mrcp part 2 written july 08,let us share our experience

Discussion in 'MRCP Forum' started by Abu kamal, Aug 1, 2008.

  1. Abu kamal

    Abu kamal Guest

    Salam,
    i think exam is very ticcky and tough also. :oops:
    let us share qs which help all of us.

    Picture first
    1) DARMATO MYOSITIS HAND PICTURE.
    2)ONE RH ARTHITIS
    3)NAIL MYCOSIS?
    4)ALOPACIA ARETA
    5)BASAL CELL CA??
  2. Guest

    Guest Guest

    ya all i have answered same
    what was that CT scan mas,spleen/kidney
    what was ECG showing inferior wall MI was that right coronary MI or aortic dissection
  3. Guest

    Guest Guest

    yes it was tough.......realy tricky and distractors ....
    answers GOD Help ALL and hope to pass

    these some topics of the questions not sure about ANSWERS :oops: :oops:

    -a long question about pulmonary embolism.
    -paracetamol toxicity and factors of bad prognosis.
    -chrionic gonadotrophine hormone with hyperthyroidism.
    -question about brucelosis or salmonellosis???
    -septic artheritis treatment in old lady.
    -malbsorption many many questions...????
    -paracetamol toxicity.



    MAY ALLAH LET US WITNESS THE HOLY MONTH RAMADJAN
  4. Guest

    Guest Guest

    experience

    please to who attend . give us ur exprience wat u miss to do befor exam . and you will pass en shaallah.
  5. Abu kamal

    Abu kamal Guest

    1)old mi pt present with syncope with st evevations in v1 to v4,cause
    vt
    2)rx. of above pt implantable defibrilator.
    3)ecg of hyperkalamia.
    4)feature of enfective endocaditis,tranthorasic echo normal,what to do next ans transesophageal echo.
    5)asd ecg
    6)burret oesophagus what to do ans proton pump inhibitor.
    7)esophageal ca,30 cm from endoscopic tube mark,what inv to do next,
    transesophageal ultrasonograp,or ct.
    8)coliac ds
    9)loose motion due to diabetic neuropathy,
    10)one diarrhoea with inv small bowel diverticui,what inv to do,ans deodenal aspiration culture,
    11)a chrons ds on prednisolon and metronidazol,again symtoms on stopping prednisolon what to do ans ?continue prednisolon,azathrio,eternecept???
    12)one middle 45 yrs man with altered bowel habit with hb 11,what to do,colonoscopy,
    13)one young female with altered bowel habit no wt oss,no other feature,menorrhagia,with anemia,what to do,reasure.
    14)ulcerative colitis pt with high alp,what to do,mrcp.
    !5)one interstisial nephritis due to nsaids,
    16)hepatitis c associated renal ds masengio capillary nephritis
    17)one 22 yrs women with 4 yrs h/o mild hirtusism,with merginal DHES high,most likely cause idiopaathic.
    18)one tia aspirin given add dypirimidol.
    19)bone scan multiple hot spot metastasis.
    20)one bone scan with increase uptake uniform in lower end of hand/leg bone HPOA?
    PL join all of u to share,
    thanks
    dr abu kamal
  6. dr mrcp

    dr mrcp Guest

    It was a terrible exam . Paper 1 is bad ,2 worst and 3vague .
    Brand new questions , never came across . this is my contribution
    1- pt with recurrent acute gout on allo given colch what t do with regard
    to allo crea 150 ? contiue the same ttt
    2- Af two times Flecanide
    3- Marfan ? Homocystinuria
    4-OSAP ?Narcolepsy
    5-Scabies ? Lichen planus
    6-Motor ND
    7 Korsa Wern three times
    8- Giardiasis 4 times
    thanks ,
    i need ur comments, What was the last pass mark
  7. al pirzada

    al pirzada Guest

    Hi,

    Thanks for posting questions for us. Please continue to do so.

    I have one question: after your experience of this exam what extra advice would you give to other people who are preparaing for part 2? What extra steps can we take to prepare better?

    Thanks
  8. dr mrcp

    dr mrcp Guest

    paper 1 :?: paper 2 a nightmare paper 3 scary????
    what to do... wish you the best..
    here are some
    1 pedegree li fraumini.. P53
    2 "" auto recessive
    3photo looser zone femur osteomalacia
    4MRSA wound ..dressing colloid..alginate gel..odour adsorbant?
    5ecg after coronary angioplasty.. infarction.. pericarditis
    6PKD with loin pain (atypical case)
    young asthmatic female eating in indonisean restaurant developed abnormal sensation in throat then suddenly BP70\0 and dificulty in breathing mx? im adrenaline iv h.cortisne....????
    7GBS
    8MND
    9CIDP
    10 giardia 2--4 cases
    11tropical sprue????
    12elderly with pneumonia chlamydia!??!??!!?
    13leptospirosis very atypical case
    14a young washing the water tank developed bloody diarrhoea ( salmonela.. shigella ..brucellosis ??
    15 middle aged worked in saudi arabia high s. calcium DX milk_alkali
    16csf high protein in elderly worked in subsaharan africa ..neurosyphilis
    17 pt undergone myelosuppresion will have BMT developed throbbing headache MRI spine ....DX??
    18Pt with PD features & dementia what to give for the dementia?
    :twisted: :twisted: :twisted:
  9. Indian Guru

    Indian Guru Guest

    MRCP question

    1. CIDp
    2.VT post MI
    3.hypocalcemia
    4.amyloidosis in a alcoholic
    5.post exposure treatment of Hep C- storage of blood
    6.Marfans syndrome
    7.Tuber sclerosis pic- warty lesion with family history of epilepsy
    8.Botulism
    9.Cervical myelopathy
    10.PCP prophylaxis with fludarabine therapy
    11.Acute ITP in young girl- ? no investigation/? monospot
    12.Acute otitis externa not responding to amoxicillin- ? pseudomonas
    13.Murmur with aortic dissection
    14.Bone scans- ? metastasis/ pagets
    15. ? HOPA
    16.dermatomyositis
    17.systemic sclerosis
    18.Pernicious anemia
    19.Autonomic neuropathy- one question in Diabetes causing diarrhea,
    20.other causing pedal oedma
    21.Management of warfarin overdose- INR >1o, minor bleed- oral vit K
    22.Fact VIII inhibitor
    23.Treatment of leptospirosis- benzypenicllin
    24.treatment of schitosomis- praziquental
    25.Nigrian boy with cough, fever, night sweats, lung fibrosis and lymphadiopathy, HIV pending- TB
    26.Methaemoglobulin due to drug in PCP
    27.Treatment of dememntia in parkinson
    28.Man with chest pain on playing squash lasting for 15 min 12 hours ago, ECG fixed T invesion in V4-6, Trop T 0.17- ? unstable angina, ? musculoskeletal CP
    29.Man with ischaemic chest pain with normal ECG- ? repeat ECG in 30 mins, ? admit and 12 hour trp T
    30.Elderly lady with raised TRop T due to Chronic renal failure
    31.Acute pancreatitis CT scan
    32.Renal cell ca CT scan
    33.Wegner granlumatosis- chest pain, SOb, haemptysis and nose bleed, CHest x ray showing cavitory lesion
    34.Retired foundary worker with CAP- ? blood cullure will show causative investigation
    35.Rhematoid hand pic
    36.licun planus
    37.Oral ulcer with blister on face and trunk- pemphigus
    38.Acclerated hypertension with axiety in a middle age women treatment- ? oral Atenalol
    39.ECG of VT
    40.PE in a post surgical lady- Hypoxia, hypotension, chest clear and JVP 20 cm raised
    41.Rhabdomyolysis in post surgical lady
    42.HIT treatment- change to danaparoid
    43.Man with bloody diarhea with history of travel, Colonoscopy s/o colitis- ? schistosomiasis
    44.ECG OF RBBB
    45.Malignancy pericardial effusion due to breat ca- Chest x ray
    46.CCF post 3 years in lady with radiotherapy and chemo for breast ca- Anthracylin effect
    47.40 year old with chest pain, ECG s/o LVH, uncle had sudden death- Beta blocker treatment
    48.Ritinitis pigmentosa fundus- causes night blindness
    49.Ciclosporin toxicity in post transplant guy due to flucanozole use
    50.CMV infection in post tranplant person
    51.Crohn disease with steroid dependence- start steroid sparing agent ie azathioprine
    52.crohn disease treated with surgery and no active disease presented with diarrhea and fe deficiency- all investigation normal apart from lymphocyte infiltrate
    53.on duodenal biopsy- coeliac disease
    54.as above but only diarrhea, no anemia, normal investigation- bile salt induced
    55.renal stones due to familial hypercalciuria- treat with thiazide diurectics
    56.Lady with chronic abdominal pain and diarrhea with VIt b12 deficency- crohn disease
    57.aspirin toxicity
    58.anorexia nervosa lady with refeeding syndrome with no choice in answers

    59.lady with fe deficiency and jejunal diverticulas- investigation is culture of aspirate
    60.photos of oncolysis- ?oncomycosis, ? psoriasis
    61.Alopecia arerta pic
    62.Post angioplasty of LAD patient presents with chest pain ECG s/o inferior wall MI- Occlusion of dominant Right coronary
    63.MEN2a
    64.Treatment of amiodarone induced thyrotoxicosis- carbimazole
    65.Lady with hyperthroidism on high dose carbimazole and thyroxine get pregnant- reduce dose of carbimazole and stop thyroxine as euthyroid
    66.Maligant hypertension with nephrotic syndrome- investigation of choice- renal biopsy as likely glomerunephritis
    67.Malignant hypertension with low albumin ex- investigation of choice- renal agio
    68.Hep C with nephrotic syndrone mesecapil GN
    69.HIV with symptoms of meningitis, CT normal, CSF s/o high protein, low glucose and lymphocytosis- cryptococcus menigitis
    70.HIV with toxoplasma
    71.Asain lady with h/o TB presents with seizure, CT s/o calcified lesion which is enchance with contrast- ? tuberculoma, ? mennigioma
    72.Rhematoid pleural effusion- High protein and very low glucose
    73.nephrocalcinosis of kidneys
    74.
    75.Guy with DM, hypogonadisn, low pituatary hormones- Haematochromosis
    76.GUy with wilson disease
    77.p53 genetic disorder
    78.Autosomal dominant with incomplete penetration pedegree chart
    79.Superior temporal branch ofopthalamic artery TIA- inferonasal visual defect, start dypridamole as on aspirin
    80.multiple myeloma case- chest pain with rib tension, renal failure, anemia
    81.lady with diarrhea, breathlessness and eosinophilia and hence hypereosinophilic syndrome and cause due to ascaris
    82.pregnant lady with Herpes infection- monitoring during 3rd trimester
    83.ECG of af with rapid ven rate and echo showing Dilated LA and LVH and hence rhythm control unlikely to be effect and hence control with verapamil as asthma and hence no B blockers and other were for chemical cardioversion
    84.Warfarin in cardioversion- 4 weeks before and atleast 4 weeks after
    85.Which investigation is must in a lady with suspected sarcoidosis- HIV
    86.Treatment of septic arthiritis
    87.lady with swollen wrist and X ray of wrist- ?
    88.Lady with load of CVD history started on lisinopril presented with GI Bleed- caustive drug is aspirin
    89.guy with HHT
    90.hepatopulmory syndrome in cirrhotic patients
    91.which is the most important prgnostic factor in GI bleed- cardiorespiraty comorbidities
    92.Lady with NYHA 3 heart failure on diurectics and ACEI- next step ? Beta blocker ? Spironlactone
    93.Flashing pulmonary edema patient on ACEI with repeat attack, ECHO s/o LVH, Mod MR- ? RAS
    94.Peritonitis due Peritoneal dialysis catheter- Stap epidermis
    95.Female with toxic shock syndrome- Investigaiton would be vaginal swab
    96.Insulin dosage changes with pateint with morning hypos- decrease evening isophane
    97.some question on giardiasis
    98.basal cell carcinoma X ray
    99.slide of lymphocyte infiltrate on bowel- coeliac disease
    100.Parcetamol poision- most important investion- already had INR, LFT and hence answer is ABG
    101.Serotonin syndrome
    102.ECG of hyperkelemia
    103.Reflux oesphagitis with H Pylori positive- H Pylori eradication
    104.Transeosophageal echo for ? Infective endocarditis Normal TTE
    105.MRSA dression- absorbant
    106.MRSA in sputum in a person getting better on amoxiclav in VAP- ? What treatemnt
    107.Intestinal nephritis
    108.Dementia with argyl robertson pupil- neurosyphilis
    109.Nhl post salvage chemo- Oral steroids as MRI s/o meningitis due to chemo/radio/disease
    110.Milk alkali syndrome
    111.asthma lady in indonasian lady develops anphylaxis- IM adrenaline
  10. Abu kamal

    Abu kamal Guest

    thanks indian guru

    thanks indian guru for 111 qs posting and waiting for more from u.you r really guru.
    dr kamal
  11. Guest

    Guest Guest

    MRCP question

    The exam was horrible, paper- I (bolt from the blue), Paper -II(new questions), Paper-III(vague with plenty of red herrings)

    Few I remembered.

    1)Person with otitis externa, inflamation spreading in-spite of fluclox, organism -- pseudomonas.

    2)Pregnant lady with painful vulval ulcers, invst--HSV-II positive. What will be your advice to her--- a) acyclovir in 1st trimester, b) acyclovir in 3rd trimester, c) advise CS,--- I marked CS.

    3)20yrs male with abd pain/?diarrhoea, no previous hist, not on any med, cousin had parkinsonism, blood tests, altered LFT, low hb, diagn-- wilsons

    4) 75yrs lady in a nursing home, carers found to have a sacral sore with plenty of slough on the base and the surrounding skin to be masserated. Choice of dressings-- a) hydrocolloid gel, b) hydrocol, c) alginate , d) absorbant cotton

    5)Patient with two family hist of cancers of different types. What is the possible gene defect in the family -choices were- a) BRCA, b) p53, c) APC

    6) 50yrs old Jamaican lady who migrated to UK around 20yr of age, presented with lethargy and breathlessness. She has never been out of UK, no hist of travel, no prev med hist. blood showed eosinophil- 1.5, cxr- normal. I marked ascariasis.

    7)Picture of a rheumatoid hand of a lady, what is the common complaint of the lady.......... can remember only one choice......enthesitis.

    8)Picture of a CT scan of a patient who had recurrence of breathlessness, after being successfuly treated with inhalers........ ans ?thymoma

    9)A patient on Fludarabine for CLL, what treatment prophylaxis will you advise for the patient...... Co-trimoxazole.

    10)picture of a pelvic x ray of a lady with hip pain.......... #left ischium.

    11) Picture of a lady with lesions over forehead, her daughter, 3yrs old, had similar lesions recently.................. molluscum contagiosum.

    12) A patient diagnosed with TB, contact tracing of his girlfriend who was present with him 3 months ago showed a heaf test reading of 11-14.CXR- normal. What will be your advice to her..a) full anti TB treatment, b) Rfmp & INH for 3 months, c) repeat CXR in 4 weeks, d)reassure.

    13) A patient with itchy lesions, used 1% hydrocortisone creame, which made some relief temporarily, but recurred...... picture showed ? lichen planus... management.......... more potent steroids.

    14) picture of hands -- ?systemic sclerosis

    15)ECG of asymptomatic pregnant lady -- ASD ostium seccundum

    16) ABG- met acidosis with resp alkalosis -- aspirin toxicity

    17) Chest pain with ECG- WPW syndrome- Rx- beta blocker

    18)Pt with pace maker, collapses while brushing his teeth, ecg during the episode shows no pacing spikes but irregular rhythm-- Dx- pace maker myoinhibition, pace maker lead fracture, .....

    19)Lady with 1 yr hist of rash , not cured with antifungals Dx- granuloma annulare

    20) treatment of schistosomiasis

    Picture questions.

    21)#left ischium

    22)CXR- multiple mets

    23)CT scan abd- liver ?hemangioma

    24)CTscan thorax - thymoma

    25)picture of lichen planus

    26)picture of molluscum contagiosum

    27)rheumatoid hand

    28)scleroderma

    29)ecg- myocardial infarction

    30)Poor prognostic factor of AS- associated AR

    31)post hemicholectomy patient for chron's disease, with low hb and mcv. endoscopy normal but lymphocytic infiltrates in the biopsy--- tropical sprue/coeliac/bacterial overgrowth

    32)Aorotogram showing Takayasu's disease

    33) picture ---Basal cell carcinoma

    34) picture --Allopecia areata

    35) ECG- showing inf MI in a patient of post MI angioplasty of LAD with drug elluting stent----- Occlusion of RCA.

    36)A lady with altered LFT, having transaminitis -- paracetamol poisioning

    37)A lady of South African origin with lethargy, having blood and protein + in urine. other invst normal. Diagnosis ----- Scistomiasis

    38)An elderly man with blood & protein in urine, raised U&E, kidney USG normal, next plan of action ---- cystoscopy.

    39)A tall man of 197 cm height, his mother 191cm, father 195cm, has got a systolic murmur at the lower left sternal edge, diagnosis --- ?marphans

    40)A lady with hot swollen left knee, aspiration- yellow coloured fluid with plenty of neutrophils, treatment --- IV cefotaxime

    41)A man with Hep C CD4 count low, low viral load, on ribavarin & pegylated alpha interferon, came to the clinic. Nurse had a needle stick injury, washed her wound with water. presented to the A/E after an hour, plan of management -- Send blood samples of the lady.

    42)AF patient on amiodarone, TFt- thyrotoxixosis with ow uptake - Rx- thyroidectomy

    43)Patient with low platelets and nose bleed, +ve family hist, treatment- tranexamic acid

    44)patient with hip pain, Indian in Uk for 40yrs, treatment-- ergocalciferol

    45)Rapid onset dementia with hallucinations-- Charles bonnet syndrome

    46)Skull x ray - acromegaly

    47)ECG- hyperkalaemia

    48)Asthma patient received treatment from GP for chest inf , now having seizzures- ciprofloxacin

    49)Patient with breathlessness, BP 70/52, on adm sats 68%, in A/E 40% oxygen provided, resp rate improved a bit, sats improved to 82% but still breathless. Whats the next immediate management---- start on colloid

    50)patient's chart provided of blood sugar from mon to friday, morn,lunch, eve, bed time. What change will you make --- decrease bed time insulin

    51)Patient with altered LFT, exam shows ascitis, with exudative ascitic fluid. What is the organism involved -- Enterobactericea
  12. saara

    saara Guest

    Here are few questions,paper was tough…..sanjay sahrma was very helpful ,onexamination very few questions asked . any corrections are welcome….
    1. ECG-Hyperkalemia,VT,
    2. Lady with ecg RBBB with LAD,DX-ASD
    3. ECG- Pacemaker with pause
    4. Pt with old MI underwent angioplasty ,now comes with IWMI,---Occluded RCA stent
    5. Herpes pt pregnant,how to prevent transmission of infection to child--????give acyclovir during 2nd and 3rd trimester
    6. Pt with heart failure with ascitis-----spironolactone
    7. Pt with dilated cardiomyopathy with AF-??
    8. ABG with metabolic acidisis with resp alkalosis—aspirin
    9. MRSA ---Vancomycin
    10. farmer with h/o lepto---benzylpencillin
    11. pt previously underwent orchidoplexy now comes with cxr s/o mets---inv-USG testis
    12. pt with renal failure,laryngeal involvement with pulmonary involvement in CXR –inv ANCA
    13. Pt with asthma with eosinophilia-Churg straus
    14. pt on statin now comes with myopathy with increased creat---statin induced myopathy
    15. photo showing butterfly rash-inv ds dna
    16. Bone scan with mets
    17. bone scan of lower limbs-?HPOA
    18. CXR-lung mets
    19. Restrictive lung disease with increased KCO-benign pleural plaques
    20. symmetric involvement of limbs without sensory involavement with CSF showing albuminocytological dissociation-CIDP
    21. pt with sudden onset of backpain with weakness of both limbs with bladder involvement ,but sparing of post column sensation-?transverse myelitis/Spinal cord infarction
    22. ulcers with painful inguinal lymph nodes-chlamydia
    23. pt with UC now with obstr jaundice-inv MRCP
    24. Pt with repeated falls,day time somnolence-narcolepsy
    25. treatment of above –modafinil
    26. VT Mx-lidocaine
    27. pt on HD with proteinuria-amyloidosis
    28. Pt with fever after transplant kidney—CMV
    29. Pt with COPD-inv-spirometry for reversibility testing
    30. prevention of above—stop smoking
    31. pt with decreased wt,apetite.hypertriglyceridemia-anorexia
    32. Pt with tall stature(1.93m)both parents tall,normal testosterone--?Familial
    33. pt with Hypertension,hypokalemia,increased rennin and aldosterone—RAS
    34. pt with pulmonary edema,HTN which is increased after ACE inhibitor---RAS
    35. Pt with increased Ca,Increased blood sugars,underwent thyroidectomy previously---MEN type 2
    36. Pic—scabies
    37. Pics of hand,proximal muscle weakness—Dermatomyositis
    38. CXR-antracycline induced cardiomyopathy
    39. Pt on HD with anemia,angina---blood transfusion
    40. young lady with eosinophilia—Ascariasis
    41. Pt with fever ,leucocytosis,arthralgia,rash since 6 months---adult stills disease
    42. drug induced methemoglobulinemia
    43. pt with high plasma osmolality and low urine osm-Diabetes insipidus
    44. pt with SIADH on fluid restriction—next step demeclocycline
    45. Takayasus arteritis
    46. RA hand pic----involved with metatarsal involvement
    47. pt with CLL on fludarabine---cotrimoxazole
    48. pt with copd on theophylline,given antibiotic recently,drug precipitating seizure---ciprofloxacin
    49. exudative pleural effusion with very low glucose---Rheumatoid
    50. CIDP
    51. MRI spine—vertebral mets
    52. mri of comprsive spinal cord---steroids
    53. CT abdomen—Renal cell ca
    54. Ct abdomen-nephrocalcinosis
    55. fundus s/o optic neuritis.old h/o stroke,afferent papillary defect—Multiple sclerosis/neurosyphilis
    56. pt with diplopia on moving towards left,decresed movt of rt eye towards left and slowin move while lookin right---????
    57. Venous ulcer—ABPI
    58. pt with hypocalciuria with hypocalcemia—bendroflumethiazide
    59. Saudi pt with increase ca and decreased PTH—Milk alkali syndrome
    60. CXR-mets
    61. pt with IgA nephropathy on ACEi ---high steroids
    62. pt with gout on sodium aurpthiomalte with proteinuria-2.6g/d----gold nephropathy
    63. ring enhancing lesion--tuberculoma
    64. pt with steroid responsive CD-give steroids
    65. CXR-anthracyclin induced cardiomyopahty
    66. pt post partum now comes with fever and shock---causative agent staphylococcus
    67. pt on peritoneal dialysis with increased sugars ----?because of decreased excretion of gliclazide,insulin????
    68. peritoneal dialysis infection---staph epidermidid,E.coli
    69. pt with otits externa,not responding to amox-pseudomonas
    70. pt with nasal discharge in past with meningitis with increased CSF TC and decreased sugar-bacterial meningitis
    71. pt with subacute meningitis—TB meningitis
    72. pt with HIV with cd4 50 .with meningitis---cryptococcal
    73. pt with epistaxis with decreased plt count---tranexamic acid
    74. pt with normal anion gap with calculated plasma osmolality less than that of serum osmolality----methanol toxicity
    75. pt with acute gout on allopurinol-----stop allo
    76. pt with pain in hands following fall---Xray of hand----HPOA/Pagets
    77. pt with normal ca ,increased ALP,Hip Xray-------Pagets
    78. pt with decreased ca, increased PTH----osteomalacia/pseudohypothyroidism
    79. pt with normal ca on fluids----pamidronate
    80. pt with depression with urinary incontinence-----?oxybutinin
    81. pt with bilateral gynaecomastia,with orchidoplexy for undescended testis----inv HCG
    82. pt with liver abscess---entamoeba serology
    83. pt with decreased LVEF with AF---Digoxin
    84. pt with transaminits with raised immunoglobulins---autoimmune hepatitis
    85. pt with acute pancreatitis------first step—supportive care
    86. ct abdomen—acute pancreatic\
    87. Ct abddo—Renal cell ca
    88. Abd Xray—nephrocalcinosis
    89. pt with infertility,bronchiectasis---immotile cilia syndrome
    90. pt with fever,night sweats-8 weeks with sputum gram stain negative---sputum for TB
    91. one more similar Q
    92. pt with COPd ,thing which improve prognosis---?sterois/B agonist
    93. pt with legionella with hypo natremia---fluid restriction
    94. tennis player with chest pain with ecg normal with raised trop---NSTEMI
    95. pt with aortic dissection with IWMI---beta blocker
    96. pt with stroke on asprin—give dipyridamole
    97. pt on carbamazepine with pancytopenia with raised vit B12---?pernicious,aplastic
    98. pt with asthma with sever acidosis----intubate and ventilate
    99. ABG with resp alkalosis
    100. pt with GERD ---PPI
    101. pt with acromegaly----oral GTT with insuin
    102. pt with hair in face only----idipathic
    103. pt with diazepam with dihydrocodeine abuse----give oral methadone
    104. Pic-molluscum contagiosum
    105. pt with h/o syncope/seizure---echo,ecg normal.next step----EEG
    106. pt with adenocarcinoma stomach--?ct chest and abdomen
    107. pic---avascular necrosis of humerus
    108. pt with odynophagia---showed candida----give fluconazole
    109. 20yr male with stroke ,mother has anemia.sister similar problem---HHT
    110. severity of AS ---symptomatic LVF
    111. severe AS treatment—Aortic valve replacement
    112. pt with alternating constipation with diarrhoea,sigmoidoscopy normal,father had ca colon at 65 yrs—next step---colonoscopy
    113. diabetic wih neurogenic edema,
    114. diabetic induced intestinal neuropathy
    115. pt on HD ,inspite EPO is stopped Hb is increased---inv-renal USG
    116. pt with hepairin induced thrombocytopenia---stop hep and start danaparanoid
    117. pt with NSAID induced bleed---prognostic---h pylori positive/cardio resp involvement
    118. pt on endicarditis treatment comes with fever,ECG prolonged PR ---inv—TOE
    119. half and half nails—hypoalbuminemia
    120. pt with pulmonary involvement,wheeze,renal involvement---Inv-ANCA
    121. churg straus syndrome
    122. pt with sudden onset of pain starting in neck radiating up—glossopharyngeal neuralgia
    123. Pt with bronchictasis,eosinophilia,asthma----next step CT chest/S ppt for aspergillus
    124. pt with DM with repeated UTI with reanl failure-----strict glycemic control
    125. FAT embolism
    126. pt with overnight dexamethasone suppression negative----next step--?24 hr urine cotisol
    127. pt with encephalopathy---inv blood glucose
    128. pt with angioedeam after eatin in restaurant---im adrenaline
    129. pt with horners with involvetn of small m of hand-----cervical myelopthy
    130. exudative pleural effuson with very low glucose—rheumatoid
    131. pt on venlafaxine now comes with rigidity ,fever –serotonin syndrome
    132. obese pt on wt management since 1 month comes for follow up----next step reassure
    133. pt with h/o brown sequard syndrome ---spinal meningioma
    134. schistosoma—praziquentel
    135. pt with dementia with parkinsonism—MMSE 19/30---memantine
    136. warfarin in cardioversion----4 weeks before and atleast 4 weeks after
    any clarifications are welcome,pray to almighty so that he passes everybody,,inshaallah
  13. drAA

    drAA Guest

    SOME MORE Q

    HI :cry: ....paper 3 was tough and actually all were a big source of mental torture.dont know why they have 3 papers....why not 2 ??

    1-a lady after travel skin rash and pancytopenia.......erythrovirus
    2-a male with metoclopramide induced DYSTONIA
    3-A PT WITH bOTULISM
    4-TREATMENT OF IDEOPATHIC PUL FIBROSIS....azathioprine
    5-a picture of kaposi sarcoma
    6-treatment of prolactinoma....bromocriptine
    7-a homosexual male with bloody rectal discharge...gonorrhoea
    8-the pt with pressure sores...ideal dressing...alginate initially and then hydrocolloid
    9-the ring enhancing lesion in HIV pt is toxoplasma i think
    10- 8) cant remember more...i'll try

    best of luck to everybody .I sat in saudiarabia and the timings are really odd for the exam there.....it was tiring....hope we all pass...bubyee
  14. Abu kamal

    Abu kamal Guest

    Thanks for posting a lot of qs.

    1)hyporenimic hypoaldestoronism cause diabetis mellitus.
    2)CRF with high phosphet which food content high phosphate banana and orange or fruit juice?
  15. Abu kamal

    Abu kamal Guest

    thanks dr saara for posting

    salam,
    thanks dr saara for qs posting.
    i agree with u in most qs only few quarry.
  16. Abu kamal

    Abu kamal Guest

    what will be pass mark?

    can any one geuss wtah will be pass mark this term,
    I think it will be around 58%
    last 3 session it was around 54%
    thanks to all
    dr kamal
  17. guest1

    guest1 Guest

    pass mark

    dont think it will go above what it was from last few times as the papers were really tough! 58% is a bit too high, at least that`s what I think. 55-56% will be more like it. anyway, when the paper has been given, lets not fret over the marks and pray to the almighty that we pass.
  18. saara

    saara Guest

    u r welcome kamal.
    wen r u xpecting results.
  19. Guest

    Guest Guest

    I can't believe that the pass cut-off percentage will go higher this time. I felt the questions to be very difficult and you could argue with the answers of most of them , since the choices were very near and the question stem was extremely important for a perfect answer.

    Anyway, hope all of us pass. Thanks to all who have contributed the questions. If you could remember more please do post, also try to remember the choices/full stem of the questions now.
    I will update as and when I remember more questions.
  20. guest1

    guest1 Guest

    mrcp 2 july 08

    MRCP website says they will post the results in the week starting 25th august
  21. Dr Iraq

    Dr Iraq Guest

    hi

    Good day every one,
    I think that paper one was the hardest, and paper three was the trickiest

    too many Qs about chronic diarrheas with defferent tricks for the solutions
    low ferritin=celiac dis , travel hx=traveller sprue, lymphocytes infeltrate=celiac(even without villus atrophy)
    Qs about drugs and therapeutics were tricky also, includes effects of fluconazole on cyclosporin, ciprofloxacin on aminophylline, serotonin synd. in venalfexine, methemoglobinemia in dapsone use, a hidden upper GI bleed in pt using asperin presented with postural hypo and low Hb, pt who is liable for azathioprine toxicity due to low purine metabolizing enzyme so you have to choose another option to treat crohn's disease(methotrexate), treatment of hyperthyroid in pregnancy where block and replace strategy is unacceptable(stop thyroxin and reduce carbimazole)

    Qs of cardiology were acceptable, pt with post MI unresolving ST elevation where vetricular aneurysm is suspected presented with fainting attack(possible arrhythmia VT) -two Qs in same case. only one Q on cardiac catheter data(surprisingly), ECGs were easy to interpretate(hypoK, VT, Inf. MI, WPW), again many Qs about studies of drugs affecting prognosis in cardiac disease and c/i of cerain drugs such as flecainide

    picture Qs were tough! many CTs and MRIs that I dont know the hell about, there were pics of: retinitis pigmentosa, central retinal vein thrombosis, hypothyroidism, repture biseps tendon, descoid lupus, dermatomyositis hand, dactylitis hand, RA hand, two bone scan with gamma camera!!, many x-ray pelvis, nephrocalsinosis, CXR:pericardial effusion, pleural mass, cannon balls,mucle biopsy in juvenile polymyositis, alopecia aeriata, onycholysis(dont know the cause)


    ABGs were hard to interpretate:near normal PH with very high HCO3=mixed metabolic acidosis and alkalosis, mild acidosis with very low bicarbs and very low pCO2=mixed metabolic acidosis and resp alkalosis(asperin), there was a normal anion gap resp acidosis, ...etc

    endocrine Qs: many misleading data(why he sends dexa supp test in pt with low cortisol level!!), type 2 amiodarone reaction hyperthyroidism(thyroiditis with low iodine uptake) give potasium perchlorate
  22. guest 1

    guest 1 Guest

    mrcp2 july08

    Most of the questions were tricky. Its Type 1 AIT which is treated with perchlorate; type 2 AIT is treated with steroids.
  23. dr mrcp

    dr mrcp Guest

    pass mark would be 50--51.5 :evil:
  24. Abu kamal

    Abu kamal Guest

    few explanations

    dear dr sara,
    i agree most of u but few ??
    1)SIADH pt na+ 108,pt was drowsy and sign of fluid over load,so i think it would be hypertonic salaine,pl,comment on it every one,may be i forget the qs.
    2)one qs about pneumonia,pt improving that mean became apyrexial with iv amoxicillin and clarithromycin, culture report shows methicilin resistant staphylococcus what to do,
    my ans was as pt improved clinically( why we look for labratory report as u done in ward,)so change to oral amoxycillin.pl comment..
    Ressult may be available in 22 in web page.
    pl join every one in this discurssion.
    i think around 180 qs already posted here.pl come on every one for next 80 to 90 qs.
    hi ,indian guru,where r u?
    thanks
    dr abu kamal
  25. drmsa

    drmsa Guest

    mrcp 2 july 2008

    hi,1/ about diazipam withdrawl symtoms to give iv lorazipam ,not methadone 2/ about pt with severe pulmonary embolism ,not to give iv heparin , to give ateleptase 3/ pt with active crhons disease to give methotrxate ,because of low purine enzyme causing toxicity with aza
  26. saara

    saara Guest

    I agree with you dr kamal with regards to MRSA.
    In SIADH Fluid restriction is first step.howeveer in symptomatic pt Hypertonic saline should be given.we should correct only half of the deficit.So I really am not sure about the answer.
    one more question-LEMS is ass with ca channel antibodies
  27. abeed

    abeed Guest

    THAT WAS NICE , Saara
  28. Guest

    Guest Guest

    I disagree, sarra
    22- Genital with painful LN= HSV ttt antiviral + swab
    24-OBSA coz obesity + snoaring +somnalence Narcolep withou catplexy
    paralysis explained by arrhyhmias
    32 Homocystinuria ? famililial how could u explain the myopia and sysolic murmur NOT marfan both parent are tall = recessive marfan is dominant
    49 tb effusion ph is 7.3 in rheuma ph lessthan 7.2!!
    73- plt tranfusion plt 20 + epistaxis
    82-pancertitis +dilated cbd GOdierctly for ERCP new guidelines
    thanks
    abeed
  29. abeed

    abeed Guest

    Furthermore,
    75- Continue allopurinol answer a? GO FOR BNF gudeline q 1 in paper 3
    107- tb arthritis have noticed indian , eaten margins ,an other clues.
    98- asthma +acidosis = Doxapran
    119- Onycomycosis
    122- trigeminal neuralgia
    Sarra may be am wrong this is mrcp . i need to see ur comments
    More questios,
    a-LFT = Obesity
    b-ABG = met acidosis and met alkalosis paper 1 vomiting + alccohol intoxication
    c- three qs in giardiasis
    d - three in vern Enceplalopathy.
    thanks,
    abeed
  30. dramr4

    dramr4 Guest

    SIADH

    Dear Dr. Saara & Dr. AbuKamal ,
    As regards ttt of SIADH , confusion is not considered as an indication for giving saline . It is given for more severe symptoms e.g. convulsions . So, the right answer is fluid restriction .
  31. dramr4

    dramr4 Guest

    As regards the Q of an over wt pnt with BP 130/80 , depression & IBS with diarrhea (on Loperamide) , the right choice is SIBUTRAMINE . Orlistat causes diarrhea & Rimonabant may cause depression as a S/E .
  32. 121

    121 Guest

    Sibutramine also causes depression.
    As wt ZLoss was adequate on diet so ans was Nothing
    Also Orlistat is used if more than 10 Kg wt loss occurs during 6 mnths
  33. dramr4

    dramr4 Guest

    Sibutramine does not cause depression , but increase BP , flushing , serotonin syndrome , if given with SSRIs .
  34. drosama

    drosama Guest

    dear dramr4,

    Regarding overwieght mngt... you would not start anti-obesity ttt unless the patient is involved in "supervised wt reduction for 3 months"!! the patient in the exam managed to lose < 2 Kg in 1 month. so I think the correct answer was: None (Check BNF anti-obesity)
  35. drosama

    drosama Guest

    SIADH.. already on fluid restriction... I think one should start demeclocycline
  36. saara

    saara Guest

    thanks for your opinion dr abeed and guest
    75) and 22)I agree with you
    24)This pt has day time sleepiness more during afternoon.symptoms improve after brief nap.cataplexy is muscle weakness leading to partial or complete collapse.main thing is consiousness is not impaired.in arrythmia ass syncope it may be asss with loss of consoiusness(refer-Q67 Sanjay sharma)
    32) still confused
    49) this pt has low pleural fluid glucose.this was repeat question from onexamination.according to onexamination causes of low glucose on pleural fluid is RA,lupus,malignancy,esophageal rupture and TB.lowest glucose is seen in RA and empyema.hence answer is RA as empyema was not in option
    98)doxapram is no longer used in management of COPD.here pt was drowsy with ph very low.hence he needs intubation and ventilation(refer-Q370 sanjay sharma and onexamination)
    82)this pt had history which was suggestive of liver abscess.there was no option for USG.hence i chose entameba serology
    122)in glossopharyngeal neuralgia pain originates from throat .in some it may be localised to ear or radiate from throat to ear because of involvemnnt of tympanic branch of IX nerve.in trigeminal neuralgia pain will be in lips ,gums,cheek and chin.this pt had pain in throat(refer-pg2437 harrison 116th edition)
    119)in onychomycossis pt may have thick nails,pitting with partial loss of nail.this pt had half and half (Half white and half normal)nails seen in CRF and hypoalbuminemia
    regarding epistaxis i could not get any satisfactory answer
    pt who is overweight --do nothing
  37. dramr4

    dramr4 Guest

    Dear Dr. Osama , u r right about the obese pnt , but there were 2 Qs of SIADH , 1 was Demelocycline , as u mentined . The other was fluid restriction as the best choice .
  38. Abu kamal

    Abu kamal Guest

    thanks to all for joining discurssion here.

    thanks to all.
    but where is the new qs?
    pl try to post as much qs as possible.
  39. Guest

    Guest Guest

    Saara,
    1- A q about preg young lady nausea , vomiting abd discomfort , occp ,
    ex bp normal jaundiced tender hep +mild ascites lab low plt
    high lfts proteinuria ++ whatv was z diagnosis ? Not anaemic
    ? RUPTURED Adenoma hellp very tough
    the pass mark will be 49-51%
    dr abeed
  40. drosama

    drosama Guest

    there was one psychiatry Q: male with suicidal attempt. what factor determines that his next attempt will be successful? Ans: his gender
  41. drAA

    drAA Guest

    1)- the q about pregnant lady ....answer acute fatty liver of preg...the platelets were normal BP was nomal
    2)--the q about which factor determines future suicide attempt in male is....the suicidal note he left behind..
  42. saara

    saara Guest

    Dear guest
    Ectopic pergancy may be possible.HELLP unlikely as there is no anemia and usually it occurs during peripartum period.if this pt had fever and hemolysis with normal APTT and FDP we could have thought of HUS .if ass seizures TTP.if APTT prolonged with increased FDP and decreased fibrinogen it may be DIC.
    Male pt with suicidal attempt-I think answer is his suicidal note.
  43. dr abeed

    dr abeed Guest

    The pt with succide attempt ,i choose he actually took a potentially
    lethal dose 32 tabs paracetmol ....succidal note !! may be he change
    his mind after that !!! Go to Kumar ...this is mrcp !!!
    a Q about amnesia is it factitious !!
    a Q alcoholic cardiomyopathy ,
    Continue till z result , i started prepairing 4 dec exam !!!
    Dr abeed
  44. bilal 74

    bilal 74 Guest

    part 2

    hi all,
    1-pregnant lady:fatty liver changes..
    2-stone in the pancreatic duct,asking about (immediate management),:supportive therapy.
    3-suicide:gender>
    4-painfull swallowing;candida..
    5-hypertension(malignant):nitropresside.
  45. bilal 74

    bilal 74 Guest

    more qS
    young boy with depression:fluxitine
    old man with depression :citalopram..
    one q<about PAN.
  46. Abu kamal

    Abu kamal Guest

    hi,

    pl more qs.

    a new idea, :twisted: :twisted:
    i went for mrcp 2nd part written form fill up for next diet via online through my account .it shows the following massege.

    * These services are currently not available for the MRCP(UK) Part 2 Clinical Examination (PACES).
    i am asking other friends ,pl do it via online account and share with us

    sorry for silly idea.
    dr abu kamal
  47. drAA

    drAA Guest

    So now how many questions have we compiled up till now? .....pls can anyone explain the new regulations of MRCP2 Paces and written...any number of attempts can be taken probably from 2009?...but for example if we pass this july exam ....then.....which rule is applicable the new or the old? although chances of passing seem bleek fr me :shock: .....yes this is MRCP the dreaded exam noone knows wht will happen till the result is out. :roll: :?:
  48. drosama

    drosama Guest

    young boy with depression age 16 yrs.. options: 3 SSRIs, 1 MAOI and TCA... according to BNF SSRIs are licensed for above 18 of age.. MAOIs is obviously incorrect (not first line) so this leaves TCA as the correct option :lol:
  49. drosama

    drosama Guest

  50. drosama

    drosama Guest

    there were 2 question about LGV.. homosexual male with proctitis... question asked about diagnosis... the other question was: genital ulcer ass with painful inguinal LNs... i think they asked about mgt

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