MRCP PART 2 WRITTEN APRIL 2011 (recall of questions)

Discussion in 'MRCP Forum' started by Guest, Apr 7, 2011.

  1. Guest

    Guest Guest

    Hi Drs,
    let us start collecting and discussing questions here.
  2. Guest

    Guest Guest

    Photographic

    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
  3. Kumar Mongar

    Kumar Mongar Guest

    .(1) CT scan Alcoholic fall & get head injury.
    a.SAH
    b.EDH
    c. Subdural h'ge
  4. Kumar Mongar

    Kumar Mongar Guest

    (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
  5. Kumar Mongar

    Kumar Mongar Guest

    (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***
    b. syncope
    c. single epilepsy
    d.TIA
  6. Kumar Mongar

    Kumar Mongar Guest

    (4) Family tree showing Breast cancer, ovarian cancer,, colon cancer. Ask the gene responsible
    a. BCRA 1***
    b. BCRA 2
    c. P53
    d c Myc
  7. Kumar Mongar

    Kumar Mongar Guest

    (5) Pt admit to ICU for sepsis, UTI,.......& stable. discharge to ward. get pneumonia. choice of antibiotic
    a. Meropenum & vancomycin***
    b. ceftriazone
    c. clarithromycin
    d. gentamycin
  8. Kumar Mongar

    Kumar Mongar Guest

    (6) Young man who has unprotected sex present with urethritis, conjunctivitis, arthritis. Knee jt aspirateshow G+ diplocci. Antibiotic of choice.
    a. ceftrixone***
    b. flucloxacillin
    c. ciprofloxacin
    d. erythromycin
  9. Kumar Mongar

    Kumar Mongar Guest

    (7) Girl works in pet shop. exposure to snake, fish, Birds. develop whezee & fever. Cause?
    a. Psitacossis***
    b. Mycobacterium aquarium,
    c. Allergic Bronchoaveolar
    d. Asthma
  10. Kumar Mongar

    Kumar Mongar Guest

    (8) Girl work as a Barmaid develop skin rash on dorsum of hand. See photo!
    a. Allergic contact dermatitis
    b. Psoriasis***
    c. lichen planus
    d. Herpes
    e. eczema
  11. Kumar Mongar

    Kumar Mongar Guest

    (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
    d. glomeruonephritis
    e.
  12. Kumar Mongar

    Kumar Mongar Guest

    (10) A question about TTP.
    DDx
    a. Haemolytic Uraemic $
    b. TTP
    c. TIA
    d. CGN
    Please correct questions!
  13. Kumar Mongar

    Kumar Mongar Guest

    (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
    c.
    d. CT
    e.
  14. Kumar Mongar

    Kumar Mongar Guest

    (12) Hyponatremia 125 not responding to fluid restriction. next step?
    Scenario of SIADH
    a. democycline***
    b. Desmopressin
    c. slow release sodium
    d. frusemide
    e.
  15. Kumar Mongar

    Kumar Mongar Guest

    (13) minor injury to shoulder followed by painful restriction of both active & passive movement (abduction) of shoulder. Cause?
    a. adhesive capsulitis***
    b. suprascapular tendonitis
    c. dermatomyositis
    d. PMR
    e.
  16. Kumar Mongar

    Kumar Mongar Guest

    (14) Old man, picture of skin lesion over cheek near ear. Nodule/ swelling of ear pinna. Dx?
    a. BCC
    b. SCC
    c. Bowen's ds
    d. Malignant Melanoma
  17. Kumar Mongar

    Kumar Mongar Guest

    (15) Old man, picture of skin lesion over cheek near ear. Nodule/ swelling of ear pinna. Dx?
    a. BCC***
    b. SCC
    c. Bowen's ds
    d. Malignant Melanoma



    Good luck
  18. Guest

    Guest Guest

    Nephrology
    1- obese diabetic with retinopathy and hypertension and ckd how to delay progression (stop smoking- wt reduction – 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
  19. MRCP2 2011

    Question about a girl with HSP who is well except for some proteinuria, joint ache -
    Q asks for initial management ...
    a) fluids
    b) paracetamol
    c) steroids

    Did you give her 'roids even though the question maintains how well she is ???
  20. drcool

    drcool Guest

    i chose paracetamol... cos the management of hsp is supportive
  21. OKO

    OKO Guest

    Q 12 not democycline but desmopressin , I think so
  22. MRCP2 2011

    Pt with PD whose co-careldopa got increased recently. Getting side-effects (can't remember what exactly but not great)
    Options were
    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
    a) donepezil
    b)rivastigmine
    c)memantine
    d)pyridostigmine

    Pt develops disinhibited behaviour
    Diagnosis?
    a) Alzheimer's
    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
    b) dysthymia
    c) bipolar

    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
    Likeliest diagnosis?
    a) atrial fibrillation
    b) atrial flutter
    c) PAF
    d) paroxysmal supraventricular tachycardia
    e) multiple supraventricular ectopics
  23. UKDoc

    UKDoc Guest

    Desmopressin is ADH Analogue. Not a good idea to give that in SIADH.
    Demeclocycline's a better choice
  24. Dr albarwari

    Dr albarwari Guest

    Hope all will pass inshaallah,,,although this was a very difficult long tricky exam

    for velocity_girl
    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
  25. Dr albarwari

    Dr albarwari Guest

    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
  26. sars

    sars Guest

    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

    tick typhus
    malaria
    dengue
    trapanosmiasis
    shistosomosisas

    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
    ct showed-
    bronchaiactasis
    extrenis allergic alveolitis
    someother options


    although ct scan appeared like bronchaictasis history seemed more like extrensi allergic alveolitis
  27. Dr albarwari

    Dr albarwari Guest

    girl who visited tanzania it was typical for typhus as there was black scar on skin
  28. paper3

    1 for att drugs,continue them as pt well and ast is not raised three times
    2 saline with honk
    3 osteomalacia
    4 pt with dka and mild ketones adjust insulin at home
    5 ogtt
    6 pictures pco
    leucocytoclastic vasculitis
    arnold chiari
    pancreatitis
    mycology scrapings? in pt who was a cook
    pagets with bowed legs
    8 iga nephritis
    9 PMLE
    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
  29. paper3

    rccarcinoma or testicular?with vericosities of testes
    2 germ cell tumor with increased igf and hypogonadotrophic hypogonadism
    3 carcinoid
    4 flucloxacillin.pt treated for skin infection and heapatic pic later
    5 nash with echogenic liver n taking chlorpromazine
    6 pancreatitis
    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
    16 pacing
    17 paroxymal svt
    18 myasthenia gravis
    19 mI TRANSTHORACIC ECHO
    20 TRACHEO MALACIA IN ENGINEER
    13
  30. PAPER3

    PACS
    hepc mesangicapillary
    nephrotic less than 5 percent
    ghb or lsd at party
    lorazepam
    nonsmall cell.palliative radio
    HRT flushing
    schistosomiasis in tanzania
    pls correct me.will most more later
  31. Dr albarwari

    Dr albarwari Guest

    Thanks sarah
    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
  32. Dr albarwari

    Dr albarwari Guest

    for nonsmall cell.palliative radio I think radiotherapy is CI as FEV1 was 25% I chose best care pallative
  33. Shez

    Shez Guest

    terrible exam guys...... :(
    cant even recall things prperaly and ones i should have done right ive made silly errors :( oh well.
  34. dr_aster

    dr_aster Guest

    Dear Albarwari..
    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)...
  35. dr_aster

    dr_aster Guest

    hai shez ,
    im Shahi000 here
    this time i am in a different name ...
  36. Dr albarwari

    Dr albarwari Guest

    Hi Shahi000 I like to continue with this name
    Hi shez
    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
  37. Dr albarwari

    Dr albarwari Guest

    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
    Diclofenac
    Methylprednisolone
    Sulphasalasin
    colchicine

    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
  38. Dr albarwari

    Dr albarwari Guest

    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
    Dissiminated malignancy
    factor 7 or 8 dificeincy

    could not remember more
  39. Dr albarwari

    Dr albarwari Guest

    for hypogonadotrophic hypogonadism
    there was pituitary mass prolactin normal other hormone normal normal calcium options

    non functioning pituitary tumor
    craniopharyngioma
    germ cell tumour
    sarcoidosis
    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

    Any opinion
  40. Dr albarwari

    Dr albarwari Guest

    for PMLE
    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
  41. Dr albarwari

    Dr albarwari Guest

    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
  42. feri

    feri Guest

    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
    :cry: :( :?
  43. Guest

    Guest Guest

    marzan

    regarding q in paper 3 prolactin was high so i think it is NON functioning pit
  44. feri

    feri Guest

    I THINK PRLOLACTIN WAS ELEVATED SO I SELECT NON FUNCTIONING PITUITARY ADENOMA
  45. Guest

    Guest Guest

    leave the prolactin other answers pls
  46. 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.
  47. am

    am Guest

    where are every one guys.. Please any one to list all msq he remember
  48. Guest

    Guest Guest

  49. r u sure?72 is a lot.
  50. 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?

    a)MAI
    b)M.TB
    c)Cryptococcus
    d)HHV 8
    e)CMV

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