision loss, diagnosis?...........PREVIOUS OPTIC NERVE DIS/ CONGENITAL COLOR VISION LOSS?
    68) Pregnancy, 12 wk, dyspnea, chest normal. Wat normal physiological change during pregnancy can account for her dyspnea? INC. MINUTE VENTILATION
    69) Dyspnea, PO2 low, PCO2 low, met acidosis, diagnosis? THROMBOEMBOLISM
    70) 2/2 table, calculate specificity
    71) Screening test was made, this was later stopped, reason for stopping? LOW SENSITIVITY
    72) Data was collected, mean+ - 2SD was calculated. What % of population lie above this range? 2.5%
    73) Data showed positively skewed distribution, wat is true abt it? MEAN IS MORE THAN MEDIAN
    74) Pigmentation around mouth, came with PR bleeding, cause of bleeding?......CARCINOMA
    75) Female pt wid h/o autoimmune dis, baby has heart block, which antibody will be positive? ANTI-RO
    76) Von-willibrand disease
    77) Multiple sclerosis, now in remission, which Rx to start? IFN-B
    78) Status epilepticus, 1st rx to give? LORAZEPAM
    79) Pt came with malena, OGD showed benign looking gastric ulcer, Rx to start? I/V PPI
    80) Pt with chest pain n dysphagia? ACHALASIA
    81) A case of MEN 1 with insulinoma, test to diagnose? SUP MESENTERIC ANGIOGRAPHY
    82) Bitemporal hemianopia, pituitary tumour with suprasellar extension, definitive Rx? SURGERY
    83) Function of somatostatins? DEC. INT. SECRETIONS
    84) Pt of ulcerative colitis, dg to keep in remission? AZT
    85) Opioid addict, drowsy, shoulder pain, which analgesic to give?
    86) Scenario of IBS
    87) Case of IBS, which feature is against diagnosis? AWAKENING AT NIGHT WID PAIN
    88) Hepatitis, inc IgM n IgG, diagnosis? AUTOIMMUNE HEPATITIS
    89) Cholestatic jaundice, drug causing it? FLUCLOXACILLIN
    90) Low Hb, low MCV, spleen enlarged? B-THALLASAEMIA MINOR
    91) ECG, which finding is against LVH?
    92) Aortic aneurysm repair, 2nd post op day hypotensive, what is the best Rx? BLOOD/ SALINE?
    93) Pt taking cranberry juice for UTI. Which med is likely to b affected? WARFARIN
    94) Pt started on antiepileptic, now needs high dose for same serum level, cause? TAKING ALCOHOL
    95) Description of rash of DISCOID LUPUS
    96) Malignant melanoma, breslow thickness 0.75, what to do? RE-EXCISE
    97) A.Fib wid AV block, pacemaker? V V I R
    98) Catheter data………COARCTATION OF AORTA
    99) Chloroquine toxicity, CNS symptoms, took 8 hr before, what to do? HEMODIALYSIS?
    100) Scenario of chr pancreatitis wid diarrhoea, what Rx 4 diarrhoea? PAN ENZYME SUPPLEMENTS
    101) B-blocker over dose, heart block, atropine given, no response, detoriationg, wat 2 do? IV GLUCAGON
    102) Vasodepressor syncope, not responding to B-blockers, next Rx? SSRI/ FLUDROCORTISONE?
    103) BNP secreted by? VENTRICLES
    104) Scenario of B12 def, wat will b found? INC HOMOCYSTEINE LEVELS
    105) Scenario of carpal tunnel syn, sensory loss? LAT 2 ½ FINGERS
    106) Pain on passive abduction of leg? INFL GREATER TROCHANTER?
    107) Cocaine abuser, hypertension, sys BP 250, Rx?.............PHENOXYBENZAMINE
    108) 80 Yr male, bedridden, constipation? ISPHAGAUL HUSK
    109) Ankylosing spondylitis, test? X-RAY SACROILLIAC JOINTS
    110) Drug has T ½ of 2hrs, when will be conc 1/8 ? 6 hrs
    111) Women getting radioiodine Rx, wat will be there after 10 yrs? HYPOTHYROIDISM
    112) Old man, smoker, works in rubber industry, ca bladder? TRANSITIONAL CELL CA
    113) Signs of hemisection of cord, diagnosis? SPINAL MENINGIOMA
    114) Oxygen dissociation curve, shifted to R, cause? ACIDOSIS
    115) DM, peripheral neuropathy, wat is accumulated for this finding? SORBITOL
    116) Pain n swelling of knee joint, inflamed? SEPTIC ARTHRITIS
    117) Scenario n data of pseudo gout, cause? OSTEOARTHRITIS
    118) Pt undergoing hip surgery, lympho raised, CLL?..wat to do? DO NOTHING
    119) Data of polycythemia, renal cyst found on USG ?? ADENOCARCINOMA RCC
    120) Post MI, thrombolysis done, still c/o pain, wat to do? PTCA
    121) Essential tremors, Rx? B-BLOCKERS
    122) Hearing loss, interpretation of weber n rinne, nerve deafness? SHWANOMA
    123) Took antibiotic a week before, renal function detoriating, inc eosinophils, diagnosis? INTERSTITIAL NEPHRITIS
    124) IHD, came wid TIA, echo vent aneurysm, wat to add? WARFARIN
    125) DCMP,new onset A.Fib, want to prevent further thromboembolism in next 48hrs, Rx? HEPARIN
    126) Pregnancy, TTP, neurological signs Rx? FFP/ PLASMA EXCHANGE?
    127) U/L scarred kidney, has F/H renal disease, cause? REFLUX NEPHROPATHY
    128) Pt came wid HONK, treated acc, when regained consciousness c/o blurring of vision not improved by refraction correction, cause? LENS OSMOTIC CHANGE/ RETINAL HGE?
    129) Common peroneal nerve injury....sensory loss? DORSUM OF FOOT
    130) Pregnancy Losses 3 Times : which antibody will b +ve? ANTICARDIOLIPIN AB
    131) Boy with head injury showing lucid interval and now deteriorating....diagnosis? EXTRADURAL HEMATOMA
    132) Pt with hypertension .... abondened treatment due to adverse effect... which anti htn to be given to avoid adverse effects like lethargy,gum hyperplasia.leg swelling, shortness of breath…….ACEI
    133) Malignant htn....treatment? NITROPRUSSIDE
    134) Patient who was recently diagnosed with small cell lung carcinoma started on etoposide and cisplatin developed tingling sensations in his hands and feet, cause? . CISPLATIN SIDE EFFECT
    135) Old man with isolate Alk POSPH raised noramal ca po4 diagnosis......PAGETS
    136) Investigation for PSC????? ERCP
    137) Peanut butter allergy...serum igE levels normal...next investigation DO NOTHING
    138) Widespread Skin Lesion With Comedone No Effect Of Tetra-Nxt Tt:……ACITR
    139) Meningitis...signs of raised ICP
    140) Elderly home, outbreak of diarhea 0-3-10-8-1-0-0-0-0-0 cause? ASYMPTOMATIC HEALTHCARE WORKER/ PERSON TO PERSON SPREAD?
    141) Colonic malignancy, Inf Endocarditis, organism? STREPT BOVIS
    142) Pain 1st carpometacarpal joint? OSTEOARTHRITIS
    143) Pt self using local steroids for long time for some skin lesion, most common s/e to b seen? SKIN ATROPHY
    144) Definition of vesicle?
    145) RECURRENT URTICARIA WHAT iG;Ig



    best of luck to everybody who appeared in exam
  7. halit2006

    halit2006 Guest

    thanks alot guest for those questions, they are actually valuable

    hope to see more questions
  8. halit2006

    halit2006 Guest

    mrcp1 12 9 06

    hi guest;

    i think regarding the screening for hemocromatosis, the question was asking specifically about screening the family members , which i think is the genotype for c282y mutations as transferring saturation is used for screening the general populaton?

    what do u thin?
  9. Guest

    Guest Guest

    yea i agree wid u

    was under time pressure at that time in exam

    didnt look for n analysed all options
    anyways
    screening for hemachromatosis is by


    TRANSFERRIN SATURATION for general population

    GENETIC ANALYSIS for family member of affected person

    thanks
  10. halit2006

    halit2006 Guest

    MRCP 1 12 09 2006

    Scenario of B12 def, wat will b found? INC HOMOCYSTEINE LEVELS

    because of ineffective eryhropoesis i think the elevated enzyme is LDH

    WHAT YOU THINK
  11. halit2006

    halit2006 Guest

    12 09 06 MRCP1

    WHEN U THINK THE RESULT CAN BE DECLARED?
  12. halit2006

    halit2006 Guest

    12 09 06 MRCP1

    Bitemporal hemianopia, pituitary tumour with suprasellar extension, definitive Rx? SURGERY

    PROLACTINOMA EVEN IF THERE ARE SIGHNS OF VISUAL COMPRESSION A TRIAL OF DOPAMIN AGONSIT IS WARRANTED ICLUDING CABERGOLINE

    WHAT DO U THINK?
  13. halit2006

    halit2006 Guest

    12 09 06 MRCP1

    1) Colonic malignancy, Inf Endocarditis, organism? STREPT BOVIS

    THE QUESTION DID NOT DECLARE CLEARLY THAT THE PATIENT HAS COLONIC CARCINOMA BUT JUST MENTIONED THAT THIS HAS HAD ALTERED BOWEL HABITS AND GENERALY THE MOST COMMON CAUSE OF IE IS STRP. VIRIDANS

    THE SAME IS IN WWW.ONEXAMINATION.COM

    WHAT DO U THINK?
  14. Guest

    Guest Guest

    Fibrate or Nicotinic acid would boost HDL.
  15. Guest

    Guest Guest

    ECG against LVH?

    Right axis would go against LVH on ECG
  16. Guest

    Guest Guest

    Homocysteine is converted into methionine by addition of methyl group...n vit B12 is a cofactor for this reaction

    def will lead to dec conversion n thus inc levels of homocysteine
  17. Guest

    Guest Guest

    for macroprolactinoma, INVASIVE AND COMPROMISED VISUAL LOSS, Rx is surgery (HARRISON)
    Beside que asked for DEFINITIVE RX, not initial RX
  18. Guest

    Guest Guest

    Nicotinic acid raises HDL by 25-35%

    " it is the most effective drug currently availible for raising HDL, because of its low cost & long term safety" HARRISON 16 ED page 2297
  19. Guest

    Guest Guest

    while RCP says they will announce result on 9 oct,

    i guess that it will be out on 6th oct FRIDAY

    lets see :) [/b]
  20. dear Doc5, You have quoted harrisons as the basis of your responses. Is it the best book to refer for MRCP 1. I have bought kalra. Do I need to read harrisons as well :?:
  21. i hope that all the hard working AIPPG members pass the exam :hug
  22. halit2005

    halit2005 Guest

    12 09 06 mrcp1

    friends anyone can expect when the result of 12 09 06 mrcp1 can be dispatched on mrcpuk.org?

    thanks alot
  23. Dr_Osama77

    Dr_Osama77 Guest

    Hi doc5,

    increased accumulation of homocystiene is seen in folate deficiency and may be in severe B12 deficiency.

    What do u think about increased LDH?

    It's also a possible answer!!
  24. Guest

    Guest Guest

    RESULT IS OUT

    CHECK IT

    I HAVE PASSED
  25. Guest

    Guest Guest

    and see my guess above


    ITS 6TH OCT, FRIDAY
  26. KASHI

    KASHI Guest

    TO doc5

    congratulations doc5 on urs success.plz give urs advice & tips.
  27. new to mrcp

    new to mrcp Guest

    12 09 2006 mrcp part one

    hi all dear friends, iam preparing for mrcp 1 nex january inshallah, hope to get ur advices?

    anyone knows what is the pass mark for the last exam(12 09 2006 mrcp part one) compred to the past two exams?

    thanks all, hope to get reply asap
  28. Guest

    Guest Guest

    Thanks a lot for the questions......

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