MRCP Part 2a Dec 2008 questions

Discussion in 'MRCP Forum' started by Guest, Dec 4, 2008.

  1. guest6

    guest6 Guest

    Paper 1 and 2 were very tough, no time to think and figure out the tricks. Very depressing.

    Just want to discuss this question here.


    ***one pt with hemiparesis, sensory inextinction, severe dysarthyria (not dysphasia), maintained conciousness & normal visual fields..... answer is lacunar stroke....once again review masterclass neurology for stroke OCSS classification score... ***

    Evidence of higher cortical involvement, e.g. spatial neglect, dysphasia, dyscalculia or visuospatial disorder, or disturbance of consciousness, excludes a lacunar syndrome.

    'Sensory inattention' is a higher cortical function. So IMHO it is not lacunar stroke, the answer here would be 'Undetermined' territory stroke.

    --------
  2. guest6

    guest6 Guest

    ***AMI and reinfarction, i put tirofiban as the answer***

    I think if reinfarction occurs after thrombolysis in AMI, primary angioplasty is the answer.
  3. Guest

    Guest Guest

    I'd like to say HI!!!! to richard hudson from pastest, who is viewing this forum :)
  4. Guest

    Guest Guest

    i think the question was asking what to do in the interim after the re-infarction... before angioplasty is done.

    I put tirofiban, others have put heparin

    i have not the answer
  5. guest6

    guest6 Guest

    What did you make of the question which gave blood picture data with microcytosis and high RBC count, and levels of HbA, A2 etc. Don't remember the question in detail?

    Options were:

    Alpha thalassemia trait
    Beta thalassemia trait
    Iron deficiency anemia, etc.
  6. Guest

    Guest Guest

    So much ambiguity - this is why I do not like this exam:-

    The timings were so clear in the stroke question - that is why I feel thrombolysis is the right answer (although I accept the concerns about him waking with symptoms). It could be red herrin the timings.

    I think tie over is IIb/IIIa antagonist (tirofiban) over heparin for PCI. That is what the majority of tertiary centres using in UK.

    I can't remember now if the methaemoglobaemia man had any symptoms - I hope he did. :p

    The water deprivation test was not consistent I don't think with psychogenic polydipsia and hyponatraemia is atypical of that too. That question is debatable!
  7. Guest

    Guest Guest

    Other questions:-

    Patient with MALT - answer H pylori eradication therapy
    Patient with ARF following CLL treatment - I think Tumour Lysis Syndrome
    Patient with rheumatoid arthritis - low sodium, high potassium, very low bicarbonate - I put alcoholic ketoacidosis as very high anion gap.
    Young patient with back pain and progressive neurology - I put Guillame-Barre
    OD with blurred vision, SVT and hypoglycaemia ?drug - I put quinine
    15 year old with history of eczema,fever and ??chicken pox - I put aciclovir (because I thought rash was describing chicken pox)
    Couple on SLE associated glomerulonephritis
    And I think a couple on mesothelioma
    Definitely 2 with cryoglobulinaemia

    Can't remember any others that haven't already been mentioned.
  8. guest6

    guest6 Guest

    ***The timings were so clear in the stroke question - that is why I feel thrombolysis is the right answer (although I accept the concerns about him waking with symptoms). It could be red herrin the timings. ***

    The stroke patient had slurred speech when he woke up, but later on, on examination his speech was fine. Improving stroke is not an indication for thrombolysis.
  9. Guest

    Guest Guest

    Hi everybody,,,,,,,

    Guest6: u caused me confusion, i will check if sensory inextinction is to be considered as higher cortical dysfunction,,,, if so, big oops

    regarding the pt with low MCV(60), near normal HGB (12), low A2(2%) A level 97%.... answer was B-Thalass trait...

    Hi Nerdie, regarding the pt with AMI thrombolysed & shortly developped reinfarction,,,, it will be rescue PCI not primary PCI,,,, i think heparin should be added pending the rescue PCI & afterwards clopedogrel or tirofiban can be added, do u agree??.........

    the case of Methemoglobinemia, i remeber very well they mention he was asymptomatic, thats why i opted observation......

    MALToma pt answer HBP eradication...

    ARF following CLL Rx: tumor lysis......

    i agree there was one case of high anion gap acidosis & the answer was alcohol but i dont remember the exact scienario....

    pt with backache, ascending LMN weakness, depressed ankle jerk... GBS

    I was in a hurry so unfortunately i missed the question of hypoglycemia & blurred vision... answer was quinine but i missed it... big shame

    pt atopic developed eczema herpeticus... answer was acyclovir

    there were 4 Qs about SLE, 2 answered DsDNA, one drug induced lupus Minocycline.... one question i think it was discoid lupus not alopecia areata, coz i think there was some skin atrophy & erythema,,, iam not sure, it could be only the bad photo material.... but i felt it was discoid lupus, i saw a similar photo in masterclass derma....
  10. Guest

    Guest Guest

    There was a question about renal tubular acidosis. I chose type 4 (I suppose it was a hyperkalaemia). Please tell me it was a hyperkalaemia guys.

    Also a question about some weird sensory loss in the arm in the distribution of C8 (I stupidly chose brachial radiculopathy as I thought the mechanism of the accident cannot damage C8 alone!)

    The exam was so tough and long (especially the 1st paper) that i frequently had to "just choose an answer" instead of really thinking the options, because I did not want to run out of time.
  11. Guest

    Guest Guest

    thanks Nerdie,

    I think reinfarction after Acute STEMI, will require Tirofiban while being transferred for Rescue Angioplasty. I have practically done for one of my patients. He was 30 yr old chap presented with (what looks like)Anterior STEMI, who showed similar changes after 21/2 hrs. He was started on Aggrasat(Tirofiban). His coronaries were normal on angiography. He was later found to have cardiac rub and high CRP. So, i think Tirofiban was right choice.

    I bought Medical masterclass package for 22000rs thru my cousin in India, which includes all the books, 2 DVDs and 3 yrs website access. Unfortunately, I will only get to my hand after my visit to india.
  12. Guest

    Guest Guest

    thanks Nerdie,

    I think reinfarction after Acute STEMI, will require Tirofiban while being transferred for Rescue Angioplasty. I have practically done for one of my patients. He was 30 yr old chap presented with (what looks like)Anterior STEMI, who showed similar changes after 21/2 hrs. He was started on Aggrasat(Tirofiban). His coronaries were normal on angiography. He was later found to have cardiac rub and high CRP. So, i think Tirofiban was right choice.

    I bought Medical masterclass package for 22000rs thru my cousin in India, which includes all the books, 2 DVDs and 3 yrs website access. Unfortunately, I will only get to my hand after my visit to india.
  13. Guest

    Guest Guest

    What did you make of the question which gave blood picture data with microcytosis and high RBC count, and levels of HbA, A2 etc. Don't remember the question in detail?

    Options were:

    Alpha thalassemia trait
    Beta thalassemia trait
    Iron deficiency anemia, etc


    Alpha-thal. I'm very sure of the answer


    Patient with MALT - answer H pylori eradication therapy
    Patient with ARF following CLL treatment - I think Tumour Lysis Syndrome
    Patient with rheumatoid arthritis - low sodium, high potassium, very low bicarbonate - I put alcoholic ketoacidosis as very high anion gap.
    Young patient with back pain and progressive neurology - I put Guillame-Barre
    OD with blurred vision, SVT and hypoglycaemia ?drug - I put quinine
    15 year old with history of eczema,fever and ??chicken pox - I put aciclovir (because I thought rash was describing chicken pox)
    Couple on SLE associated glomerulonephritis
    And I think a couple on mesothelioma
    Definitely 2 with cryoglobulinaemia


    H.pylori eradication is the answer
    Tumour lysis syndrome is right
    Alcoholic ketoacidosis is my answer
    OD with blurred vision --> quinine is right
    15 with eczema --> HSV.
    Mesothelioma/SLE/Cryoglobulinaemia, yup, a few qns on them



    pt with backache, ascending LMN weakness, depressed ankle jerk... GBS
    one question i think it was discoid lupus not alopecia areata


    yes i agree with GBS i think it was the very last qn of paper 3.
    i put alopecia areata as it was non-scarring and the qn specifically stated there were no lesions anywhere else except for another spot of hair loss (but i'm not sure about the answer, not the qn)


    There was a question about renal tubular acidosis. I chose type 4 (I suppose it was a hyperkalaemia). Please tell me it was a hyperkalaemia guys.

    Yes, type 4


    Also a question about some weird sensory loss in the arm in the distribution of C8 (I stupidly chose brachial radiculopathy as I thought the mechanism of the accident cannot damage C8 alone!)

    Erm, i put C8


    thanks Nerdie,

    I think reinfarction after Acute STEMI, will require Tirofiban while being transferred for Rescue Angioplasty. I have practically done for one of my patients. He was 30 yr old chap presented with (what looks like)Anterior STEMI, who showed similar changes after 21/2 hrs. He was started on Aggrasat(Tirofiban). His coronaries were normal on angiography. He was later found to have cardiac rub and high CRP. So, i think Tirofiban was right choice.

    I bought Medical masterclass package for 22000rs thru my cousin in India, which includes all the books, 2 DVDs and 3 yrs website access. Unfortunately, I will only get to my hand after my visit to india.


    Thanks! :)
  14. Guest

    Guest Guest

    Hellow friends , hope all who sat the exam will pass IN SHAA ALLAH -

    MY ADVICE to those preparing to the next exam is 2 solve as many problems as they can -starting with pasttest which will make others easy-The exam question format is similar to that of ON EXAMINATION .
    Studying GUIDELINES is ESSENTIAL DONT go into the details Just sstudy the Summary PARTICULARLY in GIT : British Society Of Gastroenterology (BSG) and NICE Guidance -Also Summaries OF the GUIDELINES OF BCSH are vital .

    BTS guidelines are important (Not all of them)
    For Cardiology read ESC (the major topics ) like SYNCOPE .VHD.etc
    Lastly revise the Guidelines On the important topics published by the different British Societies ( I found this very useful an dI could answer many problems cofidently based on this )

    While studying Sharma , On Examination , past test etc first check with th eguidelines , and Oxford textbook of medicine to keep urself UPTODATE
  15. Guest

    Guest Guest

    I remember one question for which I put Methanol poisoning. It may be for quinine one. I dont know.

    My answer was Alopecia Areata for the lesion on the head. I did not see any scarring either.

    I remember 2 similar questions repeated in 2 papers. Answer was MesangioCapillary GN was answer. Question basically says Increased C4 and decreased C3. I think if one is perfect on Glomerular diseases, they could have easily answered 10 questions.

    Type 4 RTA was right. Straight forward question.
  16. Guest

    Guest Guest

    I remember one question for which I put Methanol poisoning. It may be for quinine one. I dont know.

    My answer was Alopecia Areata for the lesion on the head. I did not see any scarring either.

    I remember 2 similar questions repeated in 2 papers. Answer was MesangioCapillary GN was answer. Question basically says Increased C4 and decreased C3. I think if one is perfect on Glomerular diseases, they could have easily answered 10 questions.

    Type 4 RTA was right. Straight forward question.
  17. Guest

    Guest Guest

    RE - Nerdie

    The last question on my paper 3 was a patient with hyperviscosity syndrome and not the GBS one (although that was close to the end).
  18. Guest

    Guest Guest

    One of the SLE associated glomerulonephritis questions asked which test was most likely to be abnormal I think - for that one I went for abnormal CRP as opposed to anti ds-DNA. The other question asking about which would be diagnostic I went for anti ds-DNA.


    The other question I remember - man in 80s - syncopal episodes - one whilst driving car and one whilst shaving. ?investigation.
  19. guest6

    guest6 Guest

    What answer did you choose for the question about the treatment of psoriatic erythroderma?

    Patient with no spleen with symptoms of meningitis. Most likely causative organism.

    strept pneumonia
    nisseria meningitidis
    etc.
  20. Guest

    Guest Guest

    salam , happy eid inshalla to u all......... i would like to add my comments about few qs
    1- i agree with those who say that the ecg was 3rd degree block.... yes there are constant RR in the 2nd egree as well ,,, but the clue was on some of the limb and chest leads and not on the rythm strip this time , the PR interval are varrying greatly from lead to another plus some wide and odd qrs and SOME V.WIDE PR (MORE THAN 1 SQUARE)....i'm vvvvvvvvvvvvvv surte from it ...no doubt on that ...bcz u wouldn't find such characteristectics in any tye of the 2nd degree block wether mobitz type 1 or 2 or even in 2 or 3 to 1 block...never ever
    2-pt with stroke , if i'm not wrong (but not sure as the past qs) ..he has several other risk factors of hyperlipidemia and htn and p.v.d , so he his carotid arteries need to be scanned firstly( that option was given) and then admitt to the stroke unit
    3-i want to make sure from the pt with reinfarction as i was confused with ur discussions bcz i think there are 2 pts wirth reinfarction on the 2nd and 3rd paper one has to have pci and the one that has to take tirofiban before pci
    4-pt with diverticulosis , i 'm totally agree that we can't do colonscopy with such inflamed colon but i had a similar qs through my prepartion and when i chose ct they said wrong( SUPRISINGLY) and i have to go through RIGID SIMIGDOSCOPY FIRSTTTTTTTTTTTTTTTT WHICH HAS A SIMILAR OR SEMI YIELD OF COLONSCOPY IN DIAGNOSING (AND NOT CONTRAINDICATED IN SUCH CASE)
    5-PT WITH STROKE IS NOT LACUNAR STOKE , IT IS OF UNDETERMINED TERRITORY ...U CAN'T BE SURE OF LACUNAR OR ANY OTHER TERRITORIES apathies ...
    I HAVE OTHER QS WANT TO COMMENT ON BUT CAN'T RECALL THEM ALL NOW , BUT AS SOON AS I REMMBER I WILL ADD MY POSTS....KEEP THE Hard WORKING dear doctors...
    by the way i did like the comment of a dr that found this exam as v.tough and the time didn't help him much (definetly as me) but at the same time he did like and love this exam.........nice
  21. Guest

    Guest Guest

    What answer did you choose for the question about the treatment of psoriatic erythroderma?

    Patient with no spleen with symptoms of meningitis. Most likely causative organism.

    strept pneumonia
    nisseria meningitidis
    etc.


    No idea on GED mgmt
    I put S.pneumoniae, as it is encapsulated organism.

    salam , happy eid inshalla to u all......... i would like to add my comments about few qs
    1- i agree with those who say that the ecg was 3rd degree block.... yes there are constant RR in the 2nd egree as well ,,, but the clue was on some of the limb and chest leads and not on the rythm strip this time , the PR interval are varrying greatly from lead to another plus some wide and odd qrs and SOME V.WIDE PR (MORE THAN 1 SQUARE)....i'm vvvvvvvvvvvvvv surte from it ...no doubt on that ...bcz u wouldn't find such characteristectics in any tye of the 2nd degree block wether mobitz type 1 or 2 or even in 2 or 3 to 1 block...never ever
    2-pt with stroke , if i'm not wrong (but not sure as the past qs) ..he has several other risk factors of hyperlipidemia and htn and p.v.d , so he his carotid arteries need to be scanned firstly( that option was given) and then admitt to the stroke unit
    3-i want to make sure from the pt with reinfarction as i was confused with ur discussions bcz i think there are 2 pts wirth reinfarction on the 2nd and 3rd paper one has to have pci and the one that has to take tirofiban before pci
    4-pt with diverticulosis , i 'm totally agree that we can't do colonscopy with such inflamed colon but i had a similar qs through my prepartion and when i chose ct they said wrong( SUPRISINGLY) and i have to go through RIGID SIMIGDOSCOPY FIRSTTTTTTTTTTTTTTTT WHICH HAS A SIMILAR OR SEMI YIELD OF COLONSCOPY IN DIAGNOSING (AND NOT CONTRAINDICATED IN SUCH CASE)
    5-PT WITH STROKE IS NOT LACUNAR STOKE , IT IS OF UNDETERMINED TERRITORY ...U CAN'T BE SURE OF LACUNAR OR ANY OTHER TERRITORIES apathies ...
    I HAVE OTHER QS WANT TO COMMENT ON BUT CAN'T RECALL THEM ALL NOW , BUT AS SOON AS I REMMBER I WILL ADD MY POSTS....KEEP THE Hard WORKING dear doctors...
    by the way i did like the comment of a dr that found this exam as v.tough and the time didn't help him much (definetly as me) but at the same time he did like and love this exam.........nice


    1) Ok, i still think it's 2:1
    2) No, he needs to be admitted to ASU first. Carotid US can wait, it's not urgent.
    4) Interesting

    The other question I remember - man in 80s - syncopal episodes - one whilst driving car and one whilst shaving. ?investigation.

    I think this qn had a point about the man feeling dizziness when he gets up from a sitting/lying position. I put tilt table as the answer
  22. Guest

    Guest Guest

    4. The similar question in practice paper that I did have extremely subtle and important differences from the one in exam. He had a previous barium showing diverticular disease and dysuria - suggesting potential fistula. Therefore CT is needed. In the PasTest question - no previous studies and dysuria and IBD was diagnosis - therefore flexi sig had same yield.

    For the psoriatic erythroderma - guessed methotrexate.

    One more question:-

    Man with 6(I think) lesions on his prepuce following unprotected sex ?cause - I guessed HSV.
  23. Guest

    Guest Guest

    Friends what do you think if i say most of question ould from davidson this time and the nice ss or pastest n onexam could not benefit much.
  24. Guest

    Guest Guest

    4. The similar question in practice paper that I did have extremely subtle and important differences from the one in exam. He had a previous barium showing diverticular disease and dysuria - suggesting potential fistula. Therefore CT is needed. In the PasTest question - no previous studies and dysuria and IBD was diagnosis - therefore flexi sig had same yield.

    For the psoriatic erythroderma - guessed methotrexate.

    One more question:-

    Man with 6(I think) lesions on his prepuce following unprotected sex ?cause - I guessed HSV.


    Yea, i put CT scan
    MTX
    And HSV too... agree with all
  25. john_rambo

    john_rambo Guest

    hi all ,,

    i hope all of you pass the exam .,

    i am preparing for the next diet ,, and plz need help regarding the best resources to prepare for the exam ,,

    as all of u already sat for the exam ,,

    so i am sure , u made a conclusion regarding the best books or sites

    thanx 8)
  26. Guest

    Guest Guest

    Guys, would some of those who sat the exam for more than once give us an idea on how difficult this one is compared to the previous ones? so that we can make an approximate estimation of the possible pass mark.

    For me I do not really know how good or bad I did in the first paper. I was literally ticking whatever I found logical of the options. The second and third papers were better and I think I guarantee at least 50% of the questions in them.

    What about you guys?

    By the way, never sit your exam in Manchester. The exam hall in the De Vere was freezing and very uncomfortable. I had to keep my hands below my legs in between the questions so that I don't get a frost bite!
  27. Guest

    Guest Guest

    Few more questions I remember - I think I having nightmares. :cry:

    Patient coughing up huge amounts of sputum - broncho-alveolar cell ca
    Patient with human bite - ABx - Co-amoxiclav (augmentin)
    22 with cough and GI symptoms - Cystic Fibrosis
    Patient with atypical pneumonia - felt likely mycoplasma
    X-ray with calcified pancreas - diagnostic investigation - faecal elastase
    Patient with classical IBS
    Couple of aspergillosis questions


    Can't remember any more - I don't think.
  28. Guest

    Guest Guest

    you are right that was 3rd degree block ( clear)
  29. Guest

    Guest Guest

    hi
    someoneasked about comparison of this exam withpreviuos once .i appeared in both of these and previously failed by .75% .
    this time for me paper 1 most difficult ,paper 3 on second and paper2 was good.i generally also got opinion was like that.
  30. Guest

    Guest Guest

    Paper one was vague . I think it was tough . Paper 2 and 3 are reasonable with many logical questions . Most questions are asking about common topics -
    Wishing a good success for those who sat the exam . I advice those preparing for the next exam 2 work very hard , to solve as many problems as they can . Being knowledgeable is essential . and lastly DONT FOrget GUIDELINES !

    GOOD LOOK for all
  31. Guest

    Guest Guest

    guest above is quite correct
    there are certain important topics that come in all 3 parts of the exam
    part 1 , 2 and paces
    example thyoroxicosis, mitral valve disease
    it is best to make notes on these for revision in all the parts
  32. Guest

    Guest Guest

    Few more questions I remember - I think I having nightmares.

    Patient coughing up huge amounts of sputum - broncho-alveolar cell ca
    Patient with human bite - ABx - Co-amoxiclav (augmentin)
    22 with cough and GI symptoms - Cystic Fibrosis
    Patient with atypical pneumonia - felt likely mycoplasma
    X-ray with calcified pancreas - diagnostic investigation - faecal elastase
    Patient with classical IBS
    Couple of aspergillosis questions


    agree with all except mycoplasma, i put legionella instead as the pt had low sodium if i recall correctly
  33. guest6

    guest6 Guest

    I also put legionella becauase of the low sodium.

    A pt with CNS symptoms (don't recall much) and angiokeratomas on the skin > I answered Fabry's disease.

    From the exam I remember the (much discussed) ECG as second degree heart block. Not sure now as I can't recall the details anymore.
  34. Guest

    Guest Guest

    I was sure the sodium was normal which is why I went for mycoplasma. :?
  35. Guest

    Guest Guest

    I also put legionella becauase of the low sodium.

    A pt with CNS symptoms (don't recall much) and angiokeratomas on the skin > I answered Fabry's disease.

    From the exam I remember the (much discussed) ECG as second degree heart block. Not sure now as I can't recall the details anymore.


    Fabry's --> absolutely correct
    :)
  36. Dr MRCP

    Dr MRCP Guest

    There is a lot of disagreement on answers. Let u all know this. All paper are not set same for all candidate. Its the same strategy used by RCP in Part 1. The exam questions in one paper depends on the exam no and specify for that no only. So, there are many sets of question. I too noticed several questions that never appeared in my paper. On some questions, I got asked abt treatment and not diagnosis as others and vice versa. So, keep calm
  37. guest6

    guest6 Guest

    Dr MRCP, you could be right because some of the questions being discussed here confuse me because they seem similar but they are asking something different from what I remember from the exam.

    In any case, we will just have to wait and see how we did in the exam.
  38. guest6

    guest6 Guest

    One more question that I remember: A lady with anxiety c/o irregularly irregular palpitations, most likely cause?

    SVT
    Ventricular ectopics
    atrial fib, etc
  39. Guest

    Guest Guest

    I chose ventricular ectopics for the anxious lady. there was no ECG available.

    Another question: a man who is going for an operation and they found a WPW pattern on his ECG (ECG is provided), so what to do next? I chose to go for the surgery as planned.

    Also another patient who had ST depression and T wave inversion on the treadmill test without any symptoms. Subsequently had a thallium stress test which was normal. What next? I chose to leave the poor man alone and discharge him. what do you think is the best answer?

    Also a lady with advanced oesophageal Ca who was too poorly and given indicators of end stage renal failure and many other things indicating very poor prognosis. what will you choose? radio? radio + chemo? chemo? surgery? leave the Pt alone? I chose to leave her without any intervention (of course I would give her analgesia and make her comfortable but that wasn't included in the options)

    and by the way what is the right Abx for a human bite? I could not find any guidelines on that and from what I remember from medical school a human bite is likely to introduce anaerobic organisms. I chose vancomycin as it covers the anaerobs. but even the cipro and the augmentin are logical. does anyone know the guidelines for that?

    Also a patient with an IBS syndrome who started to lose weight recently and started to get diarrhoea. But recently he also has become anxious because of his exams. would you still diagnose him as IBS or what? I chose caeliac disease but not really convinced, the chap needs investigations before any of the diagnoses given. what did you choose for this one?

    there was that liver picture with multiple lesions. they looked like abscesses to me. what is the NEXT investigation. I chose amoebic serology (because in real life I won't go for biopsy before a simple blood test like serology). what were your answers for this one?

    and what was the passmark of the previous exams and what do you predict it would be for this one given the difficulty of the blood question?
  40. london 2323

    london 2323 Guest

    My experience through prepration of part 2 written.

    1. 123docdotcom
    2.passmedicinedotcom
    3.sanjay sharma

    then if you have time
    onexam or pastest
  41. guest6

    guest6 Guest

    -I chose ventricular ectopics for the anxious lady. there was no ECG available.

    The lady was young and anxious, and in this situation the most common cause would be ventricular ectopics
  42. guest6

    guest6 Guest

    The antibiotic for human bite is co-amoxiclav.
  43. guest6

    guest6 Guest

    I checked from the July2008 sticky on the forum and someone wrote that the pass percentage for that exam was 54.8%.
  44. guest6

    guest6 Guest

    ----I chose ventricular ectopics for the anxious lady. there was no ECG available.---

    The lady was young and anxious, and in this situation the most likely cause would be ventricular ectopics
  45. guest6

    guest6 Guest

    What was the answer for the Polycythemia Rubra Vera diagnosis question?
  46. Guest

    Guest Guest

    Young lady with anxiety - should be sinus tachycardia
  47. guest6

    guest6 Guest

    Lady with anxiety - Rhythm of the palpitations was irregularly irregular.
  48. Guest

    Guest Guest

    Lady with palpitation ..rthym Irregular... ? AF
  49. Guest

    Guest Guest

    Guest6 - for the PRV question - I decided ABGs.

    Most people on here have gone for JAK mutation I think.
  50. guest6

    guest6 Guest

    I don't remember the options in the PRV question. But here is the diagnostic criteria I found on the net:

    major criteria

    1. red cell mass male >36, female >32
    2. O2 saturation >92%
    3. splenomegaly

    minor criteria

    1. Thrombocytosis >400
    2. Granulocytosis >12
    3. LAP >100
    4. serum B12 >900
    5. B12 binding capacity >2200

    PRV diagnosis:
    1- all three major criteria are present
    2- the first two major criteria plus any two minor criteria are present
    (CRC desk reference for hematology)

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