Discussion in 'MRCP Forum' started by Guest, Apr 7, 2011.
let us start collecting and discussing questions here.
Let us start with photographic:
1- MRI of chiari malformation.
2- CT Scan of bilateral infarcts.
3- Abdominal x ray of Gall stones
4- Umbilicated lesions on the face: cryptococcus
5- erythematous face (femal) croosing nasal bridge: eryseplas
6- X ray of the hand (distal phalanex of rt index): tophaceous gout.
7- Psoriatic lesion on the face: associated with Onycholysis
.(1) CT scan Alcoholic fall & get head injury.
c. Subdural h'ge
(2) Pneumothorax 5%, 1 st time, all vital are ok. What's ur Mx/
a. discharge from ED & recheck CXR 3 wk later***
b. needle aspiration
c. ICD insertion
(3) elderly woman wake up & go to toilet to pass urine. Fall without warning. Loss of conscious, confuse after that. urine incontinence.
a. drop attack***
c. single epilepsy
(4) Family tree showing Breast cancer, ovarian cancer,, colon cancer. Ask the gene responsible
a. BCRA 1***
b. BCRA 2
d c Myc
(5) Pt admit to ICU for sepsis, UTI,.......& stable. discharge to ward. get pneumonia. choice of antibiotic
a. Meropenum & vancomycin***
(6) Young man who has unprotected sex present with urethritis, conjunctivitis, arthritis. Knee jt aspirateshow G+ diplocci. Antibiotic of choice.
(7) Girl works in pet shop. exposure to snake, fish, Birds. develop whezee & fever. Cause?
b. Mycobacterium aquarium,
c. Allergic Bronchoaveolar
(8) Girl work as a Barmaid develop skin rash on dorsum of hand. See photo!
a. Allergic contact dermatitis
c. lichen planus
(9) diabetic man who has diabetic retinopathy. compliance ok. HbA1 C 9%& Hypertensive 150/90? Review 3 month earlier for urinalysis is ok. Now urine protein 6g/24hr. Cause?
a. diabetic nephropathy
b. membranous nnephropathy**
c. Hypertensive nephropathy
(10) A question about TTP.
a. Haemolytic Uraemic $
Please correct questions!
(11) 17 yr girl whose sister is Type 1 DM on insulin suffer frequent attack of palpitations, sweating & dizzy spell. Admit & check for prolong fast. FBS was 2.3 mmol/L with high insulin level after 12 hr. What ur next Investigation.
a. C peptide***
b. serum sulphonamide screen
(12) Hyponatremia 125 not responding to fluid restriction. next step?
Scenario of SIADH
c. slow release sodium
(13) minor injury to shoulder followed by painful restriction of both active & passive movement (abduction) of shoulder. Cause?
a. adhesive capsulitis***
b. suprascapular tendonitis
(14) Old man, picture of skin lesion over cheek near ear. Nodule/ swelling of ear pinna. Dx?
c. Bowen's ds
d. Malignant Melanoma
(15) Old man, picture of skin lesion over cheek near ear. Nodule/ swelling of ear pinna. Dx?
c. Bowen's ds
d. Malignant Melanoma
1- obese diabetic with retinopathy and hypertension and ckd how to delay progression (stop smoking- wt reduction â€“ ttt of hyperglycemia- ttt of hypertension)
2- APKD = hypervolemia what to add ( thiazide 2.5 or amiloride 5 )
3- Female with fat atrophy in face proinuria and hematuria what to find ( decreased c3 MPGN)
4- EPO. Resistant (fe diff- pure red cell- hyperparathyroidism)
5- Patient with 2ry hyperparathyroid ca 1.8 ph 2.1 PTH 30 what to give ?>>> ca carbonat
6- Patient 70 years whith prastatic enlarge cath >> 700 ml urine and renal function increased >>> obstructive uropathy
7- Dm patient + protinuria >>>> membranous
8- another pt. with protinuria >>>>>
9- Patient with MM and acut renal failure what to give initially >>> IV fluid
10- Pathological finding in drug induced renal failure >>>> tubulointerstitial nephritis
11- Percent of end stage in patient with nephritic syndrome (minimal change disease) within 10 years>>> 10-30% ??
12- Pt. with hepatitis c and GN>>>> membranoproliferative GN
13- Pt. sore throat 24 hours and hematuria >>>> IgA nephropathy
14- HSP>>>>>>>>>>>> prednisolon
15- Femal with hypokalemia metabolic alkalosis and increased aldosteron and rennin>>> renal a. stenosis
16- Another one with hypokalemia and decreased sodium and cl in urine >>> gastrointestinal loss
17- Pt. with hyponatremia and history sugg of malignancy>>>> SIADH
18-renal tubular acidosis
Question about a girl with HSP who is well except for some proteinuria, joint ache -
Q asks for initial management ...
Did you give her 'roids even though the question maintains how well she is ???
i chose paracetamol... cos the management of hsp is supportive
Q 12 not democycline but desmopressin , I think so
Pt with PD whose co-careldopa got increased recently. Getting side-effects (can't remember what exactly but not great)
a) decrease co-careldopa
b) switch co-careldopa for ropinirole
c)switch to something else
the recall for this one was outstandingly poor...
Pt with PD who has developed cognitive decline
Pt develops disinhibited behaviour
b) Frontotemporal dementia
c) Lewy Body dementia
d) Muti-infarct dementia
Girl with psychiatry and self harm day before after boyfriend argument but now doesn't want to die after all. Has self-harmed before.
a) borderline personality disorder
Young chap who is normally fit and well keeps getting palpitations which he is symptomatic from when they are occurring - few mins to up to 30min intervals to the episodes
a) atrial fibrillation
b) atrial flutter
d) paroxysmal supraventricular tachycardia
e) multiple supraventricular ectopics
Desmopressin is ADH Analogue. Not a good idea to give that in SIADH.
Demeclocycline's a better choice
Hope all will pass inshaallah,,,although this was a very difficult long tricky exam
Pt with PD whose co-careldopa got increased recently actually what happened it was visual hallucination after increasing the dose of co-careldopa for dyskinesia,,,I think the question was asking for lewy body and what next step really I do not the correct choice but I chosed donepezil which is given for lewy bot unsure
Pt with PD who has developed cognitive decline I chose rivastigmine and I think there was no option for donepezil
Pt develops disinhibited behaviour with dementia and good mental score 29/30 I chose frontotemporal dementia
Girl with psychiatry and self harm day before after boyfriend argument but now doesn't want to die after all. Has self-harmed before and has bad relations with close freinds when was 16,,,I chose borderline personality
Young chap who is normally fit and well keeps getting palpitations which he is symptomatic from when they are occurring - few mins to up to 30min intervals to the episodes I think best option was paroxysmal supraventricular tachycardia
for the case of hyponatremia I think best answer is demeclocycline
Asthmatic patient with recurrent left lower lobe pneumonia mild elevation of IgE and Eosinophil 0.45 what is the cause of recurrent pneumonia....I chose endobronchial tumor "carcinoid" what do other say
could the above asthamatic have Allergic pulm aspergillosis?
also there was girl who visited tanzania and now foiur week history of fever, macular rash over ant abdomen , esoisinophilia on bloods
i thought tick typhus due to rash
the ct scan od a farmer with breathless adn only one episode of pnemonia in the past
finger clubbing, no adenpathy
extrenis allergic alveolitis
although ct scan appeared like bronchaictasis history seemed more like extrensi allergic alveolitis
girl who visited tanzania it was typical for typhus as there was black scar on skin
1 for att drugs,continue them as pt well and ast is not raised three times
2 saline with honk
4 pt with dka and mild ketones adjust insulin at home
6 pictures pco
mycology scrapings? in pt who was a cook
pagets with bowed legs
8 iga nephritis
10 Cavernous sinus thrombus with recurrent abortions and pain in eye with 6th n palsy
11 factor 8 old man last question of paper3
12 frontotemporal demebtia
13 decrease levodopa as visual hallucin side effect of levo dopa
14 rivastigmine alzhiemers
15 cll dont rx
16 increased bilirubin and alk phospatase in 16yr old episodically unwell blood film for spherocytosis
rccarcinoma or testicular?with vericosities of testes
2 germ cell tumor with increased igf and hypogonadotrophic hypogonadism
4 flucloxacillin.pt treated for skin infection and heapatic pic later
5 nash with echogenic liver n taking chlorpromazine
7verapamil cluster headache
8 RAS in preg
9 lactic acidosis in pt taking metformin n high creatinine(165)
10 carcinomatous lymphangitis?in breast cancer with arm bandage
11 ehler danlos hyperventilation?
12 pneumococcus with cholesystectomy
13 CI lobectomy fvc less than 1
14 pph in fat woman taking anorexinogens
15 haoperidol old man agitated
17 paroxymal svt
18 myasthenia gravis
19 mI TRANSTHORACIC ECHO
20 TRACHEO MALACIA IN ENGINEER
nephrotic less than 5 percent
ghb or lsd at party
nonsmall cell.palliative radio
schistosomiasis in tanzania
pls correct me.will most more later
Regarding 18 myasthenia gravis if this was the case of a man with history of chest infection for last few months presented with bilateral ptosis facial weakness proximal muscle weakness normal sensory normal reflex then presented with respiratory failure,,,,,actually I put myotonic dystrophy but unsure
for nonsmall cell.palliative radio I think radiotherapy is CI as FEV1 was 25% I chose best care pallative
terrible exam guys......
cant even recall things prperaly and ones i should have done right ive made silly errors oh well.
i am here after the 2010 sep part one..
i Found the Exam Very Very Difficult...
(i didnt prepare well Though)...
i was very active in the 2010sep part 1 discussion forum in another name..
this time i didnt even try to memmorise the questions ... as i am sure of my result (fail)...
hai shez ,
im Shahi000 here
this time i am in a different name ...
Hi Shahi000 I like to continue with this name
I am happy you are here
The exam was very difficult very long tricky and specially paper 3 and for the last questions just I read the options and investigations without history,,,but I feel I answered good in paper 1 and 2 hope from ALLAH to pass us,,,,so dear shahi do not lose the hope and I am ready as I can to discuss although I can not remember most questions
Young male patient with backache jaw pain and left knee joint arithritis he was intolerant to NSAIDs "Ibubrufen" aspiration of joint show increased neutrophils "No microorganism NO crystals" options
I think the case was Ankylosing and here best choice is Methylprednisolone "intraarticular" as the patient was in pain and you can not give Diclofenac
I found this recommendations in CKS
Specific corticosteroids are recommended for different sites according to joint size; the dose depends on the severity of the condition. In general, for:
Small joints: methylprednisolone or hydrocortisone is recommended.
Medium-sized joints: methylprednisolone or triamcinolone is recommended.
Large joints: methylprednisolone or triamcinolone is recommended.
Please for any other opinion
for anti Tb drugs causing jaundice I did not remember the level of liver enzymes but I chose stop all drugs
The last questions in paper 3 as only I read the options and investigations I think there was bleeding tendency with DIC lab "Low fibrinogen and high D dimer Prolonged APTT" and I am sure I found normal blood film options
Acute promyelocytic leukemia
factor 7 or 8 dificeincy
could not remember more
for hypogonadotrophic hypogonadism
there was pituitary mass prolactin normal other hormone normal normal calcium options
non functioning pituitary tumor
germ cell tumour
Langerhans cell histiocytosis
I think the case was "Partial hypopituitarism and Langerhans cell histiocytosis" as if it was craniopharyngioma or non functioning pituitary tumor there should be increased prolactin and other hormones to be affected and germ cell tumour has no relation sarcoidosis could be but you have normal calcium and no erythema nodosom
Langerhans cell histiocytosis commonly presented with Diabetes insipidus but was not the case here
I found this case in BMJ
I do not know if this was the case of HIV patient with low CD4 and confusion CT was normal CSF only show increased lymphocyte Cryptococcal antigen was positive so I cose cryptococcosis ,,,,,if this was the case,,,as I can not remember any PMLE
IN paper 1 a case was patient with chest problems when went to malysian cave CXR nodular the case was histoplasmosis,,,I chose coccidomycosis
Pasturella multocida infection from cat bite
i think the exam was so difficult
put i think paper one was the most difficult one i canot remember the questions
i hope good like to all of us
regarding q in paper 3 prolactin was high so i think it is NON functioning pit
I THINK PRLOLACTIN WAS ELEVATED SO I SELECT NON FUNCTIONING PITUITARY ADENOMA
leave the prolactin other answers pls
it was hypogonadotrophic hypogonadism with elevated insulin like growth factor . igf can be elevated in seminomas so its the correct ans.wats the average marks we need to pass from 270.
where are every one guys.. Please any one to list all msq he remember
r u sure?72 is a lot.
MRCP Part 2
72 sounds somewhat ridiculous. 3 people will pass at that rate.
Thanks Dr albarwari - i chose the same answers as you for the ones you have gone over for me though I switched co-careldopa for ropinirole for the PD pt with hallucinations.
Does anyone also recall a man with HIV and a CD4 count of 3 with widespread lymphadenopathy, night sweats, fevers and 17kg weight loss?
Separate names with a comma.